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Gan L, Tang F, Liao J, Xiang H, Tang L. Modified superior bleb needling of rare hypertrophic bleb after trabeculectomy: A case series. Eur J Ophthalmol 2024:11206721241256689. [PMID: 38767136 DOI: 10.1177/11206721241256689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
BACKGROUND Hypertrophic bleb is a rare complication of glaucoma filtration surgery characterized by an elevated bleb extended through the nasal 180 degrees of the eye and usually with a normal IOP. Currently, there is little experience and no existing standardized treatment. We describe a new method called modified superior bleb needling and evaluate the clinical outcomes in affected eyes. METHODS In this retrospective, consecutive interventional case series, patients who developed hypertrophic blebs after trabeculectomy from November 2015 to August 2020 at West China Hospital were enrolled. We innovatively adopted a modified superior bleb needling to allow aqueous humor to outflow into the superior subconjunctival space. Repeat needlings were performed if necessary. The technical and clinical success rate and complications were reported. RESULTS At the time of the last follow-up, complete success was achieved in 8/10 patients, qualified success was achieved in 9/10 patients, and failure was achieved in 1/10 patients. Eight patients had a low filtering bleb and IOP ≤21 mmHg. There was no statistically significant difference between the preneedling and postneedling IOP (p > 0.05). CONCLUSION Modified superior bleb needling is effective for hypertrophic blebs after trabeculectomy, and there was no significant impact on anterior chamber depth or IOP, making it a viable or preferred alternative option. It is worthy of further study and wider usage.
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Affiliation(s)
- Lu Gan
- Ophthalmology, Sichuan University, West China Hospital, ChengDu, China
- Ophthalmology, Sichuan University, West China School of Public Health and West China Fourth Hospital, ChengDu, China
| | - Fei Tang
- Ophthalmology, ShangjinNanfu Hospital, Chengdu, China
| | - Jinying Liao
- Ophthalmology, Sichuan University, West China Hospital, ChengDu, China
| | - Haotian Xiang
- Ophthalmology, Sichuan University, West China Hospital, ChengDu, China
| | - Li Tang
- Ophthalmology, Sichuan University, West China Hospital, ChengDu, China
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2
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Knecht KT, Chiriac G, Guan HD. The potential impact of a vegetarian diet on glaucoma. Surv Ophthalmol 2024:S0039-6257(24)00048-1. [PMID: 38768761 DOI: 10.1016/j.survophthal.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/22/2024]
Abstract
Treatment of primary open-angle glaucoma has centered on the lowering of intraocular pressure that damages the optic nerve; however, this strategy is not uniformly successful, especially in normal tension glaucoma, and there is interest in antioxidant, anti-inflammatory, and other neuroprotective strategies. Vegetarian diets are known to be rich in antioxidant and anti-inflammatory components and have a number of established health benefits. Thus, it would be reasonable to assume that vegetarian diets would be beneficial in glaucoma, but this approach has not been well studied. We examine the possible role of vegetarian diets and their components in the incidence and progression of glaucoma.
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Affiliation(s)
- Kathryn T Knecht
- Loma Linda University School of Pharmacy, Loma Linda, California, USA
| | - Gabriela Chiriac
- Loma Linda University School of Public Health, Loma Linda, California, USA
| | - Howard D Guan
- Loma Linda University Eye Institute, Loma Linda, California, USA.
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3
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Seo JH, Lee Y. Possible Causal Association between Type 2 Diabetes and Glycaemic Traits in Primary Open-Angle Glaucoma: A Two-Sample Mendelian Randomisation Study. Biomedicines 2024; 12:866. [PMID: 38672220 PMCID: PMC11048047 DOI: 10.3390/biomedicines12040866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/03/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Existing literature suggests a controversial relationship between type 2 diabetes mellitus (T2D) and glaucoma. This study aimed to examine the potential causal connection between T2D and glycaemic traits (fasting glucose [FG] and glycated haemoglobin [HbA1c] levels) as exposures to primary open-angle glaucoma (POAG) in multi-ethnic populations. Single-nucleotide polymorphisms associated with exposure to T2D, FG, and HbA1c were selected as instrumental variables with significance (p < 5.0 × 10-8) from the genome-wide association study (GWAS)-based meta-analysis data available from the BioBank Japan and the UK Biobank (UKB). The GWAS for POAG was obtained from the meta-analyses of Genetic Epidemiology Research in Adult Health and Aging and the UKB. A two-sample Mendelian randomisation (MR) study was performed to assess the causal estimates using the inverse-variance weighted (IVW) method, and MR-Pleiotropy Residual Sum and Outlier test (MR-PRESSO). Significant causal associations of T2D (odds ratio [OR] = 1.05, 95% confidence interval [CI] = [1.00-1.10], p = 0.031 in IVW; OR = 1.06, 95% CI = [1.01-1.11], p = 0.017 in MR-PRESSO) and FG levels (OR = 1.19, 95% CI = [1.02-1.38], p = 0.026 in IVW; OR = 1.17, 95% CI = [1.01-1.35], p = 0.041 in MR-PRESSO) with POAG were observed, but not in HbA1c (all p > 0.05). The potential causal relationship between T2D or FG and POAG highlights its role in the prevention of POAG. Further investigation is necessary to authenticate these findings.
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Affiliation(s)
- Je Hyun Seo
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul 05368, Republic of Korea;
| | - Young Lee
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul 05368, Republic of Korea;
- Department of Applied Statistics, Chung-Ang University, Seoul 06974, Republic of Korea
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4
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Prem Senthil M, Kurban C, Thuy Nguyen N, Nguyen AP, Chakraborty R, Delaney C, Clark R, Anand S, Bhardwaj H. Role of noninvasive ocular imaging as a biomarker in peripheral artery disease (PAD): A systematic review. Vasc Med 2024; 29:215-222. [PMID: 38054219 PMCID: PMC11010562 DOI: 10.1177/1358863x231210866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
This study aimed to review the current literature exploring the utility of noninvasive ocular imaging for the diagnosis of peripheral artery disease (PAD). Our search was conducted in early April 2022 and included the databases Medline, Scopus, Embase, Cochrane, and others. Five articles were included in the final review. Of the five studies that used ocular imaging in PAD, two studies used retinal color fundus photography, one used optical coherence tomography (OCT), and two used optical coherence tomography angiography (OCTA) to assess the ocular changes in PAD. PAD was associated with both structural and functional changes in the retina. Structural alterations around the optic disc and temporal retinal vascular arcades were seen in color fundus photography of patients with PAD compared to healthy individuals. The presence of retinal hemorrhages, exudates, and microaneurysms in color fundus photography was associated with an increased future risk of PAD, especially the severe form of the disease. The retinal nerve fiber layer (RNFL) was significantly thinner in the nasal quadrant in patients with PAD compared to age-matched healthy individuals in OCT. Similarly, the choroidal thickness in the subfoveal region was significantly thinner in patients with PAD compared to controls. Patients with PAD also had a significant reduction in the retinal and choroidal circulation in OCTA compared to healthy controls. As PAD causes thinning and ischemic changes in retinal vessels, examination of the retinal vessels using retinal imaging techniques can provide useful information about early microvascular damage in PAD. Ocular imaging could potentially serve as a biomarker for PAD. PROSPERO ID: CRD42022310637.
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Affiliation(s)
- Mallika Prem Senthil
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Chroran Kurban
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Ngoc Thuy Nguyen
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Anh-Phuong Nguyen
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Ranjay Chakraborty
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Christopher Delaney
- Department of Vascular and Endovascular Surgery, Flinders Medical Centre, Adelaide, SA, Australia
| | - Robyn Clark
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Saumya Anand
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Heena Bhardwaj
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, SA, Australia
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Mahmoudinezhad G, Meller L, Moghimi S. Impact of smoking on glaucoma. Curr Opin Ophthalmol 2024; 35:124-130. [PMID: 38018801 PMCID: PMC10922564 DOI: 10.1097/icu.0000000000001023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
PURPOSE OF REVIEW Assessing whether lifestyle related factors play a role in causing primary open-angle glaucoma (POAG) is of great value to clinicians, public health experts and policy makers. Smoking is a major global public health concern and contributes to ocular diseases such as cataracts, and age-related macular degeneration through ischemic and oxidative mechanisms. Recently, smoking has been investigated as a modifiable risk factor for glaucoma. In the presence of an association with glaucoma, provision of advice and information regarding smoking to patients may help reduce the burden of disease caused by POAG. Therefore, the aim of this review is to summarize the current evidence regarding the effect of smoking in the pathogenesis of glaucoma and its incidence, progression as well as the benefits of smoking cessation. RECENT FINDINGS While the association between glaucoma development and smoking history is controversial, in the last decade, several recent studies have helped to identify possible effects of smoking, especially heavy smoking, in regard to glaucomatous progression. Smoking cessation may possibly be protective against glaucoma progression. SUMMARY Smoking may play a role in glaucoma progression and long-term smoking cessation may be associated with lower glaucoma progression. The dose-response relationship between smoking and glaucoma as well as therapeutic potential of smoking cessation needs to be further validated with both preclinical and rigorous clinical studies.
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Affiliation(s)
- Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
| | - Leo Meller
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, United States
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Kim DY, Kim S, Kim SA, Lee JM, Kim JH. Peripapillary Perfusion Analysis Using Optical Coherence Tomography Angiography in Patients with Normal Tension Glaucoma. KOREAN JOURNAL OF OPHTHALMOLOGY 2024; 38:51-63. [PMID: 38110184 PMCID: PMC10869420 DOI: 10.3341/kjo.2023.0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 11/22/2023] [Accepted: 12/14/2023] [Indexed: 12/20/2023] Open
Abstract
PURPOSE This study aimed to assess the difference in the vascular parameters of perfusion in the optic nerve head in normal tension glaucoma (NTG) across disease stages using optical coherence tomography angiography and its correlation with peripapillary retinal nerve fiber layer (RNFL) thickness. METHODS In this retrospective study, 83 eyes with varying stages of NTG (25 mild, 31 moderate, and 27 severe) and 90 healthy eyes were enrolled. The perfusion density (PD) and flux index (FI) of the optic nerve head divided into four sectors were determined. We compared the vascular, structural, and functional parameters between normal and glaucomatous eyes and performed a subgroup analysis among the NTG stages. Pearson correlation coefficient was used to assess the topographic correlation between vascular parameters and RNFL thickness. RESULTS PD and FI were significantly decreased in the NTG group. Subgroup analysis revealed a significant decrease in vascular parameters in most regions in the NTG group, except for the nasal PD and temporal FI. Post hoc analysis showed a significant decrease in PD in the inferior region across all severity levels (mild vs. moderate, p = 0.012; moderate vs. severe, p = 0.012; mild vs. severe, p < 0.001). PD and FI were strongly correlated with RNFL thickness in all quadrants (all p < 0.001), with the strongest correlation observed in the inferior region. CONCLUSIONS Vascular parameters were significantly decreased in glaucomatous eyes, and the degree of decrease in vascular parameters was proportional to glaucoma severity. Peripapillary perfusion analysis using optical coherence tomography angiography may complement other measurements used for glaucoma diagnosis.
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Affiliation(s)
- Do Young Kim
- Siloam Eye Hospital, Seoul,
Korea
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul,
Korea
| | - Soojin Kim
- Siloam Eye Hospital, Seoul,
Korea
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul,
Korea
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7
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Fernández-Albarral JA, Ramírez AI, de Hoz R, Matamoros JA, Salobrar-García E, Elvira-Hurtado L, López-Cuenca I, Sánchez-Puebla L, Salazar JJ, Ramírez JM. Glaucoma: from pathogenic mechanisms to retinal glial cell response to damage. Front Cell Neurosci 2024; 18:1354569. [PMID: 38333055 PMCID: PMC10850296 DOI: 10.3389/fncel.2024.1354569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/10/2024] [Indexed: 02/10/2024] Open
Abstract
Glaucoma is a neurodegenerative disease of the retina characterized by the irreversible loss of retinal ganglion cells (RGCs) leading to visual loss. Degeneration of RGCs and loss of their axons, as well as damage and remodeling of the lamina cribrosa are the main events in the pathogenesis of glaucoma. Different molecular pathways are involved in RGC death, which are triggered and exacerbated as a consequence of a number of risk factors such as elevated intraocular pressure (IOP), age, ocular biomechanics, or low ocular perfusion pressure. Increased IOP is one of the most important risk factors associated with this pathology and the only one for which treatment is currently available, nevertheless, on many cases the progression of the disease continues, despite IOP control. Thus, the IOP elevation is not the only trigger of glaucomatous damage, showing the evidence that other factors can induce RGCs death in this pathology, would be involved in the advance of glaucomatous neurodegeneration. The underlying mechanisms driving the neurodegenerative process in glaucoma include ischemia/hypoxia, mitochondrial dysfunction, oxidative stress and neuroinflammation. In glaucoma, like as other neurodegenerative disorders, the immune system is involved and immunoregulation is conducted mainly by glial cells, microglia, astrocytes, and Müller cells. The increase in IOP produces the activation of glial cells in the retinal tissue. Chronic activation of glial cells in glaucoma may provoke a proinflammatory state at the retinal level inducing blood retinal barrier disruption and RGCs death. The modulation of the immune response in glaucoma as well as the activation of glial cells constitute an interesting new approach in the treatment of glaucoma.
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Affiliation(s)
- Jose A. Fernández-Albarral
- Ramon Castroviejo Ophthalmological Research Institute, Complutense University of Madrid (UCM), Grupo UCM 920105, IdISSC, Madrid, Spain
| | - Ana I. Ramírez
- Ramon Castroviejo Ophthalmological Research Institute, Complutense University of Madrid (UCM), Grupo UCM 920105, IdISSC, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | - Rosa de Hoz
- Ramon Castroviejo Ophthalmological Research Institute, Complutense University of Madrid (UCM), Grupo UCM 920105, IdISSC, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | - José A. Matamoros
- Ramon Castroviejo Ophthalmological Research Institute, Complutense University of Madrid (UCM), Grupo UCM 920105, IdISSC, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | - Elena Salobrar-García
- Ramon Castroviejo Ophthalmological Research Institute, Complutense University of Madrid (UCM), Grupo UCM 920105, IdISSC, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | - Lorena Elvira-Hurtado
- Ramon Castroviejo Ophthalmological Research Institute, Complutense University of Madrid (UCM), Grupo UCM 920105, IdISSC, Madrid, Spain
| | - Inés López-Cuenca
- Ramon Castroviejo Ophthalmological Research Institute, Complutense University of Madrid (UCM), Grupo UCM 920105, IdISSC, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | - Lidia Sánchez-Puebla
- Ramon Castroviejo Ophthalmological Research Institute, Complutense University of Madrid (UCM), Grupo UCM 920105, IdISSC, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Juan J. Salazar
- Ramon Castroviejo Ophthalmological Research Institute, Complutense University of Madrid (UCM), Grupo UCM 920105, IdISSC, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | - José M. Ramírez
- Ramon Castroviejo Ophthalmological Research Institute, Complutense University of Madrid (UCM), Grupo UCM 920105, IdISSC, Madrid, Spain
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University of Madrid, Madrid, Spain
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Lee SY, Lee JS, Kim JY, Tchah H, Lee H. Visit-to-visit variability in blood pressure and the risk of open-angle glaucoma in individuals without systemic hypertension: a nationwide population-based cohort study. Front Med (Lausanne) 2024; 10:1300778. [PMID: 38269321 PMCID: PMC10805885 DOI: 10.3389/fmed.2023.1300778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/28/2023] [Indexed: 01/26/2024] Open
Abstract
Purpose We aimed to evaluate the effect of visit-to-visit variability in blood pressure (BP) on the risk of open-angle glaucoma (OAG) in individuals without systemic hypertension using a population-based retrospective cohort study design. Methods The Korean National Health Insurance Service-National Health Screening Cohort database, which collected data of 209,226 individuals between 2002 and 2015, was used to analyze the data of 140,910 eligible participants. The mean follow-up duration was 8.3 years. Visit-to-visit BP variability was assessed using standard deviation (SD), coefficient of variation (CV), and variability independent of the mean (VIM). Participants were categorized into four groups according to BP variability quartiles. We verified the effect of BP variability by comparing participants of the first to third quartiles of BP variability groups with those belonging to the fourth quartile group. A Cox proportional hazards model was used to determine the hazard ratio (HR) of BP variability in cases of newly diagnosed OAG. Moreover, we conducted subgroup analyses using baseline characteristics. Results In the multivariable analyses, BP variability did not significantly increase the risk of OAG development. However, subgroup analyses revealed significant interactions between age and systolic BP variability in the development of OAG (CV: p = 0.008; SD: p = 0.007). For participants aged <60 years, the risk of OAG development significantly increased with high systolic BP variability (CV: HR, 1.18; 95% confidence interval [CI], 1.00-1.39; p = 0.049). We observed a similar trend using the SD and VIM as the parameters for systolic BP variability. Conclusion Higher visit-to-visit systolic BP variability was associated with an increased risk of OAG development in participants younger than 60 years of age without systemic hypertension. These results suggest that BP variability can be the considerable factor when assessing the risk of OAG, especially in relatively young people without systemic hypertension.
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Affiliation(s)
- Sang Yeop Lee
- Department of Ophthalmology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ji Sung Lee
- Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hungwon Tchah
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hun Lee
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Ahmad F, Deshmukh N, Webel A, Johnson S, Suleiman A, Mohan RR, Fraunfelder F, Singh PK. Viral infections and pathogenesis of glaucoma: a comprehensive review. Clin Microbiol Rev 2023; 36:e0005723. [PMID: 37966199 PMCID: PMC10870729 DOI: 10.1128/cmr.00057-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023] Open
Abstract
Glaucoma is a leading cause of irreversible blindness worldwide, caused by the gradual degeneration of retinal ganglion cells and their axons. While glaucoma is primarily considered a genetic and age-related disease, some inflammatory conditions, such as uveitis and viral-induced anterior segment inflammation, cause secondary or uveitic glaucoma. Viruses are predominant ocular pathogens and can impose both acute and chronic pathological insults to the human eye. Many viruses, including herpes simplex virus, varicella-zoster virus, cytomegalovirus, rubella virus, dengue virus, chikungunya virus, Ebola virus, and, more recently, Zika virus (ZIKV) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), have been associated with sequela of either primary or secondary glaucoma. Epidemiological and clinical studies suggest the association between these viruses and subsequent glaucoma development. Despite this, the ocular manifestation and sequela of viral infections are not well understood. In fact, the association of viruses with glaucoma is considered relatively uncommon in part due to underreporting and/or lack of long-term follow-up studies. In recent years, literature on the pathological spectrum of emerging viral infections, such as ZIKV and SARS-CoV-2, has strengthened this proposition and renewed research activity in this area. Clinical studies from endemic regions as well as laboratory and preclinical investigations demonstrate a strong link between an infectious trigger and development of glaucomatous pathology. In this article, we review the current understanding of the field with a particular focus on viruses and their association with the pathogenesis of glaucoma.
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Affiliation(s)
- Faraz Ahmad
- Department of Ophthalmology, Mason Eye Institute, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Nikhil Deshmukh
- Department of Ophthalmology, Mason Eye Institute, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Aaron Webel
- Department of Ophthalmology, Mason Eye Institute, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Sandra Johnson
- Department of Ophthalmology, Mason Eye Institute, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Ayman Suleiman
- Department of Ophthalmology, Mason Eye Institute, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Rajiv R. Mohan
- Department of Ophthalmology, Mason Eye Institute, University of Missouri School of Medicine, Columbia, Missouri, USA
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri, USA
- Departments of Veterinary Medicine & Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA
| | - Frederick Fraunfelder
- Department of Ophthalmology, Mason Eye Institute, University of Missouri School of Medicine, Columbia, Missouri, USA
| | - Pawan Kumar Singh
- Department of Ophthalmology, Mason Eye Institute, University of Missouri School of Medicine, Columbia, Missouri, USA
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10
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Diane S, Okada N, Nikaido T, Kiuchi Y. Dissociation of retinal ganglion cell complex and superficial retinal vessel density on optical coherence tomography in a case of pediatric optic neuritis. Am J Ophthalmol Case Rep 2023; 32:101937. [PMID: 37860669 PMCID: PMC10582274 DOI: 10.1016/j.ajoc.2023.101937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/25/2023] [Accepted: 10/01/2023] [Indexed: 10/21/2023] Open
Abstract
Purpose To report the case of a pediatric patient with optic neuritis in whom changes in the retinal ganglion cell complex (GCC) and superficial retinal vessel density were dissociated. Observations An 8-year-old girl had an upper respiratory tract infection in early February 2019, after which she began to experience oculomotor pain and vision loss in her left eye. She was diagnosed with optic neuritis of the left eye. Initial examination showed a visual acuity of 20/20 in her right eye and light perception in her left eye. After steroid pulse therapy, her left visual acuity improved to 20/20 in April 2019, with no further symptoms to date. The GCC in the affected eye continued to become thinner until November 2019. However, optical coherence tomography angiography carried out after improvement in her visual function showed no difference in vascular density of the superficial retinal capillary plexus between the right and left eyes. Conclusions and importance In glaucoma, GCC thinning and vascular density loss occur almost simultaneously at an early stage. However, the current neuritis case showed changes in GCC but no corresponding changes in vascular density in the same area. This report suggests that optic neuritis and glaucoma involve different mechanisms of GCC thinning.
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Affiliation(s)
- Sonassa Diane
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
- Faculty of Health Sciences and Technology, Gamal Abdel Nasser University, B.P. 1147, Conakry, Equatorial Guinea
| | - Naoki Okada
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Takafumi Nikaido
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
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11
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Un Y, Sonmez M. Choroidal thickness measurements of subjects with pseudoexfoliative syndrome and pseudoexfoliative glaucoma: A contralateral eye study. Eur J Ophthalmol 2023; 33:1986-1996. [PMID: 37081772 DOI: 10.1177/11206721231171428] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
AIM In this study, we aimed to investigate the peripapillary choroidal thickness (PPCT) and macular choroidal thickness (MCT) in pseudoexfoliation (PEX) syndrome and compare the data of the contralateral eyes according to the presence of biomicroscopic eye involvement and glaucoma. METHOD In this cross-sectional case-control study, PPCT and MCT measurements were analyzed in 162 eyes of 81 subjects with PEX syndrome, diagnosed biomicroscopically with the detection of PEX material. The sample included 63 eyes with pseudoexfoliation glaucoma (PG), 49 eyes with visible PEX material alone without glaucoma (PM), 50 fellow eyes without biomicroscopically visible PEX material (F), and 48 eyes of 24 healthy individuals (controls) without any sign of PEX in the detailed ophthalmologic examination. The PEX syndrome group consisted of 25 PM-F, 25 PG-F, 19 PG-PG, and 12 PM-PM eye pairs. The PPCT and MCT values were compared between the eye-pairs of the subjects with the PEX syndrome. RESULTS The mean PPCT measurements were 183.3 ± 8.1 µm, 158.5 ± 5.4 µm, 167.8 ± 5.9 µm, and 149.9 ± 5.5 µm for the eyes in the control, F, PM, and PG groups, respectively. The eyes in the PG group had statistically significantly lower measurements than those in the control group (p < 0.01). In the contralateral eye comparison of the subjects with PEX syndrome, no significant difference was found in relation to the mean PPCT and MCT measurements between the PM-F, PG-F, and PG-PG eye pairs (p > 0.05 for all). CONCLUSION Although the eye groups with PEX syndrome had lower mean PPCT measurements than the controls, the contralateral eye analysis of the asymmetrically involved eye pairs showed no significant differences.
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Affiliation(s)
- Yasemin Un
- Department of Ophthalmology, Istanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Murat Sonmez
- Department of Ophthalmology, Istanbul Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
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12
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Wang X, Wang M, Liu H, Mercieca K, Prinz J, Feng Y, Prokosch V. The Association between Vascular Abnormalities and Glaucoma-What Comes First? Int J Mol Sci 2023; 24:13211. [PMID: 37686017 PMCID: PMC10487550 DOI: 10.3390/ijms241713211] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Glaucoma is a leading cause of irreversible blindness worldwide. While intraocular pressure (IOP) presents a major risk factor, the underlying pathophysiology still remains largely unclear. The correlation between vascular abnormalities and glaucoma has been deliberated for decades. Evidence for a role played by vascular factors in the pathogenesis of glaucomatous neurodegeneration has already been postulated. In addition, the fact that glaucoma causes both structural and functional changes to retinal blood vessels has been described. This review aims to investigate the published evidence concerning the relationship between vascular abnormalities and glaucoma, and to provide an overview of the "chicken or egg" dilemma in glaucoma. In this study, several biomarkers of glaucoma progression from a vascular perspective, including endothelin-1 (ET-1), nitric oxide, vascular endothelial growth factor (VEGF), and matrix metalloproteinases (MMPs), were identified and subsequently assessed for their potential as pharmacological intervention targets.
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Affiliation(s)
- Xiaosha Wang
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
| | - Maoren Wang
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hanhan Liu
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
| | - Karl Mercieca
- Glaucoma Section, University Hospital Eye Clinic, 53127 Bonn, Germany;
- Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester M13 9WH, UK
| | - Julia Prinz
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
- Department of Ophthalmology, RWTH Aachen University, 52074 Aachen, Germany
| | - Yuan Feng
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
| | - Verena Prokosch
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
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13
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Almeida INF, Taniguchi E, Tito CVA, Dias DT, Ushida M, Dorairaj S, Ritch R, Teixeira SH, Paranhos A, Gracitelli CPB, Kayser C, Prata TS. Vascular parameters and endothelin-1 measurements in glaucoma patients with low- and high-tension optic disc hemorrhages. Sci Rep 2023; 13:5023. [PMID: 36977700 PMCID: PMC10050085 DOI: 10.1038/s41598-023-31682-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
This prospective study aimed to compare vascular parameters (endothelin-1 [ET-1] blood levels, laser Doppler imaging [LDI] of distal phalanxes, and nailfold capillaroscopy) between open-angle glaucoma patients with low- and high-tension optic disc hemorrhages (LTDH and HTDH, respectively). The 33 enrolled patients (mean age, 62.3 ± 13 years) were classified as LTDH or HTDH if they presented at the time of DH detection an intraocular pressure (IOP) < 16 mmHg or ≥ 16 mmHg, respectively. Demographic and ophthalmological data, ET-1 concentrations, LDI (before and 1, 10, and 20 min after cold stimulation), and nailfold capillaroscopy findings were evaluated. The ET-1 blood level was 65% higher in the LTDH (2.27 ± 1.46 pg/ml) than in the HTDH (1.37 ± 0.57 pg/ml; p = 0.03) group. Moreover, there was a statistically significant negative correlation between ET-1 blood concentration and IOP at the time of DH detection (r = -0.45, p = 0.02). Blood flow measurements 10 and 20 min after cold stimulation were lower in the LTDH group than in the HTDH group (p < 0.01). Patients developing DH with lower IOPs have higher ET-1 blood levels and more peripheral vascular dysfunction as estimated by LDI than those with higher IOPs. These findings suggest that distinct underlying mechanisms may be involved in patients developing DH within different IOP ranges.
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Affiliation(s)
- Izabela N F Almeida
- Department of Ophthalmology, Federal University of São Paulo, Rua Dr Jose Rodrigues Alves Sobrinho, 125, Alto de Pinheiros, São Paulo, SP, 05466-040, Brazil
| | - Elise Taniguchi
- Department of Ophthalmology, Federal University of São Paulo, Rua Dr Jose Rodrigues Alves Sobrinho, 125, Alto de Pinheiros, São Paulo, SP, 05466-040, Brazil
| | | | - Diego Torres Dias
- Department of Ophthalmology, Federal University of São Paulo, Rua Dr Jose Rodrigues Alves Sobrinho, 125, Alto de Pinheiros, São Paulo, SP, 05466-040, Brazil
- Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, SP, Brazil
| | - Michele Ushida
- Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, SP, Brazil
| | - Syril Dorairaj
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, USA
| | - Sérgio H Teixeira
- Department of Ophthalmology, Federal University of São Paulo, Rua Dr Jose Rodrigues Alves Sobrinho, 125, Alto de Pinheiros, São Paulo, SP, 05466-040, Brazil
| | - Augusto Paranhos
- Department of Ophthalmology, Federal University of São Paulo, Rua Dr Jose Rodrigues Alves Sobrinho, 125, Alto de Pinheiros, São Paulo, SP, 05466-040, Brazil
| | - Carolina P B Gracitelli
- Department of Ophthalmology, Federal University of São Paulo, Rua Dr Jose Rodrigues Alves Sobrinho, 125, Alto de Pinheiros, São Paulo, SP, 05466-040, Brazil
- Centro de Estudos Alcides Hirai, Ver Mais Oftalmologia, Vinhedo, São Paulo, Brazil
| | - Cristiane Kayser
- Rheumatology Division, Federal University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Tiago Santos Prata
- Department of Ophthalmology, Federal University of São Paulo, Rua Dr Jose Rodrigues Alves Sobrinho, 125, Alto de Pinheiros, São Paulo, SP, 05466-040, Brazil.
- Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, SP, Brazil.
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA.
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14
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Banou L, Dastiridou A, Giannoukas A, Kouvelos G, Baros C, Androudi S. The Role of Color Doppler Imaging in the Diagnosis of Glaucoma: A Review of the Literature. Diagnostics (Basel) 2023; 13:diagnostics13040588. [PMID: 36832076 PMCID: PMC9954817 DOI: 10.3390/diagnostics13040588] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 01/31/2023] [Accepted: 02/02/2023] [Indexed: 02/08/2023] Open
Abstract
Glaucoma is a progressive optic neuropathy and one of the leading causes of irreversible blindness worldwide. Elevated intraocular pressure (IOP) is the major risk factor for the onset and progression of glaucoma. In addition to elevated IOP, impaired intraocular blood flow is also considered to be involved in the pathogenesis of glaucoma. Various techniques have been used to assess ocular blood flow (OBF), including Color Doppler Imaging (CDI), a technique used in ophthalmology in recent decades. This article reviews the role of CDI in both the diagnosis and effective monitoring of glaucoma progression, presenting the protocol for imaging and its advantages, as well as the limitations of its use. Moreover, it analyzes the pathophysiology of glaucoma, focusing on vascular theory and its role in the onset and progression of the disease.
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Affiliation(s)
- Lamprini Banou
- Department of Ophthalmology, University of Thessaly, 41334 Larissa, Greece
| | - Anna Dastiridou
- Department of Ophthalmology, University of Thessaly, 41334 Larissa, Greece
- Correspondence:
| | | | - Georgios Kouvelos
- Department of Vascular Surgery, University of Thessaly, 41334 Larissa, Greece
| | - Christos Baros
- Department of Vascular Surgery, University of Thessaly, 41334 Larissa, Greece
| | - Sofia Androudi
- Department of Ophthalmology, University of Thessaly, 41334 Larissa, Greece
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15
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Luebke J. Individualized Treatment for Glaucoma Patients with Diabetes mellitus. Klin Monbl Augenheilkd 2023; 240:142-146. [PMID: 36634690 DOI: 10.1055/a-1961-7186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Glaucoma and diabetes mellitus are two common chronic diseases in Europe and worldwide which require intensive therapy. Various pathophysiological mechanisms have been discussed which favour the development of glaucoma, especially in the presence of diabetes mellitus. Medicinal and surgical adjustment of intraocular pressure is associated with some limitations in patients with diabetes mellitus, for example, filtering interventions show lower success rates than in non-diabetic glaucoma patients. Besides pure ophthalmological endocrinological therapy, the psychological burden of two chronic diseases should also be considered and included in the individual therapy plan.
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Affiliation(s)
- Jan Luebke
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Deutschland
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16
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Wang M, Chen N, Sun BC, Guo CB, Zhang S, Huang MJ, Zhou BG, Wang XY, Huang ZB. Association between glaucoma and risk of stroke: A systematic review and meta-analysis. Front Neurol 2023; 13:1034976. [PMID: 36712433 PMCID: PMC9881460 DOI: 10.3389/fneur.2022.1034976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/21/2022] [Indexed: 01/15/2023] Open
Abstract
Background/objectives Recently, several studies explored the association between glaucoma and the risk of stroke, but these results were inconsistent. Therefore, we conducted a meta-analysis to examine this possible association. Methods We conducted a systematic literature search of PubMed, Embase, and Web of Science from inception until February 28, 2022. Random-effects meta-analysis was conducted by generic inverse variance method. Sensitivity and subgroup analyses were performed. The review protocol has been registered with PROSPERO (CRD42022312797). Results Seven studies (involving 362,267 participants) have been published from 2004 to 2017 and included in the meta-analysis. These studies included four retrospective cohort studies, two cross-sectional studies, and one case-control study. Meta-analysis of these data has shown that glaucoma was associated with an increased risk of stroke (OR = 1.94, 95% CI = 1.45-2.59). Most of the subgroup analyses demonstrated similar results. These findings were stable in sensitivity analyses. Conclusions We found that glaucoma was associated with an increased risk of stroke. The result suggests that patients with glaucoma need to be assessed the risk of stroke to reduce the incidence of stroke. To better explore the nature of any association, prospective studies that consider the stroke subtypes, sample size, district, and other confounding factors are needed.
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Affiliation(s)
- Meng Wang
- Department of Neurology, The Third Clinical Medical College of China, Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, China
| | - Ni Chen
- Department of Ophthalmology, The Third Clinical Medical College of China, Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, China
| | - Bai-chao Sun
- Department of Ophthalmology, The Third Clinical Medical College of China, Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, China
| | - Chun-Bao Guo
- Department of Neurology, The Third Clinical Medical College of China, Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, China
| | - Shuang Zhang
- Department of Neurology, The Third Clinical Medical College of China, Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, China
| | - Ming-Jie Huang
- Department of Ophthalmology, The Third Clinical Medical College of China, Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, China
| | - Ben-Gang Zhou
- Department of Gastroenterology, The First People's Hospital of Yichang, The People's Hospital of China Three Gorges University, Yichang, China
| | - Xiang-yu Wang
- Department of Neurology, The Third Clinical Medical College of China, Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, China
| | - Zheng-Biao Huang
- Department of Neurology, The Third Clinical Medical College of China, Three Gorges University, Gezhouba Central Hospital of Sinopharm, Yichang, China,*Correspondence: Zheng-Biao Huang ✉
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17
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Raga-Martínez I, Povedano-Montero FJ, Hernández-Gallego J, López-Muñoz F. Decrease Retinal Thickness in Patients with Chronic Migraine Evaluated by Optical Coherence Tomography. Diagnostics (Basel) 2022; 13:diagnostics13010005. [PMID: 36611297 PMCID: PMC9818823 DOI: 10.3390/diagnostics13010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
The purpose of this study is to determine the possible alterations that may occur in the thickness of the retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), and macular thickness in patients with chronic migraines compared with healthy controls. Hence, we examined some of the possibilities that are offered by optical coherence tomography (OCT) in order to study different neurological diseases and to study its application, in this case, how it may be applied to patients with chronic migraines. This was an observational cross-sectional study in adults aged 18-65 years. The study group consisted of 90 patients (90 eyes) with chronic migraines who met the inclusion criteria, and 90 healthy controls (90 eyes) matched for age and sex. Retinal thickness was measured by spectral domain OCT (SD-OCT). The thickness of the superior quadrant of the peripapillary RNFL, as well as the mean thickness in the macula, RNFL macular, and GCL was significantly thinner in chronic migraine patients than in healthy controls (p ≤ 0.05). Chronic migraines are associated with a decrease in retinal thickness which is detectable by an OCT diagnostic technique. The quantification of the axonal damage could be used as a biomarker to help in the diagnosis and monitoring of this pathology. Further studies will be needed to confirm these findings.
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Affiliation(s)
- Isidoro Raga-Martínez
- Faculty of Health Sciences, University Camilo José Cela, 28692 Madrid, Spain
- Centro Óptico Raga, 23700 Linares, Spain
| | - Francisco J. Povedano-Montero
- Hospital Doce de Octubre Research Institute (i+12), 28041 Madrid, Spain
- Faculty of Optics and Optometry, Complutense University, 28040 Madrid, Spain
- Centro Óptico Montero, 28032 Madrid, Spain
| | - Jesús Hernández-Gallego
- Neurology Service, Hospital Universitario Doce de Octubre, 28041 Madrid, Spain
- Department of Medicine, Faculty of Medicine, Complutense University, 28040 Madrid, Spain
| | - Francisco López-Muñoz
- Faculty of Health Sciences, University Camilo José Cela, 28692 Madrid, Spain
- Hospital Doce de Octubre Research Institute (i+12), 28041 Madrid, Spain
- Correspondence: ; Tel.: +34-91-815-3131
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18
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Cennamo G, Malvone E, Marotta M, Breve MA, Costagliola C. Study of choroidal vasculature in open angle glaucoma patients. Photodiagnosis Photodyn Ther 2022; 40:103182. [PMID: 36368450 DOI: 10.1016/j.pdpdt.2022.103182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE To investigate the vessel density (VD) of the choriocapillary (CC) plexus in patients affected by preperimetric glaucoma (PPG), advanced glaucoma (AG) and in a healthy control group using Optical Coherence Tomography Angiography (OCTA) in order to clarify the pathogenetic mechanisms of this disease. METHODS In this prospective observational study, 19 eyes from 19 patients affected by preperimetric glaucoma (PPG) and 18 eyes from 18 patients affected by advanced glaucoma were studied from January 2022 to May 2022 at the University of Naples "Federico II". These patients had been compared with 20 eyes of 20 healthy subjects that represented the control group. All subjects underwent EDI-OCT to assess the subfoveal choroidal thickness (SFCT). OCTA was used to evaluate the vessel density (VD) of the CC in whole image in the studies groups. RESULTS The PPG and AG groups showed a statistically significant reduction in CC vessel density parameters with respect to controls (p < 0.001). Regarding EDI OCT results AG patients exhibited a statistically significant increase in the SFCT compared to healthy controls (p < 0.001). Whereas,no statistically significant difference was between the PPG groups and to healthy controls (p 0.851). CONCLUSIONS CC vessel density could represent a helpful and sensible biomarker to identify early choroidal microvascular changes in PPG and MCI in order to better understand the vascular pathophysiological mechanisms involved in glaucoma diseases.
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Affiliation(s)
- Gilda Cennamo
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy; Department of Public Health, University of Naples Federico II, Via S. Pansini 5, Naples 80133, Italy.
| | - Emanuele Malvone
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Maddalena Marotta
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy; Department of Public Health, University of Naples Federico II, Via S. Pansini 5, Naples 80133, Italy
| | - Maria Angelica Breve
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Ciro Costagliola
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
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19
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Köse HC, Tekeli O. Comparison of microvascular parameters and diagnostic ability of optical coherence tomography angiography between eyes with primary angle closure glaucoma and primary open angle glaucoma. Photodiagnosis Photodyn Ther 2022; 40:103114. [PMID: 36096437 DOI: 10.1016/j.pdpdt.2022.103114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/21/2022] [Accepted: 09/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND To investigate and compare the peripapillary and macular microvascular parameters between eyes with primary angle closure glaucoma (PACG) and primary open-angle glaucoma (POAG) using optical coherence tomography angiography (OCTA). METHODS Seventy-nine eyes of 43 patients with primary angle closure glaucoma (PACG), 78 eyes of 43 patients with primary open-angle glaucoma (POAG), 64 eyes of 35 patients with primary angle closure (PAC), and 73 eyes of 40 control subjects underwent imaging with OCTA. Perfusion density (PD) and vessel density (VD) for the macular area, and PD and flux index (FI) for the peripapillary area were calculated automatically. The area under receiver operator characteristic curves (AUC) were constructed to distinguish PACG and POAG eyes from healthy control eyes. RESULTS The peripapillary FI in all quadrants and PD and VD of the macular outer circle in superior and inferior quadrants were significantly lower in PACG and POAG eyes than in control eyes. The peripapillary FI in the inferior quadrant was significantly lower in the POAG group than in the PACG group (0.348 ± 0.06 vs. 0.369 ± 0.06, p = 0.04). The remaining OCTA parameters in the peripapillary and macular area did not show a significant difference between the POAG and PACG groups. Eyes with PAC presented significantly lower PD and VD than healthy control eyes at the superior and inferior quadrant of the macular outer circle, while retinal nerve fiber layer and ganglion cell inner complex thickness were not significantly different from than control eyes. The best diagnostic parameter was peripapillary FI in both PACG (AUC: 0.922) and POAG (AUC: 0.938) eyes. CONCLUSIONS We found significantly lower peripapillary FI in the inferior quadrant in POAG eyes compared to the PACG eyes, which may indicate the different underlying pathogenesis between POAG and PACG. The PAC eyes had lower macular PD and VD than normal eyes. This suggests that retinal vascular impairment may develop earlier than structural damage in PAC eyes.
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Affiliation(s)
- Helin Ceren Köse
- Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.
| | - Oya Tekeli
- Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
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20
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Mahmoudinezhad G, Nishida T, Weinreb RN, Baxter SL, Eslani M, Micheletti E, Liebmann JM, Fazio MA, Girkin CA, Zangwill LM, Moghimi S. Impact of Smoking on Visual Field Progression in a Long-term Clinical Follow-up. Ophthalmology 2022; 129:1235-1244. [PMID: 35752211 PMCID: PMC10002405 DOI: 10.1016/j.ophtha.2022.06.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To investigate the effect of smoking on rates of progressive visual field (VF) damage over time in glaucoma. DESIGN Retrospective cohort study. PARTICIPANTS Five hundred eleven eyes of 354 patients with glaucoma followed up from multicenter glaucoma registries. METHODS In this longitudinal study, 354 patients with primary open-angle glaucoma with a minimum of 3 years of follow-up and 5 VF tests were enrolled from the Diagnostic Innovations in Glaucoma Study and the African Descent and Glaucoma Evaluation Study. Univariate and multivariate linear mixed models were used to investigate the effects of smoking on rates of 24-2 VF mean deviation loss. Visual field progression was defined using pointwise linear and significant negative VF mean deviation loss. Logistic regression was used to identify baseline factors and whether different levels of smoking intensity were associated with VF progression. Kaplan-Meier survival analysis and the log-rank test were used to compare the cumulative risk ratio of progression between smoker and never smoker groups. MAIN OUTCOME MEASURES Visual field progression. RESULTS Five hundred eleven eyes of 354 patients were included over the median follow-up of 12.5 years. Median baseline age was 64.8 years. Of the 354 patients, 124 (35%) were Black, and 149 (42.1%) and 168 (59.8%) had reported a history of smoking or alcohol consumption, respectively. In a multivariate model, higher smoking intensity was associated with faster VF loss (coefficient, -0.05 decibels (dB)/year per 10 pack-years; 95% confidence interval [CI], -0.08 to -0.01 dB/year per 10 pack-years; P = 0.010). Developing VF progression in eyes of heavy smokers (≥ 20 pack-years) was 2.2 times more than in eyes of patients without smoking history (odds ratio, 2.21; 95% CI, 1.02-4.76; P = 0.044). Statistically significant differences were found between heavy smokers (≥ 20 pack-years) and never smokers by Kaplan-Meier analysis (P = 0.011, log-rank test). CONCLUSIONS Heavy smokers are more likely to sustain VF loss in eyes with glaucoma. The prospective longitudinal design of this study supports the hypothesis that levels of smoking may be a significant predictor for glaucoma progression. Additionally, this information can be used for clinically relevant tobacco prevention and intervention messages.
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Affiliation(s)
- Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Takashi Nishida
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Sally L Baxter
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California; Department of Biomedical Informatics, University of California, San Diego, La Jolla, California
| | - Medi Eslani
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Eleonora Micheletti
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York
| | - Massimo A Fazio
- Bernard School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Christopher A Girkin
- Bernard School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California.
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21
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Lotfy A, Mattout HK, Fouda SM, Hemeda S. Correlation between radial peripapillary vascular density and reduced central corneal thickness in glaucoma suspect patients. BMC Ophthalmol 2022; 22:414. [PMID: 36316681 PMCID: PMC9620628 DOI: 10.1186/s12886-022-02628-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 11/27/2022] Open
Abstract
Background Optical coherence tomography (OCT) angiography (OCTA) provides a quantitative assessment of the microcirculation of the retina and choroid. It may precede the retinal nerve layer (RNFL) and optic disc head defects. Retinal nerve fiber layer defects and reduced central corneal thickness (CCT) are important parameters in the assessment of a glaucoma suspect patients. The aim of this study is to investigate any possible relationship between the reduced central corneal thickness and the radial peripapillary capillary (RPC) density defect in glaucoma suspect. Methods In this cross sectional study, 92 eyes were incorporated. Peripapillary OCT angiography (4.5 mm) and Anterior segment OCT for corneal pachymetry were done. C/D Ratio, thickness of nerve fiber layer, the blood flow indices and central corneal thickness also were evaluated. Results In eyes of glaucoma suspect patients; a significant positive correlation between CCT and total RPC density was detected (r = 0.38, P < 0.001). A strong positive correlation was also found between total RPC and peripapillary RNFL thickness (r = 0.55, P < 0.001). Conclusion Reduced central corneal thickness and peripapillary capillary density are two screening parameters for glaucoma suspect patients. The radial peripapillary capillary density is a valid diagnostic tool for glaucoma. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02628-z.
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Affiliation(s)
- Ayman Lotfy
- grid.31451.320000 0001 2158 2757Zagazig University, Zagazig, Egypt
| | | | | | - Sahar Hemeda
- grid.31451.320000 0001 2158 2757Zagazig University, Zagazig, Egypt
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22
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Yoshikawa Y, Shoji T, Kanno J, Ishii H, Chino M, Igawa Y, Shinoda K, Miyake Y. Relationship Between Deep Retinal Macular Vessel Density and Bipolar Cell Function in Glaucomatous Eyes. Transl Vis Sci Technol 2022; 11:4. [PMID: 36180028 PMCID: PMC9547355 DOI: 10.1167/tvst.11.10.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the correlation between macular retinal function and the changes in the macular retinal vascular structure in glaucomatous eyes. Methods The study included patients with glaucoma who visited Saitama Medical University and underwent optical coherence tomography angiography, and multifocal electroretinographic examinations at the same time between February 2020 and April 2021. Correlations among the ocular parameters, macular vessel density, and multifocal electroretinographic parameters were evaluated using a mixed model. Results Forty-one eyes (mean deviation, −12.4 ± 7.8 dB) of 24 subjects (mean age, 75.2 ± 8.3 years) were included in the analysis. There were no significant correlations for macular vessel density in the superficial retinal layer. However, macular vessel density in the deep retinal layer showed a significant positive correlation with P1–N1 amplitude (coefficient = 0.724; P = 0.001). There were no significant correlations between the optical coherence tomography parameters and any of the multifocal electroretinographic parameters. Conclusions A decrease in N1–P1 amplitude was observed in glaucomatous eyes in relation to a reduction in macular vessel density in the deep retinal layer, which suggests that ischemia-induced bipolar cell dysfunction may be involved in the intermediate retinal dysfunction associated with glaucoma. Translational Relevance Intermediate retinal dysfunction in glaucoma is related to the changes in deep retinal microvasculature.
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Affiliation(s)
- Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Junji Kanno
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Hirokazu Ishii
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Minami Chino
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Yuro Igawa
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
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23
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Dada T, Verma S, Gagrani M, Bhartiya S, Chauhan N, Satpute K, Sharma N. Ocular and Systemic Factors Associated with Glaucoma. J Curr Glaucoma Pract 2022; 16:179-191. [PMID: 36793269 PMCID: PMC9905876 DOI: 10.5005/jp-journals-10078-1383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/14/2022] [Indexed: 01/25/2023] Open
Abstract
Glaucoma is one of the leading causes of irreversible blindness in the world. Although numerous factors have been implicated in the pathogenesis of glaucoma, the main focus of management still remains lowering the intraocular pressure (IOP) by medical or surgical therapy. However, a major challenge is that many glaucoma patients continue to progress despite good control of IOP. In this regard, the importance of other coexisting factors that may contribute to disease progression needs to be explored. Ophthalmologists need to be aware of ocular risk factors and the impact of systemic diseases and their medications, along with lifestyle modifications on the course of glaucomatous optic neuropathy and adopt a holistic approach in treating the eye as well as the patient to alleviate the suffering from glaucoma in a comprehensive manner. How to cite this article Dada T, Verma S, Gagrani M, et al. Ocular and Systemic Factors associated with Glaucoma. J Curr Glaucoma Pract 2022;16(3):179-191.
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Affiliation(s)
- Tanuj Dada
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Saurabh Verma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Meghal Gagrani
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Shibal Bhartiya
- Senior consultant, Department of Opthalmology, fortis memorial research institute, Gurugram, Haryana, India
| | - Nidhi Chauhan
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Kanchan Satpute
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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24
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Bojic L, Rogosic V, Markovic D, Rogosic LV, Glavas D. Brachial flow-mediated dilation and carotid intima-media thickness in glaucoma patients. BMC Ophthalmol 2022; 22:275. [PMID: 35739540 PMCID: PMC9229099 DOI: 10.1186/s12886-022-02498-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 06/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of the study was to assess the ultrasound measurements of the brachial artery flow-mediated dilation (FMD) and carotid artery intima-media thickness (IMT) and their relationship in glaucoma patients. Methods Thirty-seven patients with glaucoma and thirty-one healthy controls were included in the study. All glaucoma patients and controls underwent ultrasound measurement of FMD of the brachial artery and ultrasound measurement of IMT of the carotid artery. Results The mean values of brachial FMD were significantly lower among the glaucoma compared with controls (16.4 ± 10.6% vs 20.3 ± 8.5%, p = 0.034). No significant difference was found in carotid IMT (1.2 ± 0.4 vs. 1.1 ± 0.4, p = 0.3), and brachial artery diameter at rest (4.7 ± 0.6 vs. 4.9 ± 0.3, p = 0.2) between the glaucoma patients and controls. The significant difference in brachial artery diameter in hyperemia between the glaucoma patients and controls (5.5 ± 0.6 vs. 5.9 ± 0.4 p = 0.002) was found. A negative correlation among brachial FMD and carotid IMT as well as among brachial FMD and brachial artery diameter at rest was found. Conclusions Impaired brachial FMD indicates presence of systemic vascular endothelial dysfunction in glaucoma; glaucoma patients with lower values of the brachial FMD are at increased risk of having thickened carotid IMT.
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Affiliation(s)
| | - Veljko Rogosic
- Department of Ophthalmology, University Hospital Split, Split, Croatia
| | - Domagoj Markovic
- Clinic for Heart and Cardiovascular Diseases, University Hospital Split, Spinciceva 1, 21000, Split, Croatia.
| | | | - Duska Glavas
- Clinic for Heart and Cardiovascular Diseases, University Hospital Split, Spinciceva 1, 21000, Split, Croatia
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25
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Liu D, Fan C, Zhang E, Yang J, Zhang Y, Jiang J. Evaluation of Macular and Peripapillary Blood Flow in Response to Intraocular Pressure Reduction in Patients With Posner-Schlossman Syndrome. Front Physiol 2022; 13:886871. [PMID: 35721539 PMCID: PMC9198647 DOI: 10.3389/fphys.2022.886871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose: The study aimed to evaluate the effect of intraocular pressure (IOP) reduction on macular and peripapillary microcirculation in patients with Posner-Schlossman syndrome (PSS) by optical coherence tomography angiography (OCTA). Methods: A prospective comparative study was conducted. Patients diagnosed with PSS at the Eye Center of Xiangya Hospital, Central South University, from February 2020 to November 2021 were consecutively included. OCTA was used for the macular and peripapillary microcirculation measurements, and optical coherence tomography (OCT) was employed for the retinal nerve fiber layer (RNFL) and lamina cribrosa depth (LCD) measurements. The patients received OCT and OCTA examinations at baseline and 1 week post-treatment when the IOP was under control. Changes in macular and peripapillary microcirculation, RNFL, and LCD were calculated for all the analyzed areas. Results: Twenty-one eyes from 21 patients were included in the study. Pre-treatment and post-treatment IOP were 43.17 ± 10.36 mm Hg (range, 30-60 mm Hg) and 17.17 ± 2.85 mm Hg (range, 13-23 mm Hg), respectively. No statistically significant changes were detected in RNFL, LCD, or macular and peripapillary microcirculation after significant IOP reduction. Conclusion: The results suggested that a large IOP reduction may not result in a significant increase in peripapillary and macular capillary perfusion in patients with PSS.
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Affiliation(s)
- Dan Liu
- Eye Center of Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Cong Fan
- Eye Center of Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Endong Zhang
- Eye Center of Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jie Yang
- Eye Center of Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yue Zhang
- Eye Center of Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jian Jiang
- Eye Center of Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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26
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Peripapillary and Macular Vascular Density in Patients with Preperimetric and Early Primary Open-Angle Glaucoma. J Glaucoma 2022; 31:724-733. [DOI: 10.1097/ijg.0000000000002069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 06/03/2022] [Indexed: 11/27/2022]
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27
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Wang Z, Wiggs JL, Aung T, Khawaja AP, Khor CC. The genetic basis for adult onset glaucoma: Recent advances and future directions. Prog Retin Eye Res 2022; 90:101066. [PMID: 35589495 DOI: 10.1016/j.preteyeres.2022.101066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/19/2022] [Accepted: 04/23/2022] [Indexed: 11/26/2022]
Abstract
Glaucoma, a diverse group of eye disorders that results in the degeneration of retinal ganglion cells, is the world's leading cause of irreversible blindness. Apart from age and ancestry, the major risk factor for glaucoma is increased intraocular pressure (IOP). In primary open-angle glaucoma (POAG), the anterior chamber angle is open but there is resistance to aqueous outflow. In primary angle-closure glaucoma (PACG), crowding of the anterior chamber angle due to anatomical alterations impede aqueous drainage through the angle. In exfoliation syndrome and exfoliation glaucoma, deposition of white flaky material throughout the anterior chamber directly interfere with aqueous outflow. Observational studies have established that there is a strong hereditable component for glaucoma onset and progression. Indeed, a succession of genome wide association studies (GWAS) that were centered upon single nucleotide polymorphisms (SNP) have yielded more than a hundred genetic markers associated with glaucoma risk. However, a shortcoming of GWAS studies is the difficulty in identifying the actual effector genes responsible for disease pathogenesis. Building on the foundation laid by GWAS studies, research groups have recently begun to perform whole exome-sequencing to evaluate the contribution of protein-changing, coding sequence genetic variants to glaucoma risk. The adoption of this technology in both large population-based studies as well as family studies are revealing the presence of novel, protein-changing genetic variants that could enrich our understanding of the pathogenesis of glaucoma. This review will cover recent advances in the genetics of primary open-angle glaucoma, primary angle-closure glaucoma and exfoliation glaucoma, which collectively make up the vast majority of all glaucoma cases in the world today. We will discuss how recent advances in research methodology have uncovered new risk genes, and how follow up biological investigations could be undertaken in order to define how the risk encoded by a genetic sequence variant comes into play in patients. We will also hypothesise how data arising from characterising these genetic variants could be utilized to predict glaucoma risk and the manner in which new therapeutic strategies might be informed.
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Affiliation(s)
- Zhenxun Wang
- Duke-NUS Medical School, Singapore; Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Tin Aung
- Duke-NUS Medical School, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Chiea Chuen Khor
- Duke-NUS Medical School, Singapore; Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
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28
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Iwase A, Tsutsumi T, Kawasaki R, Suehiro J, Sekine A, Araie M. Effects of optic nerve head-related parameters on retinal vessel calibers measurement results on fundus photographs. BMC Ophthalmol 2022; 22:215. [PMID: 35549690 PMCID: PMC9097128 DOI: 10.1186/s12886-022-02428-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/29/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although relationship between the retinal vessel caliber (RVC) and glaucoma is well known, there has been a paucity of information on the effects of glaucoma-related optic nerve head (ONH) structural factors on the RVC. Information on this relationship should be useful in studying possible roles of ocular circulation in the development and progression of glaucoma. METHOD Subjects were from Kumejima Study participants aged 40 years and older in Kumejima, Japan. Normal subjects and eyes were defined according to standardized systemic and ocular examinations. The central retinal artery and vein equivalents (CRAE and CRVE) were determined on fundus photographs by correcting the magnification using the refractive error, corneal curvature, and axial length (AL) of an individual eye and paraxial ray tracing; the ONH structural parameters were determined by planimetry. RESULTS In a total of 558 right eyes (558 normal subjects), aged 49.0 ± 7.1 (standard deviation) years with gradable photographs and planimetric results, CRAE averaged 136.1 ± 12.3 μm and CRVE 216.9 ± 17.4 μm. After adjustment for the effects of confounding factors in multivariate analysis, the AL (P < 0.001), rim area (P = 0.019), disc area (P = 0.042), and smoking (P = 0.035-0.043) correlated positively, and the mean blood pressure (P < 0.001) negatively with CRAE; the AL (P < 0.001), rim area (P = 0.001), disc area (P = 0.005), smoking (P < 0.001), and male sex (P = 0.013) correlated positively, and the β-peripapillary atrophy (β-PPA) area (P = 0.044), vertical Cup/Disc ratio (v-C/D) (P = 0.035), and age (P < 0.001) negatively with CRVE. CONCLUSION The current study showed significant effects of rim area, v-C/D or β-PPA area determined on the photographs on the RVC measurement results. Further, it showed a necessity to incorporate the glaucoma-related ONH structural parameters as co-variables to correctly estimate the effects of various factors on the RVC.
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Affiliation(s)
- Aiko Iwase
- Tajimi Iwase Eye Clinic, 3-101-1, Hon-machi, Tajimi, Gifu Prefecture, Tajimi, 507-0033, Japan.
| | | | - Ryo Kawasaki
- Department of Informatics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Jun Suehiro
- Topcon Corporation, Itabashi-ku, Tokyo, Japan
| | | | - Makoto Araie
- Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Setagaya-ku, Tokyo, Japan
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29
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Li H, Ye Z, Li Z. Identification of the potential biological target molecules related to primary open-angle glaucoma. BMC Ophthalmol 2022; 22:188. [PMID: 35461232 PMCID: PMC9034601 DOI: 10.1186/s12886-022-02368-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 03/21/2022] [Indexed: 12/31/2022] Open
Abstract
Background To identify the potential biological target molecules and the corresponding interaction networks in primary open-angle glaucoma (POAG) development. Methods The microarray datasets of GSE138125 and GSE27276 concerning lncRNA and mRNA expression profiles in trabecular meshwork of POAG were downloaded from the Gene Expression Omnibus database. The R software was applied to identify differentially expressed (DE) lncRNAs and mRNAs in POAG, and to perform GO and KEGG functional enrichment analysis. Protein–protein interaction (PPI) network and module analysis, and lncRNA-miRNA-mRNA competing endogenous RNA (ceRNA) network were performed by Cytoscape software. Results A total of 567 DE-mRNAs were identified from GSE138125 and GSE27276, including 298 up-regulated and 269 down-regulated mRNAs, which were found enriching in biological processes of extracellular matrix organization and epidermis development, respectively. KEGG pathway enrichment analysis further revealed that module genes in PPI network were primarily involved in the AGE-PAGE, PI3K-Akt and TGF-β signaling pathways. Moreover, 897 up-regulated and 1036 down-regulated DE-lncRNAs were identified from GSE138125. Through literature review and databases searching, we obtained 712 lncRNA-miRNA and 337 miRNA-mRNA pairs based on the selected eight POAG-related miRNAs. After excluding 702 lncRNAs and 284 mRNAs that were not comprised in the DE-lncRNA and DE-mRNAs, a total of 53 lncRNA nodes, eight miRNA nodes, 10 mRNA nodes, and 78 edges were included in the final ceRNA network. Conclusions This study demonstrated the lncRNA and mRNA expression profiles of trabecular meshwork in POAG patients and the normal controls, and identified potentially ceRNAs and pathways which might improve the pathogenic understanding of this ocular disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02368-0.
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Affiliation(s)
- Hongyu Li
- Medical School of Chinese PLA, Beijing, China.,Senior Department of Ophthalmology, the Third Medical Center of PLA General Hospital, Beijing, China
| | - Zi Ye
- Senior Department of Ophthalmology, the Third Medical Center of PLA General Hospital, Beijing, China.
| | - Zhaohui Li
- Medical School of Chinese PLA, Beijing, China. .,Senior Department of Ophthalmology, the Third Medical Center of PLA General Hospital, Beijing, China.
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30
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Clinical Significance of Albumin- and Bilirubin-Based Biomarkers in Glaucoma: A Retrospective Case-Control Study. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:8063651. [PMID: 35281459 PMCID: PMC8916859 DOI: 10.1155/2022/8063651] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/12/2022] [Accepted: 02/16/2022] [Indexed: 11/18/2022]
Abstract
Glaucoma is the second leading cause of global blindness. The etiology of glaucoma is complicated. In addition to elevated intraocular pressure (IOP), several other mechanisms have been implicated in pathogenesis, such as oxidative stress and systemic inflammation. Serum albumin (ALB) and bilirubin (BIL) have been reported to have potent antioxidant properties and contribute to maintain redox homeostasis in various diseases. However, associations between these parameters and glaucoma remain mostly unknown. Here, we conducted a retrospective case-control study, revealing that serum ALB, total BIL (TBIL), and indirect BIL (IBIL) levels were markedly lower in glaucoma patients than those in healthy controls. Furthermore, the neutrophil-to-ALB (NAR), neutrophil-to-TBIL (NTBR), and neutrophil-to-IBIL (NIBR) ratios were greatly higher in glaucoma. Additionally, interestingly, lower ALB and BIL levels and higher NAR, NTBR, and NIBR were associated with severer glaucomatous visual impairment, and NAR, NTBR, and NIBR showed good accuracy as diagnostic tests for glaucoma severity, suggesting these indices might be useful as discriminative biomarkers for disease severity. Our current findings demonstrate associations between ALB, BIL, NAR, NTBR, NIBL, and glaucoma. It might be useful to use NAR, NTBR, and NIBR as predictive markers for disease severity and employ ALB/BIL as alternative therapy or adjuvant medicines in glaucoma patients.
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31
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Fu L, Chan YK, Fang J, Liu J, Wen SM, Shen LJ, Wang J, Yu GS, Nie L. Optical coherence tomography angiography of the macular microcirculation in acute primary angle closure treated with phacoemulsification. Int Ophthalmol 2022; 42:1781-1788. [PMID: 34989954 DOI: 10.1007/s10792-021-02175-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/18/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To measure the changes of macular microcirculation in cases with unilateral acute primary angle closure (APAC) who were managed by phacoemulsification. METHODS Patients with unilateral APAC and managed by phacoemulsification were enrolled. The contralateral unaffected eyes were served as fellow group, and normal individuals were recruited as control group. Optical coherence tomography angiography (OCT-A) was performed to analyze the macular whole image vessel density (wiVD) and parafoveal vessel density (pfVD). The retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thicknesses were assessed using spectral-domain optical coherence tomography. RESULTS A total of 36 APAC patients and 35 eyes from 35 normal individuals were recruited. In the APAC eyes, the mean wiVD (42.1% ± 3.7%) and pfVD (45.2% ± 3.8%) in the superficial layers (wiVD-SL and pfVD-SL) were both significantly reduced, compared to fellow eyes (45.7% ± 3.1%, 48.7% ± 3.1%) and control eyes (44.4% ± 4.7%, 47.4% ± 5.1%) (P < 0.05). They were all statistically correlated with RNFL, GCC, visual field pattern standard deviation (PSD), and mean deviation (MD). CONCLUSION The macular OCT-A parameters including wiVD-SL and pfVD-SL were significantly reduced in the eyes with APAC compared to the fellow unaffected eyes and normal control eyes. They were correlated well with RNFL, GCC, PSD and MD. The macular vessel density parameters may help monitor the progression of APAC.
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Affiliation(s)
- Lin Fu
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuanxi Road, Wenzhou, Zhejiang Province, China
| | - Yau Kei Chan
- Department of Ophthalmology, University of Hong Kong, Hong Kong SAR, China
| | - Jia Fang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuanxi Road, Wenzhou, Zhejiang Province, China
| | - Junbo Liu
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuanxi Road, Wenzhou, Zhejiang Province, China
| | - Shu Mei Wen
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuanxi Road, Wenzhou, Zhejiang Province, China
| | - Li Jun Shen
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuanxi Road, Wenzhou, Zhejiang Province, China
| | - Jun Wang
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuanxi Road, Wenzhou, Zhejiang Province, China
| | - Guan Shun Yu
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuanxi Road, Wenzhou, Zhejiang Province, China
| | - Li Nie
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuanxi Road, Wenzhou, Zhejiang Province, China.
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32
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Sun Y, Chen A, Zou M, Zhang Y, Jin L, Li Y, Zheng D, Jin G, Congdon N. Time trends, associations and prevalence of blindness and vision loss due to glaucoma: an analysis of observational data from the Global Burden of Disease Study 2017. BMJ Open 2022; 12:e053805. [PMID: 34992115 PMCID: PMC8739070 DOI: 10.1136/bmjopen-2021-053805] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To estimate global prevalence of blindness and vision loss caused by glaucoma, and to evaluate the impact of socioeconomic factors on it. DESIGN A population-based observational study. SETTING The prevalence of blindness and vision loss due to glaucoma were obtained from the Global Burden of Disease Study 2017 database. The Human Development Index (HDI), inequality-adjusted HDI and other socioeconomic data were acquired from international open databases. MAIN OUTCOME MEASURES The prevalence of blindness and vision loss due to glaucoma by age, gender, subregion and Socio-Demographic Index (SDI) levels. Multiple linear regression analysis was performed to explore the associations between the prevalence and socioeconomic indicators. RESULTS The overall age-standardised prevalence of blindness and vision loss due to glaucoma worldwide was 81.5 per 100 000 in 1990 and 75.6 per 100 000 in 2017. In 2017, men had a higher age-standardised prevalence than women (6.07% vs 5.42%), and the worldwide prevalence increased with age, from 0.5 per 100 000 in the 45-49 year age group to 112.9 per 100 000 among those 70+. Eastern Mediterranean and African regions had the highest prevalence during the whole period, while the Americas region had the lowest prevalence. The prevalence was highest in low-SDI and low-income regions while lowest in high-SDI and high-income regions over the past 27 years. Multiple linear regression showed cataract surgery rate (β=-0.01, p=0.009), refractive error prevalence (β=-0.03, p=0.024) and expected years of schooling (β= -8.33, p=0.035) were associated with lower prevalence, while gross national income per capita (β=0.002, p<0.001) was associated with higher prevalence. CONCLUSIONS Lower socioeconomic levels and worse access to eyecare services are associated with higher prevalence of glaucoma-related blindness and vision loss. These findings provide evidence for policy-makers that investments in these areas may reduce the burden of the leading cause of irreversible blindness.
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Affiliation(s)
- Yi Sun
- Department of Ophthalmology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Aiming Chen
- Department of Pharmacy, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Minjie Zou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yichi Zhang
- Department of Ophthalmology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yi Li
- Department of Applied Biology and Chemical Technology, Hong Kong Polytechnic University, Hongkong, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Nathan Congdon
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Orbis International, New York, New York, USA
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Musial G, Adhikari S, Mirhajianmoghadam H, Queener HM, Schill AW, Patel NB, Porter J. Longitudinal In Vivo Changes in Radial Peripapillary Capillaries and Optic Nerve Head Structure in Non-Human Primates With Early Experimental Glaucoma. Invest Ophthalmol Vis Sci 2022; 63:10. [PMID: 34994770 PMCID: PMC8742514 DOI: 10.1167/iovs.63.1.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose There is conflicting evidence regarding whether a loss of radial peripapillary capillaries (RPCs) precedes neuronal loss in glaucoma. We examined the time course of in vivo changes in RPCs, optic nerve head (ONH) structure, and retinal nerve fiber layer thickness (RNFLT) in experimental glaucoma (EG). Methods Spectral domain optical coherence tomography images were acquired before and approximately every two weeks after inducing unilateral EG in nine rhesus monkeys to quantify mean anterior lamina cribrosa surface depth (ALCSD), minimum rim width (MRW), and RNFLT. Perfused RPC density was measured from adaptive optics scanning laser ophthalmoscope images acquired on the temporal half of the ONH. The time of first significant change was quantified as when values fell and remained outside of the 95% confidence interval established from control eyes. Results Mean ALCSD and/or MRW were the first parameters to change in eight EG eyes. RPC density changed first in the ninth. At their first points of change, mean ALCSD posteriorly deformed by 100.2 ± 101.2 µm, MRW thinned by 82.3 ± 65.9 µm, RNFLT decreased by 25 ± 14 µm, and RPC density decreased by 4.5 ± 2.1%. RPC density decreased before RNFL thinning in 5 EG eyes. RNFLT decreased before RPC density decreased in two EG eyes, whereas two EG eyes had simultaneous changes. Conclusions In most EG eyes, RPC density decreased before (or simultaneous with) a change in RNFLT, suggesting that vascular factors may play a role in axonal loss in some eyes in early glaucoma.
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Affiliation(s)
- Gwen Musial
- University of Houston, Houston, Texas, United States
| | | | | | | | | | | | - Jason Porter
- University of Houston, Houston, Texas, United States
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Radial peripapillary vessel density as early biomarker in preperimetric glaucoma and amnestic mild cognitive impairment. Graefes Arch Clin Exp Ophthalmol 2022; 260:2321-2328. [PMID: 35064364 PMCID: PMC9203372 DOI: 10.1007/s00417-022-05561-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 12/08/2021] [Accepted: 01/11/2022] [Indexed: 01/15/2023] Open
Abstract
PURPOSE To investigate the vessel density (VD) of the radial peripapillary capillary (RPC) plexus in patients affected by preperimetric glaucoma (PPG), amnestic mild cognitive impairment (aMCI) and in a healthy control group using optical coherence tomography angiography (OCTA) in order to clarify the pathogenetic mechanisms of these neurodegenerative diseases. METHODS In this prospective study, we studied 54 eyes of 54 patients with PPG, 54 eyes of 54 patients with aMCI and 54 healthy controls. All subjects underwent structural spectral domain optical coherence tomography (SD)-OCT to assess the ganglion cell complex (GCC) and the retinal nerve fibre layer (RNFL). OCTA was used to evaluate the VD of the RPC in different regions (whole image, inside disc and peripapillary). RESULTS The PPG and aMCI groups showed a statistically significant reduction in SD-OCT and parameters with respect to controls (p < 0.001). No statistically significant difference was found in GCC and RNFL parameters between the two study groups (p > 0.05). At OCTA examination, PPG and aMCI patients exhibited a statistically significant reduction in the VD of the RPC in whole image, inside and peripapillary regions compared to healthy controls (p < 0.001). When comparing the two study groups, the OCTA parameters were significantly impaired in PPG with respect to aMCI patients. Significant correlations were found between structural OCT and OCTA parameters in PPG and aMCI groups (p < 0.05). CONCLUSIONS RPC vessel density could represent a helpful and sensible biomarker to identify early retinal microvascular changes in PPG and MCI in order to better understand the vascular pathophysiological mechanisms involved in these neurodegenerative diseases.
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Zagidullina AS, Aznabaev BM. Primary Open-Angle Glaucoma Combined With Concomitant Somatic Pathology. RUSSIAN OPEN MEDICAL JOURNAL 2021. [DOI: 10.15275/rusomj.2021.0417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The goal of the study was to assess the role of concomitant somatic pathology and calculate the total comorbidity index of primary open-angle glaucoma (POAG) in different age groups. Material and Methods — The study included 624 patients (1199 eyes) with POAG aged 45 to 93 years. The control group included 161 people without glaucoma. Patients underwent a comprehensive ophthalmological examination. The Charlson comorbidity index (CI) was calculated, taking into account the concomitant somatic diseases and the age of the patients. Statistical processing of the obtained material was carried out using the IBM SPSS Statistics v.21 program with standard methods of descriptive statistics. Results — with an increase in the age of POAG patients, significant growth in the number of patients with hypertension, coronary heart disease, cerebrovascular accident, atherosclerosis, degenerative diseases of the nervous system, diabetes mellitus, respiratory diseases, musculoskeletal system, and other pathologies were observed. CI was increased in POAG patients with age: 3.02 times for the old age patients, 4.2 times for very old age subjects, compared with middle-aged patients (p<0.001), as well as 1.42 and 1.97 times, respectively, compared with the control group (p<0.001). Conclusion —In patients with POAG, the number of patients with hypertension, ischemic heart disease, cerebrovascular disorders, atherosclerosis, degenerative diseases of the nervous system, diabetes mellitus, respiratory diseases, musculoskeletal system disorders, and other pathologies increased significantly with age. The comorbidity index in POAG patients exhibited growth with age: 3.02 times in the old age group and 4.2 times in the group of very old age people vs. the group of middle-aged patients (p<0.001); and 1.42 and 1.97 times, respectively, vs. the control group (p<0.001).
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Changes in Peripapillary and Macular Vessel Densities and Their Relationship with Visual Field Progression after Trabeculectomy. J Clin Med 2021; 10:jcm10245862. [PMID: 34945158 PMCID: PMC8708329 DOI: 10.3390/jcm10245862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 12/01/2022] Open
Abstract
The aim of this study was to determine the factors associated with visual field (VF) deterioration after trabeculectomy, including the peripapillary vessel density (pVD) and macular vessel density (mVD) changes assessed by optical coherence tomography angiography (OCT-A). Primary open-angle glaucoma patients with more than two years of follow-up after trabeculectomy were included. pVD was calculated in a region defined as a 750 μm-wide elliptical annulus extending from the optic disc boundary. mVD was calculated in the parafoveal (1–3 mm) and perifoveal (3–6 mm) regions. VF deterioration was defined as the rate of mean deviation (MD) worse than −1.5 dB/year. The change rates of pVD and mVD were compared between the deteriorated VF and non-deteriorated VF groups. The factors associated with the rate of MD were determined by linear regression analyses. VF deterioration was noted in 14 (21.5%) of the 65 eyes that underwent trabeculectomy. The pVD (−2.26 ± 2.67 vs. −0.02 ± 1.74%/year, p ≤ 0.001) reduction rate was significantly greater in the deteriorated VF group than in the non-deteriorated VF group, while that of parafoveal (p = 0.267) and perifoveal (p = 0.350) VD did not show a significant difference. The linear regression analysis showed that the postoperative MD reduction rate was significantly associated with the rate of pVD reduction (p = 0.016), while other clinical parameters and preoperative vascular parameters did not show any association. Eyes with greater loss of peripapillary retinal circulation after trabeculectomy tended to exhibit VF deterioration. The assessment of peripapillary vascular status can be an adjunctive strategy to predict visual function after trabeculectomy.
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Protein Biomarkers in Glaucoma: A Review. J Clin Med 2021; 10:jcm10225388. [PMID: 34830671 PMCID: PMC8624910 DOI: 10.3390/jcm10225388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/09/2021] [Accepted: 11/17/2021] [Indexed: 11/16/2022] Open
Abstract
Glaucoma is a multifactorial disease. Early diagnosis of this disease can support treatment and reduce the effects of pathophysiological processes. A significant problem in the diagnosis of glaucoma is limited access to the tested material. Therefore, intensive research is underway to develop biomarkers for fast, noninvasive, and reliable testing. Biomarkers indicated in the formation of glaucoma include chemical compounds from different chemical groups, such as proteins, sugars, and lipids. This review summarizes our knowledge about protein and/or their protein-like derived biomarkers used for glaucoma diagnosis since 2000. The described possibilities resulting from a biomarker search may contribute to identifying a group of compounds strongly correlated with glaucoma development. Such a find would be of great importance in the diagnosis and treatment of this disorder, as current screening techniques have low sensitivity and are unable to diagnose early primary open-angle glaucoma.
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Collar B, Shah J, Cox A, Simon G, Irazoqui P. Parylene-C Microbore Tubing: A Simpler Shunt for Reducing Intraocular Pressure. IEEE Trans Biomed Eng 2021; 69:1264-1272. [PMID: 34714731 DOI: 10.1109/tbme.2021.3123887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Current minimally-invasive glaucoma surgery (MIGS) devices promise to control elevated levels of intraocular pressure (IOP) while avoiding many of the downsides of traditional glaucoma surgery. However, there remains room for improvement in performance metrics, including drainage efficacy, device longevity, and time to implant, as outlined by benchmarks set forth by the Audacious Goals Initiative. We introduce a better shunt, which achieves similar or improved pre-clinical safety and efficacy outcomes to commercial MIGS devices, while reducing surgical profile and implantation time. METHODS We developed a parylene-based microbore glaucoma drainage device capable of modulating IOP via a minimally-invasive implantation procedure. We surgically implanted microbore tubing in five healthy New Zealand White rabbits and measured IOP levels biweekly using handheld applanation tonometry to assess device efficacy in lowering and maintaining IOP. After 6 weeks, the rabbits were euthanized and eyes were enucleated to evaluate inflammatory and histologic response to a foreign-body implant. RESULTS This device is the only one that fulfills the 10-minute benchmark for implantation time compared to other commercial MIGS devices. In 4 of 5 animals implanted, post-op IOP in the experimental eye dropped by an average of 16.17%. Histopathologic evaluation revealed localized evidence of minor inflammatory reaction and tissue irritation, as well as minimal fibrosis along the tube-tissue interface. CONCLUSION AND SIGNIFICANCE Based on these findings, this device stands as a promising platform to lowering IOP, particularly in patients with mild to moderate glaucoma requiring no need for cataract intervention, without eliciting a severe biological response.
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Qian X, Huang C, Li R, Song BJ, Tchelepi H, Shung KK, Chen S, Humayun MS, Zhou Q. Super-resolution Ultrasound Localization Microscopy for Visualization of the Ocular Blood Flow. IEEE Trans Biomed Eng 2021; 69:1585-1594. [PMID: 34652993 PMCID: PMC9113921 DOI: 10.1109/tbme.2021.3120368] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The ocular vascular system plays an important role in preserving the visual function. Alterations in either anatomy or hemodynamics of the eye may have adverse effects on vision. Thus, an imaging approach that can monitor alterations of ocular blood flow of the deep eye vasculature ranging from capillary-level vessels to large supporting vessels would be advantageous for detection of early stage retinal and optic nerve diseases. METHODS We propose a super-resolution ultrasound localization microscopy (ULM) technique that can assess both the microvessel and flow velocity of the deep eye with high resolution. Ultrafast plane wave imaging was acquired using an L22-14v linear array on a high frequency Verasonics Vantage system. A robust microbubble localization and tracking technique was applied to reconstruct ULM images. The experiment was first performed on pre-designed flow phantoms in vitro and then tested on a New Zealand white rabbit eye in vivo calibrated to various intraocular pressures (IOP) 10 mmHg, 30 mmHg and 50 mmHg. RESULTS We demonstrated that retinal/choroidal vessels, central retinal artery, posterior ciliary artery, and vortex vein were all visible at high resolution. In addition, reduction of vascular density and flow velocity were observed with elevated IOPs. CONCLUSION These results indicate that super-resolution ULM is able to image the deep ocular tissue while maintaining high resolution that is comparable with optical coherence tomography angiography. SIGNIFICANCE Capability to detect subtle changes of blood flow may be clinically important in detecting and monitoring eye diseases such as glaucoma.
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Wang L, Zhu Z, Huang W, Scheetz J, He M. Association of glaucoma with 10-year mortality in a population-based longitudinal study in urban Southern China: the Liwan Eye Study. BMJ Open 2021; 11:e040795. [PMID: 34620651 PMCID: PMC8499258 DOI: 10.1136/bmjopen-2020-040795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To investigate the association between glaucoma and 10-year mortality rate in an adult population in China. DESIGN Population-based cohort study. SETTING The Liwan Eye Study, China. PARTICIPANTS 1405 baseline participants aged 50 years and older were invited to attend a 10-year follow-up examination. PRIMARY AND SECONDARY OUTCOME MEASURES The International Society of Geographic and Epidemiologic Ophthalmology criteria was used to define glaucoma. Detailed information of mortality was confirmed using the Chinese Centre for Disease Control and Prevention. Presenting visual impairment (PVI) was defined as a presenting visual acuity of less than 20/40 in the better-seeing eye. The 10-year mortality rates were compared using the log-rank test. Cox proportional hazards regression models were used to investigate the association between glaucoma and mortality. RESULTS A total of 1372 (97.7%) participants with available gonioscopic data were included in the analysis. Of these, 136 (9.9%), 33 (2.4%) and 21 (1.5%) participants had primary angle closure (PAC) suspect (PACS), PAC and PAC glaucoma (PACG), and 29 (2.1%) had primary open angle glaucoma (POAG). After 10 years, 306 (22.3%) participants were deceased. The 10-year mortality was significantly associated with PACG (HR, 2.15, 95% CI 1.14 to 4.04, p=0.018) but not associated with PAC (HR, 1.27, 95% CI 0.67 to 2.39, p=0.463), PACS (HR, 1.32, 95% CI 0.95 to 1.83, p=0.099) and POAG (HR, 0.74, 95% CI 0.36 to 1.49, p=0.395) when age and gender were adjusted for. This association was no longer statistically significant (HR, 1.60, 95% CI 0.70 to 3.61, p=0.263) when covariables, such as income, education, body mass index, PVI, history of diabetes and hypertension, were adjusted for. Larger vertical cup-to-disc ratio (VCDR >0.30) was only a significant risk factor in multivariable analysis (HR, 1.60, 95% CI 1.11 to 2.33, p=0.011). CONCLUSIONS PACG was significantly associated with higher long-term mortality, but this association was likely to be confounded by other systemic risk factors. VCDR >0.3 was the only independent predictor, implying that it may be a marker of ageing and frailty.
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Affiliation(s)
- Lanhua Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wenyong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jane Scheetz
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
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Yu L, Chen Y, Xu X, Dong Q, Xiu W, Chen Q, Wang J, He C, Ye J, Lu F. Alterations in Peripheral B Cell Subsets Correlate with the Disease Severity of Human Glaucoma. J Inflamm Res 2021; 14:4827-4838. [PMID: 34584441 PMCID: PMC8464325 DOI: 10.2147/jir.s329084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/16/2021] [Indexed: 12/13/2022] Open
Abstract
Background Glaucoma is a group of retinal neurodegenerative diseases causing irreversible visual impairment. The pathogenesis of this disease is complicated. Studies have shown that the immune system is involved in the neurodegenerative process of glaucoma. There are continuous evidences that autoantibodies play a crucial role in the pathogenesis of glaucoma. However, focuses on B cells, the antibody-producing cells in glaucoma are surprisingly limited. Methods Fresh peripheral blood samples were collected from 44 glaucoma patients (38 with primary angle-closure glaucoma (PACG) and 6 with (primary open-angle glaucoma POAG)) and 36 age-matched healthy donors (HD). Density gradient centrifugation was performed to obtain peripheral blood mononuclear cells (PBMC). Flow cytometry was performed to determine B cell phenotypes. The severity of glaucoma was determined based on the mean deviation (MD) of visual field. Results In this study, we demonstrated that total B cells was significantly increased in glaucoma patients compared to HD. Next, we checked changes of different B cell subsets in glaucoma. Glaucoma patients were found to have a significant increase in the frequencies of antibody-secreting cells (ASC)/plasmablasts, naïve, and CD19+ CD27− IgD− double negative (DN) subpopulations, but a decrease in the CD27+ IgD+ unswitched memory compartment. Notably, we found that the increment of CD27− IgD− DN B cells was significantly magnified according to the clinical severity. Conclusion We demonstrate, for the first time, that peripheral B cell subsets are altered and unveil the correlation of a newly identified pro-inflammatory CD27− IgD− DN subset with clinical features of glaucoma, suggesting that these B cell subsets could serve as potential biomarkers to monitor the disease progression of glaucoma patients.
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Affiliation(s)
- Ling Yu
- Department of Ophthalmology, Daping Hospital, Army Medical Center, Army Medical University, Chongqing, People's Republic of China
| | - Yang Chen
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Xiang Xu
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Qiwei Dong
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.,Medico-Engineering Cooperation on Applied Medicine Research Center, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Wenbo Xiu
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Qinyuan Chen
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Jinxia Wang
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Chong He
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.,Medico-Engineering Cooperation on Applied Medicine Research Center, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
| | - Jian Ye
- Department of Ophthalmology, Daping Hospital, Army Medical Center, Army Medical University, Chongqing, People's Republic of China
| | - Fang Lu
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, People's Republic of China.,Medico-Engineering Cooperation on Applied Medicine Research Center, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
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Lin Y, Chen S, Zhang M. Peripapillary vessel density measurement of quadrant and clock-hour sectors in primary angle closure glaucoma using optical coherence tomography angiography. BMC Ophthalmol 2021; 21:328. [PMID: 34503457 PMCID: PMC8428096 DOI: 10.1186/s12886-021-02093-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 08/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate diagnostic ability of peripapillary vessel density of primary angle closure glaucoma (PACG) eyes in quadrant and clock-hour sectors by optical coherence tomography angiography (OCTA). METHODS This was a cross-sectional study on forty-one PACG patients (41eyes) and twenty-seven healthy subjects (27 eyes). All subjects underwent OCTA (DRI OCT Triton; Topcon Corporation, Tokyo, Japan) and peripapillary retinal nerve fiber layer (RNFL) thickness imaging with swept-source optical coherence tomography (OCT). The peripapillary vessel density of quadrant and clock-hour sectors was quantified by imageJ software. The diagnostic capability of OCTA and OCT parameters was evaluated by the areas under the receiver operating characteristics curves (AUCs). Pearson correlation analysis or Spearman correlation test was used to evaluate the correlation between vessel density parameters and related factors. RESULTS Compared with the control group, the peripapillary vessel density of glaucomatous group was lower to different degrees in the four quadrants and each clock-hour sectors, and vessel density reduced most at 7 o'clock. The difference between the diagnostic ability of peripapillary vessel density and peripapillary RNFL thickness was not statistically significant, except 4 o'clock and inferior quadrant. The inferior quadrant peripapillary vessel density had the best diagnostic value (AUC0.969), followed by the 7 o'clock vessel density (AUC0.964), average vessel density (AUC0.939) and the 7 o'clock RNFL thickness (AUC0.919). The average peripapillary vessel density was correlated with average RNFL and visual field (VF) mean deviation (P < 0.001). CONCLUSIONS In PACG, the diagnostic ability of the peripapillary vessel density is equivalent to the peripapillary RNFL thickness. Understanding spatial characteristics of the peripapillary vessel density in PACG may be helpful for clinical diagnosis and monitoring the progress of diseases.
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Affiliation(s)
- Yongdong Lin
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Dong xia Road, Shantou, Guangdong Province, People's Republic of China
| | - Shirong Chen
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Dong xia Road, Shantou, Guangdong Province, People's Republic of China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Dong xia Road, Shantou, Guangdong Province, People's Republic of China.
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Li Y, Mitchell W, Elze T, Zebardast N. Association Between Diabetes, Diabetic Retinopathy, and Glaucoma. Curr Diab Rep 2021; 21:38. [PMID: 34495413 DOI: 10.1007/s11892-021-01404-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW The strength of the relationship between diabetes, diabetic retinopathy (DR), and glaucoma remains controversial. We review evidence supporting and refuting this association and explore mechanistic pathological and treatment relationships linking these diseases. RECENT FINDINGS While studies have shown diabetes/DR may increase the risk for glaucoma, this remains inconsistently demonstrated. Diabetes/DR may contribute toward glaucomatous optic neuropathy indirectly (either by increasing intraocular pressure or vasculopathy) or through direct damage to the optic nerve. However, certain elements of diabetes may slow glaucoma progression, and diabetic treatment may concurrently be beneficial in glaucoma management. Diabetes plays a significant role in poor outcomes after glaucoma surgery. While the relationship between diabetes/DR and glaucoma remains controversial, multiple mechanistic links connecting pathophysiology and management of diabetes, DR, and glaucoma have been made. However, a deeper understanding of the causes of disease association is needed.
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Affiliation(s)
- Yangjiani Li
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, 510060, China
| | - William Mitchell
- Department of Ophthalmology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA
- Department of Ophthalmology, Royal Victorian Eye and Ear, Melbourne, VIC, 3002, Australia
| | - Tobias Elze
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, 02114, USA
| | - Nazlee Zebardast
- Department of Ophthalmology, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA.
- Department of Ophthalmology, Harvard Medical School, Boston, MA, 02115, USA.
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Wu JH, Penteado RC, Moghimi S, Zangwill LM, Proudfoot JA, Weinreb RN. Diurnal Variation of Retinal Vessel Density in Healthy Human Eyes. J Glaucoma 2021; 30:820-826. [PMID: 34172629 PMCID: PMC8405550 DOI: 10.1097/ijg.0000000000001903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/04/2021] [Indexed: 12/23/2022]
Abstract
PRECIS A small increase in optic nerve head vessel density (VD), but not macular VD, in the evening compared with the morning is observed in healthy subjects. PURPOSE To evaluate the diurnal variation of the macular and optic nerve head (ONH) VD in healthy eyes as measured with optical coherence tomography angiography (OCT-A). METHODS In this prospective study of healthy individuals older than 18 years old, VD parameters, including macular whole image vessel density, parafoveal vessel density, ONH whole image vessel density, ONH whole image capillary density, circumpapillary vessel density (cpVD), and circumpapillary capillary density, were measured with OCT-A at 4 time points throughout the day (8 am, 12 pm, 4 pm, and 8 pm). RESULTS Twenty-nine healthy eyes were included from 15 subjects (mean age: 30.9 y). After adjustment for age and mean ocular perfusion pressure, a significant positive rate of change was found for cpVD (0.05%/h; P=0.027). In contrast, macular VD changes were not significantly different. When comparing morning (8 am and 12 pm) and evening (4 pm and 8 pm) measurements, there were small, but statistically significant, increases for all ONH measurements. The greatest increase was found for cpVD (0.58%; P=0.022). Significant but small increases in mean arterial pressure and mean ocular perfusion pressure were also observed. CONCLUSIONS There was a small increase in ONH VD, but not macular VD, in the evening compared with the morning in healthy human eyes. As the observed difference was within the measurement variability, our results suggest the timing of OCT-A examination does not affect retinal VD measurements.
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Affiliation(s)
- Jo-Hsuan Wu
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Rafaella C. Penteado
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Linda M. Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - James A. Proudfoot
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Robert N. Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
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Zhang Y, Zhang Q, Thomas R, Li SZ, Wang NL. Association of Hypertriglyceridemia and Incident Glaucoma in a Rural Chinese Population: The Handan Eye Study. Transl Vis Sci Technol 2021; 10:25. [PMID: 34319388 PMCID: PMC8322711 DOI: 10.1167/tvst.10.8.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this paper was to investigate the association between baseline metabolic risk factors and incident glaucoma over a 5-year period in rural Chinese adults. Methods Population-based prospective cohort study. Participants aged 30 years and older without glaucoma at baseline who underwent comprehensive examinations at baseline and after a 5-year interval in the Handan Eye Study were enrolled. Incident glaucoma was defined as people without glaucoma in either eye at baseline that had developed glaucoma in at least one eye in the 5-year follow-up. Five metabolic syndrome components, mean blood pressure, fasting plasma glucose, total cholesterol, triglycerides (TGs), low density lipoprotein cholesterol, high-density lipoprotein cholesterol, and obesity, determined as body mass index ≥30 kg/m2 at baseline were considered as potential metabolic risk factors for incident glaucoma. Univariate and multivariate logistic regression analyses were carried out to determine baseline metabolic risk factors associated with incident glaucoma. Results A total of 5184 participants were included in our study. During the 5-year follow-up, incident glaucoma developed in 82 subjects. Age (odds ratio [OR] = 1.060, 95% confidence interval [CI] = 1.034, 1.086, P < 0.001) and TGs level (OR = 1.213, 95% CI = 1.030, 1.429, P = 0.021) were independently and positively associated with incident glaucoma. Conclusions Our study revealed that increased age and high TGs level, one of the baseline metabolic features, were independent risk factors for incident glaucoma. The data implied that the metabolic features be involved in the pathogenesis of glaucoma. Translational Relevance This study shed the light on that the TGs level was involved in the pathogenesis of glaucoma.
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Affiliation(s)
- Ye Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing, China
| | - Qing Zhang
- Beijing Institute of Ophthalmology, Beijing, China
| | - Ravi Thomas
- University of Queensland, Brisbane, Australia
| | - Si Zhen Li
- Nanjing Tongren Hospital, Jiangsu, China
| | - Ning Li Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing, China.,Beijing Institute of Ophthalmology, Beijing, China
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Cano J, Rahimi M, Xu BY, Richter GM, Tan O, Huang D, Shahidi M. Relationship Between Macular Vessel Density and Total Retinal Blood Flow in Primary Open-angle Glaucoma. J Glaucoma 2021; 30:666-671. [PMID: 33979111 PMCID: PMC8373641 DOI: 10.1097/ijg.0000000000001880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/21/2021] [Indexed: 01/12/2023]
Abstract
PRECIS An association between macular vessel density (VD) and total retinal blood flow (TRBF) was demonstrated in subjects with primary open-angle glaucoma (POAG) and visual field (VF) loss. PURPOSE The purpose of this study was to report relationships of macular VD metrics and TRBF in POAG. MATERIALS AND METHODS A total of 24 POAG and 19 healthy control subjects participated in the study. Subjects underwent optical coherence tomography and angiography for measurements of inner retinal thickness (IRT), VD, and spacing between large vessels (SLV) and small vessels (SSV). Doppler optical coherence tomography imaging was performed for TRBF measurement. In POAG subjects, automated perimetry was performed and VF loss expressed as mean deviation was measured. RESULTS Compared with the control group, POAG group had decreased VD, TRBF, IRT, and increased SLV (P<0.0001). Decreased VD (Pearson correlation, r=0.51; P<0.0001; N=43) and increased SLV (Spearman correlation, rs=-0.47; P=0.001) were correlated with decreased TRBF. Decreased VD and SSV (r≥0.39; P≤0.001; N=43) and increased SLV (rs=-0.71; P<0.0001) were associated with decreased IRT. Decreased VF mean deviation was correlated with decreased VD, SSV, IRT (r≥0.53; P≤0.001; N=24), and with increased SLV (rs=-0.84; P<0.0001). CONCLUSIONS The finding of an association between macular VD and TRBF supports the role of vascular factors in the pathophysiology of POAG and potential conduct of future studies aimed at identifying multiple image-based vascular metrics for disease diagnosis.
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Affiliation(s)
- Jennifer Cano
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA
| | - Mansour Rahimi
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA
| | - Benjamin Y. Xu
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA
| | - Grace M. Richter
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA
| | - Ou Tan
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Mahnaz Shahidi
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA
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Suggestive evidence of genetic association of -572G > C polymorphism with primary open angle glaucoma in a North Indian Punjabi population. Hum Immunol 2021; 82:791-797. [PMID: 34301420 DOI: 10.1016/j.humimm.2021.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/09/2021] [Accepted: 06/23/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND IL6 is an important candidate gene implicated in the pathogenesis of glaucoma. The present study assessed the genetic association of -174G > C and -572G > C polymorphisms in the IL6 promoter region with primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) in a north Indian Punjabi cohort. METHODS 910 subjects (313 POAG, 148 PACG cases and 449 controls) were recruited. Genotyping was done by TaqMan assays. Genetic association was tested under different genetic models using Plink. Diplotype and linkage disequilibrium (LD) analysis was done through Haploview. Association of clinical parameters with the genotypes was assessed by one-way ANOVA. Adjustment for potential confounding variables was done by binary logistic regression. IL6 levels were measured in POAG patients and controls. RESULTS 572G > C variant showed marginal difference in genotype frequency between pooled cases and POAG subgroup with respect to controls (p = 0.042; OR = 1.33; and p = 0.041; OR = 1.37). The GC genotype conferred 1.37-fold protection under codominant model in POAG cases (p = 0.034, OR = 1.37, 95% CI = 1.02-1.85; pcorr = 0.025, OR = 1.45, 95% CI = 1.04-2.02). The mean value for IOP was elevated among cases having 'CC' genotype at the -572G > C locus (p = 0.037). Lower levels of IL6 were detected in POAG patients in plasma samples (p = 0.0001). CONCLUSION The study reports suggestive evidence for -572G > C variant in IL6 in affecting genetic susceptibility to POAG in the targeted North Indian Punjabi cohort. A correlation of IL6 levels in aqueous humor (AH) and systemic circulation in POAG was observed, the functional and diagnostic relevance of which may be further investigated.
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Jeon SJ, Park HYL, Park CK. Vessel Density Loss of the Deep Peripapillary Area in Glaucoma Suspects and Its Association with Features of the Lamina Cribrosa. J Clin Med 2021; 10:jcm10112373. [PMID: 34071218 PMCID: PMC8197842 DOI: 10.3390/jcm10112373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/21/2021] [Accepted: 05/25/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose: To investigate the association of decreased vessel density (VD) in the deep peripapillary region and structural features of the lamina cribrosa (LC). Materials and Methods: 70 eyes of glaucoma suspects with enlarged cup-to-disc ratio were scanned and 51 eyes with adequate image quality were included in this study. All subjects had localized VD defects in the deep layer but intact VD in the superficial layer around the peripapillary region using optical coherence tomography angiography (OCTA). Only single-hemizone OCTA results from one eye of each subject had to fulfill the distinctive feature mentioned above to perform inter-eye and inter-hemizone comparisons. The thickness and depth of the LC, and prelaminar thickness were measured using enhanced depth imaging OCT (EDI-OCT). Paired t-tests were performed to evaluate differences in measurements of the LC and prelaminar thickness within each individual. p-values lower than 0.05 was considered to be statistically significant. Results: Eyes with deep VD defects in the peripapillary region in OCTA had thinner LC than the fellow eyes. The hemizone with the deep VD defects in the peripapillary region had a thinner LC and a deeper depth of LC than the other hemizone in the same eye. According to logistic regression analysis, a thin LC was a significant factor associated with deep VD defect in the peripapillary region. Conclusions: Glaucoma suspect eyes with deep VD defects in the peripapillary area exhibited structural differences in the LC. The structural changes of the LC was associated with the vessel density in the deep peripapillary layer at the stage of suspected glaucoma.
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Affiliation(s)
- Soo-Ji Jeon
- Apgujeong St. Mary’s Eye Center, 859 Eonju-ro, Gangnam-gu, Seoul 06023, Korea;
| | - Hae-Young Lopilly Park
- Department of Ophthalmology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea;
| | - Chan-Kee Park
- Department of Ophthalmology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea;
- Correspondence: ; Tel.: +82-2-2258-1188; Fax: +82-2-599-7405
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Nie L, Xu J, Fu L, Ye Y, Chan YK, Li T, Pan W, Lu P. Changes in circumpapillary retinal vessel density after acute primary angle closure episode via OCT angiography. Int Ophthalmol 2021; 41:2389-2397. [PMID: 33948808 DOI: 10.1007/s10792-021-01793-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 03/06/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the changes and evaluate the diagnosis value of circumpapillary vessel density (VD) in cases of acute primary angle closure (APAC). DESIGN Case-control study. METHODS APAC patients with a history of unilateral acute attack were enrolled. The eyes with acute episode constituted the case group while the contralateral eyes without attack consisted of the control group. Ophthalmic examinations including slit-lamp examination, best-corrected visual acuity, intraocular pressure and visual field were carried out. Retinal nerve fiber layer (RNFL), macular ganglion cell complex (GCC) were measured by spectral-domain optical coherence tomography, while VD was assessed by optical coherence tomography angiography. RESULTS The whole en face image vessel density (wiVD), circumpapillary vessel density (cpVD) and inside disk VD for both all vessels and capillary were all significantly lower in the APAC eyes compared to the fellow eyes (P < 0.01 for all). In APAC eyes, the wiVD, inside disk VD and cpVD both for all vessels and capillary were all positively correlated with RNFL and GCC thicknesses but negatively correlated with the mean deviation (MD), pattern standard deviation (PSD) and the duration of acute attack (all P < 0.01). From the ROC curve, the cpVDcap, wiVDcap, cpVDall and wiVDall all showed comparable diagnostic ability with RNFL, GCC and MD to differentiate eyes with APAC from the fellow eyes (all P > 0.05). The inside disk VDcap and VDall demonstrated significant lower diagnostic ability than the cpVDcap, wiVDcap, cpVDall and wiVDall (all P < 0.001). CONCLUSIONS In APAC eyes, circumpapillary VD decreased significantly compared with the fellow unaffected eyes. They were significantly correlated with thicknesses of RNFL and GCC, and visual field MD and PSD in the APAC eyes. The patients with longer duration of acute attack were more likely to have lower cpVD. For APAC, the diagnostic ability of wiVD and cpVD was similar with RNFL, GCC and MD and was higher than inside disk VD.
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Affiliation(s)
- Li Nie
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.,Department of Glaucoma, Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Hangzhou, 310000, Zhejiang, China
| | - Jiawen Xu
- Department of Glaucoma, Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Hangzhou, 310000, Zhejiang, China
| | - Lin Fu
- Department of Glaucoma, Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Hangzhou, 310000, Zhejiang, China
| | - Yufeng Ye
- Department of Glaucoma, Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Hangzhou, 310000, Zhejiang, China
| | - Yau Kei Chan
- Department of Ophthalmology, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Tiankun Li
- Department of Glaucoma, Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Hangzhou, 310000, Zhejiang, China
| | - Weihua Pan
- Department of Glaucoma, Affiliated Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Hangzhou, 310000, Zhejiang, China
| | - Peirong Lu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
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Liu H, Xiu Y, Zhang Q, Xu Y, Wan Q, Tao L. Silencing microRNA‑29b‑3p expression protects human trabecular meshwork cells against oxidative injury via upregulation of RNF138 to activate the ERK pathway. Int J Mol Med 2021; 47:101. [PMID: 33907817 PMCID: PMC8054636 DOI: 10.3892/ijmm.2021.4934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/26/2021] [Indexed: 12/25/2022] Open
Abstract
In recent years, the potential involvement of numerous microRNAs (miRNAs) in glaucoma has been widely reported. However, the role of microRNA-29b-3p (miR-29b-3p) in the pathogenesis of glaucoma remains unknown. This study aimed to explore the biological role and regulatory mechanism of miR-29b-3p in the oxidative injury of human trabecular meshwork (HTM) cells induced by H2O2 stimulation. By establishing a glaucoma rat model, the effects of miR-29-3p in glaucoma were detected in vivo. Our findings demonstrated that miR-29b-3p was upregulated in a glaucoma model and antagomiR-29b-3p alleviated the symptoms of glaucoma. In vitro assays revealed that miR-29b-3p expression was significantly upregulated in HTM cells with H2O2 stimulation. Knockdown of miR-29b-3p alleviated H2O2-induced oxidative injury in HTM cells by promoting cell viability, and inhibiting cell apoptosis, reactive oxygen species generation and extracellular matrix production. Subsequently, it was found that E3 ubiquitin-protein ligase RNF138 (RNF138) was a downstream target of miR-29b-3p. RNF138 expression was downregulated in HTM cells with H2O2 stimulation. RNF138 knockdown significantly rescued the protective effect of miR-29b-3p inhibitor on HTM cells under oxidative injury. Additionally, miR-29b-3p silencing activated the ERK pathway via upregulating RNF138. Collectively, silencing of miR-29b-3p protected HTM cells against oxidative injury by upregulation of RNF138 to activate the ERK pathway.
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Affiliation(s)
- Heting Liu
- Department of Ophthalmology, The Second Hospital of Anhui Medical University, Hefei, Anhui 230601, P.R. China
| | - Yanghui Xiu
- Eye Institute and Xiamen Eye Center, Affiliated Xiamen University, Xiamen, Fujian 361000, P.R. China
| | - Qing Zhang
- Department of Ophthalmology, The Second Hospital of Anhui Medical University, Hefei, Anhui 230601, P.R. China
| | - Yuxin Xu
- Department of Ophthalmology, The Second Hospital of Anhui Medical University, Hefei, Anhui 230601, P.R. China
| | - Qianqian Wan
- Department of Ophthalmology, The Second Hospital of Anhui Medical University, Hefei, Anhui 230601, P.R. China
| | - Liming Tao
- Department of Ophthalmology, The Second Hospital of Anhui Medical University, Hefei, Anhui 230601, P.R. China
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