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Kim K, Kang YS, Kim JY. Effects of intracameral tissue plasminogen activator injection on posterior capsular opacification, fibrin formation, and intraocular pressure in dogs after phacoemulsification. Vet Ophthalmol 2024. [PMID: 39289864 DOI: 10.1111/vop.13277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 08/11/2024] [Accepted: 09/08/2024] [Indexed: 09/19/2024]
Abstract
OBJECTIVE To evaluate whether intracameral tissue plasminogen activator (tPA) injection is effective in regulating posterior capsular opacification (PCO), fibrin formation and intraocular pressure (IOP) after cataract surgery. ANIMAL STUDIED Prospective study involving 30 eyes of 21 dogs that underwent phacoemulsification. PROCEDURES Thirty eyes were randomly divided into two groups of 15 eyes (control and tPA groups). Intracameral tPA (25 μg/0.1 mL) was injected into tPA group eyes before corneal incision closure but not into the eyes of the control group. The grades of anterior fibrin formation and PCO were compared based on slit lamp biomicroscope examination at 1 and 2 weeks, 1 month, and 2-3 months postoperatively. IOP was measured using applanation tonometry every 30 min for 4 h immediately after operation and on the following morning. The IOP of the two groups at each time was compared. RESULTS The grade of anterior fibrin formation and that of PCO were not significantly different between the two groups at any time point (p > .05). However, the IOP of the tPA group was significantly lower than that of the control group at each point on the day of surgery (p < .05). No complications were observed with tPA injection, except for temporary hyphema (for 3 days) in one eye. CONCLUSIONS Although the intracameral tPA injection did not affect anterior fibrin formation and PCO, it effectively maintained normal IOP immediately after phacoemulsification. Thus, our findings provide valuable insights into the potential benefits of intracameral tPA injection in achieving immediate IOP control after phacoemulsification.
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Affiliation(s)
- Kyulee Kim
- Department of Veterinary Ophthalmology, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Young-Sun Kang
- Department of Veterinary Pharmacology and Toxicology, Veterinary Science Research Institute, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Joon Young Kim
- Department of Veterinary Ophthalmology, College of Veterinary Medicine, Konkuk University, Seoul, Korea
- KU Center for Animal Blood Medical Science, Konkuk University, Seoul, Korea
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Patel PD, Kodati B, Clark AF. Role of Glucocorticoids and Glucocorticoid Receptors in Glaucoma Pathogenesis. Cells 2023; 12:2452. [PMID: 37887296 PMCID: PMC10605158 DOI: 10.3390/cells12202452] [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: 09/01/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
The glucocorticoid receptor (GR), including both alternative spliced isoforms (GRα and GRβ), has been implicated in the development of primary open-angle glaucoma (POAG) and iatrogenic glucocorticoid-induced glaucoma (GIG). POAG is the most common form of glaucoma, which is the leading cause of irreversible vision loss and blindness in the world. Glucocorticoids (GCs) are commonly used therapeutically for ocular and numerous other diseases/conditions. One serious side effect of prolonged GC therapy is the development of iatrogenic secondary ocular hypertension (OHT) and OAG (i.e., GC-induced glaucoma (GIG)) that clinically and pathologically mimics POAG. GC-induced OHT is caused by pathogenic damage to the trabecular meshwork (TM), a tissue involved in regulating aqueous humor outflow and intraocular pressure. TM cells derived from POAG eyes (GTM cells) have a lower expression of GRβ, a dominant negative regulator of GC activity, compared to TM cells from age-matched control eyes. Therefore, GTM cells have a greater pathogenic response to GCs. Almost all POAG patients develop GC-OHT when treated with GCs, in contrast to a GC responder rate of 40% in the normal population. An increased expression of GRβ can block GC-induced pathogenic changes in TM cells and reverse GC-OHT in mice. The endogenous expression of GRβ in the TM may relate to differences in the development of GC-OHT in the normal population. A number of studies have suggested increased levels of endogenous cortisol in POAG patients as well as differences in cortisol metabolism, suggesting that GCs may be involved in the development of POAG. Additional studies are warranted to better understand the molecular mechanisms involved in POAG and GIG in order to develop new disease-modifying therapies to better treat these two sight threatening forms of glaucoma. The purpose of this timely review is to highlight the pathological and clinical features of GC-OHT and GIG, mechanisms responsible for GC responsiveness, potential therapeutic options, as well as to compare the similar features of GIG with POAG.
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Affiliation(s)
| | | | - Abbot F. Clark
- Department of Pharmacology & Neuroscience, North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA; (P.D.P.); (B.K.)
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Atai T, Ozmaie S, Anoushepour A. Comparison of the Effects of 0.1% Fluorometholone and 1% Prednisolone on Intraocular Pressure and Schirmer Tear Test in Equine Eye. J Equine Vet Sci 2023; 128:104840. [PMID: 37348824 DOI: 10.1016/j.jevs.2023.104840] [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: 03/25/2023] [Revised: 05/23/2023] [Accepted: 05/31/2023] [Indexed: 06/24/2023]
Abstract
This research was performed to compare the effects of prednisolone and fluorometholone on intraocular pressure (IOP) and Schirmer tear test (STT) in the normal equine eye. Sixteen normal mares aged between 6 and 10 years were used for this study. Horses were randomly assigned to two groups. Eight horses in the first group received 0.2 mL of topical 1% prednisolone in one eye and the contralateral eye was used as control (0.2 mL of saline was instilled). The second group received 0.2 mL of 0.1% fluorometholone in a randomly selected eye and the contralateral eye served as control and received 0.2 mL of saline. STT values and IOP were determined using STT strips and rebound, respectively, at the baseline, and 30-, 60-, 90-, and 180-minutes post eyedrop instillation. Mean (SD) IOPs at the baseline in the treated eyes of the first and second groups were 28.5 (5.4) and 27.5 (4.9) mm Hg, respectively. STT values at the baseline in the treated eyes of the first and second groups were 26.0 (1.8) mm/min and 24.0 (4.0) mm/min, respectively. Neither prednisolone nor fluorometholone caused significant changes in the IOP during 3 hours of monitoring (P > .05). There were no significant differences in the mean levels of STT in the control and treatment eyes, either between groups or within each group (P > .05). In conclusion, one dose (0.2 mL) of 1% prednisolone or 0.1% fluorometholone after 3 hours did not alter the IOP and STT in healthy horses. Further research for a longer period on normal horses and horses with uveitis is warranted.
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Affiliation(s)
- Taraneh Atai
- Department of Clinical Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Saeed Ozmaie
- Department of Clinical Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran.
| | - Amin Anoushepour
- Department of Clinical Sciences, Karaj Branch, Islamic Azad University, Tehran, Iran
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Abstract
Eosinophilic keratitis is a disease of the feline ocular surface. It is characterized by conjunctivitis, white to pink raised plaques on the corneal and conjunctival surfaces, corneal vascularization, and variable ocular pain. Cytology is the diagnostic test of choice. Identification of eosinophils in a corneal cytology sample usually confirms the diagnosis, although lymphocytes, mast cells, and neutrophils are often present concurrently. Immunosuppressives are the mainstay of therapy, topically or systemically. The role of feline herpesvirus-1 in the pathogenesis of eosinophilic keratoconjunctivitis (EK) remains unclear. Eosinophilic conjunctivitis is a less common manifestation of EK and presents as severe conjunctivitis without corneal involvement.
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Affiliation(s)
- Amber Labelle
- Bright Light Veterinary Eye Care, Ottawa, Ontario, Canada.
| | - Philippe Labelle
- Antech Diagnostics, 7555 Danbro Crescent, Mississauga, Ontario L5N 6P9, Canada
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Feline Glaucoma. Vet Clin North Am Small Anim Pract 2023; 53:367-387. [PMID: 36813391 DOI: 10.1016/j.cvsm.2022.10.002] [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: 02/22/2023]
Abstract
Feline glaucoma is best categorized as either secondary, congenital and anterior segment dysgenesis associated, or primary. More than 90% of all feline glaucoma develops secondary to uveitis or intraocular neoplasia. The uveitis is usually idiopathic and assumed to be immune-mediated, whereas lymphosarcoma and diffuse iridal melanoma account for many of the intraocular neoplastic-induced glaucoma in cats. Several topical and systemic therapies are useful in the control of the inflammation and elevated intraocular pressures associated with feline glaucoma. Enucleation remains the recommended therapy for blind glaucomatous feline eyes. Enucleated globes from cats with chronic glaucoma should be submitted to an appropriate laboratory for histologic confirmation of the type of glaucoma.
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James-Jenks EM, Pinard CL. Topical Ocular Therapeutics in Small Animals. Vet Clin North Am Small Anim Pract 2023; 53:473-492. [PMID: 36813396 DOI: 10.1016/j.cvsm.2022.10.008] [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: 02/22/2023]
Abstract
This article reviews the administration of common topical ophthalmic medications, in relation to factors influencing absorption including composition of topical ophthalmic preparations, and potential systemic effects. Commonly prescribed, commercially available topical ophthalmic medications are discussed with respect to pharmacology, their indications for use, and adverse effects. Knowledge of topical ocular pharmacokinetics is essential for the management of veterinary ophthalmic disease.
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Affiliation(s)
- Elizabeth M James-Jenks
- Department of Clinical Studies, University of Guelph, Ontario Veterinary College, 50 Stone Road East, Guelph, Ontario N1G 2W1, Canada.
| | - Chantale L Pinard
- Department of Clinical Studies, University of Guelph, Ontario Veterinary College, 50 Stone Road East, Guelph, Ontario N1G 2W1, Canada
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Diehl KA, Hofmeister EH, Keys DA, Kennedy CR. Single instead of triplicate intraocular pressure measurements in dogs do not substantially lower accuracy and precision but do slightly reduce statistical power. Am J Vet Res 2022; 83:349-355. [DOI: 10.2460/ajvr.21.08.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
OBJECTIVE
To compare single and triplicate applanation tonometry values across previous intraocular pressure (IOP) studies in dogs.
ANIMALS
116 ophthalmologically normal dogs.
PROCEDURES
Triplicate IOP readings (n = 1432) from studies evaluating effect of anesthetic protocols were analyzed to estimate a range of probable differences between averaged triplicate and first, averaged and lowest, and first and lowest IOPs. The decrease in variability with triplicate measurements and the magnitude of effects on statistical power were quantified.
RESULTS
The 2.5th to 97.5th interpercentile range for differences of averaged triplicate values minus first IOP readings was –3 to 2.7 mm Hg; for averaged minus lowest: 0 to 3.7 mm Hg; for first minus lowest: 0 to 5 mm Hg. The 95% prediction interval for differences in study group means (n = 160 groups, n = 5 to 11 eyes per group) based on averaged minus first measurements was –1.0 to 0.9 mm Hg with associated SDs reduced by 4% on average. Analysis of previous studies using averaged instead of first IOP values resulted in minimal decreases in SEs of 3–9% (0.03 to 0.09 mm Hg). Of 11 comparisons found significant with averaged data, 2 (18%) were found nonsignificant with first measurements. Of 96 comparisons found nonsignificant with averaged data, 3 (3%) were found significant with first measurements.
CLINICAL RELEVANCE
With applanation tonometry in ophthalmologically normal dogs, no clinically meaningful difference was found between the first, lowest, or averaged triplicate IOP measurements, but the first reading has a larger variance and hence will result in lower statistical power.
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Affiliation(s)
- Kathryn A. Diehl
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA
| | - Erik H. Hofmeister
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA
| | - Deborah A. Keys
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA
| | - Chris R. Kennedy
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA
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White CN, Downes MJ, Jones G, Wigfall C, Dean RS, Brennan ML. Use of clinical vignette questionnaires to investigate the variation in management of keratoconjunctivitis sicca and acute glaucoma in dogs. Vet Rec 2017; 182:21. [PMID: 29275324 DOI: 10.1136/vr.104390] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 10/17/2017] [Accepted: 11/02/2017] [Indexed: 02/03/2023]
Abstract
There is little peer-reviewed research assessing therapeutic effectiveness in canine eye disease. Current treatments used in first opinion and ophthalmology referral practices are also somewhat poorly documented. The aim of this study was to investigate the current management of canine keratoconjunctivitis sicca (KCS) and acute primary angle-closure glaucoma (PACG) by veterinary surgeons. Questionnaires using clinical vignettes were administered to a cross section of general practitioners ('GPs') and veterinarians engaged in or training for postgraduate ophthalmology practice ('PGs'). Similar treatment recommendations for KCS (topical cyclosporine, lubricant, antibiotic) were given by both groups of veterinarians with the single exception of increased topical antibiotic use by GPs. Treatment of acute glaucoma diverged between groups: PGs were much more likely to recommend topical prostaglandin analogues and a wider array of both topical and systemic treatments were recommended by both groups. Systemic ocular hypotensive agents were suggested infrequently. Our results suggest that treatments may vary substantially in ocular conditions, particularly in conditions for which neither guidelines nor high-quality evidence exists. This study highlights the need for novel strategies to address evidence gaps in veterinary medicine, as well as for better evaluation and dissemination of current treatment experience.
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Affiliation(s)
| | - Martin J Downes
- Centre for Applied Health Economics, School of Medicine, Griffith University, Meadowbrook, Queensland, Australia
| | | | | | - Rachel S Dean
- School of Veterinary Medicine and Science, Centre for Evidence-based Veterinary Medicine, University of Nottingham, Loughborough, UK
| | - Marnie L Brennan
- School of Veterinary Medicine and Science, Centre for Evidence-based Veterinary Medicine, University of Nottingham, Loughborough, UK
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Rybkin I, Gerometta R, Fridman G, Candia O, Danias J. Model systems for the study of steroid-induced IOP elevation. Exp Eye Res 2016; 158:51-58. [PMID: 27450911 DOI: 10.1016/j.exer.2016.07.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 06/24/2016] [Accepted: 07/19/2016] [Indexed: 12/16/2022]
Abstract
Steroid-induced IOP elevation affects a significant number of patients. It results from a decrease in outflow facility of the aqueous humor. To understand the pathophysiology of this condition a number of model systems have been created. These include ex-vivo cell and organ cultures as well as in-vivo animal models in organisms ranging from rodents to primates. These model systems can be used to investigate specific aspects of steroid-induced IOP elevation. This brief review summarizes the strengths and limitations of the various model systems and provides examples of where these systems have been successfully used to advance our understanding of steroid-induced IOP elevation.
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Affiliation(s)
- Ilya Rybkin
- Department of Cell Biology, SUNY Downstate, NY, USA
| | - Rosana Gerometta
- Departamento de Oftalmologia, Facultad de Medicina, Universidad Nacional del Nordeste, Corrientes, Argentina; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Oscar Candia
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John Danias
- Department of Cell Biology, SUNY Downstate, NY, USA; Department of Ophthalmology, SUNY Downstate, NY, USA.
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