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Jang YH, Choi EY, Lee H, Woo J, Park S, Noh Y, Jeon JY, Yoo EY, Shin JY, Lee YW. Long-Term Use of Oral Corticosteroids and Safety Outcomes for Patients With Atopic Dermatitis. JAMA Netw Open 2024; 7:e2423563. [PMID: 39028668 PMCID: PMC11259904 DOI: 10.1001/jamanetworkopen.2024.23563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/23/2024] [Indexed: 07/21/2024] Open
Abstract
Importance The use of oral corticosteroids for prolonged periods may be associated with adverse events (AEs). Nevertheless, the risk of AEs with oral corticosteroids, especially among patients with atopic dermatitis (AD), has not been comprehensively investigated and lacks evidence on duration of treatment. Objective To assess the association between long-term exposure to oral corticosteroids and AEs among adult patients with AD. Design, Setting, and Participants This nested case-control study used data from the Health Insurance Review and Assessment Service database of South Korea between January 1, 2012, and October 31, 2021, which included 1 year prior to the cohort entry date of January 1, 2013, for assessing exclusion criteria and baseline characteristics, and 1 year after the study end date of October 31, 2020, to ensure a minimum duration for assessing exposure. Among the population of adults with AD, patients diagnosed with any of 11 AEs were matched with patients who had never received a diagnosis of any of the 11 AEs. Exposure Long-term use of oral corticosteroids was defined as cumulative supply of more than 30 days or more than 90 days of oral corticosteroid prescription per year. Main Outcomes and Measures We used multivariable conditional logistic regression analyses to measure the risk of 11 individual outcomes (osteoporosis, fracture, type 2 diabetes, hyperlipidemia, hypertension, myocardial infarction, stroke, heart failure, avascular necrosis, cataract, or glaucoma) as the composite outcome, controlling for potential confounders. We further classified the composite outcome to individual outcomes to evaluate the AE-specific risk. Results Among 1 025 270 patients with AD between 2013 and 2020, 164 809 cases (mean [SD] age, 39.4 [14.8]; 56.9% women) were matched with 328 303 controls (mean [SD] age, 39.3 [14.7]; 56.9% women) for sex, age, cohort entry date, follow-up duration, and severity of AD, where the balance of most baseline characteristics was achieved. A total of 5533 cases (3.4%) and 10 561 controls (3.2%) were exposed to oral corticosteroids for more than 30 days, while 684 cases (0.4%) and 1153 controls (0.4%) were exposed to oral corticosteroids for more than 90 days. Overall, there was no increased risk of AEs with use of oral corticosteroids for more than 30 days (adjusted odds ratio [AOR], 1.00; 95% CI, 0.97-1.04), whereas the risk was slightly higher with use of oral corticosteroids for more than 90 days (AOR, 1.11; 95% CI, 1.01-1.23). The small elevation in experiencing an AE was observed with each cumulative or consecutive year of ever long-term use. Conclusions and Relevance This case-control study found a slightly increased risk of AEs associated with use of oral corticosteroids for more than 90 days per year, which warrants future research to fully elucidate the observed findings.
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Affiliation(s)
- Yong Hyun Jang
- Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
| | - Eun-Young Choi
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Hyesung Lee
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
| | - Jieun Woo
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
| | - Sohee Park
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, United Kingdom
- School of Pharmacy, Aston University, Birmingham, United Kingdom
| | - Yunha Noh
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Ja-Young Jeon
- Department of Inflammation & Immunology Medical Affairs, Pfizer Pharmaceuticals Korea Ltd, Seoul, South Korea
| | - Eun-Young Yoo
- Department of Inflammation & Immunology Medical Affairs, Pfizer Pharmaceuticals Korea Ltd, Seoul, South Korea
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
- Department of Biohealth Regulatory Science, Sungkyunkwan University, Suwon, South Korea
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea
| | - Yang Won Lee
- Department of Dermatology, Konkuk University School of Medicine, Seoul, South Korea
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Hsu AY, Kuo HT, Lin CJ, Hsia NY, Kuo SC, Wei CC, Lai CT, Chen HS, Wang YH, Wei JCC, Tsai YY. Cataract Development Among Pediatric Patients With Uveitis. JAMA Netw Open 2024; 7:e2419366. [PMID: 38949811 PMCID: PMC11217876 DOI: 10.1001/jamanetworkopen.2024.19366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/28/2024] [Indexed: 07/02/2024] Open
Abstract
Importance The long-term estimated risk of development of cataracts among pediatric patients with uveitis is not clear. Objective To describe factors associated with the development of cataracts among pediatric patients with uveitis. Design, Setting, and Participants This cohort study used the international TriNetX database to enroll pediatric patients with and without uveitis from January 1, 2002, to December 31, 2022. The nonuveitis cohort consisted of randomly selected control patients matched by age, sex, race and ethnicity, and specific comorbidities. Exposure Diagnosis of uveitis, identified using diagnostic codes. Main Outcomes and Measures The primary outcome was the risk of developing cataracts among the uveitis group compared with the nonuveitis comparison group, with hazard ratios (HRs) and 95% CIs reported. Results A total of 22 687 pediatric patients with uveitis (mean [SD] age, 10.3 [5.6] years; 54.2% male) and 22 687 comparators without uveitis (mean [SD] age, 10.3 [5.6] years; 54.5% male) were enrolled in the study. The risk of cataracts was increased among pediatric patients with uveitis up to a follow-up duration of 20 years (HR, 17.17; 95%CI, 12.90-22.80) from the index date. Subgroup analyses revealed an elevated cataract risk across age groups: 0 to 6 years (HR, 19.09; 95% CI, 10.10-36.00), 7 to 12 years (HR, 27.16; 95% CI, 15.59-47.20), and 13 to 18 years (HR, 13.39; 95% CI, 8.84-20.30); both female sex (HR, 13.76; 95% CI, 9.60-19.71) and male sex (HR, 11.97; 95% CI, 8.47-16.91); and Asian (HR, 13.80; 95% CI, 3.28-58.07), Black or African American (HR, 10.41; 95% CI, 5.60-19.36), and White (HR, 15.82; 95% CI, 11.05-22.60) race. Furthermore, increased cataract risks were also observed among those with and without a history of immunosuppressive agents (with: HR, 26.52 [95% CI, 16.75-41.90]; without: HR, 17.69 [95% CI: 11.39-27.40]), a history of steroid eye drop use (with: HR, 29.51 [95% CI, 14.56-59.70]; without: HR, 16.49 [95% CI, 11.92-22.70]), and a history of intraocular procedures (with: HR, 11.07 [95%CI, 4.42-27.71]; without: HR, 14.49 [95% CI, 10.11-20.70]). Conclusions and Relevance In this cohort study of pediatric patients with uveitis, an elevated risk of cataracts following a uveitis diagnosis was found compared with pediatric patients without uveitis. The findings suggest that pediatric patients with uveitis should be monitored for cataract development.
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Affiliation(s)
- Alan Y. Hsu
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan
| | - Hou-Ting Kuo
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan
- Department of General Medicine, China Medical University Hospital, Taifchung City, Taiwan
| | - Chun-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan
- Department of Optometry, Asia University, Taichung City, Taiwan
| | - Ning-Yi Hsia
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan
- Department of Optometry, Asia University, Taichung City, Taiwan
| | - Shu-Chun Kuo
- Department of Ophthalmology, Chi Mei Medical Center, Tainan City, Taiwan
- Department of Optometry, Chung Hwa University of Medical Technology, Tainan City, Taiwan
| | - Chang-Ching Wei
- School of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan
- Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, Children’s Hospital, China Medical University Hospital, Taichung City, Taiwan
| | - Chun-Ting Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan
- Department of Optometry, Asia University, Taichung City, Taiwan
| | - Huan-Sheng Chen
- An-Shin Dialysis Center, NephroCare Ltd, Fresenius Medical Care, Taichung City, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung City, Taiwan
| | - James Cheng-Chung Wei
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung City, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung City, Taiwan
- Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung City, Taiwan
- Institute of Integrated Medicine, China Medical University, Taichung City, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung City, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung City, Taiwan
- Department of Optometry, Asia University, Taichung City, Taiwan
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Viswanathan M, Gu W, Blanch RJ, Groves LL. Cataracts after Ophthalmic and Nonophthalmic Trauma Exposure in Service Members, U.S. Armed Forces. Mil Med 2024; 189:e1009-e1015. [PMID: 37930775 DOI: 10.1093/milmed/usad414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/11/2023] [Accepted: 10/06/2023] [Indexed: 11/07/2023] Open
Abstract
ABSTRACT IntroductionWe aimed to identify injury-related risk factors for secondary cataract incidence after eye and brain injury and polytrauma. We also examined the effect of direct and indirect eye injury management on cataract diagnosis and treatment. Prevention or mitigation strategies require knowledge of the causes and types of combat injuries, which will enable more appropriate targeting of resources toward prevention and more efficient management of such injuries. MATERIALS AND METHODS Data were gathered from the Military Health System using the Military Health System Management and Analysis Reporting Tool (M2) between 2017 and 2021 from inpatient and outpatient Service Members (SMs) (active duty and National Guard). The date of the first cataract diagnosis was tracked to estimate the annual incidence rate, and it was longitudinally linked to any prior diagnosis of ocular trauma (OT), traumatic brain injury (TBI), or polytrauma to calculate the relative risk. International Classification of Disease codes, 10th Revision, were used to identify those diagnosed with cataracts, TBI, and polytrauma. Defense and Veterans Eye Injury and Vision Registry data were used to examine SMs who sustained ocular injuries from 2003-2020 and who may have had cataract surgery following a cataract diagnosis. RESULTS The relative risk of traumatic cataract formation from OT, TBI, and polytrauma are 5.71 (95% CI, 5.05-6.42), 2.32 (95% CI, 2.03-2.63), and 8.95 (95% CI, 6.23-12.38), respectively. Traumatic cataracts in SMs more commonly result from open-globe injuries (70%) than closed-globe injuries (30%). By specific sub-injury type, traumatic cataracts occur most frequently from intraocular foreign bodies (22%). More than 400 patients in the cohort suffered from TBI and traumatic cataracts, more than 300 from OT and cataracts, and more than 20 from polytrauma and cataracts. The battlefield is the riskiest environment for trauma exposure, with 62% of OT occurring in combat. There was a statistically significant difference between the mean visual acuity value before cataract surgery (M = 1.17, SD = 0.72) and the mean visual acuity value after cataract surgery (M = 0.44, SD = 0.66, P < .001). CONCLUSION Traumatic cataracts often occur in SMs who sustain ocular injuries. New to the literature is that relationships exist between traumatic cataract formation and nonglobe trauma, specifically TBI and polytrauma. Ocular injury calls for an ophthalmic examination. A low threshold should exist for routine ocular exam consultation in the setting of TBI and polytrauma. Separately, polytrauma patients should undergo a review of systems questions, particularly questions about the ocular and visual pathways. A positive response to screening warrants further investigation of possible ocular pathology, including traumatic cataract formation. Cataract surgery is an effective treatment in improving the vision of SMs who suffer from traumatic cataracts. Constant effort must be made to limit occurrences of occupation-related traumatic cataracts.
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Affiliation(s)
- Mariia Viswanathan
- Vision Center of Excellence, Defense Health Agency, Research and Engineering, Bethesda, MD 20889-5629, USA
| | - Weidong Gu
- Vision Center of Excellence, Defense Health Agency, Research and Engineering, Bethesda, MD 20889-5629, USA
| | - Richard J Blanch
- Academic Department of Military Surgery and Trauma, Royal Centre for Defense Medicine, Birmingham B15 2GW, UK
- Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham B15 2TH, UK
| | - Lucas L Groves
- Blanchfield Army Community Hospital, US Army, Fort Campbell, KY 42223, USA
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Kim BR, Lee KH, Paik K, Kim M, Bae JM, Choi CW, Youn SW. Automated mass screening and association rules analysis for comorbidities of psoriasis: A population-based case-control study. J Dermatol 2024; 51:539-551. [PMID: 38345288 DOI: 10.1111/1346-8138.17121] [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] [Received: 11/10/2023] [Revised: 12/25/2023] [Accepted: 12/30/2023] [Indexed: 04/04/2024]
Abstract
Patients with psoriasis frequently have comorbidities, which are linked to higher mortality rates. An in-depth investigation of comorbidities and their effects on health can help improve the management of patients with psoriasis. We conducted a comprehensive and unbiased investigation of comorbidities in patients with psoriasis and explored the pattern of association between comorbidities. A nationwide population-based study included 384 914 patients with psoriasis and 384 914 matched controls between 2011 and 2021. We used automated mass screening of all diagnostic codes to identify psoriasis-associated comorbidities and applied association rule analysis to explore the patterns of comorbidity associations in patients with psoriasis. Patients with psoriasis had an increased risk of autoimmunity-related diseases such as inflammatory arthritis, Crohn's disease, type 1 diabetes, and acute myocardial infarction. The comorbidities of patients with psoriasis with a history of cardiovascular events demonstrated strong interrelationships with other cardiovascular risk factors including type 2 diabetes mellitus, essential hypertension, and dyslipidemia. We also found comorbidities, such as malignant skin tumors and kidney and liver diseases, which could have adverse effects of anti-psoriasis therapy. In contrast, patients with psoriasis showed a decreased association with upper respiratory tract infection. Our results imply that comorbidities in patients with psoriasis are associated with the systemic inflammation of psoriasis and the detrimental effects of its treatment. Furthermore, we found patterns of associations between the cardiovascular risk factors and psoriasis. Mass screening and association analyses using large-scale databases can be used to investigate impartially the comorbidities of psoriasis and other diseases.
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Affiliation(s)
- Bo Ri Kim
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Kun Hee Lee
- Department of Applied Statistics, Yonsei University, Seoul, Korea
| | - Kyungho Paik
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Minjae Kim
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jung Min Bae
- Department of Dermatology, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chong Won Choi
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sang Woong Youn
- Department of Dermatology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Zhang X, Wang G, Wang Q, Jiang R. Dexamethasone and MicroRNA-204 Inhibit Corneal Neovascularization. Mil Med 2024; 189:374-378. [PMID: 36043264 DOI: 10.1093/milmed/usac260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/14/2022] [Accepted: 08/18/2022] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION This was an in vivo animal study designed to investigate the interaction between dexamethasone (Dex) and microRNA-204 (miR-204) in a mouse alkali burn-induced corneal neovascularization (CNV) model. The function of miR-204 was then investigated in human mammary epithelial cells (HMECs) in vitro. MATERIALS AND METHODS The CNV model was induced by corneal alkali burn in BLAB/c mice. The mice were randomly divided into five groups: normal control (Ctrl), alkali burn-induced corneal injury (Alkali), alkali burn + Dex (Dex), alkali burn + negative control (NTC), and alkali burn + miR-204 agomir (miR-204). Subconjunctival injection of NTC, Dex, or miR-204 agomir was conducted at 0, 3, and 6 days, respectively, after alkali burn. The corneas were collected at day 7 after injury, and the CNV area was observed using immunofluorescence staining. The expression of miR-204 was analyzed with quantitative real time (qRT)-PCR. In HMECs, exogenous miR-204 agomir or antagomir was used to strengthen or inhibit the expression of miR-204. Migration assays and tube formation studies were conducted to evaluate the function of miR-204 on HMECs. RESULTS At 7 days post-alkali burn, CNV grew aggressively into the cornea. MicroRNA-204 expression was reduced in the Alkali group in contrast with the Ctrl group (P = .003). However, miR-204 was upregulated in the Dex group (vs. alkali group, P = .008). The CNV areas in the NTC and miR-204 groups were 59.30 ± 8.32% and 25.60 ± 2.30%, respectively (P = .002). In vitro, miR-204 agomir showed obvious inhibition on HMEC migration in contrast with NTC (P = .033) and miR-204 antagomir (P = .017). Compared with NTC, miR-204 agomir attenuated tube formation, while miR-204 antagomir accelerated HMEC tube formation (P < .05). CONCLUSION The role of Dex in attenuating CNV may be partly attributed to miR-204. MiR-204 may be a potential therapeutic target in alkali burn-induced CNV.
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Affiliation(s)
- Xiaoping Zhang
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266002, China
| | - Gang Wang
- Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266002, China
| | - Qing Wang
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266002, China
| | - Rui Jiang
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266002, China
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Kang KH, Shin D, Ryu IH, Kim JK, Lee IS, Koh K, Yoo TK. Association between cataract and fatty liver diseases from a nationwide cross-sectional study in South Korea. Sci Rep 2024; 14:77. [PMID: 38167592 PMCID: PMC10761897 DOI: 10.1038/s41598-023-50582-7] [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: 08/04/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
This study examined the link between fatty liver disease (FLD) and cataracts, as previous research has suggested that FLD may contribute to metabolic syndrome, systemic inflammation, and potentially cataracts. We studied a nationwide cross-sectional cohort of the Fifth Korean National Health and Nutrition Examination Survey 2010-2011. FLD was defined as nonalcoholic FLD (NAFLD) and metabolic dysfunction-associated FLD (MAFLD). Multinomial logistic regression was utilized to investigate the relationship between cataracts and FLD after adjustment for potential confounders. Participants with cataracts had higher liver fibrosis scores, including the NAFLD fibrosis score (NFS; P < 0.001), fibrosis-4 index (FIB4; P < 0.001), and fatty liver index (FLI; P = 0.001). NAFLD was not associated with a higher odds ratio (OR) for cataracts in the fully adjusted model (OR = 1.23, P = 0.058). MAFLD was significantly associated with a higher OR (OR = 1.34, P = 0.006). After adjusting for all factors, the severity of FLD was linked to an increased risk of cataracts, with significant linear trends (P values for linear trends of NFS, FIB4, and FLI < 0.05). After adjusting for well-known cataract risk factors, MAFLD was significantly associated with cataracts. Our analysis suggests that FLD may serve as an independent risk factor for cataracts.
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Affiliation(s)
- Kyoung Hae Kang
- Cornea, Cataract and Refractive Surgery Division, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Yeongshinro, Youngdeungpogu, Seoul, 07301, Republic of Korea
| | - Daeun Shin
- Cornea, Cataract and Refractive Surgery Division, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Yeongshinro, Youngdeungpogu, Seoul, 07301, Republic of Korea
| | - Ik Hee Ryu
- Department of Refractive Surgery, B&VIIT Eye Center, B2 GT Tower, 1317-23 Seocho-Dong, Seocho-Gu, Seoul, Republic of Korea
- Research and development department, VISUWORKS, Seoul, South Korea
| | - Jin Kuk Kim
- Department of Refractive Surgery, B&VIIT Eye Center, B2 GT Tower, 1317-23 Seocho-Dong, Seocho-Gu, Seoul, Republic of Korea
- Research and development department, VISUWORKS, Seoul, South Korea
| | - In Sik Lee
- Department of Refractive Surgery, B&VIIT Eye Center, B2 GT Tower, 1317-23 Seocho-Dong, Seocho-Gu, Seoul, Republic of Korea
| | - Kyungmin Koh
- Cornea, Cataract and Refractive Surgery Division, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Yeongshinro, Youngdeungpogu, Seoul, 07301, Republic of Korea.
| | - Tae Keun Yoo
- Department of Refractive Surgery, B&VIIT Eye Center, B2 GT Tower, 1317-23 Seocho-Dong, Seocho-Gu, Seoul, Republic of Korea.
- Research and development department, VISUWORKS, Seoul, South Korea.
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Bamahfouz A, Elmorsy S, Alharbi ER, Bakry SM, Alnemari W, Alzahrani SM, Almousa AA. Assessment of the Level of Knowledge and Awareness of the Risk of Chronic Use of Steroids in Causing Cataracts Among the General Population in the Western Region of the Kingdom of Saudi Arabia (KSA): A Cross-Sectional Study. Cureus 2024; 16:e52288. [PMID: 38357076 PMCID: PMC10865282 DOI: 10.7759/cureus.52288] [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] [Accepted: 01/14/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND/AIM Cataracts consequence blindness to burden and impose health and economic burdens on communities. Steroid-induced cataracts have scarcely been highlighted in previous literature, creating a demand for reinvestigating this issue among the general population of western Saudi Arabia. METHODS A cross-sectional study was conducted in 2022 using an online survey distributed among the target participants via social media platforms. The data were gathered and statistically analyzed using IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. software. RESULTS Overall, 866 respondents (males = 42.5%, females = 57.5%) were enrolled in this survey (mean age = 28.08, SD = 13). The participants' correct responses to questions about steroid-induced cataracts showed inadequate representation (below 50%). Additionally, most of the participants (94.23%) had a poor understanding of steroid-induced cataracts. CONCLUSION The participants' level of understanding of the risk factors associated with chronic steroid usage and its impact on cataracts was inadequate.
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Affiliation(s)
- Ashjan Bamahfouz
- Ophthalmology, Umm Al-Qura University, Makkah, SAU
- Ophthalmology, King Abdullah Medical City, Makkah, SAU
- Ophthalmology, Security Forces Hospital-Makkah, Makkah, SAU
| | - Soha Elmorsy
- Research and Development, King Abdullah Medical City, Makkah, SAU
| | | | - Salah M Bakry
- Faculty of Medicine, Umm Al-Qura University, Makkah, SAU
| | | | | | - Amr A Almousa
- Medicine and Surgery, Umm Al-Qura University, Makkah, SAU
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Thathapudi NC, Groleau M, Degué DS, Aghajanzadeh Kiyaseh M, Kujawa P, Soulhi F, Akla N, Griffith M, Robert MC. Novel micellar CB2 receptor agonist with anti-inflammatory action for treating corneal alkali burns in a mouse model. Front Pharmacol 2023; 14:1270699. [PMID: 38161702 PMCID: PMC10755873 DOI: 10.3389/fphar.2023.1270699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/25/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction: Moderate corneal alkali burns such as those sustained from accidental exposure to household chemicals are treated with topical corticosteroids. Side effects include increased intraocular pressure and slowing of wound healing. Here, we compare the effects of a cannabinoid receptor 2 (CB2r) agonist, TA-A001, that is involved in wound healing with that of the corticosteroid, prednisolone. Methods: TA-A001 was encapsulated with a polymeric micelle comprising polyvinylpyrrolidone: polylactide block copolymers referred to as SmartCelle™ to allow delivery of the very hydrophobic drug. Mouse corneas were given moderate alkali burns. Different doses of TA-A001 of 0.125%, 0.25% and 0.5% were used to treat the burns in comparison to the corticosteroid, prednisolone. Results: TA-A001 at 0.25% and 0.5% allowed for faster wound closure. However, the higher 0.5% dose also induced unwanted neovascularization. By comparison, burned corneas treated with prednisolone showed slower healing as well as disorganization of the cornea. Although 0.25% TA-A001 appeared to produce the most-optimal responses, this dose resulted in marked expression of the macrophage chemoattractant protein, MCP-1. However, there was also an increase in CD163 positive stained M2 anti-inflammatory macrophages in the TA-A001 corneas. TA-A001 treated corneas showed the presence of sensory nerve fibers throughout the corneal epithelium including the superficial cell layers as did Substance P staining. Discussion: We found that TA-A001 at the 0.25% doses was able to modulate inflammation resulting from a moderate alkali burn to the cornea. With more extensive testing, TA-A001 might prove to be a potential alternative to corticosteroids for treating alkali burns or other causes of corneal inflammation.
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Affiliation(s)
- Neethi C. Thathapudi
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, QC, Canada
- Institute of Biomedical Engineering, Université de Montréal, Montreal, QC, Canada
| | - Marc Groleau
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, QC, Canada
- Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montreal, QC, Canada
| | - Delali S. Degué
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, QC, Canada
- Institute of Biomedical Engineering, Université de Montréal, Montreal, QC, Canada
| | - Mozhgan Aghajanzadeh Kiyaseh
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, QC, Canada
- Institute of Biomedical Engineering, Université de Montréal, Montreal, QC, Canada
| | - Piotr Kujawa
- Pharmaceutical Research and Development, Altus Formulation Inc., Laval, QC, Canada
| | - Fouzia Soulhi
- Pharmaceutical Research and Development, Altus Formulation Inc., Laval, QC, Canada
| | - Naoufal Akla
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, QC, Canada
| | - May Griffith
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, QC, Canada
- Institute of Biomedical Engineering, Université de Montréal, Montreal, QC, Canada
| | - Marie-Claude Robert
- Maisonneuve-Rosemont Hospital Research Centre, Montreal, QC, Canada
- Department of Ophthalmology, Université de Montréal, Montreal, QC, Canada
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9
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Trung NL, Toan PQ, Trung NK, Tuan VA, Huyen NT. Eye Lesions in Patients After One Year of Kidney Transplantation. Clin Ophthalmol 2023; 17:2861-2869. [PMID: 37799147 PMCID: PMC10547587 DOI: 10.2147/opth.s424883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023] Open
Abstract
Purpose Determine the incidence of some eye lesions in kidney transplant patients after one year at Military Hospital 103 and comment on related factors. Patients and Methods A cross-sectional study description of 111 kidney transplant patients (222 eyes) at Military Hospital 103. We assessed several eye lesions, including dry eyes, corneal conjunctival calcification, cataracts, and retinopathy. Results The rate of retinopathy was 84.7%, dry eye was 59.5%, cataract was 29.7%, and corneal conjunctival calcification was 24.8%, atrophy optic nerve was 9.9%, epiretinal membrane was 1.8%. Post-transplant influence factors associated with cataracts include the dose of prednisolone (OR= 1.6, p < 0.05) and post-transplant diabetes (OR=1.4, p < 0.05). The influence factor related to the atrophy of the optic nerve is systemic infection after transplantation (OR=2.4, p < 0.05). Conclusion Retinopathy accounted for the highest rate, followed by dry eye disease; cataracts ranked third; and finally, calcified corneal conjunctiva. Factors that affect cataracts are diabetes mellitus and prednisolone dose. Factors affecting optic nerve atrophy are infections after kidney transplantation.
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Affiliation(s)
- Nguyen Le Trung
- Vietnam Department of Ophthalmology, Hanoi Medical University, Hanoi, Vietnam
- Vietnam Department of Ophthalmology, Military Hospital 103, Hanoi, Vietnam
| | - Pham Quoc Toan
- Vietnam Department of Nephrology, Military Hospital 103, Hanoi, Vietnam
| | | | - Vu Anh Tuan
- Vietnam Department of Ophthalmology, Hanoi Medical University, Hanoi, Vietnam
| | - Nguyen Thu Huyen
- Vietnam Department of Ophthalmology, National Military Hospital 108, Hanoi, Vietnam
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10
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Zhu Y, Li D, Reyes-Ortega F, Chinnery HR, Schneider-Futschik EK. Ocular development after highly effective modulator treatment early in life. Front Pharmacol 2023; 14:1265138. [PMID: 37795027 PMCID: PMC10547496 DOI: 10.3389/fphar.2023.1265138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 09/06/2023] [Indexed: 10/06/2023] Open
Abstract
Highly effective cystic fibrosis (CF) transmembrane conductance regulator (CFTR) modulator therapies (HEMT), including elexacaftor-tezacaftor-ivacaftor, correct the underlying molecular defect causing CF. HEMT decreases general symptom burden by improving clinical metrics and quality of life for most people with CF (PwCF) with eligible CFTR variants. This has resulted in more pregnancies in women living with CF. All HEMT are known to be able pass through the placenta and into breast milk in mothers who continue on this therapy while pregnant and breast feeding. Toxicity studies of HEMT in young rats demonstrated infant cataracts, and case reports have reported the presence of congenital cataracts in early life exposure to HEMT. This article reviews the evidence for how HEMT influences the dynamic and interdependent processes of healthy and abnormal lens development in the context of HEMT exposure during pregnancy and breastfeeding, and raises questions that remain unanswered.
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Affiliation(s)
- Yimin Zhu
- Department of Biochemistry and Pharmacology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Danni Li
- Department of Biochemistry and Pharmacology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Felisa Reyes-Ortega
- Department of Biochemistry and Pharmacology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia
- Department of Ophthalmology, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital and University of Cordoba, Cordoba, Spain
| | - Holly R. Chinnery
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Elena K. Schneider-Futschik
- Department of Biochemistry and Pharmacology, School of Biomedical Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, Australia
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11
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Yoo WS, Seong H, Song C, Choi MY, Lee B, Eom Y, Kim HJ, Yun SP, Kim SJ. Role of Chondroitin Sulfate Proteoglycan 5 in Steroid-Induced Cataract. Cells 2023; 12:1705. [PMID: 37443739 PMCID: PMC10340432 DOI: 10.3390/cells12131705] [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] [Received: 05/23/2023] [Revised: 06/21/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Steroid-induced cataracts (SIC) are defined as cataracts associated with the administration of corticosteroids. Long-term glucocorticoid treatment for inflammatory diseases reportedly increases the risk of SIC, and steroids can induce cataracts by disrupting ocular growth factor balance or homeostasis. In this study, we verified the effect of chondroitin sulfate proteoglycan 5 (CSPG5) using dexamethasone (dexa)-treated human lens epithelial (HLE-B3) cells and the lens epithelium from the anterior capsule of SIC patients obtained during cataract surgery. CSPG5 expression increased in the lens epithelium of SIC patients. The downregulation of CSPG5 suppressed the dexa-induced epithelial-mesenchymal transition (EMT)-related protein expression and motility in HLE-B3 cells. The disruption of the transcription factors EZH2 and B-Myb downregulated CSPG5, dexa-induced fibronectin expression, and cell migration in HLE-B3 cells, reaffirming that CSPG5 expression regulates EMT in lens epithelial cells. Taken together, these results indicate that the steroid-induced effects on lens epithelial cells are mediated via alterations in CSPG5 expression. Therefore, our study emphasizes the potential of CSPG5 as a therapeutic target for the prevention and treatment of SIC.
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Affiliation(s)
- Woong-Sun Yoo
- Department of Ophthalmology, Gyeongsang National University College of Medicine, and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
- Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea
| | - Hyemin Seong
- Department of Ophthalmology, Gyeongsang National University College of Medicine, and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
- Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea
| | - Chieun Song
- Department of Ophthalmology, Gyeongsang National University College of Medicine, and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
- Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea
| | - Mee-Young Choi
- Department of Ophthalmology, Gyeongsang National University College of Medicine, and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
- Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea
| | - Bina Lee
- Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea
- Department of Pharmacology and Convergence Medical Science, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea
| | - Youngsub Eom
- Department of Ophthalmology, Korea University College of Medicine, Seoul 02842, Republic of Korea
- Department of Ophthalmology, Korea University Ansan Hospital, Ansan 15355, Republic of Korea
| | - Hae-Jin Kim
- School of Mechanical and Aerospace Engineering, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Seung Pil Yun
- Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea
- Department of Pharmacology and Convergence Medical Science, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea
| | - Seong-Jae Kim
- Department of Ophthalmology, Gyeongsang National University College of Medicine, and Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
- Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea
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12
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Balıkçı AT, Ulutaş HG, Akacı O. Evaluation of corneal and lens densitometry with Pentacam HR in children with Nephrotic Syndrome: A controlled, prospective study. Photodiagnosis Photodyn Ther 2022; 40:103184. [PMID: 36602067 DOI: 10.1016/j.pdpdt.2022.103184] [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: 08/26/2022] [Revised: 10/14/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND This study aimed to compare the corneal and lens densitometry values between children with Nephrotic Syndrome (NS) and healthy individuals. METHODS This cross-sectional comparative study included 23 patients with NS and 26 healthy controls. Corneal topographic and corneal and lens densitometric values were measured using Pentacam HR. Densitometry measurements in different layers were analyzed and compared between groups. Correlations between steroid cumulative dose, age at diagnosis of the disease, duration of disease, number of relapses, and patients' densitometries values were evaluated. RESULTS The measurements of the keratometry, horizontal white-to-white, and iridocorneal angle values were significantly different between groups (p < 0.05). The 0-2 mm and 2-6 mm anterior corneal densitometry values were significantly higher in NS patients. (p = 0.009 and p = 0.033, respectively). The lens densitometry values of all zones were higher in the eyes with NS but there was no statistically significant difference from the healthy control eyes (p > 0.05). There was a positive strong correlation between the cumulative steroid dose and the posterior lens zone densitometry, a positive weak correlation between the number of attacks and anterior corneal densitometry, and between disease duration and central corneal densitometry and average lens density. CONCLUSION In eyes with NS, changes occur in corneal and lens densitometry in correlation with disease duration, number of attacks, and cumulative steroid dose. Significant density changes were detected especially in the anterior cornea and central 0-6 mm area.
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Affiliation(s)
- Ayşe Tüfekçi Balıkçı
- Department of Ophthalmology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey.
| | - Hafize Gökben Ulutaş
- Department of Ophthalmology, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Okan Akacı
- Department of Pediatric Nephrology Clinic, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
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13
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Balasubramaniam B, Chong YJ, Azzopardi M, Logeswaran A, Denniston AK. Topical Anti-Inflammatory Agents for Non-Infectious Uveitis: Current Treatment and Perspectives. J Inflamm Res 2022; 15:6439-6451. [PMID: 36467992 PMCID: PMC9717596 DOI: 10.2147/jir.s288294] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 11/12/2022] [Indexed: 10/07/2023] Open
Abstract
Non-infectious uveitis represents a heterogenous group of immune-mediated ocular diseases, which can be associated with underlying systemic disease. While the initial choice of treatment of non-infectious uveitis depends on a number of factors such as anatomical location and degree of inflammation, topical therapies often remain the initial choice of non-invasive therapy. In this narrative review, we aim to describe the literature on non-infectious uveitis, with specific focus on the current perspective on topical anti-inflammatory therapy.
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Affiliation(s)
- Balini Balasubramaniam
- Ophthalmology Department, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK
| | - Yu Jeat Chong
- Birmingham & Midland Eye Centre, Birmingham, B18 7QH, UK
| | - Matthew Azzopardi
- Ophthalmology Department, Royal London Hospital, Barts Health NHS Trust, London, E1 1BB, UK
| | | | - Alastair K Denniston
- Ophthalmology Department, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, B15 2TH, UK
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14
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Xu C, Prager AJ, Alonso CD, Pawar AS. Insights From the Eye for Patients With Kidney Transplant. Transplant Proc 2022; 54:2182-2191. [PMID: 36096946 DOI: 10.1016/j.transproceed.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 07/12/2022] [Indexed: 11/29/2022]
Abstract
The eye and the kidney share structural and developmental similarities on a cellular and clinical level, and they are often affected by the same disease processes. Performing an eye exam to look for signs of conditions such as hypertension and diabetes can provide a helpful window into the health of the kidney. Patients with kidney transplants (KT) are a unique population that require close monitoring. These patients are maintained on a number of immunosuppressive medications and may face complications such as medication side effects, infections, and graft rejection. Patients with KT are at higher risk of both infectious and noninfectious eye conditions related to underlying systemic disease or use of immunosuppressive medications. Screening for eye conditions is important because preserving visual function is integral to quality of life, and also because the eye exam can help with early detection and treatment of systemic conditions. Here we describe some of the common eye findings and conditions in patients with KT. We recommend that patients with KT receive annual eye exams, and we hope that the information provided here can help nephrologists become more familiar with eye findings and identify situations where a referral to ophthalmology is warranted.
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Affiliation(s)
| | - Alisa J Prager
- Harvard Medical School, Boston, Massachusetts; Division of Ophthalmology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Carolyn D Alonso
- Harvard Medical School, Boston, Massachusetts; Division of Infectious Disease, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Aditya S Pawar
- Harvard Medical School, Boston, Massachusetts; Division of Nephrology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
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15
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Al-Bakri M, Skovgaard AM, Bach-Holm D, Larsen DA, Siersma V, Kessel L. Increased Incidence of Mental Disorders in Children with Cataract: Findings from a Population-based Study. Am J Ophthalmol 2022; 236:204-211. [PMID: 34648774 DOI: 10.1016/j.ajo.2021.09.034] [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: 06/26/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine the incidence of mental disorders in children with cataract compared with children without cataract. DESIGN Nationwide cohort study based on entries in comprehensive national databases. METHODS The incidence of mental disorders in children born between 2000 and 2017 diagnosed with cataract before 10 years of age (n = 485) was compared with sex- and age-matched controls (n = 4358). Analyses were corrected to somatic disease in the child and parental socioeconomic status and psychiatric morbidity. The study was conducted as 2 university hospitals in Denmark managing children 6 years of age our younger with cataract. RESULTS The incidence of mental disorders was nearly doubled in children with cataract compared with controls (odds ratio [OR], 1.83; 95% CI, 1.28-3.63). The risk of anxiety disorders was quadrupled (OR, 4.10; 95% CI, 1.90-8.84) and the risk of developmental delay was doubled (OR, 2.66; 95% CI, 1.45-4.90). The risk of mental disorders was significantly higher in children diagnosed with cataract in the first 3 years of life compared with controls (OR, 2.36; 95% CI, 1.53-3.64), whereas those diagnosed with cataract later in childhood did not have an increased risk (OR, 1.24; 95% CI, 0.66-2.30). CONCLUSIONS The risk of mental disorders, in particular anxiety and neurodevelopmental delay, is markedly increased in children with cataract and even more so in those diagnosed within the first 3 years of life. Psychiatric screening instruments may be integrated in the management of these children.
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Affiliation(s)
- Moug Al-Bakri
- From the Department of Ophthalmology, Rigshospitalet (M.A.-L., D.B.-HH, L.K.).
| | | | - Daniella Bach-Holm
- From the Department of Ophthalmology, Rigshospitalet (M.A.-L., D.B.-HH, L.K.); Department of Clinical Medicine, University of Copenhagen, Copenhagen
| | | | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen (V.S.), Copenhagen, Denmark
| | - Line Kessel
- From the Department of Ophthalmology, Rigshospitalet (M.A.-L., D.B.-HH, L.K.); Department of Clinical Medicine, University of Copenhagen, Copenhagen
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16
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The occurrence timeline of steroid-induced ocular hypertension and cataract in children with systemic autoimmune diseases. Int Ophthalmol 2022; 42:2175-2184. [DOI: 10.1007/s10792-022-02217-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 01/03/2022] [Indexed: 10/19/2022]
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17
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Multani EK, Bajwa D, Multani PK, Nobakht E, Raj D, Paul RS, Paul RS. EYE DISEASE IN KIDNEY TRANSPLANTATION: CLINICAL CHALLENGES IN A UNIQUE PATIENT POPULATION. Surv Ophthalmol 2021; 67:1252-1269. [PMID: 34954092 DOI: 10.1016/j.survophthal.2021.12.007] [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: 10/28/2020] [Revised: 12/14/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022]
Abstract
Eye disease is common among kidney transplant recipients and their management is challenging. Chronic kidney disease is associated with ocular complications, both independently and in the context of various systemic disorders. In addition, chronic immunosuppression predisposes kidney transplant recipients to an array of long-term ocular issues. This may be broadly categorized into infections, malignancies, and other immunosuppression-specific side effects. The interdependence of kidney disease, transplant pharmacotherapy and ocular health therefore requires a multispecialty approach. Although the kidney transplant population has grown along with the burden of associated oculopathies, systematic guidelines targeting this patient group are lacking. This evidenced-based narrative review summarizes the pertinent issues that may present in the ophthalmic and optometric clinical settings, with emphasis on collaborative management and directions for future research.
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Affiliation(s)
- Eisha K Multani
- MY EYE DR OPTOMETRISTS LLC, 1330 CONNECTICUT AVE NW, WASHINGTON DC, 20037, UNITED STATES
| | - Dalvir Bajwa
- THE NEWCASTLE UPON TYNE HOSPITALS, NHS FOUNDATION TRUST, ROYAL VICTORIA INFIRMARY, QUEEN VICTORIA ROAD, NEWCASTLE UPON TYNE NE1 4LP, UNITED KINGDOM
| | - Priyanika K Multani
- INLAND VISION CENTER OPTOMETRY, 473 E CARNEGIE DR, SUITE 100, SAN BERNADINO, CA 92408
| | - Ehsan Nobakht
- DIVISION OF KIDNEY DISEASE & HYPERTENSION, GEORGE WASHINGTON UNIVERSITY, 2150 PENNSYVANIA AVENUE, SUITE 3-438, WASHINGTON DC, 20037, UNITED STATES
| | - Dominic Raj
- DIVISION OF KIDNEY DISEASE & HYPERTENSION, GEORGE WASHINGTON UNIVERSITY, 2150 PENNSYVANIA AVENUE, SUITE 3-438, WASHINGTON DC, 20037, UNITED STATES
| | - Rohan S Paul
- DIVISION OF KIDNEY DISEASE & HYPERTENSION, GEORGE WASHINGTON UNIVERSITY, 2150 PENNSYVANIA AVENUE, SUITE 3-438, WASHINGTON DC, 20037, UNITED STATES
| | - Rohan S Paul
- DIVISION OF KIDNEY DISEASE & HYPERTENSION, GEORGE WASHINGTON UNIVERSITY, 2150 PENNSYVANIA AVENUE, SUITE 3-438, WASHINGTON DC, 20037, UNITED STATES.
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18
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Wang Z, Huang Y, Chu F, Ji S, Liao K, Cui Z, Chen J, Tang S. Clock Gene Nr1d1 Alleviates Retinal Inflammation Through Repression of Hmga2 in Microglia. J Inflamm Res 2021; 14:5901-5918. [PMID: 34795498 PMCID: PMC8594447 DOI: 10.2147/jir.s326091] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/30/2021] [Indexed: 12/13/2022] Open
Abstract
Purpose Retinal inflammation is involved in the pathogenesis of several retinal diseases. As one of the core clock genes, Nr1d1 has been reported to suppress inflammation in many diseases. We investigated whether pharmacological activation of Nr1d1 can inhibit retinal inflammation and delineated the mechanisms of Nr1d1 in alleviating microglia activation. Methods Lipopolysaccharide (LPS) induced mice models were used to examine the effects of SR9009 (agonist of NR1D1) treatment on inflammatory phenotypes in vivo. Anti-inflammatory effects of Nr1d1 and associated mechanisms were investigated in the BV2 microglia cell line, and in primary retinal microglia in vitro. Results SR9009 treatment alleviated LPS-induced inflammatory cell infiltration, elevated cytokine levels and morphological changes of the microglia in mice models. In LPS-stimulated BV2 cells and primary retinal microglia, SR9009 suppressed cytokine expressions by inhibiting the NF-κB signaling pathway. Moreover, SR9009 treatment increased the levels of the M2 phenotype marker (CD206) and the proportions of ramified microglia. Suppression of Nr1d1 with siRNA reversed the inhibitory effects of SR9009 on cytokine production in BV2 cells. RNA-seq analysis showed that genes that were upregulated following Nr1d1 knockdown were enriched in inflammatory-associated biological processes. Subsequently, ChIP-seq of NR1D1 in BV2 was performed, and the results were integrated with RNA-seq results using the Binding and Expression Target Analysis (BETA) tool. Luciferase assays, electrophoretic mobility shift assay (EMSA), qPCR and Western blotting assays revealed that NR1D1 binds the promoter of Hmga2 to suppress its transcription. Notably, overexpressed Hmga2 in activated microglia could partly abolish the anti-inflammatory effects of Nr1d1. Conclusion The clock gene Nr1d1 protects against retinal inflammation and microglia activation in part by suppressing Hmga2 transcription.
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Affiliation(s)
- Zhijie Wang
- Aier School of Ophthalmology, Central South University, Changsha, People's Republic of China.,Aier Eye Institute, Aier Eye Hospital Group, Changsha, People's Republic of China
| | - Yinhua Huang
- Aier School of Ophthalmology, Central South University, Changsha, People's Republic of China.,Aier Eye Institute, Aier Eye Hospital Group, Changsha, People's Republic of China
| | - Feixue Chu
- Department of Ophthalmology, Hangzhou Xihu Zhijiang Eye Hospital, Hangzhou, People's Republic of China
| | - Shangli Ji
- Aier Eye Institute, Aier Eye Hospital Group, Changsha, People's Republic of China
| | - Kai Liao
- Aier School of Ophthalmology, Central South University, Changsha, People's Republic of China.,Aier Eye Institute, Aier Eye Hospital Group, Changsha, People's Republic of China
| | - Zekai Cui
- Aier Eye Institute, Aier Eye Hospital Group, Changsha, People's Republic of China
| | - Jiansu Chen
- Aier School of Ophthalmology, Central South University, Changsha, People's Republic of China.,Aier Eye Institute, Aier Eye Hospital Group, Changsha, People's Republic of China.,Key Laboratory for Regenerative Medicine, Jinan University, Guangzhou, People's Republic of China.,Institute of Ophthalmology, Jinan University, Guangzhou, People's Republic of China
| | - Shibo Tang
- Aier School of Ophthalmology, Central South University, Changsha, People's Republic of China.,Aier Eye Institute, Aier Eye Hospital Group, Changsha, People's Republic of China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, People's Republic of China
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19
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Mathew S, Finny P, Samuel Johnson AK, Maria M, Samuel PS, Armstrong LJ, David A. Evaluation of Glucocorticoids Utilization in Central Kerala using Pharmacy Sales Overview. Indian J Endocrinol Metab 2021; 25:516-519. [PMID: 35355914 PMCID: PMC8959190 DOI: 10.4103/ijem.ijem_439_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/09/2021] [Accepted: 12/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Misuse of prescription drugs is a major public health problem in India and developing countries. Emerging evidence indicates that glucocorticoids are a class of drugs that are silently misused. These drugs are inexpensive and easily available as over-the-counter drugs in India are widely used by local practitioners and self-prescribed by patients for swift symptomatic relief of febrile illnesses, joint pain, asthma, other respiratory illnesses, and skin diseases. Many people have become dependent on glucocorticoids unintentionally and remain completely unaware of the metabolic changes occurring in their bodies. Methodology A descriptive cross-sectional study involving 38 pharmacies in Thiruvalla municipality of South India was conducted to indirectly assess the utilization of glucocorticoids in the region using a pharmacy sales overview. Results Most people approach pharmacies with prescriptions than without. A high majority of pharmacists do not have any knowledge about the uses (37%) or adverse effects (66%) of glucocorticoids. More than 50% of the community pharmacies have more than 1% of their sales attributed to glucocorticoids when compared with the total sales volume of drugs.
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Affiliation(s)
- Sara Mathew
- Department of Community Medicine, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
| | - Philip Finny
- Department of Endocrinology, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
| | - Abel K Samuel Johnson
- Department of Community Medicine, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
| | - Mridula Maria
- Department of Community Medicine, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
| | - Preethy S Samuel
- Department of Health Care Services (Occupational Therapy), Wayne State University, Michigan, USA
| | - Lois J Armstrong
- Department of Nursing and Research, Emmanuel Hospital Association, New Delhi, India
| | - Alice David
- Medical Research, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
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20
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Wang M, Yennam S, McMillin J, Chen HH, de la Sen-Corcuera B, Hemmati R, Pflugfelder S. Combined therapy of ocular surface disease with plasma rich in growth factors and scleral contact lenses. Ocul Surf 2021; 23:162-168. [PMID: 34537416 DOI: 10.1016/j.jtos.2021.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 09/05/2021] [Accepted: 09/11/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE To review safety and efficacy of combined plasma rich in growth factors (PRGF) eye drops and scleral contact lens (SCL) therapy in patients with ocular surface disease. METHODS Patients with ocular surface disease of various etiologies were screened for at least 3 months of concurrent treatment with PRGF and SCL. Retrospective pre- and post-treatment measurements were collected, including patient satisfaction, severity and frequency of dry eye symptoms measured by a modified Symptom Assessment in Dry Eye (SANDE) questionnaire, visual acuity, and number of concurrent treatments. RESULTS 26 patients with ocular surface disease were included in the study with 20 patients answering the questionnaire (77% response rate). There were no adverse events reported. Most patients thought the combined therapy was better than previous treatments and would recommend to others (80%, 90% respectively). SANDE scores significantly decreased after use of concurrent therapy. There was a small but significant decrease in the number of other concurrent treatments. Visual acuity was unchanged. CONCLUSIONS This retrospective cohort study found PRGF used in combination with SCL is safe and significantly decreases symptoms in patients with recalcitrant ocular surface disease.
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Affiliation(s)
- Margaret Wang
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Sowmya Yennam
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Jake McMillin
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Hongan Hannah Chen
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Borja de la Sen-Corcuera
- University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain; Biotechnology Institute (BTI), Vitoria, Spain
| | - Roxana Hemmati
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States
| | - Stephen Pflugfelder
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, United States.
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21
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Kunze S, Cecil A, Prehn C, Möller G, Ohlmann A, Wildner G, Thurau S, Unger K, Rößler U, Hölter SM, Tapio S, Wagner F, Beyerlein A, Theis F, Zitzelsberger H, Kulka U, Adamski J, Graw J, Dalke C. Posterior subcapsular cataracts are a late effect after acute exposure to 0.5 Gy ionizing radiation in mice. Int J Radiat Biol 2021; 97:529-540. [PMID: 33464160 DOI: 10.1080/09553002.2021.1876951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/28/2020] [Accepted: 01/11/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The long-term effect of low and moderate doses of ionizing radiation on the lens is still a matter of debate and needs to be evaluated in more detail. MATERIAL AND METHODS We conducted a detailed histological analysis of eyes from B6C3F1 mice cohorts after acute gamma irradiation (60Co source; 0.063 Gy/min) at young adult age of 10 weeks with doses of 0.063, 0.125, and 0.5 Gy. Sham irradiated (0 Gy) mice were used as controls. To test for genetic susceptibility heterozygous Ercc2 mutant mice were used and compared to wild-type mice of the same strain background. Mice of both sexes were included in all cohorts. Eyes were collected 4 h, 12, 18 and 24 months after irradiation. For a better understanding of the underlying mechanisms, metabolomics analyses were performed in lenses and plasma samples of the same mouse cohorts at 4 and 12 h as well as 12, 18 and 24 months after irradiation. For this purpose, a targeted analysis was chosen. RESULTS This analysis revealed histological changes particularly in the posterior part of the lens that rarely can be observed by using Scheimpflug imaging, as we reported previously. We detected a significant increase of posterior subcapsular cataracts (PSCs) 18 and 24 months after irradiation with 0.5 Gy (odds ratio 9.3; 95% confidence interval 2.1-41.3) independent of sex and genotype. Doses below 0.5 Gy (i.e. 0.063 and 0.125 Gy) did not significantly increase the frequency of PSCs at any time point. In lenses, we observed a clear effect of sex and aging but not of irradiation or genotype. While metabolomics analyses of plasma from the same mice showed only a sex effect. CONCLUSIONS This article demonstrates a significant radiation-induced increase in the incidence of PSCs, which could not be identified using Scheimpflug imaging as the only diagnostic tool.
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Affiliation(s)
- Sarah Kunze
- Institute of Developmental Genetics, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Neuherberg, Germany
| | - Alexander Cecil
- Research Unit Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | - Cornelia Prehn
- Research Unit Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | - Gabriele Möller
- Research Unit Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | - Andreas Ohlmann
- Department of Ophthalmology, University Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Gerhild Wildner
- Department of Ophthalmology, University Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Stephan Thurau
- Department of Ophthalmology, University Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Kristian Unger
- Research Unit Radiation Cytogenetics, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | - Ute Rößler
- Department Radiation Protection and Health, Federal Office of Radiation Protection, Oberschleissheim, Germany
| | - Sabine M Hölter
- Institute of Developmental Genetics, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Neuherberg, Germany
| | - Soile Tapio
- Institute of Radiation Biology, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
- School of Medicine, Technical University of Munich, Munich, Germany
| | - Florian Wagner
- Institute of Radiation Medicine, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | | | - Fabian Theis
- Institute of Computational Biology, Neuherberg, Germany
| | - Horst Zitzelsberger
- Research Unit Radiation Cytogenetics, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
| | - Ulrike Kulka
- Department Radiation Protection and Health, Federal Office of Radiation Protection, Oberschleissheim, Germany
| | - Jerzy Adamski
- Research Unit Molecular Endocrinology and Metabolism, Genome Analysis Center, Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany
- Lehrstuhl für Experimentelle Genetik, Technical University of Munich, Freising-Weihenstephan, Germany
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jochen Graw
- Institute of Developmental Genetics, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Neuherberg, Germany
| | - Claudia Dalke
- Institute of Developmental Genetics, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Neuherberg, Germany
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22
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Prevalence and predictors of ocular complications among children undergoing nephrotic syndrome treatment in a resource-limited setting. BMC Ophthalmol 2021; 21:55. [PMID: 33482766 PMCID: PMC7821477 DOI: 10.1186/s12886-021-01817-6] [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: 09/04/2020] [Accepted: 01/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background Nephrotic syndrome is the most common glomerulopathy among children aged 2–18 years and high dose corticosteroids are the backbone of its management. Potentially blinding ocular complications often result from nephrotic syndrome and/or its treatment. We conducted a study to determine the prevalence and predictors of ocular complications among children undergoing nephrotic syndrome treatment at Mulago National Referral Hospital. Methods This was a cross-sectional study conducted for three [3] months at the pediatric renal unit of Mulago National Referral Hospital (MNRH). Data from a consecutive sample of 100 children was collected using a semi-structured questionnaire, entered into Epi-data 4.4.2 and exported to STATA 14 for analysis at univariate, bivariate and multivariate levels. A robust Poisson regression model was used to identify predictors of ocular complications. Results Out of 100 patients examined, 80(80%) had ocular complications. The median age was 10 (IQR: 7–12) and 52 (52%) were girls. The most frequent complications were hypertrichosis and refractive errors in 71% (95%CI 61.1–79.6) and 56% (95%CI 45.7–65.9) of the patients respectively. Age above 10 years was the predictor for ocular complications with a RR = 1.37 (95%CI:1.14–1.64) p = 0.001. Conclusions We found a high prevalence of ocular complications among children with nephrotic syndrome in this tertiary hospital. The predictor of ocular complications was age greater than 10 years. We recommend that all children with nephrotic syndrome undergo a baseline ocular examination prior to commencement of treatment and be reviewed periodically by an ophthalmologist. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01817-6.
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The Protective Effects of Flavonoids in Cataract Formation through the Activation of Nrf2 and the Inhibition of MMP-9. Nutrients 2020; 12:nu12123651. [PMID: 33261005 PMCID: PMC7759919 DOI: 10.3390/nu12123651] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 12/11/2022] Open
Abstract
Cataracts account for over half of global blindness. Cataracts formations occur mainly due to aging and to the direct insults of oxidative stress and inflammation to the eye lens. The nuclear factor-erythroid-2-related factor 2 (Nrf2), a transcriptional factor for cell cytoprotection, is known as the master regulator of redox homeostasis. Nrf2 regulates nearly 600 genes involved in cellular protection against contributing factors of oxidative stress, including aging, disease, and inflammation. Nrf2 was reported to disrupt the oxidative stress that activates Nuclear factor-κB (NFκB) and proinflammatory cytokines. One of these cytokines is matrix metalloproteinase 9 (MMP-9), which participates in the decomposition of lens epithelial cells (LECs) extracellular matrix and has been correlated with cataract development. Thus, during inflammatory processes, MMP production may be attenuated by the Nrf2 pathway or by the Nrf2 inhibition of NFκB pathway activation. Moreover, plant-based polyphenols have garnered attention due to their presumed safety and efficacy, nutritional, and antioxidant effects. Polyphenol compounds can activate Nrf2 and inhibit MMP-9. Therefore, this review focuses on discussing Nrf2's role in oxidative stress and cataract formation, epigenetic effect in Nrf2 activity, and the association between Nrf2 and MMP-9 in cataract development. Moreover, we describe the protective role of flavonoids in cataract formation, targeting Nrf2 activation and MMP-9 synthesis inhibition as potential molecular targets in preventing cataracts.
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24
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Richardson RB, Ainsbury EA, Prescott CR, Lovicu FJ. Etiology of posterior subcapsular cataracts based on a review of risk factors including aging, diabetes, and ionizing radiation. Int J Radiat Biol 2020; 96:1339-1361. [DOI: 10.1080/09553002.2020.1812759] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Richard B. Richardson
- Radiobiology and Health Branch, Canadian Nuclear Laboratories (CNL), Chalk River, Canada
- McGill University’s Medical Physics Unit, Cedars Cancer Centre, Montreal, Canada
| | - Elizabeth A. Ainsbury
- Public Health England’s Centre for Chemical, Radiological and Environmental Hazards, Oxford, UK
| | | | - Frank J. Lovicu
- School of Medical Sciences, The University of Sydney, Sydney, Australia
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25
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Iwasaki H, Wakamatsu M, Sugihara K, Kamio K, Tsuji S, Morita J, Kurihara Y, Izumi T, Nishimoto T, Kinoshita K, Nakanishi Y, Sasaki M. Drug-induced lenticular opacity and accumulation of cholesterol-related substances in the lens cortex of dogs. J Toxicol Sci 2020; 45:201-218. [PMID: 32238695 DOI: 10.2131/jts.45.201] [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] [Indexed: 11/02/2022]
Abstract
TP0446131, developed as an antidepressant agent, was found to cause lenticular opacity in a 13-week repeated-dose study in dogs. Histopathologically, the lenticular opacity was observed as a degeneration of the lens fibers, characterized by irregularity in the ordered arrangement of the fibers which is necessary to maintain the transparency of the lens, and was considered to manifest clinically as cataract. To evaluate the development mechanism of the lenticular opacity, the chemical constituents of the lens, which is known to be associated with the development of cataract, were examined. The results of liquid chromatography-tandem mass spectrometry analysis revealed an increase in the amplitudes of 3 unknown peaks in a dose- and time-dependent manner in the lens, with no remarkable changes in the other chemical components tested. In addition, the content of cholesterol, alterations of which have been reported to be associated with cataract, remained unchanged. The mass spectral data and chromatographic behavior of the 3 peaks indicated that these peaks corresponded to sterol-related substances, and that one of them was 7-dehydrocholesterol, a precursor of cholesterol biosynthesis. This finding suggested that TP0446131 exerts some effects on the cholesterol biosynthesis pathway, which could be involved in the development of the cataracts. Furthermore, increases in the levels of these sterol-related substances were also detected in the serum, and were, in fact, noted prior to the onset of the cataract, suggesting the possibility that these substances in the serum could be used as potential safety biomarkers for predicting the onset of cataract induced by TP0446131.
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Affiliation(s)
- Hiroshi Iwasaki
- Drug Safety Laboratories, Research Center, Taisho Pharmaceutical Co., Ltd
| | - Masaki Wakamatsu
- Drug Safety Laboratories, Research Center, Taisho Pharmaceutical Co., Ltd
| | - Kazunari Sugihara
- Drug Safety Laboratories, Research Center, Taisho Pharmaceutical Co., Ltd
| | - Kyohei Kamio
- Drug Safety Laboratories, Research Center, Taisho Pharmaceutical Co., Ltd
| | - Satoshi Tsuji
- Drug Safety Laboratories, Research Center, Taisho Pharmaceutical Co., Ltd
| | - Junya Morita
- Drug Safety Laboratories, Research Center, Taisho Pharmaceutical Co., Ltd
| | - Yasuhiro Kurihara
- Drug Safety Laboratories, Research Center, Taisho Pharmaceutical Co., Ltd
| | - Tomoko Izumi
- Drug Safety Laboratories, Research Center, Taisho Pharmaceutical Co., Ltd
| | - Tomohiro Nishimoto
- Pharmacokinetics Laboratories, Research Center, Taisho Pharmaceutical Co., Ltd
| | - Kohnosuke Kinoshita
- Pharmacokinetics Laboratories, Research Center, Taisho Pharmaceutical Co., Ltd
| | - Yutaka Nakanishi
- Drug Safety Laboratories, Research Center, Taisho Pharmaceutical Co., Ltd
| | - Minoru Sasaki
- Drug Safety Laboratories, Research Center, Taisho Pharmaceutical Co., Ltd
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Corticosteroids in ophthalmology: drug delivery innovations, pharmacology, clinical applications, and future perspectives. Drug Deliv Transl Res 2020; 11:866-893. [PMID: 32901367 DOI: 10.1007/s13346-020-00843-z] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Corticosteroids remain the mainstay of the treatment for various ocular conditions affecting the ocular surface, anterior and posterior segments of the eye due to their anti-inflammatory, anti-oedematous, and anti-neovascularization properties. Prednisolone, prednisolone acetate, dexamethasone, triamcinolone acetonide, fluocinolone acetonide, and loteprednol etabonate are amongst the most widely used ophthalmic corticosteroids. Corticosteroids differ in their activity and potency in the eye due to their inherent pharmacological and pharmaceutical differences. Different routes and regimens are available for ocular administration of corticosteroids. Conventional topical application to the eye is the route of choice when targeting diseases affecting the ocular surface and anterior segment, while periocular, intravitreal, and suprachoroidal injections can be potentially effective for posterior segment diseases. Corticosteroid-induced intraocular pressure elevation and cataract formation remain the most significant local risks following topical as well as systemic corticosteroid administration. Invasive drug administration via intracameral, subconjunctival, and intravitreal injection can enhance ocular bioavailability and minimize dose and dosing frequency of administration, yet may exacerbate ocular side effects of corticosteroids. This review provides a critical appraisal of the ophthalmic uses of corticosteroid, routes of administration, drug delivery fundamentals and novel ocular implantable steroid delivery systems, factors influencing side effects, and future perspectives for ocular corticosteroid therapy.
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27
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Yıldız A, Şehitoğlu MH, Karaboğa İ, Arıkan S. Ozone treatment for high-dose systemic Steroid-Induced retinal injury. Cutan Ocul Toxicol 2020; 39:274-280. [PMID: 32619116 DOI: 10.1080/15569527.2020.1790590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/13/2020] [Accepted: 06/27/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate the effect of high-dose systemic steroids on retinal tissues and the effectiveness of ozone (O3) therapy. METHODS Twenty-four New Zealand white rabbits were divided into three groups of eight. Group 1 was accepted as the control group, Group 2 received intramuscular 20 mg/kg methylprednisolone acetate and Group 3 received 14 sessions of ozone treatment in addition to methylprednisolone acetate. The subjects were sacrificed on the 30th day. Retinal tissues were removed. Superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), total antioxidant status (TAS) and total oxidant status (TOS) levels were evaluated for tissue biochemistry and serum ischaemic modified albumin (IMA), interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) levels were evaluated with the ELISA method. Haematoxylin-eosin staining and TUNEL evaluation for apoptosis were evaluated as histopathological methods. RESULTS In the treatment group, antioxidant parameters of TAS, SOD and CAT were higher, oxidative and ischaemic parameters of MDA, TOS and IMA were lower, inflammatory parameters of IL-6 and TNF-α were lower, retinal thickness was better and apoptosis amount was lower. CONCLUSION Apoptosis increases in retinal tissues due to high dose systemic steroid administration and the retina becomes thinner. With biochemical examination, oxidation parameters increased while antioxidant parameters decreased. Both histopathological and biochemical parameters improved significantly with ozone treatment.
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Affiliation(s)
- Aydın Yıldız
- Department of Ophthalmology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Müşerref Hilal Şehitoğlu
- Department of Medical Biochemistry, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - İhsan Karaboğa
- Department of Emergency and Disaster Management, Health School, Namık Kemal University, Tekirdağ, Turkey
| | - Sedat Arıkan
- Department of Ophthalmology, Faculty of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
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Changes in corneal thickness, upper and lower tear film in seasonal allergic conjunctivitis by steroid treatment: anterior segment optical coherence tomography study. Int Ophthalmol 2020; 40:2275-2281. [PMID: 32409942 DOI: 10.1007/s10792-020-01410-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/02/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the effects of loteprednol etabonate on cornea and tear film in patients with seasonal allergic conjunctivitis by anterior segment optical coherence tomography (OCT). METHODS The right eyes of 52 subjects with seasonal allergic conjunctivitis were evaluated in the study. Central corneal thickness (CCT), the thicknesses of central corneal epithelium (CET) and central non-epithelial cornea (CnET), and lower and upper tear meniscus areas were measured by spectral-domain OCT and ocular surface disease index (OSDI) were obtained at baseline. After topical use of loteprednol etabonate 0.5% eye drop three times a day for 1 week, the measurements were repeated. Paired T test was used for analysis. RESULTS Mean CCT and mean thicknesses of CET and CnET at baseline were 528.19 ± 34.47 µm, 64.10 ± 5.30 µm and 462.84 ± 33.43 µm, respectively, and these were 526.31 ± 33.37 µm, 64.65 ± 4.84 µm and 459.84 ± 32.11 µm after the treatment, respectively. OSDI score was 21.55 ± 4.40 at baseline and 13.13 ± 2.39 after 1 week. The lower and upper tear meniscus areas at baseline were 0.026 ± 0.017 mm2 and 0.017 ± 0.007 mm2, respectively, and they were 0.017 ± 0.009 mm2 and 0.016 ± 0.007 mm2, respectively, after the treatment. There is statistically significant difference between before and after values of CCT, CnET, lower tear meniscus area and OSDI score (p < 0.05). CONCLUSION There is no change in corneal epithelial thickness and upper tear meniscus area after 1-week treatment with loteprednol etabonate in patients with seasonal allergic conjunctivitis, but it may cause decrease in non-epithelial corneal thickness and lower tear meniscus area.
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29
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Yoo WS, Seo JS, Cho YW, Hah YS, Chung IY, Seo SW, Kim SJ. Genes Expressed in Steroid-exposed Lens Epithelial Cells as Revealed by Polymerase Chain Reaction. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.5.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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30
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Duman R, Ertekin T, Duman R, Vurmaz A, Çetinkaya E, Güzel H. Anticataractogenic effect of betaine in chick embryo hydrocortisone-induced cataract model. Indian J Med Res 2020; 150:407-411. [PMID: 31823923 PMCID: PMC6902364 DOI: 10.4103/ijmr.ijmr_50_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background & objectives: Cataract is one of the leading causes of blindness in the world. The aim of the present study was to investigate anticataractogenic effect of betaine in chick embryo hydrocortisone (HC)-induced cataract model. Methods: The study included 60 fertilized eggs divided into six groups each having 10 eggs: one group treated with only HC (HC group); three treated with both HC and different doses of betaine (HC/B 1.00, HC/B 0.50 and HC/B 0.25 groups) and two non-HC groups treated with only phosphate-buffered saline (PBS group) or betaine (B group). After the injections, lenses of the embryos were removed and classified into five stages according to the lens opacification. The amounts of reduced glutathione (GSH) in the removed lenses were measured. Results: All the lenses in non-HC-treated groups were clear, whereas in the HC-treated group, 90 per cent of the lenses had cataract (stages 4 and 5). The mean score of lens opacity was significantly lower in all HC/B groups compared to HC group (2.4-3.5 vs. 4.4, P<0.05). Among HC/B groups, the HC/B 0.25 group had significantly lower mean score of lens opacity compared to remaining HC/B groups treated with higher doses of betaine. In addition, the mean reduced GSH level was significantly higher in HC/B 0.25 group compared to HC, HC/B 1.00 and HC/B 0.50 groups (P<0.001). Interpretation & conclusions: The present results show beneficial anti-cataract and anti-oxidant effects of 0.25 μmol/egg betaine on HC-induced cataract in the chick embryo.
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Affiliation(s)
- Reşat Duman
- Department of Ophthalmology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Tolga Ertekin
- Department of Anatomy, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Rahmi Duman
- Department of Ophthalmology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Ayhan Vurmaz
- Department of Clinical Biochemistry, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Ersan Çetinkaya
- Department of Ophthalmology, Antalya Education & Research Hospital, Antalya, Turkey
| | - Hilal Güzel
- Department of Anatomy, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
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Chua AWY, Chua MJ, Harrisberg BP, Kumar CM. Review of anaesthetic management for cataract surgery in transplant recipients. Anaesth Intensive Care 2020; 48:25-35. [DOI: 10.1177/0310057x19891737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The prevalence of transplantation is on the increase worldwide. Corneal transplantation is the most common form of human donor transplantation. Transplantation of other organs and bone marrow is established treatment for various end-organ failure and many haematological conditions, respectively. Success and survival of these patients have increased with advances in immunosuppression. Unfortunately, these patients are susceptible to cataract formation as a consequence of immunosuppressive therapy and accelerated progression of several diseases. Topical anaesthesia and regional ophthalmic blocks are ideal for cataract surgery in cooperative adults. General anaesthesia may be required in children, for extremely anxious or claustrophobic adults and for complex surgery such as simultaneous cataract and corneal transplantation. The perioperative anaesthetic management of cataract surgery in a transplant recipient is no different to a standard technique in a healthy adult, but additional challenges are posed by the underlying pathology necessitating transplantation, function of the transplanted organ, physiological and pharmacological problems of allograft denervation, side-effects of immunosuppression, risk of infection and potential for rejection. This narrative review summarises optimal anaesthetic management in transplant recipients undergoing cataract surgery.
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Affiliation(s)
- Alfred WY Chua
- Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, Australia
| | | | - Brian P Harrisberg
- Ophthalmology Department, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Chandra M Kumar
- Department of Anaesthesia, Khoo Teck Puat Hospital, Singapore
- Newcastle University, Newcastle, UK
- Newcastle University Medical School, Johor, Malaysia
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32
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Bell SJ, Oluonye N, Harding P, Moosajee M. Congenital cataract: a guide to genetic and clinical management. THERAPEUTIC ADVANCES IN RARE DISEASE 2020; 1:2633004020938061. [PMID: 37180497 PMCID: PMC10032449 DOI: 10.1177/2633004020938061] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/05/2020] [Indexed: 05/13/2023]
Abstract
Worldwide 20,000-40,000 children with congenital or childhood cataract are born every year with varying degrees and patterns of lens opacification with a broad aetiology. In most cases of bilateral cataract, a causative genetic mutation can be identified, with autosomal dominant inheritance being most common in 44% of cases. Variants in genes involve lens-specific proteins or those that regulate eye development, thus giving rise to other associated ocular abnormalities. Approximately 15% of cases have systemic features, hence paediatric input is essential to minimise comorbidities and support overall development of children at high risk of visual impairment. In some metabolic conditions, congenital cataract may be the presenting sign, and therefore prompt diagnosis is important where there is an available treatment. Multidisciplinary management of children is essential, including ophthalmic surgeons, orthoptists, paediatricians, geneticists and genetic counsellors, and should extend beyond the medical team to include school and local paediatric visual support services. Early surgery and close follow up in ophthalmology is important to optimise visual potential and prevent amblyopia. Routine genetic testing is essential for the complete clinical management of patients, with next-generation sequencing of 115 genes shown to expedite molecular diagnosis, streamline care pathways and inform genetic counselling and reproductive options for the future. Lay abstract Childhood cataract: how to manage patients Cataract is a clouding of the lens in the eye. Cataract occurring in children has many different causes, which may include infections passed from mother to child during pregnancy, trauma, medications and exposure to radiation. In most cases of cataract occurring in both eyes, a genetic cause can be found which may be inherited from parents or occur sporadically in the developing baby itself while in the womb. Cataracts may occur on their own, with other eye conditions or be present with other disorders in the body as part of a syndrome. Genetic testing is important for all children with cataract as it can provide valuable information about cause, inheritance and risk to further children and signpost any other features of the disease in the rest of the body, permitting the assembly of the correct multidisciplinary care team. Genetic testing currently involves screening for mutations in 115 genes already known to cause cataract and has been shown to expedite diagnosis and help better manage children. Genetic counselling services can support families in understanding their diagnosis and inform future family planning. In order to optimise vision, early surgery for cataract in children is important. This is because the brain is still developing and an unobstructed pathway for light to reach the back of the eye is required for normal visual development. Any obstruction (such as cataract) if left untreated may lead to permanent sight impairment or blindness, even if it is removed later. A multidisciplinary team involved in the care of a child with cataract should include ophthalmic surgeons, orthoptists, paediatricians, geneticists and genetic counsellors, and should extend beyond the medical team to include school and local child visual support services. They will help to diagnose and manage systemic conditions, optimise vision potential and help patients and their families access best supportive care.
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Affiliation(s)
| | - Ngozi Oluonye
- Department of Genetics, Moorfields Eye Hospital,
London, UK
- Department of Ophthalmology, Great Ormond Street
Hospital for Children, London, UK
| | | | - Mariya Moosajee
- UCL Institute of Ophthalmology 11-43 Bath Street
London EC1V 9EL, UK
- Department of Genetics, Moorfields Eye Hospital,
London, UK
- Department of Ophthalmology, Great Ormond Street
Hospital for Children, London, UK
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Hah YS, Yoo WS, Seo SW, Chung I, Kim HA, Cho HY, Kim SJ. Reduced NGF Level Promotes Epithelial-Mesenchymal Transition in Human Lens Epithelial Cells Exposed to High Dexamethasone Concentrations. Curr Eye Res 2019; 45:686-695. [PMID: 31751158 DOI: 10.1080/02713683.2019.1695844] [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: 10/25/2022]
Abstract
Purpose: To investigate the protective effects of nerve growth factor (NGF) against steroid-induced cataract formation in dexamethasone (Dex)-treated human lens epithelial B-3 (HLE-B3) cells and the possible molecular mechanisms underlying this protection.Materials and Methods: HLE-B3 cells were treated with Dex, and cell viability was assessed using the Cell Counting Kit-8 (CCK-8) assay. The levels of expression of NGF, fibronectin, α-smooth muscle actin (α-SMA), and E-cadherin mRNAs were measured by real-time quantitative polymerase chain reaction (qPCR), and the levels of NGF, fibronectin, α-SMA, E-cadherin, tropomyosin receptor kinase A (TrkA), and Akt proteins were measured by Western blot analysis. Gene expression profiles of growth factors in Dex-treated HLE-B3 cells were determined by PCR arrays. In addition, anterior capsule tissue was obtained during cataract surgery, and the specimens were also examined expressions of NGF.Results: NGF was expressed in HLE-B3 cells and also in lens epithelial cells of anterior lens capsules. Dex treatment of HLE-B3 cells increased their expression of epithelial-mesenchymal transition (EMT) markers and migration activity, while markedly downregulating the expression of NGF. NGF treatment significantly reduced the expression of α-SMA and fibronectin, as well as cell proliferation. The decreased phosphorylation of p38 MAPK and Akt induced by Dex treatment was significantly reversed by treatment with NGF.Conclusion: NGF/TrkA may repress EMT by targeting the p38 MAPK and pAkt pathways in Dex-treated HLE-B3 cells. NGF may be a novel therapeutic target for patients with steroid-induced cataract.
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Affiliation(s)
- Young-Sool Hah
- Biomedical Research Institute, Gyeongsang National University Hospital, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Woong-Sun Yoo
- Department of Ophthalmology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Seong-Wook Seo
- Department of Ophthalmology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Inyoung Chung
- Department of Ophthalmology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Hyun-A Kim
- Department of Ophthalmology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
| | - Hee Young Cho
- Biomedical Research Institute, Gyeongsang National University Hospital, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Seong-Jae Kim
- Department of Ophthalmology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea
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Macías Saint-Gerons D, Bosco Cortez F, Jiménez López G, Castro JL, Tabarés-Seisdedos R. Cataracts and statins. A disproportionality analysis using data from VigiBase. Regul Toxicol Pharmacol 2019; 109:104509. [PMID: 31669197 DOI: 10.1016/j.yrtph.2019.104509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/03/2019] [Accepted: 10/24/2019] [Indexed: 01/21/2023]
Abstract
The basis of the association between statin use and cataract has been explored using the World Health Organization (WHO) global database of individual case safety reports (ICSRs) for drug monitoring (VigiBase) through January 2019. The reporting odds ratios (RORs) as a measure of disproportionality for reported cataracts and individual statins have been calculated. Subgroup analyses according statin lipophilicity, sex, and age groups have been performed. Moreover, RORs have been calculated for non-statin lipid lowering drugs. An increased disproportionality have been found for most individual statins lovastatin: [ROR: 14.80, 95% confidence interval (CI): 13.30, 16.46)], atorvastatin (ROR: 3.48, 95% CI 3.19-3.80), pravastatin (ROR: 3.15, 95% CI: 2.54-3.90), rosuvastatin (ROR: 2.90, 95% CI: 2.53-3.31), simvastatin (ROR: 2.27, 95%CI: 1.99-2.60), fluvastatin (ROR: 2.03, 95% CI: 1.33-3.08) and statins (overall) ROR: 3.66, 95% CI:3.46-3.86). Increased disproportionality for cataract and statins (drug-class) have been found regardless of statin lipophilicity, sex and group age (more or less than 65 years old). No disproportionality was found for other lipid-lowering drugs (ezetimibe, fibrates or PCSK9 inhibitors). These findings suggest an increased risk of cataract associated with statins as a drug-class. Further studies to characterize the risk are advised. Benefits and potential harms should be considered before starting treatment with statins.
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Affiliation(s)
- Diego Macías Saint-Gerons
- Department of Medicine, University of Valencia, INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain; Unit of Medicines and Health Technologies (MT), Dep. of Health Systems and Services (HSS), Pan American Health Organization (PAHO/WHO), United States.
| | | | | | - José Luis Castro
- Unit of Medicines and Health Technologies (MT), Dep. of Health Systems and Services (HSS), Pan American Health Organization (PAHO/WHO), United States
| | - Rafael Tabarés-Seisdedos
- Department of Medicine, University of Valencia, INCLIVA Health Research Institute and CIBERSAM, Valencia, Spain
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Srinivasarao DA, Reddy SS, Reddy GB, Katti DS. Spatio-temporal control on the delivery of triamcinolone acetonide using polymeric nanoparticles reduces steroid induced cataract. Int J Pharm 2019; 568:118474. [DOI: 10.1016/j.ijpharm.2019.118474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/21/2019] [Accepted: 06/25/2019] [Indexed: 01/13/2023]
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Abstract
PURPOSE Conjunctivitis, or inflammation of the conjunctiva, is a common condition that can be caused by infectious (eg, bacterial or viral infections) and noninfectious (eg, allergy) etiologies. Treatment involves diagnosis of the underlying cause and use of appropriate therapies. A broad-spectrum therapy that can address multiple etiologies, and also the accompanying inflammation, would be very useful. In this review, we discuss the usefulness of topical ophthalmic corticosteroids and ophthalmic formulations that combine corticosteroids with anti-infectives/antibiotics for treating acute infectious conjunctivitis. METHODS A review of the published literature and relevant treatment guidelines. RESULTS Topical corticosteroids are useful in treating ocular inflammation, but most treatment guidelines recommend steroid use generally in severe cases of conjunctivitis. This is partly due to risks associated with steroid use. These risks include potential for prolonging adenoviral infections and potentiating/worsening herpes simplex virus infections, increased intraocular pressure, glaucoma, and cataracts. Most of these perceived risks are not, however, supported by high-quality clinical data. They are also associated with long-term steroid uses that are dissimilar to applications for infectious conjunctivitis. Clinical data show that ophthalmic formulations that combine corticosteroids with broad-spectrum anti-infectives could be effective and well tolerated when used for short-term treatment (≤2 weeks). CONCLUSIONS Corticosteroids, in combination with anti-infectives, could be a promising treatment option for acute conjunctivitis subject to development of further evidence on their effectiveness and safety in conjunctivitis treatment.
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de Oliveira RC, Wilson SE. Practical guidance for the use of cyclosporine ophthalmic solutions in the management of dry eye disease. Clin Ophthalmol 2019; 13:1115-1122. [PMID: 31308620 PMCID: PMC6612764 DOI: 10.2147/opth.s184412] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/07/2019] [Indexed: 01/02/2023] Open
Abstract
Dry eye disease (DED) is a multifactorial disease of ocular surface and tear film, and is a common disorder treated by eye care providers. It is well established that ocular surface inflammation has an important role in the pathophysiology of DED and that anti-inflammatory cyclosporine A (CsA) improves the treatment outcomes of most patients with DED. The purpose of this review is to provide guidance for practitioners in the use of topical CsA for the management of DED to improve patient satisfaction and the quality of life.
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Sutyawan WE, Widiastuti IAP, Ryalino C. Steroid Induced Cataract in Langerhans Cell Histiocytosis Patient. Open Access Maced J Med Sci 2019; 7:1025-1028. [PMID: 30976354 PMCID: PMC6454174 DOI: 10.3889/oamjms.2019.233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND: Cataract is an opacification of the lens. Pediatric cataracts can be congenital or acquired. Acquired cataract including the one caused by corticosteroid used. It occurred as bilateral posterior subcapsular cataracts and tended to be progressive. Treatment of choice is lens extraction with or without intraocular lens (IOL). CASE PRESENTATION: We present a case of posterior subcapsular cataract that occurs in a patient with Langerhans cell histiocytosis that was using corticosteroid therapy. CONCLUSION: The routine ophthalmologic examination should be performed in children who received treatment with corticosteroids in the long term so that with early detection it can be given early treatment.
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Affiliation(s)
- Wayan Eka Sutyawan
- Department of Ophthalmology, Faculty of Medicine, Udayana University, Bali, Indonesia
| | | | - Christopher Ryalino
- Department of Anesthesiology and Intensive Care, Faculty of Medicine, Udayana University, Bali, Indonesia
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Imam L, Haboubi HN. G-Eye: ocular manifestations of gastrointestinal disease. Frontline Gastroenterol 2019; 11:162-167. [PMID: 32133116 PMCID: PMC7043099 DOI: 10.1136/flgastro-2018-101083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/14/2019] [Accepted: 01/22/2019] [Indexed: 02/04/2023] Open
Abstract
Extraintestinal manifestations of gastrointestinal disease can form an important aspect of the diagnosis, monitoring and management in these diseases. Ocular manifestations in particular are often disregarded and can, albeit rarely, present as an emergency.
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Affiliation(s)
- Lema Imam
- Department of Medicine, Glangwili General Hospital, Carmarthen, UK
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Vurmaz A, Duman R, Sabaner MC, Ertekin T, Bilir A. Antioxidant effects of piperine in in-vivo chick embryo cataract model induced by steroids. Cutan Ocul Toxicol 2019; 38:182-189. [PMID: 30678496 DOI: 10.1080/15569527.2019.1570521] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE The etiopathogenesis of steroid-induced cataracts is unknown. One hypothesis is that the higher reactive oxygen species (ROS) levels play an important role in the pathogenesis of several disorders, including the evolution of cataracts. This study investigated the antioxidant effects of piperine in our steroid-induced chick embryo lens model. METHODS The study included 36 specific pathogen-free (SPF) fertilized eggs divided into six groups: phosphate buffer saline (PBS, pH 7.4 Saline Solution (0.9%) isotonic) group (G1), hydrocortisone succinate sodium (HC)-treated group (G2), 100 mg/kg piperine and HC treated group (G3), 50 mg/kg piperine and HC treated group (G4), 25 mg/kg piperine and HC treated group (G5), and 10 mg/kg piperine and HC treated group (G6). On the 15th day of incubation, the SPF eggs in the six groups were removed from the incubator; all were injected using insulin injectors into the chorioallantoic membrane. On day 17, all of the chick embryos were removed from the eggs and all lenses were dissected from the embryos. Cataract formation was evaluated in all lenses, and total antioxidant status (TAS), total oxidant status (TOS), reduced glutathione (GSH), and lipid peroxidation (MDA, malondialdehyde) levels were measured in all lens. RESULTS The lenses in the G1 group had higher levels of GSH and TAS (p < 0.01), and lower levels of MDA and TOS than the G2 group (p < 0.05 and p < 0.01, respectively). Group 3 had higher levels of GSH and TAS (p < 0.001 and p < 0.001 respectively), and lower levels of MDA and TOS than the G2 group (p < 0.01 and p < 0.001, respectively). CONCLUSION Steroid therapy causes a decrease in GSH and TAS levels and an increase in TOS and MDA levels in lens tissues, indicating increased oxidative stress. Piperine exerts its effects as an antioxidant substance, in increasing doses.
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Affiliation(s)
- Ayhan Vurmaz
- a The Department of the Biochemistry , Afyonkarahisar Health Sciences University , Afyonkarahisar , Turkey
| | - Reşat Duman
- b The Department of the Ophthalmology , Afyonkarahisar Health Sciences University , Afyonkarahisar , Turkey
| | - Mehmet Cem Sabaner
- b The Department of the Ophthalmology , Afyonkarahisar Health Sciences University , Afyonkarahisar , Turkey
| | - Tolga Ertekin
- c The Department of the Anatomy , Afyonkarahisar Health Sciences University , Afyonkarahisar , Turkey
| | - Abdülkadir Bilir
- c The Department of the Anatomy , Afyonkarahisar Health Sciences University , Afyonkarahisar , Turkey
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Lee SH, Lee SH, Lee SH, Park YL. Cataract, Glaucoma, and Dry Eye Disease in Adults with Atopic Dermatitis: A Nationwide Cross-Sectional Study from the Republic of Korea. Ann Dermatol 2019; 31:37-43. [PMID: 33911537 PMCID: PMC7992703 DOI: 10.5021/ad.2019.31.1.37] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/02/2018] [Accepted: 08/14/2018] [Indexed: 01/19/2023] Open
Abstract
Background Atopic dermatitis (AD) is an inflammatory skin disorder characterized by relapsing eczema with intractable itching. Ocular diseases in patients with AD, including cataract, retinal detachment, blepharitis, glaucoma, keratoconjunctivitis, and keratoconus, have frequently been reported worldwide. However, only a few studies using a large-sample, population-based study design have been reported so far. Objective We investigated the association between cataract, glaucoma, and dry eye disease and AD in an adult population in the Republic of Korea. Methods A total of 14,900 adults who participated in the Korean National Health and Nutrition Examination Survey, a nationwide, population-based, cross-sectional survey, between 2010 and 2012 were included in the study. Multiple logistic regression analyses identified the possible association between cataract, glaucoma, and dry eye disease and AD relative to matched controls. Results After we adjusted for confounding factors in patients with AD, cataract and glaucoma were significantly associated with AD. Moreover, patients with AD had a higher prevalence of ophthalmic surgery compared to those without AD. Conclusion Dermatologists should therefore be aware of possible ocular disorders in patients with AD and should recommend regular ophthalmic screening for early detection.
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Affiliation(s)
- Sul Hee Lee
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sang-Hoon Lee
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Si Hyung Lee
- Department of Ophthalmology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Young Lip Park
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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Park S, Choi NK. The J-shape association of serum total IgE levels with age-related cataract. Int J Ophthalmol 2018; 11:1009-1012. [PMID: 29977816 DOI: 10.18240/ijo.2018.06.19] [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: 01/09/2017] [Accepted: 02/28/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To address the association between serum total IgE levels and age-related cataract in adults. METHODS The study participants consisted of 1052 adults aged 40y or older in the Korean National Health and Nutrition Examination Survey 2010. We performed multivariable logistic regression analyses using the quartile cut-points of total IgE levels. RESULTS The odds ratios (ORs) for nuclear and any cataract with ≥267 kU/L of serum IgE levels were 1.75 [95% confidence intervals (CI), 1.04-2.96] and 2.00 (95%CI, 1.22-3.27), respectively, comparing to 35-87 kU/L. Interestingly, participants with ≤35 kU/L of IgE levels (OR, 1.67; 95%CI, 1.02-2.72) also had higher risk for any cataract than those with 35-87 kU/L. The risk for any cataract (OR, 1.48; 95%CI, 1.03-2.13) was higher in participants with high total IgE levels (>150 kU/L), comparing to normal participants. CONCLUSION Our findings indicate a J-shaped relationship between serum IgE levels and age-related cataract.
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Affiliation(s)
- Sangshin Park
- Center for International Health Research, Rhode Island Hospital, the Warren Alpert Medical School of Brown University, Providence 02912, RI, USA.,Department of Pediatrics, the Warren Alpert Medical School of Brown University, Providence 02912, RI, USA
| | - Nam-Kyong Choi
- Department of Health Convergence, Ewha Womans University, Seoul 03760, Republic of Korea
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Inhibition of Noncanonical Murine Double Minute 2 Homolog Abrogates Ocular Inflammation through NF-κB Suppression. THE AMERICAN JOURNAL OF PATHOLOGY 2018; 188:2087-2096. [PMID: 30126549 DOI: 10.1016/j.ajpath.2018.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/10/2018] [Accepted: 05/17/2018] [Indexed: 11/22/2022]
Abstract
Uveitis is estimated to account for 10% of all cases of blindness in the United States, including 30,000 new cases of legal blindness each year. Intraocular and oral corticosteroids are the effective mainstay treatment, but they carry the risk of serious long-term ocular and systemic morbidity. New noncorticosteroid therapies with a favorable side effect profile are necessary for the treatment of chronic uveitis, given the paucity of existing treatment choices. We have previously demonstrated that Nutlin-3, a small-molecule inhibitor of murine double minute 2 (MDM2) homolog, suppresses pathologic retinal angiogenesis through a p53-dependent mechanism, but the noncanonical p53-independent functions have not been adequately elucidated. Herein, we demonstrate an unanticipated function of MDM2 inhibition, where Nutlin-3 potently abrogates lipopolysaccharide-induced ocular inflammation. Furthermore, we identified a mechanism by which transcription and translation of NF-κB is mediated by MDM2, independent of p53, in ocular inflammation. Small-molecule MDM2 inhibition is a novel noncorticosteroid strategy for inhibiting ocular inflammation, which may potentially benefit patients with chronic uveitis.
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Shroff S, Thomas RK, D'Souza G, Nithyanandan S. The effect of inhaled steroids on the intraocular pressure. Digit J Ophthalmol 2018; 24:6-9. [PMID: 30800006 DOI: 10.5693/djo.01.2018.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Steroids are known to play a role in the pathogenesis of glaucoma, but little is known about the effect of inhaled corticosteroids (ICS). The purpose of this study was to investigate whether there is a clinically significant association between inhalational steroids and intraocular pressure (IOP). Methods This was a cross-sectional, case-control study performed at St John's Medical College, Bengaluru, India, from October 2013 to July 2015 of 200 patients using 800 mcg of budesonide or its equivalent dose of ICS and 200 healthy controls not using any form of steroids. Patients using ICS for a period of at least 6 months with no usage of oral or topical steroids within the last 3 months were included as cases. Age- and sex-matched controls were recruited from among the general patient population of the ophthalmological department. IOP and central corneal thickness (CCT) were analyzed. Cases were divided into two subgroups. Group 1 had IOP of <21 mm Hg and cup-to-disc ratio of <0.5. Group 2 had IOP of ≥21 mm Hg or cup-to-disc ratio of ≥0.5 or cup-disc asymmetry ≥0.2. These two subgroups were analyzed to determine whether there was an increased risk of developing ocular hypertension or glaucoma with extended use of ICS. Results A total of 400 subjects participated, with 200 in each group. The mean IOP of cases was 15.31 ± 3.27 mm Hg, statistically significantly higher than the mean of 13.39 mm Hg ± 1.95 in controls (P < 0.001). The mean CCT in cases was 522.02 ± 30.47 μm, lower than the mean of 528.73 ± 29.09 μm of the control group (P > 0.001). Of the 200 cases, 11 (5.5%) had ocular hypertension and 2 (1%) had open-angle glaucoma. There was no statistically significant correlation between duration of inhaled steroids usage and increase in IOP (P = 0.62). There was no development of ocular hypertension or glaucoma among the controls. Conclusions Our findings suggest a probable association between ICS and IOP and that it may be advisable to measure baseline IOPs and CCT and to follow patients on ICS at regular intervals.
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Affiliation(s)
- Sujani Shroff
- St John's Medical College, Bengaluru, Karnataka, India
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45
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The optical properties of rat, porcine and human lenses in organ culture treated with dexamethasone. Exp Eye Res 2018; 170:67-75. [DOI: 10.1016/j.exer.2018.02.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 02/15/2018] [Accepted: 02/15/2018] [Indexed: 11/23/2022]
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Duman R, Vurmaz A. Role of innate immunity and oxidative stress in steroid-induced cataracts in developing chick embryos. Cutan Ocul Toxicol 2018. [DOI: 10.1080/15569527.2018.1452929] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Reşat Duman
- Department of Ophthalmology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Ayhan Vurmaz
- Department of Clinical Biochemistry, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
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Thrimawithana TR, Rupenthal ID, Räsch SS, Lim JC, Morton JD, Bunt CR. Drug delivery to the lens for the management of cataracts. Adv Drug Deliv Rev 2018; 126:185-194. [PMID: 29604375 DOI: 10.1016/j.addr.2018.03.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 03/02/2018] [Accepted: 03/20/2018] [Indexed: 11/16/2022]
Abstract
Cataracts are one of the most prevalent diseases of the lens, affecting its transparency and are the leading cause of reversible blindness in the world. The clarity of the lens is essential for its normal physiological function of refracting light onto the retina. Currently there is no pharmaceutical treatment for prevention or cure of cataracts and surgery to replace the affected lens remains the gold standard in the management of cataracts. Pharmacological treatment for prevention of cataracts is hindered by many physiological barriers that must be overcome by a therapeutic agent to reach the avascular lens. Various therapeutic agents and formulation strategies are currently being investigated to prevent cataract formation as access to surgery is limited. This review provides a summary of recent research in the field of drug delivery to the lens for the management of cataracts including models used to study cataract treatments and discusses the future perspectives in the field.
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Affiliation(s)
- Thilini R Thrimawithana
- Discipline of Pharmacy, School Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia.
| | - Ilva D Rupenthal
- Buchanan Ocular Therapeutics Unit, Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Simon S Räsch
- Buchanan Ocular Therapeutics Unit, Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Julie C Lim
- Department of Physiology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - James D Morton
- Faculty of Agricultural Sciences, Lincoln University, P O Box 85084, New Zealand
| | - Craig R Bunt
- Faculty of Agricultural Sciences, Lincoln University, P O Box 85084, New Zealand
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Vrolyk V, Haruna J, Benoit-Biancamano MO. Neonatal and Juvenile Ocular Development in Sprague-Dawley Rats: A Histomorphological and Immunohistochemical Study. Vet Pathol 2017; 55:310-330. [DOI: 10.1177/0300985817738098] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
As in many altricial species, rats are born with fused eyelids and markedly underdeveloped eyes. While the normal histology of the eyes of mature rats is known, the histomorphological changes occurring during postnatal eye development in this species remain incompletely characterized. This study was conducted to describe the postnatal development of ocular structures in Sprague-Dawley (SD) rats during the first month of age using histology and immunohistochemistry (IHC). Both eyes were collected from 51 SD rats at 13 time points between postnatal day (PND)1 and PND30. Histologic examination of hematoxylin and eosin-stained sections was performed, as well as IHC for cleaved-caspase-3 and terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) to evaluate apoptosis, and IHC for Ki-67 and phospho-histone-H3 to evaluate cell proliferation. Extensive ocular tissue remodeling occurred prior to the eyelid opening around PND14 and reflected the interplay between apoptosis and cell proliferation. Apoptosis was particularly remarkable in the maturing subcapsular anterior epithelium of the lens, the inner nuclear and ganglion cell layers of the developing retina, and the Harderian gland, and was involved in the regression of the hyaloid vasculature. Nuclear degradation in the newly formed secondary lens fibers was noteworthy after birth and was associated with TUNEL-positive nuclear remnants lining the lens organelle-free zone. Cell proliferation was marked in the developing retina, cornea, iris, ciliary body and Harderian gland. The rat eye reached histomorphological maturity at PND21 after a rapid phase of morphological changes characterized by the coexistence of cell death and proliferation.
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Affiliation(s)
- Vanessa Vrolyk
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | | | - Marie-Odile Benoit-Biancamano
- Department of Pathology and Microbiology, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
- Groupe de recherche en pharmacologie animale du Québec (GREPAQ), Faculty of Veterinary Medicne University of Montreal, Saint-Hyacinthe, QC, Canada
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Mukwaya A, Mirabelli P, Lennikov A, Xeroudaki M, Schaupper M, Peebo B, Lagali N. Genome-wide expression datasets of anti-VEGF and dexamethasone treatment of angiogenesis in the rat cornea. Sci Data 2017; 4:170111. [PMID: 28809847 PMCID: PMC5556618 DOI: 10.1038/sdata.2017.111] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 02/27/2017] [Indexed: 11/09/2022] Open
Abstract
Therapeutics against pathologic new blood vessel growth, particularly those targeting vascular endothelial growth factor (VEGF) are of enormous clinical interest. In the eye, where anti-VEGF agents are in widespread clinical use for treating retinal and corneal blindness, only partial or transient efficacy and resistance to anti-VEGF agents are among the major drawbacks. Conversely, corticosteroids have long been used in ophthalmology for their potency in suppressing inflammation and angiogenesis, but their broad biological activity can give rise to side effects such as glaucoma and cataract. To aid in the search for more targeted and effective anti-angiogenic therapies in the eye, we present here a dataset comparing gene expression changes in dexamethasone versus anti-Vegfa treatment of inflammation leading to angiogenesis in the rat cornea. Global gene expression analysis with GeneChip Rat 230 2.0 microarrays was conducted and the metadata submitted to Expression Omnibus repository. Here, we present a high-quality validated dataset enabling genome-wide comparison of genes differentially targeted by dexamethasone and anti-Vegf treatments, to identify potential alternative therapeutic targets for evaluation.
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Affiliation(s)
- Anthony Mukwaya
- Department of Ophthalmology, Institute for Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping 58183, Sweden
| | - Pierfrancesco Mirabelli
- Department of Ophthalmology, Institute for Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping 58183, Sweden
| | - Anton Lennikov
- Department of Ophthalmology, Institute for Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping 58183, Sweden
| | - Maria Xeroudaki
- Department of Ophthalmology, Institute for Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping 58183, Sweden
| | - Mira Schaupper
- Department of Ophthalmology, Institute for Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping 58183, Sweden
| | - Beatrice Peebo
- Department of Ophthalmology, Institute for Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping 58183, Sweden
| | - Neil Lagali
- Department of Ophthalmology, Institute for Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, Linköping 58183, Sweden
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Lee HJ, Song HJ, Jeong JH, Kim HU, Boo SJ, Na SY. Ophthalmologic manifestations in patients with inflammatory bowel disease. Intest Res 2017; 15:380-387. [PMID: 28670235 PMCID: PMC5478763 DOI: 10.5217/ir.2017.15.3.380] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/03/2016] [Accepted: 11/22/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND/AIMS Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), has been reported to have various ophthalmologic manifestations. The aim of this study was to evaluate the prevalence of ophthalmologic manifestations associated with IBD in Korea. METHODS Sixty-one patients were examined between May 2013 and October 2014. We performed complete ophthalmologic examinations. RESULTS Findings included 36 patients with CD and 25 with UC. The mean age of the patients was 34±16 years and disease duration was 45.3±23.9 months. Ophthalmologic manifestations were positive in 44 cases. Primary complication was diagnosed in 5 cases, as follows; iritis in 2 cases, episcleritis in one case, iritis with optic neuritis in 1 case, and serous retinal detachment in 1 case, without secondary complications. The most common coincidental complication was dry eye syndrome (DES), in 35 patients (57.4%). The prevalence of DES in the control group was 21.3%. The proportion of DES in patients with IBD was significantly higher than in the control group (P=0.002). CONCLUSIONS Ophthalmologic manifestations were high (72.1%) in IBD patients. Clinically significant primary ocular inflammation occurred in 8.2% of patients. The most common complication was DES. There was a higher rate of DES in patients with IBD compared to the control group. Evaluation of the eye should be a routine component in patients with IBD.
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Affiliation(s)
- Hye Jin Lee
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
| | - Hyun Joo Song
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Jin Ho Jeong
- Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea
| | - Heung Up Kim
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Sun-Jin Boo
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Soo-Young Na
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
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