1
|
Ravichandran S, Snyder PJ, Alber J, Kenny MR, Rothstein A, Brown K, Murchison CF, Clay OJ, Roberson ED, Arthur E. Quantifying Putative Retinal Gliosis in Preclinical Alzheimer's Disease. Invest Ophthalmol Vis Sci 2024; 65:5. [PMID: 38696189 PMCID: PMC11077916 DOI: 10.1167/iovs.65.5.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
Purpose Neuroinflammation plays a significant role in the pathology of Alzheimer's disease (AD). Mouse models of AD and postmortem biopsy of patients with AD reveal retinal glial activation comparable to central nervous system immunoreactivity. We hypothesized that the surface area of putative retinal gliosis observed in vivo using en face optical coherence tomography (OCT) imaging will be larger in patients with preclinical AD versus controls. Methods The Spectralis II instrument was used to acquire macular centered 20 × 20 and 30 × 25-degrees spectral domain OCT images of 76 participants (132 eyes). A cohort of 22 patients with preclinical AD (40 eyes, mean age = 69 years, range = 60-80 years) and 20 control participants (32 eyes, mean age = 66 years, range = 58-82 years, P = 0.11) were included for the assessment of difference in surface area of putative retinal gliosis and retinal nerve fiber layer (RNFL) thickness. The surface area of putative retinal gliosis and RNFL thickness for the nine sectors of the Early Treatment Diabetic Retinopathy Study (ETDRS) map were compared between groups using generalized linear mixed models. Results The surface area of putative retinal gliosis was significantly greater in the preclinical AD group (0.97 ± 0.55 mm2) compared to controls (0.68 ± 0.40 mm2); F(1,70) = 4.41, P = 0.039; Cohen's d = 0.61. There was no significant difference between groups for RNFL thickness in the 9 ETDRS sectors, P > 0.05. Conclusions Our analysis shows greater putative retinal gliosis in preclinical AD compared to controls. This demonstrates putative retinal gliosis as a potential biomarker for AD-related neuroinflammation.
Collapse
Affiliation(s)
- Swetha Ravichandran
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Peter J. Snyder
- Department of Neurology, Alpert Medical School of Brown University, Providence, Rhode Island, United States
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island, United States
| | - Jessica Alber
- Department of Biomedical and Pharmaceutical Sciences, University of Rhode Island, Kingston, Rhode Island, United States
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, Rhode Island, United States
- Butler Hospital Memory and Aging Program, Providence, Rhode Island, United States
| | - Madelyn R. Kenny
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Andrew Rothstein
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Keisha Brown
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Charles F. Murchison
- Alzheimer's Disease Research Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Olivio J. Clay
- Alzheimer's Disease Research Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Erik D. Roberson
- Alzheimer's Disease Research Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Edmund Arthur
- School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| |
Collapse
|
2
|
Swanson WH, King BJ, Alluwimi MS, Malik R. Predicting perimetric defects from en face maps of retinal nerve fibre layer reflectance. Ophthalmic Physiol Opt 2024; 44:613-625. [PMID: 38404167 PMCID: PMC10999345 DOI: 10.1111/opo.13289] [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: 09/19/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE To develop criteria to predict visual hemifields with deep perimetric defects based on retinal nerve fibre layer (RNFL) reflectance, in a transparent process whose components can be assessed by independent laboratories analysing data from their own small groups. METHODS The analysis was carried out in four stages, using three independent groups of patients-30, 33 and 62 participants-with glaucoma and age-similar controls. The first stage used Group 1 to develop a criterion for RNFL reflectance images at 24, 36 or 48 μm below the inner limiting membrane (ILM). The second stage evaluated the criterion using Group 2. The third stage developed a second criterion to improve performance for Groups 1 and 2 combined. The fourth stage evaluated the second criterion with Group 3. Confidence intervals for sensitivity and specificity were then computed by combining results from all three groups. RESULTS The first criterion identified all hemifields with deep defects and no hemifields from controls, using a within-eye reference for healthy RNFL. For Group 2, specificity remained high but sensitivity was reduced. The second criterion improved sensitivity by using location-specific reference values. For Group 3, sensitivity remained high but reduced specificity was found. Confidence intervals showed substantial overlap for the two criteria. CONCLUSIONS We developed two criteria to identify patients with deep perimetric defects with high specificity and sensitivity. Several improvements are warranted: automated identification of the fovea-disc angle and optic disc locations, evaluation of normal variation in patterns of RNFL thickness, improved segmentation of ILM and major vasculature, reduction of within-eye variability in RNFL reflectance of healthy eyes, assessment of effects of image quality, assessment of effects of comorbidity and effectiveness of other devices.
Collapse
Affiliation(s)
| | - Brett J King
- Indiana University School of Optometry, Bloomington, Indiana, USA
| | - Muhammed S Alluwimi
- Department of Optometry, College of Applied Medical Sciences, Qassim University, Buraidah, Saudi Arabia
| | - Rizwan Malik
- Department of Surgery, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| |
Collapse
|
3
|
Fernández-Albarral JA, de Hoz R, Matamoros JA, Chen L, López-Cuenca I, Salobrar-García E, Sánchez-Puebla L, Ramírez JM, Triviño A, Salazar JJ, Ramírez AI. Retinal Changes in Astrocytes and Müller Glia in a Mouse Model of Laser-Induced Glaucoma: A Time-Course Study. Biomedicines 2022; 10:biomedicines10050939. [PMID: 35625676 PMCID: PMC9138377 DOI: 10.3390/biomedicines10050939] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/15/2022] [Accepted: 04/16/2022] [Indexed: 11/28/2022] Open
Abstract
Macroglia (astrocytes and Müller glia) may play an important role in the pathogenesis of glaucoma. In a glaucoma mouse model, we studied the effects of unilateral laser-induced ocular hypertension (OHT) on macroglia in OHT and contralateral eyes at different time points after laser treatment (1, 3, 5, 8 and 15 days) using anti-GFAP and anti-MHC-II, analyzing the morphological changes, GFAP-labelled retinal area (GFAP-PA), and GFAP and MHC-II immunoreactivity intensities ((GFAP-IRI and MHC-II-IRI)). In OHT and contralateral eyes, with respect to naïve eyes, at all the time points, we found the following: (i) astrocytes with thicker somas and more secondary processes, mainly in the intermediate (IR) and peripheral retina (PR); (ii) astrocytes with low GFAP-IRI and only primary processes near the optic disc (OD); (iii) an increase in total GFAP-RA, which was higher at 3 and 5 days, except for at 15 days; (iv) an increase in GFAP-IRI in the IR and especially in the PR; (v) a decrease in GFAP-IRI near the OD, especially at 1 and 5 days; (vi) a significant increase in MHC-II-IRI, which was higher in the IR and PR; and (vii) the Müller glia were GFAP+ and MHC-II+. In conclusion, in this model of glaucoma, there is a bilateral macroglial activation maintained over time involved in the inflammatory glaucoma process.
Collapse
Affiliation(s)
- Jose A. Fernández-Albarral
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Grupo UCM 920105, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.F.-A.); (R.d.H.); (J.A.M.); (L.C.); (I.L.-C.); (E.S.-G.); (L.S.-P.); (J.M.R.); (A.T.)
| | - Rosa de Hoz
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Grupo UCM 920105, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.F.-A.); (R.d.H.); (J.A.M.); (L.C.); (I.L.-C.); (E.S.-G.); (L.S.-P.); (J.M.R.); (A.T.)
- Departamento de Inmunología, Facultad de Óptica y Optometría, Oftalmología y ORL, Universidad Complutense de Madrid, 28037 Madrid, Spain
| | - José A. Matamoros
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Grupo UCM 920105, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.F.-A.); (R.d.H.); (J.A.M.); (L.C.); (I.L.-C.); (E.S.-G.); (L.S.-P.); (J.M.R.); (A.T.)
| | - Lejing Chen
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Grupo UCM 920105, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.F.-A.); (R.d.H.); (J.A.M.); (L.C.); (I.L.-C.); (E.S.-G.); (L.S.-P.); (J.M.R.); (A.T.)
| | - Inés López-Cuenca
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Grupo UCM 920105, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.F.-A.); (R.d.H.); (J.A.M.); (L.C.); (I.L.-C.); (E.S.-G.); (L.S.-P.); (J.M.R.); (A.T.)
| | - Elena Salobrar-García
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Grupo UCM 920105, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.F.-A.); (R.d.H.); (J.A.M.); (L.C.); (I.L.-C.); (E.S.-G.); (L.S.-P.); (J.M.R.); (A.T.)
- Departamento de Inmunología, Facultad de Óptica y Optometría, Oftalmología y ORL, Universidad Complutense de Madrid, 28037 Madrid, Spain
| | - Lidia Sánchez-Puebla
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Grupo UCM 920105, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.F.-A.); (R.d.H.); (J.A.M.); (L.C.); (I.L.-C.); (E.S.-G.); (L.S.-P.); (J.M.R.); (A.T.)
| | - José M. Ramírez
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Grupo UCM 920105, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.F.-A.); (R.d.H.); (J.A.M.); (L.C.); (I.L.-C.); (E.S.-G.); (L.S.-P.); (J.M.R.); (A.T.)
- Departamento de Inmunología, Facultad de Medicina, Oftalmología y ORL, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Alberto Triviño
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Grupo UCM 920105, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.F.-A.); (R.d.H.); (J.A.M.); (L.C.); (I.L.-C.); (E.S.-G.); (L.S.-P.); (J.M.R.); (A.T.)
- Departamento de Inmunología, Facultad de Medicina, Oftalmología y ORL, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Juan J. Salazar
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Grupo UCM 920105, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.F.-A.); (R.d.H.); (J.A.M.); (L.C.); (I.L.-C.); (E.S.-G.); (L.S.-P.); (J.M.R.); (A.T.)
- Departamento de Inmunología, Facultad de Óptica y Optometría, Oftalmología y ORL, Universidad Complutense de Madrid, 28037 Madrid, Spain
- Correspondence: (J.J.S.); (A.I.R.)
| | - Ana I. Ramírez
- Instituto de Investigaciones Oftalmológicas Ramón Castroviejo, Grupo UCM 920105, IdISSC, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.A.F.-A.); (R.d.H.); (J.A.M.); (L.C.); (I.L.-C.); (E.S.-G.); (L.S.-P.); (J.M.R.); (A.T.)
- Departamento de Inmunología, Facultad de Óptica y Optometría, Oftalmología y ORL, Universidad Complutense de Madrid, 28037 Madrid, Spain
- Correspondence: (J.J.S.); (A.I.R.)
| |
Collapse
|
4
|
Yu X, Kline B, Han Y, Gao Y, Fan Z, Shi Y. Weill-Marchesani syndrome 4 caused by compound heterozygosity of a maternal submicroscopic deletion and a paternal nonsense variant in the ADAMTS17 gene: A case report. Am J Ophthalmol Case Rep 2022; 26:101541. [PMID: 35496767 PMCID: PMC9046107 DOI: 10.1016/j.ajoc.2022.101541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 03/26/2022] [Accepted: 04/11/2022] [Indexed: 11/20/2022] Open
Abstract
Purpose To retrospectively report a case of Weill-Marchesani syndrome 4 (WMS4) with compound heterozygous variants of ADAMTS17 gene. Observations The patient was a 7-year-old boy with progressively worsening eyesight and intermittent elevated intraocular pressure (IOP) for two years. His IOPs were temporarily controlled using anti-glaucoma drugs. At presentation he had a shallow anterior chamber, lens subluxation, spherophakia and extensive synechial angle closure with high myopia in both eyes. Ultrasound biomicroscopy (UBM) identified thickened zonule fibers and anteriorly rotated, flat and slender ciliary processes, both of which worsened and were accompanied by obvious iris bombe after miosis. Gene testing showed compound heterozygosity of a maternal submicroscopic deletion on chromosome 15q26.3 (0.774 Mb) affecting the sequences of ADAMTS17, LYSMD4 and CERS3 as well as a paternal nonsense variant (c.1051_1053delAAGinsTAA, P.K351X) in the ADAMTS17 gene in the proband. The diagnosis of WMS4 was confirmed by genetic testing. Phacoemulsification (Phaco), intraocular lens (IOL) implantation, and irido-zonulo-hyaloid-vitrectomy (IZHV) combined with Ahmed Glaucoma Valve (AGV) implantation as a staged or one-stage surgery effectively lowered IOP, deepened ACD, improved visual acuity, and resolved the configuration of the ciliary processes in both eyes. Conclusion and Importance Recessive ADAMTS17 variants are associated with WMS4. We report here compound heterozygous variants in ADAMTS17 causing WMS4, and anatomically highlighted the possible pathophysiology for its clinical phenotype. A modified surgical approach with Phaco, IOL implantation, and IZHV combined with AGV implantation could be used to treat these complicated cases.
Collapse
|
5
|
Cheung H, King BJ, Gast TJ. Presumed activated retinal astrocytes and Müller cells in healthy and glaucomatous eyes detected by spectral domain optical coherence tomography. Ophthalmic Physiol Opt 2020; 40:738-751. [PMID: 32885879 PMCID: PMC7692888 DOI: 10.1111/opo.12731] [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] [Received: 04/14/2020] [Accepted: 08/05/2020] [Indexed: 12/02/2022]
Abstract
Purpose To investigate presumed activated retinal astrocytes and Müller cells (ARAM) detected by scanning laser ophthalmoscopy (SLO) and spectral domain optical coherence tomography, and to investigate its presence in healthy controls as well as its relationship to posterior vitreal detachment (PVD) and glaucoma. Methods This retrospective study involved 1337 eyes of 805 controls between ages 8 and 90, and 250 eyes of 146 patients with glaucoma between the ages of 28 and 95. Subjects were counted as possessing ARAM only if they met the following criteria: (1) a patchy, discrete, glittering appearance on SLO, (2) a distinct, flat, hyper‐reflective layer at the internal limiting membrane on at least one B‐scan crossing the glittering area and (3) absence of any surface wrinkling retinopathy. The diagnosis of PVD was based on both the patient’s clinical examination and imaging data. Frequency tables were used to describe categorical variables and differences were compared by means of χ2. Analyses were separated based on right and left eye, first on controls and then between glaucomatous eyes and age‐similar sex‐matched controls. Results ARAM was found in both healthy controls and patients with glaucoma at similar frequencies. There was no association between having glaucoma and the presence of ARAM. ARAM was not different between the sexes but was associated with age and having a PVD. Conclusions This large retrospective study found that ARAM can be seen in healthy controls, is associated with PVD and possibly independently with age, and occurred at similar frequency in glaucomatous eyes.
Collapse
Affiliation(s)
- Hin Cheung
- School of Optometry, Indiana University, Bloomington, USA
| | - Brett J King
- School of Optometry, Indiana University, Bloomington, USA
| | - Thomas J Gast
- School of Optometry, Indiana University, Bloomington, USA
| |
Collapse
|