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Kumar A, Yang E, Du Y. Trabecular Meshwork Regeneration for Glaucoma Treatment Using Stem Cell-Derived Trophic Factors. Methods Mol Biol 2025; 2848:59-71. [PMID: 39240516 DOI: 10.1007/978-1-0716-4087-6_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
Glaucoma is one of the leading causes of irreversible blindness. Stem cell therapy has shown promise in the treatment of primary open-angle glaucoma in animal models. Stem cell-free therapy using stem cell-derived trophic factors might be in demand in patients with high-risk conditions or religious restrictions. In this chapter, we describe methods for trabecular meshwork stem cell (TMSC) cultivation, secretome harvesting, and protein isolation, as well as assays to ensure the health of TMSC post-secretome harvesting and for secretome periocular injection into mice for therapeutic purposes.
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Affiliation(s)
- Ajay Kumar
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Enzhi Yang
- Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Yiqin Du
- Department of Ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
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Roddy GW, Kohli D, Niknam P, Omer ME, Chowdhury UR, Anderson KJ, Pacheco Marrero JM, Rinkoski TA, Fautsch MP. Subconjunctival Administration of an Adeno-Associated Virus Expressing Stanniocalcin-1 Provides Sustained Intraocular Pressure Reduction in Mice. OPHTHALMOLOGY SCIENCE 2025; 5:100590. [PMID: 39328825 PMCID: PMC11426120 DOI: 10.1016/j.xops.2024.100590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 07/23/2024] [Accepted: 07/25/2024] [Indexed: 09/28/2024]
Abstract
Purpose To investigate subconjunctival administration of a single-stranded, adeno-associated virus, serotype 2, engineered to express stanniocalcin-1 with a FLAG tag (ssAAV2-STC-1-FLAG) as a novel sustained (IOP) lowering agent with a reduced ocular surface side effect profile. Design In vivo preclinical investigation in mice. Subjects C57BL/6J, DBA/2J, prostaglandin F (FP) receptor knockout mice. Methods Normotensive C57BL/6J mice were treated with a subconjunctival injection of ssAAV2-STC-1-FLAG (2 μL; 6 × 109 viral genomes [VGs]) in 1 eye and the same volume and concentration of ssAAV2-green fluorescent protein (GFP) or the same volume of phosphate-buffered saline in the fellow eye. Ocular hypertensive DBA/2J mice were subconjunctivally injected with 6 × 109 VGs of ssAAV2-STC-1-FLAG or ssAAV2-GFP. Steroid-mediated ocular hypertension was induced in C57BL/6J mice with weekly injections of dexamethasone into the conjunctival fornix, and mice were then injected subconjunctivally with 6 × 109 VGs of ssAAV2-STC-1-FLAG or ssAAV2-GFP. Prostaglandin F receptor knockout mice were injected subconjunctivally with 6 × 109 VGs of ssAAV2-STC-1-FLAG or phosphate-buffered saline. An identical vector was constructed without the FLAG tag (ssAAV2-STC-1) and evaluated in normotensive C57BL/6J mice. Intraocular pressure was assessed using the Tonolab tonometer for all experiments. Tumor necrosis factor alpha (TNFα), a marker of ocular surface inflammation, was compared between subconjunctivally delivered ssAAV2-STC-1-FLAG and other treatments including daily topical latanoprost. Main Outcome Measures Intraocular pressure assessment. Results Subconjunctival delivery of ssAAV2-STC-1-FLAG significantly reduced IOP for 10 weeks post injection in normotensive mice. Maximal IOP reduction was seen at week 3 postinjection (17.4%; 17.1 ± 0.8 vs. 14.1 ± 0.8 mmHg, P < 0.001). After the IOP-lowering effect had waned, a second injection restored the ocular hypotensive effect. Subconjunctivally delivered ssAAV2-STC-1-FLAG lowered IOP in DBA/2J mice (16.9%; 17.8 ± 2.0 vs. 14.8 ± 0.9 mmHg, P < 0.001) and steroid-mediated ocular hypertensive mice (20.0%; 19.0 ± 0.6 vs. 15.2 ± 0.7 mmHg, P < 0.001) over the experimental period. This construct also reduced IOP to a similar extent in wild-type (15.9%) and FP receptor knockout (15.7%) mice compared with the fellow eye. A related construct also lowered IOP without the FLAG tag in a similar manner. Reduction in conjunctival TNFα was seen when comparing subconjunctivally delivered ssAAV2-STC-1-FLAG to daily topical latanoprost. Conclusions Subconjunctival delivery of the STC-1 transgene with a vector system may represent a novel treatment strategy for sustained IOP reduction and improved ocular tolerability that also avoids the daily dosing requirements of currently available medications. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Gavin W. Roddy
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, 55905
| | - Darrell Kohli
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, 55905
| | - Parvin Niknam
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, 55905
| | - Mohammed E. Omer
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, 55905
| | | | | | | | - Tommy A. Rinkoski
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, 55905
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Yang MC, Sun MT, Liu WW. Amniotic membrane graft to patch an overfiltering trabeculectomy flap. Am J Ophthalmol Case Rep 2024; 36:102128. [PMID: 39139207 PMCID: PMC11320425 DOI: 10.1016/j.ajoc.2024.102128] [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: 03/05/2024] [Revised: 06/29/2024] [Accepted: 07/12/2024] [Indexed: 08/15/2024] Open
Abstract
Purpose To describe the use of an amniotic membrane graft (AMG) with fibrin sealant to address an overfiltering trabeculectomy flap encountered intraoperatively. Observations A 35-year-old female with severe primary open angle glaucoma underwent trabeculectomy with mitomycin C due to uncontrolled intraocular pressure (IOP). Intraoperatively, the elastic nature of the scleral flap led to overfiltration, causing persistent anterior chamber shallowing despite numerous sutures. To decrease but not completely shut down aqueous outflow through the trabeculectomy flap, we utilized AMG and fibrin sealant to stabilize the flap. Postoperatively, the patient had a formed anterior chamber, elevated bleb and significantly reduced IOP, without the need for additional glaucoma medications. Conclusions and importance Amniotic membrane grafts (AMG) with fibrin sealant may help regulate aqueous flow efflux, maintain anterior chamber stability, and mitigate the risk of postoperative hypotony in trabeculectomy surgery. AMG was chosen in this setting given its anti-inflammatory, anti-fibrotic properties, as well as its optically clear nature to allow for post-operative visualization of the flap. AMG allows for early postoperative stabilization of the scleral flap without complete obstruction, and may be useful in patients at risk of early postoperative hypotony.
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Affiliation(s)
- Michael C. Yang
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Michelle T. Sun
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Wendy W. Liu
- Byers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA
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Wang S, Tong S, Jin X, Li N, Dang P, Sui Y, Liu Y, Wang D. Single-cell RNA sequencing analysis of the retina under acute high intraocular pressure. Neural Regen Res 2024; 19:2522-2531. [PMID: 38526288 PMCID: PMC11090430 DOI: 10.4103/1673-5374.389363] [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: 05/24/2023] [Revised: 07/27/2023] [Accepted: 09/13/2023] [Indexed: 03/26/2024] Open
Abstract
JOURNAL/nrgr/04.03/01300535-202419110-00032/figure1/v/2024-03-08T184507Z/r/image-tiff High intraocular pressure causes retinal ganglion cell injury in primary and secondary glaucoma diseases, yet the molecular landscape characteristics of retinal cells under high intraocular pressure remain unknown. Rat models of acute hypertension ocular pressure were established by injection of cross-linked hyaluronic acid hydrogel (Healaflow®). Single-cell RNA sequencing was then used to describe the cellular composition and molecular profile of the retina following high intraocular pressure. Our results identified a total of 12 cell types, namely retinal pigment epithelial cells, rod-photoreceptor cells, bipolar cells, Müller cells, microglia, cone-photoreceptor cells, retinal ganglion cells, endothelial cells, retinal progenitor cells, oligodendrocytes, pericytes, and fibroblasts. The single-cell RNA sequencing analysis of the retina under acute high intraocular pressure revealed obvious changes in the proportions of various retinal cells, with ganglion cells decreased by 23%. Hematoxylin and eosin staining and TUNEL staining confirmed the damage to retinal ganglion cells under high intraocular pressure. We extracted data from retinal ganglion cells and analyzed the retinal ganglion cell cluster with the most distinct expression. We found upregulation of the B3gat2 gene, which is associated with neuronal migration and adhesion, and downregulation of the Tsc22d gene, which participates in inhibition of inflammation. This study is the first to reveal molecular changes and intercellular interactions in the retina under high intraocular pressure. These data contribute to understanding of the molecular mechanism of retinal injury induced by high intraocular pressure and will benefit the development of novel therapies.
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Affiliation(s)
- Shaojun Wang
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Siti Tong
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Xin Jin
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Na Li
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Pingxiu Dang
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Yang Sui
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Ying Liu
- Department of Ophthalmology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Dajiang Wang
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
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Maulvi FA, Patel AR, Shetty KH, Desai DT, Shah DO, Willcox MDP. Chitosan nanoparticles laden contact lenses for enzyme-triggered controlled delivery of timolol maleate: A promising strategy for managing glaucoma. Drug Deliv Transl Res 2024; 14:3212-3224. [PMID: 38407770 DOI: 10.1007/s13346-024-01543-8] [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] [Accepted: 02/07/2024] [Indexed: 02/27/2024]
Abstract
To improve drug bioavailability, eye drops can be replaced by drug-eluting contact lenses. However, issues of drug leaching from lenses during manufacture and storage, and sterilization, currently limit their commercial application. To address the issues, stimuli-(lysozyme)-sensitive chitosan nanoparticles were developed to provide controlled ocular drug delivery. Nanoparticles were prepared by ionic gelation and characterized by TEM, X-ray diffraction, DSC, and FTIR. In the flux study, conventional-soaked contact lenses (SM-TM-CL) showed high-burst release, while with direct drug-only laden contact lenses (DL-TM-CL) the drug was lost during extraction and sterilization, as well as having poor swelling and optical properties. The nanoparticle-laden contact lenses (TM-Cht-NPs) showed controlled release of timolol for 120 h in the presence of lysozyme, with acceptable opto-physical properties. In the shelf-life study, the TM-Cht-NPs contact lenses showed no leaching or alteration in the drug release pattern. In animal studies, the TM-NPs-CL lenses gave a high drug concentration in rabbit tear fluid (mean = 11.01 µg/mL for 56 h) and helped maintain a low intraocular pressure for 120 h. In conclusion, the chitosan nanoparticle-laden contact lenses demonstrated the potential application to treat glaucoma with acceptable opto-physical properties and addressed the issues of drug-leaching during sterilization and storage.
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Affiliation(s)
- Furqan A Maulvi
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, 2052, Australia
- Maliba Pharmacy College, Uka Tarsadia University, Surat, 394350, India
| | - Ashmi R Patel
- Maliba Pharmacy College, Uka Tarsadia University, Surat, 394350, India
| | - Kiran H Shetty
- Maliba Pharmacy College, Uka Tarsadia University, Surat, 394350, India
| | - Ditixa T Desai
- Maliba Pharmacy College, Uka Tarsadia University, Surat, 394350, India.
| | - Dinesh O Shah
- Department of Chemical Engineering and Department of Anesthesiology, University of Florida, Gainesville, FL, 32611, USA
| | - Mark D P Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, 2052, Australia
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Zhong YL, Liu H, Huang X. Altered dynamic large-scale brain networks and combined machine learning in primary angle-closure glaucoma. Neuroscience 2024; 558:11-21. [PMID: 39154845 DOI: 10.1016/j.neuroscience.2024.08.013] [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: 05/12/2024] [Revised: 07/16/2024] [Accepted: 08/08/2024] [Indexed: 08/20/2024]
Abstract
Primary angle-closure glaucoma (PACG) is a severe and irreversible blinding eye disease characterized by progressive retinal ganglion cell death. However, prior research has predominantly focused on static brain activity changes, neglecting the exploration of how PACG impacts the dynamic characteristics of functional brain networks. This study enrolled forty-four patients diagnosed with PACG and forty-four age, gender, and education level-matched healthy controls (HCs). The study employed Independent Component Analysis (ICA) techniques to extract resting-state networks (RSNs) from resting-state functional magnetic resonance imaging (rs-fMRI) data. Subsequently, the RSNs was utilized as the basis for examining and comparing the functional connectivity variations within and between the two groups of resting-state networks. To further explore, a combination of sliding time window and k-means cluster analyses identified seven stable and repetitive dynamic functional network connectivity (dFNC) states. This approach facilitated the comparison of dynamic functional network connectivity and temporal metrics between PACG patients and HCs for each state. Subsequently, a support vector machine (SVM) model leveraging functional connectivity (FC) and FNC was applied to differentiate PACG patients from HCs. Our study underscores the presence of modified functional connectivity within large-scale brain networks and abnormalities in dynamic temporal metrics among PACG patients. By elucidating the impact of changes in large-scale brain networks on disease evolution, researchers may enhance the development of targeted therapies and interventions to preserve vision and cognitive function in PACG.
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Affiliation(s)
- Yu-Lin Zhong
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi 330006, China
| | - Hao Liu
- School of Ophthalmology and Optometry, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China
| | - Xin Huang
- Department of Ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi 330006, China.
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Vasconcelos AT, Rosa LA, De Fendi LI, Fontes VJB, Garcia DM, Cardoso GC, De Moraes CG, Paula JS. Factors Associated with Retinal Microvasculature Dropout Induced by Elevation of Intraocular Pressure in Primary Open-Angle Glaucoma. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06652-1. [PMID: 39382637 DOI: 10.1007/s00417-024-06652-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 08/14/2024] [Accepted: 09/27/2024] [Indexed: 10/10/2024] Open
Abstract
PURPOSE To investigate the risk factors related to decrease in vessel density (VD) observed in primary open-angle glaucoma (POAG), due to acute increase in intraocular pressure (IOP) by an ophthalmodynamometer (OPD). METHODS This cross-sectional study involved 42 eyes of participants (22 Controls and 20 POAG patients) that underwent optical coherence tomography angiography (OCT-A) to assess VD in the peripapillary region in three examination sets: primary gaze position (1), 25-degree adduction (2) and 25-degree adduction with OPD compression (3). Individual relationships between IOP levels and changes in the superficial complex VD were evaluated after image processing and exclusion of large retinal vessels. Multivariable regression analysis was used to verify factors associated with differences in VD induced by IOP elevation. RESULTS A significant increase in IOP was induced by OPD compression during adduction (mean ± SD, Control: + 13.8 ± 2.8; POAG: + 13.4 ± 2.1 mmHg). Only during IOP elevation (set 3), a significant VD decrease was observed both in POAG eyes (p = 0.008) and controls (p = 0.022). Baseline IOP (p = 0.022), maximum IOP (p = 0.003), and scleral rigidity (p = 0.029) were significantly associated with VD decreases in eyes with POAG. No changes were observed in VD during adduction gaze exclusively. CONCLUSION Acute IOP elevation induced with OPD, but not adduction gaze, decreased peripapillary VD measured with OCT-A imaging. IOP levels and scleral rigidity significantly affected VD reduction in POAG patients. Thus, high scleral rigidity may decrease the ability of the globe to dampen the well-known effects of IOP fluctuation on glaucoma onset and progression. KEY MESSAGES What is known Decrease vascular density in the peripapillary retina was associated with POAG, but factors related to the vascular response to elevated IOP are unexplored. What is new OCT-A quantification shows decreases in vascular density of the superficial layers of the peripapillary retina during an acute elevation in IOP. High IOP levels and scleral rigidity significantly affected vascular density reduction in POAG patients.
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Affiliation(s)
- Alex T Vasconcelos
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
| | - Lucas A Rosa
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Lígia I De Fendi
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Vítor J B Fontes
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Denny M Garcia
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - George C Cardoso
- Department of Physics, FFCLRP, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Jayter S Paula
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Chung YG, Fan S, Gulati V, Li HL, Gong H, Toris CB, Prausnitz MR, Ethier CR. IOP Reduction in Nonhuman Primates by Microneedle Injection of Drug-Free Hydrogel to Expand the Suprachoroidal Space. Transl Vis Sci Technol 2024; 13:14. [PMID: 39377753 DOI: 10.1167/tvst.13.10.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/09/2024] Open
Abstract
Purpose Expansion of the suprachoroidal space (SCS) by a hydrogel injection has been shown to reduce intraocular pressure (IOP) in rabbits as a potential treatment for ocular hypertension in glaucoma. Here, we evaluate the safety and efficacy of this approach in hypertensive and normotensive eyes in nonhuman primates. Methods A microneedle was used to inject a hyaluronic acid-based hydrogel or saline solution (control) into the SCS of cynomolgus monkey eyes that were either normotensive (n = 7 experimental; n = 2 control eyes) or had induced ocular hypertension (n = 6 experimental; n = 3 control eyes). IOP and the degree of SCS expansion were monitored over time by tonometry and ultrasound biomicroscopy, respectively. Safety was evaluated through slit lamp, fundus, and histology examinations. Results In hypertensive eyes, SCS injection with hydrogel initially reduced IOP by 47.5 ± 16.7%, and IOP returned to baseline in 38 days. In normotensive eyes, hydrogel injection initially reduced IOP by 38.8 ± 8.1% and IOP gradually returned to baseline also in 39 days. Sham injections resulted in mild IOP reduction in hypertensive eyes and normotensive eyes. The hydrogel injections were well tolerated by clinical assessments. Conclusions IOP was reduced in nonhuman primates for over one month by sustained SCS expansion. This procedure was safe and simple to perform. These data confirm the translational potential of this treatment method. Further optimization of the hydrogel may provide longer durations of IOP reduction. Translational Relevance A microneedle injection of hydrogel into the suprachoroidal space may provide a non-surgical, non-pharmacologic treatment for ocular hypertension in glaucoma patients.
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Affiliation(s)
- Yooree G Chung
- Wallace Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, Georgia Institute of Technology, Atlanta, GA, USA
| | - Shan Fan
- Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Vikas Gulati
- Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Hoi-Lam Li
- Department of Ophthalmology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Haiyan Gong
- Department of Ophthalmology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Carol B Toris
- Department of Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Ophthalmology and Visual Sciences, The Ohio State University, Columbus, OH, USA
| | - Mark R Prausnitz
- Wallace Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, Georgia Institute of Technology, Atlanta, GA, USA
- School of Chemical & Biomolecular Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - C Ross Ethier
- Wallace Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, Georgia Institute of Technology, Atlanta, GA, USA
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Chansangpetch S, Phinyo P, Patumanond J, Choovuthayakorn J, Lin SC. Diagnostic Abilities of Three-Dimensional Anterior Segment Optical Coherence Tomography in Detecting Angle Closure. J Glaucoma 2024; 33:801-807. [PMID: 38780278 DOI: 10.1097/ijg.0000000000002442] [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: 01/21/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024]
Abstract
PRCIS Three-dimensional (3D) angle parameters and cutoff values for detecting angle closure were proposed. The 3D parameters demonstrated excellent diagnostic performance. Certain horizontal two-dimensional (2D) parameters [ie, trabecular iris space area (TISA)-750, angle opening distance (AOD)-750, and AOD-500] can attain similar performance to their high-performing 3D counterparts. OBJECTIVE To investigate the diagnostic performance of single horizontal 2D versus 3D angle parameters from swept-source anterior segment optical coherence tomography (CASIA2) in detecting angle closure. MATERIALS AND METHODS The cross-sectional study included 118 phakic patients (59 open angles, 59 closed angles). AOD, angle recess area (ARA), and TISA at 250, 500, and 750 μm from scleral spur were measured in 360-degree radial-scan images. The 3D information of each measurement was analyzed in 2 patterns: (1) average 3D parameter-the averaged value from 360-degree angle values and (2) estimate 3D parameter-the estimation of surface area of circumferential angle inlet (using AOD) or circumferential angle volume (using ARA and TISA). The areas under the receiver operating characteristic curve [areas under the curve (AUCs)] of eighteen 3D parameters were compared with 2D horizontal parameters. RESULTS Among 3D parameters, AOD-500 estimate 3D gave the highest AUC (AUC: 0.950, cutoff: 6.09 mm 2 ), followed by AOD-750 estimate 3D (AUC: 0.948, cutoff: 8.26 mm 2 ). 3D parameters significantly increased the AUC of ARA-250 and TISA-250 (all P < 0.02) compared with the 2D parameters. No significant improvement in AUC was demonstrated for AOD-250 and all parameters at 500 and 750 μm. No significant difference in AUC was found among the 6 maximum AUC parameters, which were AOD-750 horizontal 2D, AOD-500 estimate 3D, TISA-750 horizontal 2D, AOD-500 horizontal 2D, AOD-750 estimate 3D, and TISA-750 average 3D. CONCLUSIONS The 3D-angle parameters had high performance in detecting angle closure. However, comparing a horizontal measurement to 3D parameters, the AUC improvement was mostly insignificant.
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Affiliation(s)
- Sunee Chansangpetch
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok
- Center of Excellence in Glaucoma, Chulalongkorn University, Bangkok
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai
| | - Phichayut Phinyo
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University
| | - Jayanton Patumanond
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai
| | - Janejit Choovuthayakorn
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Shan C Lin
- Glaucoma Center of San Francisco, San Francisco, CA
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Song WK, Sung KR, Kim KE. Anterior Chamber Angle and Intraocular Pressure Control After Phacoemulsification in Primary Angle Closure With Different Mechanisms. J Glaucoma 2024; 33:748-757. [PMID: 38934849 DOI: 10.1097/ijg.0000000000002454] [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: 09/06/2023] [Accepted: 06/15/2024] [Indexed: 06/28/2024]
Abstract
PRCIS Different mechanisms of angle closure represented distinct aspects of intraocular pressure (IOP) control after phacoemulsification. Classification of angle closure mechanisms is necessary for postoperative IOP management and glaucoma progression in primary angle closure eyes. PURPOSE To investigate the relationship between the anterior chamber angle (ACA) characteristics, measured by swept-source anterior segment optical coherence tomography (SS AS-OCT), and intraocular pressure (IOP) control after phacoemulsification in eyes with primary angle closure disease (PACD) with different angle closure mechanisms. METHODS PACD eyes were classified into 3 groups according to angle closure mechanisms using preoperative SS AS-OCT images; pupillary block (PB), plateau iris configuration (PIC), exaggerated lens vault (ELV). This retrospective, clinical cohort study included eighty-five eyes of 85 PACD patients: 34 with PB, 23 with PIC, and 28 with ELV. ACA parameters were measured preoperatively and 1 month postoperatively using SS AS-OCT. IOP measurements were performed preoperatively and during 6 months postoperatively. Postoperative IOP reduction and fluctuation were calculated, and their correlations with SS AS-OCT parameters were analyzed. RESULTS PIC group showed the lowest postoperative IOP reduction compared with the other groups ( P =0.023). Preoperative ACA measurements were significantly associated with postoperative IOP reduction in ELV and PB groups, while postoperative measurements were in PIC group. Preoperative and postoperative change of iridotrabecular contact (ITC) index and area were correlated with postoperative IOP reduction in PB and ELV groups but not in PIC group. Postoperative ITC index ( P =0.031) and area ( P =0.003) showed significant correlations with postoperative IOP fluctuation only in PIC group. CONCLUSIONS SS AS-OCT parameters including ITC index and area showed different associations with postoperative IOP control, which should be considered in determination of lens extraction and treatment of PACD eyes.
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Affiliation(s)
- Woo Keun Song
- Department of Ophthalmology, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea
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Yang SG, Wang XW, Li CP, Huang T, Qian C, Li Q, Zhao L, Zhou SY, Saijilafu, Liu CM, Zhou FQ. Roles of Kdm6a and Kdm6b in regulation of mammalian neural regeneration. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.09.12.557354. [PMID: 37745499 PMCID: PMC10515817 DOI: 10.1101/2023.09.12.557354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Epigenetic regulation of neuronal transcriptomic landscape is emerging to be a key coordinator of mammalian neural regeneration. Here we investigated roles of two histone 3 lysine 27 (H3K27) demethylases Kdm6a/b in controlling neuroprotection and axon regeneration. Deleting either Kdm6a or Kdm6b led to enhanced sensory axon regeneration in PNS, whereas in the CNS only deleting Kdm6a in retinal ganglion cells (RGCs) significantly enhanced optic nerve regeneration. Moreover, both Kdm6a and Kdm6b functioned to regulate RGC survival but with different mechanisms. Mechanistically, Kdm6a regulates RGC regeneration via distinct pathway from that of Pten and co-deleting Kdm6a and Pten resulted in long distance optic nerve regeneration passing the optic chiasm. In addition, RNA-seq profiling revealed that Kdm6a deletion switched the RGC transcriptomics into a developmental-like state and suppressed several known repressors of neural regeneration. Klf4 was identified as a direct downstream target of Kdm6a-H3K27me3 signaling in both sensory neurons and RGCs to regulate axon regeneration. These findings not only revealed different roles of Kdm6a and Kdm6b in regulation of neural regeneration and their underlying mechanisms, but also identified Kdm6a-mediated histone demethylation signaling as a novel epigenetic target for supporting CNS neural regeneration.
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12
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Buonfiglio F, Pfeiffer N, Gericke A. Glaucoma and the ocular renin-angiotensin-aldosterone system: Update on molecular signalling and treatment perspectives. Cell Signal 2024; 122:111343. [PMID: 39127136 DOI: 10.1016/j.cellsig.2024.111343] [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: 06/30/2024] [Revised: 07/29/2024] [Accepted: 08/08/2024] [Indexed: 08/12/2024]
Abstract
Glaucoma, a leading cause of blindness worldwide, encompasses a group of pathological conditions affecting the optic nerve and is characterized by progressive retinal ganglion cell loss, cupping of the optic nerve head, and distinct visual field defects. While elevated intraocular pressure (IOP) is the main risk factor for glaucoma, many patients do not have elevated IOP. Consequently, other risk factors, such as ocular blood flow abnormalities and immunological factors, have been implicated in its pathophysiology. Traditional therapeutic strategies primarily aim to reduce IOP, but there is growing interest in developing novel treatment approaches to improve disease management and reduce the high rates of severe visual impairment. In this context, targeting the ocular renin-angiotensin-aldosterone system (RAAS) has been found as a potential curative strategy. The RAAS contributes to glaucoma development through key effectors such as prorenin, angiotensin II, and aldosterone. Recent evidence has highlighted the potential of using RAAS modulators to combat glaucoma, yielding encouraging results. Our study aims to explore the molecular pathways linking the ocular RAAS and glaucoma, summarizing recent advances that elucidate the role of the RAAS in triggering oxidative stress, inflammation, and remodelling in the pathogenesis of glaucoma. Additionally, we will present emerging therapeutic approaches that utilize RAAS modulators and antioxidants to slow the progression of glaucoma.
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Affiliation(s)
- Francesco Buonfiglio
- Departments of Ophthalmology, University Medical Center of the Johannes Gutenberg- University, Langenbeckstr.1, 55131 Mainz, Germany.
| | - Norbert Pfeiffer
- Departments of Ophthalmology, University Medical Center of the Johannes Gutenberg- University, Langenbeckstr.1, 55131 Mainz, Germany.
| | - Adrian Gericke
- Departments of Ophthalmology, University Medical Center of the Johannes Gutenberg- University, Langenbeckstr.1, 55131 Mainz, Germany.
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13
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Hays RD, Tarver ME, Eydelman M, Spaeth GL, Parke DW, Singh K, Nguyen D, Saltzmann RM, Smith O, Shaw ML, Rosenberg L, Seibold L, Teymoorian S, Provencher LM, Bicket AK, Arora N, Junk AK, Chaya C, Salim S, Kuo D, Weiner A, Zhang Z, Rhee BFD, McMillan B, Choo C, Garris W, Noecker R, Fellman R, Caprioli J, Vold S, Pasquale L, Cui Q, Mbagwu M. A Health-Related Quality of Life Measure for Patients Who Undergo Minimally Invasive Glaucoma Surgery. Am J Ophthalmol 2024; 266:313-320. [PMID: 38880374 DOI: 10.1016/j.ajo.2024.05.031] [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: 05/17/2024] [Accepted: 05/31/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE To develop a patient-reported outcome measure to assess the impact of glaucoma and treatment, including minimally invasive glaucoma surgery (MIGS). DESIGN Observational study before and after concomitant cataract and Food and Drug Administration-approved implantable MIGS device surgery. SETTING Survey administration was on a computer, iPad, or similar device. PATIENT POPULATION 184 adults completed the baseline survey, 124 a survey 3 months after surgery, and 106 the 1-month test-retest reliability survey. The age range was 37 to 89 (average age = 72). Most were female (57%), non-Hispanic White (81%), and had a college degree (56%). MAIN OUTCOME MEASURES The Glaucoma Outcomes Survey (GOS) assesses functional limitations (27 items), vision-related symptoms (7 items), psychosocial issues (7 items), and satisfaction with microinvasive glaucoma surgery (1 item). These multiple-item scales were scored on a 0 to 100 range, with a higher score indicating worse health. RESULTS Internal consistency reliability estimates ranged from 0.75 to 0.93, and 1-month test-retest intraclass correlations ranged from 0.83 to 0.92 for the GOS scales. Product-moment correlations among the scales ranged from 0.56 to 0.60. Improvement in visual acuity in the study eye from baseline to the 3-month follow-up was significantly related to improvements in GOS functional limitations (r = 0.18, P = .0485), vision-related symptoms (r = 0.19, P = .0386), and psychosocial concerns (r = 0.18, P = .0503). Responders to treatment ranged from 17% for vision-related symptoms to 48% for functional limitations. CONCLUSIONS This study supports using the GOS for ophthalmic procedures such as MIGS. Further evaluation of the GOS in different patient subgroups and clinical settings is needed.
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Affiliation(s)
- Ron D Hays
- Department of Medicine (RDH), University of California, Los Angeles, California, USA; The RAND Corporation (RDH), Santa Monica, California, USA.
| | - Michelle E Tarver
- US Food and Drug Administration (MET and ME), Center for Devices and Radiologic Health, Silver Spring, Maryland, USA
| | - Malvina Eydelman
- US Food and Drug Administration (MET and ME), Center for Devices and Radiologic Health, Silver Spring, Maryland, USA
| | - George L Spaeth
- Wills Eye Hospital, Sidney Kimmel School of Medicine (GLS), Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Kuldev Singh
- Stanford University School of Medicine (KS), Stanford, California, USA
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14
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Kiyota N, Onay T, Leeaw P, Liu P, Deb DK, Thomson BR, Segrè AV, Wiggs JL, Quaggin SE. Glaucoma-Protective Human Single-Nucleotide Polymorphism in the Angpt2 Locus Increased ANGPT2 Expression and Schlemm Canal Area in Mice-Brief Report. Arterioscler Thromb Vasc Biol 2024; 44:2207-2212. [PMID: 39206543 DOI: 10.1161/atvbaha.124.321555] [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: 07/19/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND The ANGPT (angiopoietin)-TEK (tyrosine kinase, endothelial) vascular signaling pathway plays a key role in the formation of Schlemm canal, and loss-of-function mutations in the TEK or ANGPT1 gene are associated with primary congenital glaucoma in children. In genome-wide association studies, an association was identified between protection from primary open-angle glaucoma and the single-nucleotide polymorphism rs76020419 (G>T), located within a predicted miR-145-binding site in the 3' untranslated region of ANGPT2. To date, the functional impact of this variant in the anterior chamber of the eye remains largely unexplored. METHODS MT (mutant) mice harboring an orthologous rs76020419 minor allele (T) were generated using CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats/clustered regularly interspaced short palindromic repeat-associated 9). Plasma and tissue samples, including eyes, were collected, and ANGPT2 expression was quantified using ELISA. Anterior segments from eyes were collected from WT (wild-type) and MT mice, and Schlemm canal area was quantified. RESULTS In the MT group, higher ANGPT2 concentrations were observed in the plasma, lungs, kidneys, and eyes (P=0.0212, P<0.001, P=0.0815, and P=0.0215, respectively). Additionally, the Schlemm canal was larger in MT mice compared with WT mice (P=0.0430). CONCLUSIONS The rs76020419 minor allele (T) is associated with increased levels of ANGPT2 and a larger Schlemm canal in mice. These findings suggest a potential protective mechanism in glaucoma.
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Affiliation(s)
- Naoki Kiyota
- Feinberg Cardiovascular and Renal Research Institute (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
- Division of Nephrology and Hypertension (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
| | - Tuncer Onay
- Feinberg Cardiovascular and Renal Research Institute (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
- Division of Nephrology and Hypertension (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
| | - Phoebe Leeaw
- Feinberg Cardiovascular and Renal Research Institute (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
- Division of Nephrology and Hypertension (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
| | - Pan Liu
- Feinberg Cardiovascular and Renal Research Institute (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
- Division of Nephrology and Hypertension (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
| | - Dilip K Deb
- Feinberg Cardiovascular and Renal Research Institute (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
- Division of Nephrology and Hypertension (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
| | - Benjamin R Thomson
- Feinberg Cardiovascular and Renal Research Institute (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
- Division of Nephrology and Hypertension (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
| | - Ayellet V Segrè
- Department of Ophthalmology, Ocular Genomics Institute, Massachusetts Eye and Ear, Boston (A.V.S., J.L.W.)
- Department of Ophthalmology, Harvard Medical School, Boston, MA (A.V.S., J.L.W.)
- Broad Institute of Harvard and MIT, Cambridge, MA (A.V.S., J.L.W.)
| | - Janey L Wiggs
- Department of Ophthalmology, Ocular Genomics Institute, Massachusetts Eye and Ear, Boston (A.V.S., J.L.W.)
- Department of Ophthalmology, Harvard Medical School, Boston, MA (A.V.S., J.L.W.)
- Broad Institute of Harvard and MIT, Cambridge, MA (A.V.S., J.L.W.)
| | - Susan E Quaggin
- Feinberg Cardiovascular and Renal Research Institute (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
- Division of Nephrology and Hypertension (N.K., T.O., P. Leeaw, P. Liu, D.K.D., B.R.T., S.E.Q.), Northwestern University Feinberg School of Medicine, Chicago
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Mudalegundi S, Mihailovic A, Almidani L, Ciociola EC, Zebardast N, Rajendrababu S, Kader MA, Raman GV, Rengaraj V, Srinivasan K, Ramulu PY. Ophthalmological examination and imaging features that better predict risk of Angle Closure in siblings. Ophthalmol Glaucoma 2024:S2589-4196(24)00175-3. [PMID: 39332766 DOI: 10.1016/j.ogla.2024.09.003] [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: 04/22/2024] [Revised: 08/26/2024] [Accepted: 09/19/2024] [Indexed: 09/29/2024]
Abstract
OBJECTIVE Characteristics of individuals with angle closure may be useful in targeted screening of family members. Here, we assess if findings gathered during examination and imaging of patients with a known angle closure diagnosis (probands) could better determine the risk of angle closure in the patients' siblings. DESIGN Cross-sectional study of patients with known angle closure and their siblings. SUBJECTS Participants, and Controls: South Indian patients (probands) 30 years and older with open angles, suspect primary angle closure (PACS), or primary angle closure/primary angle closure glaucoma (PAC/PACG), and a biological sibling age 30 years or older (n=292 proband/sibling pairs). METHODS Demographic data, relevant ocular history, and a comprehensive ophthalmic examination with Anterior Segment Optical Coherence Tomography (ASOCT) were obtained. Three clinically relevant models were created to analyze the contribution of specific proband factors in predicting sibling angle closure diagnosis, using demographic (age, gender), ocular exam (gonioscopy, optic nerve exam, visual acuity, intraocular pressure [IOP]), and ASOCT features to improve prediction beyond proband diagnosis alone evaluated by log likelihood ratio testing and statistical comparison of receiver operating characteristics (ROC). MAIN OUTCOME MEASURES Sibling angle closure diagnostic accuracy. RESULTS Demographic and ocular exam metrics did not improve the prediction of sibling angle closure for all three outcomes (sibling diagnosis: (1) PACS/PAC/PACG vs OA, (2) PAC/PACG vs PACS/OA, and (3) PAC/PACG vs PACS), adding no model improvement when compared to diagnosis alone. Models adding ASOCT metrics to the prior model including proband diagnosis, demographics and ocular exam measures led to significantly improved prediction of 2 of the 3 angle closure outcomes. Specifically, improvement was noted via likelihood ratio testing for prediction of PAC/PACG vs PACS/OA (p=0.01), or PAC/PACG vs PACS (p=0.001). For all 3 angle closure outcomes, ROC comparisons demonstrated significant improvement in AUC between the three models predicting sibling outcomes, demonstrating an increase in AUC with each successive nested model across all 3 sibling angle closure outcomes. CONCLUSIONS Structural features of eyes with angle closure may assist in stratifying the risk of angle closure in patients' siblings. Further studies should consider evaluating this approach to achieve more targeted screenings.
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Affiliation(s)
| | | | - Louay Almidani
- Wilmer Eye Institute, John Hopkins University, Baltimore, Maryland
| | | | - Nazlee Zebardast
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | | | | | - Ganesh V Raman
- Department of Glaucoma, Aravind Eye Hospital, Pondicherry, India
| | | | | | - Pradeep Y Ramulu
- Wilmer Eye Institute, John Hopkins University, Baltimore, Maryland
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16
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Sgambellone S, Khanfar MA, Marri S, Villano S, Nardini P, Frank A, Reiner-Link D, Stark H, Lucarini L. Histamine H 3 receptor antagonist/nitric oxide donors as novel promising therapeutic hybrid-tools for glaucoma and retinal neuroprotection. Biomed Pharmacother 2024; 180:117454. [PMID: 39321511 DOI: 10.1016/j.biopha.2024.117454] [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: 08/03/2024] [Revised: 09/11/2024] [Accepted: 09/19/2024] [Indexed: 09/27/2024] Open
Abstract
Glaucoma is a degenerative optic neuropathy in which the degeneration of optic nerve and blindness occur. The main cause is a malfunction of ciliary processes (protrusions of the ciliary bodies) resulting in increased intraocular pressure (IOP). Ocular hypertension (OHT) causes ischemic events leading to retinal ganglion cell (RGC) depletion and blindness. Histaminergic and nitrergic systems are involved in the regulation of IOP. Therefore, we developed novel hybrid compounds that target histamine H3 receptor (H3R) with nitric oxide (NO) releasing features (ST-1989 and ST-2130). After H3R binding was proven in vitro, we investigated their effects in two OHT models in New Zealand White rabbits. Compound ST-1989 showed the highest NO elevation, together with antioxidative and anti-inflammatory features partly superior to the co-administered H3R antagonist (ciproxifan) and NO donor (molsidomine). This hybrid compound demonstrated IOP reduction in both OHT models induced by intravitreal injection of hypertonic saline and carbomer into the anterior chamber of the eye, respectively. Ocular perfusion and photoreceptor neuroprotection were evaluated in a model of ischemia/reperfusion (I/R) of the ophthalmic artery induced by repeated sub-tenon injections of endothelin-1 (ET-1), twice a week for six weeks. Compound ST-1989 counteracts retinal degeneration reducing ophthalmic artery resistance index and increasing photoreceptor responses, thus rescuing RGCs. Our results indicate that compound ST-1989 is a promising molecule with long-lasting hypotensive effects and good effectiveness in reducing inflammation, oxidative stress, and RGCs apoptosis. In conclusion, these hybrid compounds could be a novel strategy to combat glaucomatous blindness and RGC depletion for ocular diseases involving retinal damage.
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Affiliation(s)
- Silvia Sgambellone
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Mohammad A Khanfar
- Institute of Pharmaceutical and Medicinal Chemistry, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; College of Pharmacy, Alfaisal University, Al Takhassusi Rd, Riyadh 11533, Saudi Arabia
| | - Silvia Marri
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Serafina Villano
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Patrizia Nardini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Annika Frank
- Institute of Pharmaceutical and Medicinal Chemistry, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - David Reiner-Link
- Institute of Pharmaceutical and Medicinal Chemistry, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Department of Drug Design & Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Holger Stark
- Institute of Pharmaceutical and Medicinal Chemistry, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Laura Lucarini
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy.
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17
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Tian X, Yuan L, Li L, Yuan X. Alterations in anterior lens capsule structure and LTBP-2 expression in primary angle-closure glaucoma. BMJ Open Ophthalmol 2024; 9:e001535. [PMID: 39317460 PMCID: PMC11423727 DOI: 10.1136/bmjophth-2023-001535] [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: 11/05/2023] [Accepted: 09/12/2024] [Indexed: 09/26/2024] Open
Abstract
OBJECTIVE This study investigated the role of latent-transforming growth factor β-binding protein 2 (LTBP-2) in primary angle-closure glaucoma (PACG) by analysing its expression and the ultrastructure of the anterior lens capsule in PACG patients with age-related cataract (ARC). METHODS Tissue samples of the anterior lens capsule were collected from patients undergoing cataract phacoemulsification surgery. Patients in the experimental group were diagnosed with primary angle-closure (PAC) combined with ARC (PAC+ARC) and PACG combined with ARC (PACG+ARC). The control group consisted of patients with only ARC. The techniques used included scanning electron microscopy, real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), western blotting and immunofluorescence. RESULTS Ultrastructural analysis revealed disordered connections in PAC+ARC, loose connections in PACG+ARC and well-ordered connections in ARC. RT-qPCR and western blotting showed significantly lower LTBP-2 mRNA and protein expression in PAC+ARC and PACG+ARC than in ARC, with PAC+ARC having the lowest levels. Immunofluorescence confirmed these findings, showing varying LTBP-2 fluorescence intensities across groups. CONCLUSION The study identified ultrastructural changes in the anterior lens capsules in PACG accompanied by reduced LTBP-2 expression, especially in PAC+ARC patients. This suggests a potential role for LTBP-2 in PACG development, warranting further investigation.
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Affiliation(s)
- Xiaofeng Tian
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, China
| | - Liyun Yuan
- School of Medicine, Nankai University, Tianjin, China
| | - Liangpin Li
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, China
| | - Xiaoyong Yuan
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Tianjin, China
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18
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Langer F, Binter M, Hu X, Hufendiek K, Meister R, Tode J, Framme C, Fuchs H. In vitro comparison of human and murine trabecular meshwork cells: implications for glaucoma research. Sci Rep 2024; 14:22002. [PMID: 39313534 PMCID: PMC11420201 DOI: 10.1038/s41598-024-73057-9] [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: 03/22/2024] [Accepted: 09/12/2024] [Indexed: 09/25/2024] Open
Abstract
The trabecular meshwork (TM) is crucial for regulating intraocular pressure (IOP), and its dysfunction significantly contributes to glaucoma, a leading cause of vision loss and blindness worldwide. Although rodents are commonly used as animal models in glaucoma research, the applicability of these findings to humans is limited due to the insufficient understanding of murine TM. This study aimed to compare primary human TM (hTM) and murine TM (mTM) cells in vitro to enhance the robustness and translatability of murine glaucoma models. In this in vitro study, we compared primary hTM and mTM cells under simulated physiological and pathological conditions by exposing both cell types to the glucocorticoid dexamethasone (DEX) and Transforming Growth Factor β (TGFB2), both of which are critical in the pathogenesis of several ophthalmological diseases, including glaucoma. Phagocytic properties were assessed using microbeads. Cells were analyzed through immunocytochemistry (ICC) and Western blot (WB) to evaluate the expression of extracellular matrix (ECM) components, such as Fibronectin 1 (FN1) and Collagen IV (COL IV). Filamentous-Actin (F-Act) staining was used to analyze cross-linked actin network (CLAN) formation. Additionally, we evaluated cytoskeletal components, including Vimentin (VIM), Myocilin (MYOC), and Actin-alpha-2 (ACTA2). Our results demonstrated significant similarities between human and murine TM cells in basic morphology, phagocytic properties, and ECM and cytoskeletal component expression under both homeostatic and pathological conditions in vitro. Both human and murine TM cells exhibited epithelial-to-mesenchymal transition (EMT) after exposure to DEX or TGFB2, with comparable CLAN formation observed in both species. However, there were significant differences in FN1 and MYOC induction between human and murine TM cells. Additionally, MYOC expression in hTM cells depended on fibronectin coating. Our study suggests that murine glaucoma models are potentially translatable to human TM. The observed similarities in ECM and cytoskeletal component expression and the comparable EMT response and CLAN formation support the utility of murine models in glaucoma research. The differences in FN1 and MYOC expression between hTM and mTM warrant further investigation due to their potential impact on TM properties. Overall, this study provides valuable insights into the species-specific characteristics of TM and highlights opportunities to refine murine models for better relevance to human glaucoma.
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Affiliation(s)
- Fridolin Langer
- University Eye Hospital, Hannover Medical School, 30625, Hannover, Germany
| | - Maximilian Binter
- University Eye Hospital, Hannover Medical School, 30625, Hannover, Germany
| | - Xiaonan Hu
- University Eye Hospital, Hannover Medical School, 30625, Hannover, Germany
| | - Karsten Hufendiek
- University Eye Hospital, Hannover Medical School, 30625, Hannover, Germany
| | - Roland Meister
- University Eye Hospital, Hannover Medical School, 30625, Hannover, Germany
| | - Jan Tode
- University Eye Hospital, Hannover Medical School, 30625, Hannover, Germany
| | - Carsten Framme
- University Eye Hospital, Hannover Medical School, 30625, Hannover, Germany
| | - Heiko Fuchs
- University Eye Hospital, Hannover Medical School, 30625, Hannover, Germany.
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Kaipa BR, Kasetti R, Li L, Millar JC, Cho W, Skowronska-Krawczyk D, Maddineni P, Sundaresan Y, Zode GS. Ocular hypertension impairs axonal transport in the optic nerve head leading to neurodegeneration in a novel Cre-inducible mouse model of myocilin glaucoma. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.09.18.613712. [PMID: 39345520 PMCID: PMC11429981 DOI: 10.1101/2024.09.18.613712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Background Degeneration of optic nerve (ON) axons and loss of retinal ganglion cells (RGCs) are the pathological hallmarks of Primary Open Angle Glaucoma (POAG). Elevation of intraocular pressure (IOP) due to dysfunction of trabecular meshwork (TM) is known to induce neurodegeneration. However, the early pathological events of glaucomatous neurodegeneration are poorly understood due to lack of robust and faithful mouse model that replicates all features of human POAG. Here, we report the generation and characterization of a novel Cre-inducible transgenic mouse model of myocilin (MYOC), the leading known genetic cause of POAG. Using this model, we further explore early pathological events of glaucomatous neurodegeneration due to chronic IOP elevation. Methods We generated a Cre-inducible transgenic mouse model expressing DsRed-tagged Y437H mutant of human myocilin ( Tg.CreMYOC Y437H ). A single intravitreal injection of helper adenovirus (HAd) 5 expressing empty cassette or Cre was performed in adult Tg.CreMYOC Y437H mice, and glaucoma phenotypes including IOP, outflow facility, structural and functional loss of RGCs, ON degeneration, gliosis, and axonal transport deficits were examined at various stages of IOP elevation. Results An intravitreal injection of HAd5-Cre led to selective MYOC expression in the TM at the level similar to endogenous Myoc . Expression of mutant MYOC induced biochemical and ultrastructural changes in TM leading to reduced outflow facility and significant IOP elevation. Notably, sustained IOP elevation led to significant functional and structural loss of RGCs and progressive ON degeneration. Glaucomatous neurodegeneration was associated with activation of astrocytes and neurodegenerative changes in the optic nerve head (ONH) region. Remarkably, chronic IOP elevation blocked anterograde axonal transport at the ONH prior to axonal degeneration and RGC loss. Interestingly, impaired axonal transport was associated with loss of cytoskeleton proteins including microtubules and neurofilaments resulting into accumulation of mitochondria in the ONH and neuronal dysfunction. Conclusions Our studies indicate that Cre-inducible Tg.CreMYOC Y437H mice recapitulates all glaucoma phenotypes observed in POAG patients. Importantly, sustained IOP elevation impairs axonal transport at ONH leading to glaucomatous neurodegeneration.
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20
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Asrani SG, McGlumphy EJ, Al-Aswad LA, Chaya CJ, Lin S, Musch DC, Pitha I, Robin AL, Wirostko B, Johnson TV. The relationship between intraocular pressure and glaucoma: An evolving concept. Prog Retin Eye Res 2024; 103:101303. [PMID: 39303763 DOI: 10.1016/j.preteyeres.2024.101303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 09/17/2024] [Accepted: 09/18/2024] [Indexed: 09/22/2024]
Abstract
Intraocular pressure (IOP) is the most important modifiable risk factor for glaucoma and fluctuates considerably within patients over short and long time periods. Our field's understanding of IOP has evolved considerably in recent years, driven by tonometric technologies with increasing accuracy, reproducibility, and temporal resolution that have refined our knowledge regarding the relationship between IOP and glaucoma risk and pathogenesis. The goal of this article is to review the published literature pertinent to the following points: 1) the factors that determine IOP in physiologic and pathologic states; 2) technologies for measuring IOP; 3) scientific and clinical rationale for measuring diverse IOP metrics in patients with glaucoma; 4) the impact and shortcomings of current standard-of-care IOP monitoring approaches; 5) recommendations for approaches to IOP monitoring that could improve patient outcomes; and 6) research questions that must be answered to improve our understanding of how IOP contributes to disease progression. Retrospective and prospective data, including that from landmark clinical trials, document greater IOP fluctuations in glaucomatous than healthy eyes, tendencies for maximal daily IOP to occur outside of office hours, and, in addition to mean and maximal IOP, an association between IOP fluctuation and glaucoma progression that is independent of mean in-office IOP. Ambulatory IOP monitoring, measuring IOP outside of office hours and at different times of day and night, provides clinicians with discrete data that could improve patient outcomes. Eye care clinicians treating glaucoma based on isolated in-office IOP measurements may make treatment decisions without fully capturing the entire IOP profile of an individual. Data linking home blood pressure monitors and home glucose sensors to dramatically improved outcomes for patients with systemic hypertension and diabetes and will be reviewed as they pertain to the question of whether ambulatory tonometry is positioned to do the same for glaucoma management. Prospective randomized controlled studies are warranted to determine whether remote tonometry-based glaucoma management might reduce vision loss and improve patient outcomes.
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Affiliation(s)
- Sanjay G Asrani
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
| | | | - Lama A Al-Aswad
- Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, USA
| | - Craig J Chaya
- John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | - Shan Lin
- Glaucoma Center of San Francisco, San Francisco, CA, USA
| | - David C Musch
- Department of Ophthalmology & Visual Sciences and Department of Epidemiology, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA
| | - Ian Pitha
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alan L Robin
- Department of Ophthalmology & Visual Sciences and Department of Epidemiology, Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA; Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Barbara Wirostko
- John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA.
| | - Thomas V Johnson
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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21
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Liu C, Wang LY, Zhu KY, Liu CM, Duan JG. Systematic bibliometric and visualized analysis of research hotspots and trends on the application of artificial intelligence in glaucoma from 2013 to 2022. Int J Ophthalmol 2024; 17:1731-1742. [PMID: 39296573 PMCID: PMC11367425 DOI: 10.18240/ijo.2024.09.22] [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: 11/10/2023] [Accepted: 05/24/2024] [Indexed: 09/21/2024] Open
Abstract
AIM To conduct a bibliometric analysis of research on artificial intelligence (AI) in the field of glaucoma to gain a comprehensive understanding of the current state of research and identify potential new directions for future studies. METHODS Relevant articles on the application of AI in the field of glaucoma from the Web of Science Core Collection were retrieved, covering the period from January 1, 2013, to December 31, 2022. In order to assess the contributions and co-occurrence relationships among different countries/regions, institutions, authors, and journals, CiteSpace and VOSviewer software were employed and the research hotspots and future trends within the field were identified. RESULTS A total of 750 English articles published between 2013 and 2022 were collected, and the number of publications exhibited an overall increasing trend. The majority of the articles were from China, followed by the United States and India. National University of Singapore, Chinese Academy of Sciences, and Sun Yat-sen University made significant contributions to the published works. Weinreb RN and Fu HZ ranked first among authors and cited authors. American Journal of Ophthalmology is the most impactful academic journal in the field of AI application in glaucoma. The disciplinary scope of this field includes ophthalmology, computer science, mathematics, molecular biology, genetics, and other related disciplines. The clustering and identification of keyword nodes in the co-occurrence network reveal the evolving landscape of AI application in the field of glaucoma. Initially, the hot topics in this field were primarily "segmentation", "classification" and "diagnosis". However, in recent years, the focus has shifted to "deep learning", "convolutional neural network" and "artificial intelligence". CONCLUSION With the rapid development of AI technology, scholars have shown increasing interest in its application in the field of glaucoma. Moreover, the application of AI in assisting treatment and predicting prognosis in glaucoma may become a future research hotspot. However, the reliability and interpretability of AI data remain pressing issues that require resolution.
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Affiliation(s)
- Chun Liu
- Eye School of Chengdu University of TCM, Chengdu 610072, Sichuan Province, China
| | - Lu-Yao Wang
- Eye School of Chengdu University of TCM, Chengdu 610072, Sichuan Province, China
| | - Ke-Yu Zhu
- Eye School of Chengdu University of TCM, Chengdu 610072, Sichuan Province, China
| | - Chun-Meng Liu
- Eye School of Chengdu University of TCM, Chengdu 610072, Sichuan Province, China
| | - Jun-Guo Duan
- Ineye Hospital of Chengdu University of TCM, Chengdu 610084, Sichuan Province, China
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection with TCM Laboratory, Chengdu 610072, Sichuan Province, China
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22
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Wang Y, Guo Y, Zhang Y, Huang S, Zhong Y. Differences and Similarities Between Primary Open Angle Glaucoma and Primary Angle-Closure Glaucoma. Eye Brain 2024; 16:39-54. [PMID: 39309574 PMCID: PMC11416111 DOI: 10.2147/eb.s472920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 08/29/2024] [Indexed: 09/25/2024] Open
Abstract
Glaucoma is the leading cause of irreversible blindness worldwide. It is an ocular disease characterized by an increase in intraocular pressure or, in some cases, normal intraocular pressure, which leads to optic nerve damage and progressive constriction of the visual field (VF). Primary Open-Angle Glaucoma (POAG) and Primary Angle-Closure Glaucoma (PACG) represent the predominant forms of glaucoma. Numerous hypotheses have been posited to elucidate the pathogenic mechanisms underlying these conditions. There is an emerging understanding of the distinct pathological processes that differentiate the various types of glaucoma. While some similarities in the mechanisms between PACG and POAG have been suggested, evidence indicates that there are also significant differences between the two. This review synthesizes the similarities and differences in the etiology of optic neuropathy caused by POAG and PACG, considering their respective pathophysiological mechanisms, the morphology of the optic disc and surrounding tissues, genetic characteristics, optical coherence tomography angiography, optical coherence tomography, and structural and functional features from VF examinations. These characteristics may contribute to a deeper comprehension of the underlying pathogenesis of glaucoma and enhance the management of different types of this ocular condition.
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Affiliation(s)
- Yiwei Wang
- Author Affiliations Department of Ophthalmology, Ruijin Hospital Affiliated Medical School, Shanghai Jiao tong University, Shanghai, 200025, People’s Republic of China
| | - Yanzhi Guo
- Author Affiliations Department of Ophthalmology, Ruijin Hospital Affiliated Medical School, Shanghai Jiao tong University, Shanghai, 200025, People’s Republic of China
| | - Yang Zhang
- Author Affiliations Department of Ophthalmology, Ruijin Hospital Affiliated Medical School, Shanghai Jiao tong University, Shanghai, 200025, People’s Republic of China
| | - Shouyue Huang
- Author Affiliations Department of Ophthalmology, Ruijin Hospital Affiliated Medical School, Shanghai Jiao tong University, Shanghai, 200025, People’s Republic of China
| | - Yisheng Zhong
- Author Affiliations Department of Ophthalmology, Ruijin Hospital Affiliated Medical School, Shanghai Jiao tong University, Shanghai, 200025, People’s Republic of China
- Author affiliations Department of Ophthalmology, Wuxi Branch of Ruijin Hospital Affiliated Medical School, Shanghai Jiao tong University, Wuxi, People’s Republic of China
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23
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Potop V, Dragosloveanu CDM, Ciocâlteu AM, Burcel MG, Marinescu MC, Dăscălescu DMC. The Mirror Theory: Parallels between Open Angle and Angle Closure Glaucoma. Life (Basel) 2024; 14:1154. [PMID: 39337937 PMCID: PMC11433309 DOI: 10.3390/life14091154] [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: 06/21/2024] [Revised: 08/19/2024] [Accepted: 09/09/2024] [Indexed: 09/30/2024] Open
Abstract
Glaucoma is a widespread ophthalmological disease, with a high impact and frequent visual morbidity. While the physiopathology of the two types of primary glaucoma (open angle and angle closure) has been studied, there seems to be little relationship between the two. In this study, we gather clinical and preclinical data to support the idea that the two primary glaucomas are "mirrored" in terms of morphological parameters and disease physiopathology. In short, primary angle closure glaucoma (PACG) is associated with hyperopia and low axial length, and primary open angle glaucoma (POAG) is associated with myopia and high axial length. Moreover, in PACG and in primary angle closure or primary angle closure suspect cases, while there is extensive iridotrabecular contact, the intraocular pressure (IOP) is still maintained in the lower half of the normal range throughout the evolution of the disease, which suggests a baseline trabecular hyperfiltration in PACG. In the opposite case, myopic eyes with open angles and a higher risk of developing POAG often have a baseline IOP in the upper half of the normal range, suggesting a baseline trabecular hypofiltration. As we explore clinical, genetic and animal model data regarding these opposing aspects, we hypothesize the existence of a mirroring relationship between PACG and POAG. Defining the relationship between the two potentially blinding diseases, with a high prevalence worldwide, may aid in understanding the mechanisms better and refining diagnosis and treatment. Thus, our theory has been named the Mirror Theory of Primary Glaucomas.
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Affiliation(s)
- Vasile Potop
- Ophthalmology Discipline, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Christiana Diana Maria Dragosloveanu
- Ophthalmology Discipline, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | - Alina Mihaela Ciocâlteu
- Ophthalmology Discipline, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
| | | | - Maria Cristina Marinescu
- Discipline Physiology III, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Dana Margareta Cornelia Dăscălescu
- Ophthalmology Discipline, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania
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24
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Del Prete S, Pagano M. Enzyme Inhibitors as Multifaceted Tools in Medicine and Agriculture. Molecules 2024; 29:4314. [PMID: 39339309 PMCID: PMC11433695 DOI: 10.3390/molecules29184314] [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: 08/01/2024] [Revised: 09/05/2024] [Accepted: 09/09/2024] [Indexed: 09/30/2024] Open
Abstract
Enzymes are molecules that play a crucial role in maintaining homeostasis and balance in all living organisms by catalyzing metabolic and cellular processes. If an enzyme's mechanism of action is inhibited, the progression of certain diseases can be slowed or halted, making enzymes a key therapeutic target. Therefore, identifying or developing enzyme inhibitors is essential for treating significant diseases and ensuring plant defense against pathogens. This review aims to compile information on various types of enzyme inhibitors, particularly those that are well studied and beneficial in both human and plant contexts, by analyzing their mechanisms of action and the resulting benefits. Specifically, this review focuses on three different types of enzyme inhibitors that are most studied, recognized, and cited, each with distinct areas of action and potential benefits. For instance, serine enzyme inhibitors in plants help defend against pathogens, while the other two classes-alpha-glucosidase inhibitors and carbonic anhydrase inhibitors-have significant effects on human health. Furthermore, this review is also intended to assist other researchers by providing valuable insights into the biological effects of specific natural or synthetic inhibitors. Based on the current understanding of these enzyme inhibitors, which are among the most extensively studied in the scientific community, future research could explore their use in additional applications or the development of synthetic inhibitors derived from natural ones. Such inhibitors could aid in defending against pathogenic organisms, preventing the onset of diseases in humans, or even slowing the growth of certain pathogenic microorganisms. Notably, carbonic anhydrase inhibitors have shown promising results in potentially replacing antibiotics, thereby addressing the growing issue of antibiotic resistance.
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Affiliation(s)
- Sonia Del Prete
- Institute of Biosciences and Bioresources (IBBR), National Research Council (CNR), Via Pietro Castellino 111, 80131 Naples, Italy
| | - Mario Pagano
- Institute of Research on Terrestrial Ecosystems (IRET), National Research Council (CNR), Via Madonna del Piano 10, Sesto Fiorentino, 50019 Florence, Italy
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25
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Boodram V, Lim H. Differential protection by nicotinamide in a mouse model of glaucoma DBA/2J revealed by second-harmonic generation microscopy. PLoS One 2024; 19:e0309400. [PMID: 39255314 PMCID: PMC11386466 DOI: 10.1371/journal.pone.0309400] [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: 04/17/2024] [Accepted: 08/12/2024] [Indexed: 09/12/2024] Open
Abstract
Glaucoma is a blinding disease where the retinal ganglion cells and their axons degenerate. Degradation of axonal microtubules is thought to play a critical role in the pathogenesis, but the mechanism is unknown. Here we investigate whether microtubule disruption in glaucoma can be alleviated by metabolic rescue. The integrity of axonal microtubules and the morphology of the retinal nerve fibers were evaluated by second-harmonic generation microscopy in a mouse model of glaucoma, DBA/2J, which received a dietary supplement of nicotinamide (NAM) for reducing metabolic stress. It was compared with control DBA/2J, which did not receive NAM, and non-glaucomatous DBA/2J-Gpnmb+. We found that the morphology of the retinal nerve fibers, but not axonal microtubules, are significantly protected by NAM. The decoupling is analogous to microtubule deficit, a glaucoma pathology in which axonal microtubules exhibit rapid degradation compared to the morphology of the retinal nerve fibers. Understanding microtubule deficit could provide insights into the divergent responses to NAM. From co-registered images of second-harmonic generation and immunofluorescence, it was determined that microtubule deficit was not due to a shortage of tubulins. Furthermore, microtubule deficit colocalized with the sectors in which the retinal ganglion cells were disconnected from the brain, suggesting that microtubule disruption is associated with axonal transport deficit in glaucoma. Together, our data suggests significant role axonal microtubules play in glaucomatous degeneration, offering a new opportunity for neuroprotection.
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Affiliation(s)
- Vinessia Boodram
- Department of Physics and Astronomy, Hunter College of the City University of New York, New York, NY, United States of America
| | - Hyungsik Lim
- Department of Physics and Astronomy, Hunter College of the City University of New York, New York, NY, United States of America
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26
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Pei K, Georgi M, Hill D, Lam CFJ, Wei W, Cordeiro MF. Review: Neuroprotective Nanocarriers in Glaucoma. Pharmaceuticals (Basel) 2024; 17:1190. [PMID: 39338350 PMCID: PMC11435059 DOI: 10.3390/ph17091190] [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: 07/12/2024] [Revised: 09/01/2024] [Accepted: 09/06/2024] [Indexed: 09/30/2024] Open
Abstract
Glaucoma stands as a primary cause of irreversible blindness globally, characterized by the progressive dysfunction and loss of retinal ganglion cells (RGCs). While current treatments primarily focus on controlling intraocular pressure (IOP), many patients continue to experience vision loss. Therefore, the research focus has shifted to therapeutic targets aimed at preventing or delaying RGC death and optic nerve degeneration to slow or halt disease progression. Traditional ocular drug administration, such as eye drops or oral medications, face significant challenges due to the eye's unique structural and physiological barriers, which limit effective drug delivery. Invasive methods like intravitreal injections can cause side effects such as bleeding, inflammation, and infection, making non-invasive delivery methods with high bioavailability very desirable. Nanotechnology presents a promising approach to addressing these limitations in glaucoma treatment. This review summarizes current approaches involving neuroprotective drugs combined with nanocarriers, and their impact for future use.
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Affiliation(s)
- Kun Pei
- UCL Institute of Ophthalmology, London EC1V 9EL, UK
| | - Maria Georgi
- St Mary's Hospital, Imperial College Healthcare NHS Trust, London W2 1NY, UK
- Department of Surgery & Cancer, Imperial College London, London SW7 5NG, UK
| | - Daniel Hill
- UCL Institute of Ophthalmology, London EC1V 9EL, UK
| | | | - Wei Wei
- Department of Surgery & Cancer, Imperial College London, London SW7 5NG, UK
- Imperial College Ophthalmic Research Group (ICORG) Unit, Imperial College, London NW1 5QH, UK
| | - Maria Francesca Cordeiro
- UCL Institute of Ophthalmology, London EC1V 9EL, UK
- Department of Surgery & Cancer, Imperial College London, London SW7 5NG, UK
- Imperial College Ophthalmic Research Group (ICORG) Unit, Imperial College, London NW1 5QH, UK
- Western Eye Hospital, London NW1 5QH, UK
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27
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Irnaten M, Gaynor E, O'Brien C. The Role of αvβ3 Integrin in Lamina Cribrosa Cell Mechanotransduction in Glaucoma. Cells 2024; 13:1487. [PMID: 39273058 PMCID: PMC11394537 DOI: 10.3390/cells13171487] [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: 06/27/2024] [Revised: 08/23/2024] [Accepted: 08/27/2024] [Indexed: 09/15/2024] Open
Abstract
Purpose: Glaucoma, one of the leading causes of irreversible blindness, is a common progressive optic neuropathy characterised by visual field defects and structural changes to the optic nerve head (ONH). There is extracellular matrix (ECM) accumulation and fibrosis of the lamina cribrosa (LC) in the ONH, and consequently increased tissue stiffness of the LC connective tissue. Integrins are cell surface proteins that provide the key molecular link connecting cells to the ECM and serve as bidirectional sensors transmitting signals between cells and their environment to promote cell adhesion, proliferation, and remodelling of the ECM. Here, we investigated the expression of αVβ3 integrin in glaucoma LC cell, and its effect on stiffness-induced ECM gene transcription and cellular proliferation rate in normal (NLC) and glaucoma (GLC) LC cells, by down-regulating αVβ3 integrin expression using cilengitide (a known potent αVβ3 and αVβ5 inhibitor) and β3 integrin siRNA knockdown. Methods: GLC cells were compared to age-matched controls NLC to determine differential expression levels of αVβ3 integrin, ECM genes (Col1A1, α-SMA, fibronectin, vitronectin), and proliferation rates. The effects of αVβ3 integrin blockade (with cilengitide) and silencing (with a pool of four predesigned αVβ3 integrin siRNAs) on ECM gene expression and proliferation rates were evaluated using both reverse transcription quantitative polymerase chain reaction (RT-qPCR) and Western blotting in the human NLC cells cultured on soft (4 kPa) and stiff (100 kPa) substrate and in GLC cells grown on standard plastic plates. Results: αVβ3 integrin gene and protein expression were enhanced (p < 0.05) in GLC cells as compared to NLC. Both cilengitide and siRNA significantly reduced αVβ3 expression in GLC. When NLC were grown in the stiff substrate, cilengitide and siRNA also significantly reduced the increased expression in αVβ3, ECM components, and proliferation rate. Conclusions: Here, we provide evidence of cilengitide- and siRNA-mediated silencing of αVβ3 integrin expression, and inhibition of ECM synthesis in LC cells. Therefore, αVβ3 integrin may be a promising target for the development of novel anti-fibrotic therapies for treating the LC cupping of the ONH in glaucoma.
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Affiliation(s)
- Mustapha Irnaten
- Clinical Research Centre, School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Ellen Gaynor
- Clinical Research Centre, School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Colm O'Brien
- Clinical Research Centre, School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland
- Department of Ophthalmology, Mater Misericordiae University Hospital, D07 R2WY Dublin, Ireland
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28
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Riina N, Harris A, Siesky BA, Ritzer L, Pasquale LR, Tsai JC, Keller J, Wirostko B, Arciero J, Fry B, Eckert G, Verticchio Vercellin A, Antman G, Sidoti PA, Guidoboni G. Using Multi-Layer Perceptron Driven Diagnosis to Compare Biomarkers for Primary Open Angle Glaucoma. Invest Ophthalmol Vis Sci 2024; 65:16. [PMID: 39250119 PMCID: PMC11385878 DOI: 10.1167/iovs.65.11.16] [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] [Indexed: 09/10/2024] Open
Abstract
Purpose To use neural network machine learning (ML) models to identify the most relevant ocular biomarkers for the diagnosis of primary open-angle glaucoma (POAG). Methods Neural network models, also known as multi-layer perceptrons (MLPs), were trained on a prospectively collected observational dataset comprised of 93 glaucoma patients confirmed by a glaucoma specialist and 113 control subjects. The base model used only intraocular pressure, blood pressure, heart rate, and visual field (VF) parameters to diagnose glaucoma. The following models were given the base parameters in addition to one of the following biomarkers: structural features (optic nerve parameters, retinal nerve fiber layer [RNFL], ganglion cell complex [GCC] and macular thickness), choroidal thickness, and RNFL and GCC thickness only, by optical coherence tomography (OCT); and vascular features by OCT angiography (OCTA). Results MLPs of three different structures were evaluated with tenfold cross validation. The testing area under the receiver operating characteristic curve (AUC) of the models were compared with independent samples t-tests. The vascular and structural models both had significantly higher accuracies than the base model, with the hemodynamic AUC (0.819) insignificantly outperforming the structural set AUC (0.816). The GCC + RNFL model and the model containing all structural and vascular features were also significantly more accurate than the base model. Conclusions Neural network models indicate that OCTA optic nerve head vascular biomarkers are equally useful for ML diagnosis of POAG when compared to OCT structural biomarker features alone.
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Affiliation(s)
- Nicholas Riina
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Alon Harris
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Brent A Siesky
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Lukas Ritzer
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - James C Tsai
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - James Keller
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, Missouri, United States
| | - Barbara Wirostko
- University of Utah Health John A Moran Eye Center, Salt Lake City, Utah, United States
| | - Julia Arciero
- Department of Mathematical Sciences, IUPUI School of Science, Indianapolis, Indiana, United States
| | - Brendan Fry
- Department of Mathematics and Statistics, Metropolitan State University of Denver, Denver, Colorado, United States
| | - George Eckert
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, Indiana, United States
| | | | - Gal Antman
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Central, Israel
- Faculty of Medicine, Tel Aviv University, Israel
| | - Paul A Sidoti
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- New York Eye and Ear Infirmary of Mount Sinai, New York, New York, United States
| | - Giovanna Guidoboni
- Maine College of Engineering and Computing, The University of Maine, Orono, Maine, United States
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29
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Lee HP, Tsung TH, Tsai YC, Chen YH, Lu DW. Glaucoma: Current and New Therapeutic Approaches. Biomedicines 2024; 12:2000. [PMID: 39335514 PMCID: PMC11429057 DOI: 10.3390/biomedicines12092000] [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: 06/25/2024] [Revised: 08/26/2024] [Accepted: 08/30/2024] [Indexed: 09/30/2024] Open
Abstract
Glaucoma is identified by the loss of retinal ganglion cells (RGCs). The primary approach to managing glaucoma is to control intraocular pressure (IOP). Lately, there has been an increasing focus on neuroprotective therapies for glaucoma because of the limited effectiveness of standard methods in reducing IOP and preventing ongoing vision deterioration in certain glaucoma patients. Various drug-based techniques with neuroprotective properties have demonstrated the ability to decrease the mortality of retinal ganglion cells. This study will analyze the currently recommended drug-based techniques for neuroprotection in the prospective treatment of glaucoma.
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Affiliation(s)
- Hsin-Pei Lee
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Ta-Hsin Tsung
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Yu-Chien Tsai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Department of Ophthalmology, Taoyuan Armed Forces General Hospital, Taoyuan 325, Taiwan
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Da-Wen Lu
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
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30
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Malewicz K, Pender A, Chabowski M, Jankowska-Polańska B. Impact of Sociodemographic and Psychological Factors on Adherence to Glaucoma Treatment - A Cross-Sectional Study. Clin Ophthalmol 2024; 18:2503-2520. [PMID: 39246554 PMCID: PMC11380480 DOI: 10.2147/opth.s475812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Accepted: 08/14/2024] [Indexed: 09/10/2024] Open
Abstract
Introduction Glaucoma is a group of eye diseases characterized by progressive and irreversible damage to the optic nerve. The aim of the study was to examine the impact of sociodemographic and psychological factors on adherence to glaucoma therapy. Methods The study was carried out among 190 adults treated for glaucoma at the Ophthalmology Outpatient Clinic of the University Teaching Hospital in Wroclaw between January 2019 and September 2019. Treatment adherence was measured using the Adherence to Refills and Medications Scale (ARMS). We used the Acceptance of Illness Scale (AIS), the Revised Life Orientation Test (LOT-R) and the Satisfaction with Life Scale (SWLS). Results 58.9% patients reported low treatment adherence. Educated females aged 68 or under living in cities had higher adherence. The regression analysis showed an association between dispositional optimism and glaucoma treatment adherence. The higher the level of dispositional optimism, the better the adherence. Higher dispositional optimism is directly associated with a sense of self-esteem and self-efficacy and a feeling of internal control. Patients reporting a high level of illness acceptance were found to have 2.5 times higher odds of adhering to glaucoma therapy. Illness acceptance is an indicator of the degree of adaptation to an illness and is positively correlated with a sense of self-esteem and self-efficacy and engagement in healthy behavior. Conclusion More than half of patients with glaucoma have low adherence. Sociodemographic characteristics (female gender, age 68 or under, tertiary education and living in an urban area) and psychological characteristics (high level of illness acceptance, dispositional optimism and satisfaction with life) are significant predictors of high adherence.
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Affiliation(s)
- Katarzyna Malewicz
- Division of Family and Pediatric Nursing, Department of Nursing and Obstetrics, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland
| | - Aleksandra Pender
- Student Research Group No. 180, Faculty of Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Mariusz Chabowski
- Department of Surgery, 4th Military Clinical Hospital, Wroclaw, Poland
- Department of Clinical Surgical Sciences, Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland
| | - Beata Jankowska-Polańska
- Department of Preclinical Sciences, Pharmacology and Medical Diagnostics, Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland
- Center for Research and Innovation, 4th Military Clinical Hospital, Wroclaw, 50-981, Poland
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Maria DN, Ibrahim MM, Kim MJ, Maria SN, White WA, Wang X, Hollingsworth TJ, Jablonski MM. Evaluation of Pregabalin bioadhesive multilayered microemulsion IOP-lowering eye drops. J Control Release 2024; 373:667-687. [PMID: 39079659 PMCID: PMC11384292 DOI: 10.1016/j.jconrel.2024.07.061] [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: 04/22/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024]
Abstract
In spite of available treatment options, glaucoma continues to be a leading cause of irreversible blindness in the world. Current glaucoma medications have multiple limitations including: lack of sustained action; requirement for multiple dosing per day, ocular irritation and limited options for drugs with different mechanisms of action. Previously, we demonstrated that pregabalin, a drug with high affinity and selectivity for CACNA2D1, lowered IOP in a dose-dependent manner. The current study was designed to evaluate pregabalin microemulsion eye drops and to estimate its efficacy in humans using in silico methods. Molecular docking studies of pregabalin against CACNA2D1 of mouse, rabbit, and human were performed. Pregabalin microemulsion eye drops were characterized using multiple in vivo studies and its stability was evaluated over one year at different storage conditions. Molecular docking analyses and QSPR of pregabalin confirmed its suitability as a new IOP-lowering medication that functions using a new mechanism of action by binding to CACNA2D1 in all species evaluated. Because of its prolonged corneal residence time and corneal penetration enhancement, a single topical application of pregabalin ME can provide an extended IOP reduction of more than day in different animal models. Repeated daily dosing for 2 months confirms the lack of any tachyphylactic effect, which is a common drawback among marketed IOP-lowering medications. In addition, pregabalin microemulsion demonstrated good physical stability for one year, and chemical stability for 3-6 months if stored below 25 °C. Collectively, these outcomes greatly support the use of pregabalin eye drops as once daily IOP-lowering therapy for glaucoma management.
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Affiliation(s)
- Doaa N Maria
- Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN 38163, United States; Department of Pharmaceutics, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Mohamed M Ibrahim
- Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN 38163, United States; Department of Pharmaceutics, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt
| | - Minjae J Kim
- Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Sara N Maria
- Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN 38163, United States; Department of Pharmaceutics, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt; Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - William A White
- Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - XiangDi Wang
- Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - T J Hollingsworth
- Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN 38163, United States
| | - Monica M Jablonski
- Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN 38163, United States; Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, Memphis, TN 38163, United States.
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Olyntho MAC, Jorge CAC, Castanha EB, Gonçalves AN, Silva BL, Nogueira BV, Lima GM, Gracitelli CPB, Tatham AJ. Artificial Intelligence in Anterior Chamber Evaluation: A Systematic Review and Meta-Analysis. J Glaucoma 2024; 33:658-664. [PMID: 38747721 DOI: 10.1097/ijg.0000000000002428] [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: 08/22/2023] [Accepted: 05/02/2024] [Indexed: 08/30/2024]
Abstract
PRCIS In this meta-analysis of 6 studies and 5269 patients, deep learning algorithms applied to AS-OCT demonstrated excellent diagnostic performance for closed angle compared with gonioscopy, with a pooled sensitivity and specificity of 94% and 93.6%, respectively. PURPOSE This study aimed to review the literature and compare the accuracy of deep learning algorithms (DLA) applied to anterior segment optical coherence tomography images (AS-OCT) against gonioscopy in detecting angle closure in patients with glaucoma. METHODS We performed a systematic review and meta-analysis evaluating DLA in AS-OCT images for the diagnosis of angle closure compared with gonioscopic evaluation. PubMed, Scopus, Embase, Lilacs, Scielo, and Cochrane Central Register of Controlled Trials were searched. The bivariate model was used to calculate pooled sensitivity and specificity. RESULTS The initial search identified 214 studies, of which 6 were included for final analysis. The total study population included 5269 patients. The combined sensitivity of the DLA compared with gonioscopy was 94.0% (95% CI: 83.8%-97.9%), whereas the pooled specificity was 93.6% (95% CI: 85.7%-97.3%). Sensitivity analyses removing each individual study showed a pooled sensitivity in the range of 90.1%-95.1%. Similarly, specificity results ranged from 90.3% to 94.5% with the removal of each individual study and recalculation of pooled specificity. CONCLUSION DLA applied to AS-OCT has excellent sensitivity and specificity in the identification of angle closure. This technology may be a valuable resource in the screening of populations without access to experienced ophthalmologists who perform gonioscopy.
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Affiliation(s)
| | - Carlos A C Jorge
- Department of Medicine, Federal University of Mato Grosso, Cuiabá-MT
| | | | - Andreia N Gonçalves
- Department of Technological Science, Virtual University of the State of São Paulo
| | | | | | - Geovana M Lima
- Department of Medicine, University of Gurupi, Gurupi-TO, Brazil
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Berberat J, Pircher A, Remonda L, Killer HE. Age related cerebrospinal fluid flow dynamics in the subarachnoid space of the optic nerve in patients with normal tension glaucoma, measured by diffusion weighted MRI. Eye (Lond) 2024; 38:2575-2580. [PMID: 38664515 PMCID: PMC11384767 DOI: 10.1038/s41433-024-03084-3] [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: 11/13/2023] [Revised: 04/03/2024] [Accepted: 04/11/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND/OBJECTIVES We aimed to measure cerebrospinal fluid (CSF) flow rates in the subarachnoid space (SAS) of the optic nerve (ON) by applying non-invasive diffusion-weighted MRI in patients with normal tension glaucoma (NTG) compared to age-matched controls. SUBJECTS/METHODS In this prospective study, an analysis of diffusion-weighted images of 26 patients with NTG (49ONs) and age-matched volunteers (52ONs) was conducted. Subjects were classified into 4 groups: group I (50-59 y., n = 12 eyes), group II (60-69 y., n = 16 eyes), group III (70-79 y., n = 18 eyes) and group IV ( > 80 y., n = 6 eyes) for NTGs and healthy volunteers, respectively. The flow-range ratio (FRR) between the frontal lobe SAS and the SAS of the ON was calculated for each age category group and then compared between age-categories as well as between NTGs and controls. RESULTS The mean FRR for age groups were (I) 0.54 ± 0.06 and 0.62 ± 0.03 (p < 0.05), (II) 0.56 ± 0.08 and 0.63 ± 0.03 (p < 0.05), (III) 0.54 ± 0.06 and 0.62 ± 0.02 (p < 0.001) as well as (IV) 0.61 ± 0.03 and 0.61 ± 0.04, for NTGs and controls, respectively. Using pooled data, the difference between the FRR in NTGs and controls was statistically significant (p < 0.0001). There were no statistically significant differences within the age categories of the control group. When comparing the FRR of NTGs by age categories, no statistically significant difference was found between the subgroups. CONCLUSIONS FRR was significantly reduced in NTGs compared to age-matched controls without any significant differences within the age groups themselves. Given the physiological importance of CSF for the integrity of neurons, axons and glial cells, reduced CSF flow dynamics might be part of the underlying neurodegenerative process of NTG.
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Affiliation(s)
- Jatta Berberat
- Institute of Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland.
| | - Achmed Pircher
- Department of Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Luca Remonda
- Institute of Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland
- Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Hanspeter E Killer
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Augenärzte Zentrum Aarau, Aarau, Switzerland
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Ghenciu LA, Șișu AM, Stoicescu ER, Dănilă AI, Iacob R, Săndesc MA, Hațegan OA. Thyroid Eye Disease and Glaucoma: A Cross-Sectional Study Comparing Clinical Characteristics and Disease Severity. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1430. [PMID: 39336471 PMCID: PMC11434148 DOI: 10.3390/medicina60091430] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 08/29/2024] [Accepted: 08/30/2024] [Indexed: 09/30/2024]
Abstract
Background and Objectives: This study investigates the relationship between thyroid eye disease (TED) and open-angle glaucoma (OAG), focusing on disease severity and clinical features. Materials and Methods: Conducted at the Timis County Emergency Clinical Hospital, the research included 106 patients, with 53 having both conditions and 53 having only OAG. Key metrics analyzed included intraocular pressure (IOP) using a Goldmann applanation tonometer, the retinal nerve fiber layer (RNFL) thickness, and optic nerve head (ONH) characteristics evaluated using optical coherence tomography (OCT). Results: Results indicated that patients with both TED and OAG experienced a 6.09% reduction in RNFL thickness and showed more rapid disease progression, with 48.35% having active TED. The mean IOP in TED patients was 27.5 ± 4.9 mmHg, which was similar to those with only OAG. Demographic factors, including age and gender, influenced the clinical course and disease severity. Conclusions: These findings underscore the importance of specialized monitoring and treatment strategies for patients with coexisting TED and OAG to prevent vision loss.
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Affiliation(s)
- Laura Andreea Ghenciu
- Department of Functional Sciences, 'Victor Babes' University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
- Center for Translational Research and Systems Medicine, 'Victor Babes' University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Alina Maria Șișu
- Department of Anatomy and Embriology, 'Victor Babes' University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Emil Robert Stoicescu
- Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, Faculty of Mechanics, 'Politehnica' University Timisoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania
- Department of Radiology and Medical Imaging, 'Victor Babes' University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
- Research Center for Pharmaco-Toxicological Evaluations, 'Victor Babes' University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Alexandra-Ioana Dănilă
- Department of Anatomy and Embriology, 'Victor Babes' University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Roxana Iacob
- Department of Anatomy and Embriology, 'Victor Babes' University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
- Field of Applied Engineering Sciences, Specialization Statistical Methods and Techniques in Health and Clinical Research, Faculty of Mechanics, 'Politehnica' University Timisoara, Mihai Viteazul Boulevard No. 1, 300222 Timisoara, Romania
- Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Mihai-Alexandru Săndesc
- Department of Orthopedics and Traumatology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Ovidiu Alin Hațegan
- Discipline of Anatomy and Embriology, Medicine Faculty, Vasile Goldis" Western University of Arad, Revolution Boulevard 94, 310025 Arad, Romania
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Oo HH, Hong ASY, Lim SY, Ang BCH. Angle-based minimally invasive glaucoma surgery in normal tension glaucoma: A systematic review and meta-analysis. Clin Exp Ophthalmol 2024; 52:740-760. [PMID: 38853535 DOI: 10.1111/ceo.14408] [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: 03/16/2024] [Accepted: 05/23/2024] [Indexed: 06/11/2024]
Abstract
BACKGROUND This systematic review and meta-analysis quantitatively examines the efficacy of angle-based minimally invasive glaucoma surgery (MIGS) in normal tension glaucoma (NTG). METHODS A literature search was performed on Medline, Embase, PubMed, CINAHL and Cochrane Library from inception until 20 December 2022. Pilot, cohort, observational studies and randomised controlled trials including at least 5 subjects undergoing angle-based MIGS (trabecular-bypass devices, excisional trabeculotomy, goniotomy and ab-interno canaloplasty) for NTG, with or without cataract surgery, were included. Meta-analysis of continuous outcome using the meta routine in R version 2022.12.0+353 was performed to determine mean intraocular pressure (IOP) and anti-glaucoma medication (AGM) reduction post-operatively. RESULTS Of the 846 studies initially identified, 15 studies with a pooled total of 367 eyes which underwent combined phacoemulsification and angle-based MIGS were included for final meta-analysis. Outcomes of the iStent were reported in 5 studies, iStent inject in 7 studies, Hydrus Microstent in 1 study, Kahook Dual Blade in 3 studies, and Trabectome in 2 studies. There was significant reduction in both IOP and AGM post-operatively at 6 months (2.44 mmHg, 95%CI: 1.83-3.06; 1.21 AGM, 95%CI: 0.99-1.44), 12 months (2.28 mmHg, 95%CI: 1.71-2.84; 1.18 AGM, 95%CI: 0.90-1.47), 24 months (2.10 mmHg, 95%CI: 1.51-2.68; 1.26 AGM, 95%CI: 0.85-1.68) and 36 months (2.43 mmHg, 95%CI: 1.71-3.15, 0.87 AGM, 95%CI: 0.21-1.53) (all p < 0.05). Subgroup analysis on combined phacoemulsification-iStent inject surgery demonstrated a reduction in both IOP (2.31 mmHg, 95%CI: 1.07-3.56, p < 0.001) and AGM (1.07 AGM, 95%CI: 0.86-1.29, p < 0.001) at 12 months post-operatively. CONCLUSIONS Angle-based MIGS combined with phacoemulsification effectively reduces IOP and AGM in NTG eyes for up to 36 months after surgery.
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Affiliation(s)
- Hnin Hnin Oo
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Sheng Yang Lim
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
| | - Bryan Chin Hou Ang
- Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Ophthalmology, National Healthcare Group Eye Institute, Woodlands Health, Singapore, Singapore
- Department of Ophthalmology, Mayo Clinic, Jacksonville, Florida, USA
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Tan SS, Tun TA, Aung T, Nongpiur ME. Comparison of intraocular pressure and anterior segment parameters in subjects with asymmetrical primary angle closure disease. Clin Exp Ophthalmol 2024; 52:724-731. [PMID: 38803136 DOI: 10.1111/ceo.14402] [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: 02/04/2024] [Revised: 04/17/2024] [Accepted: 05/11/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND To compare intraocular pressure (IOP) and anterior segment parameters between eyes with unilateral primary angle closure glaucoma (PACG) and their fellow eyes with primary angle closure (PAC) or primary angle closure suspect (PACS). METHODS Subjects underwent anterior segment imaging using 360-degree swept-source optical coherence tomography (SS-OCT, CASIA Tomey, Nagoya, Japan) and ocular investigations including gonioscopy and IOP measurement. Each SS-OCT scan (divided into 8 frames, 22.5 degrees apart) was analysed and an average was obtained for the following anterior segment parameters: iridotrabecular contact (ITC), angle opening distance (AOD750), iris thickness and curvature, anterior chamber width, depth and area (ACW, ACD and ACA) and lens vault (LV). RESULTS Among 132 unilateral PACG subjects (mean age: 62.91 ± 7.2 years; 59.1% male), eyes with PACG had significantly higher presenting IOP (24.81 ± 0.94 vs. 18.43 ± 0.57 mmHg, p < 0.001), smaller gonioscopic Shaffer grade (2.07 ± 0.07 vs. 2.31 ± 0.07, p < 0.001) and a greater extent of peripheral anterior synechiae (PAS, 1.21 ± 0.21 vs. 0.54 ± 0.16 clock hours, p = 0.001). PACG eyes also exhibited increased ITC, ITC area, greater LV and smaller AOD750, ACD and ACA (all p < 0.05). Using the forward stepwise regression model, an increase in 1 mmHg in presenting IOP before laser peripheral iridotomy (LPI) increases the odds of having PACG by 9% (95% confidence interval 5%-14%). CONCLUSIONS PACG eyes have higher presenting IOP, smaller anterior segment parameters, greater extent of PAS, and larger LV compared to their fellow eyes with angle closure. Narrower anterior chamber dimensions and higher presenting IOP before LPI may increase risk of chronic elevated IOP and glaucomatous optic neuropathy after LPI.
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Affiliation(s)
- Shayne S Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Tin A Tun
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Monisha E Nongpiur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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Liu CK, Ali O, Murdoch I, Simon J. Proportion of Angle Closure Glaucoma in Tamale, Ghana. J Glaucoma 2024; 33:709-714. [PMID: 38551403 DOI: 10.1097/ijg.0000000000002383] [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: 08/27/2023] [Accepted: 02/29/2024] [Indexed: 08/30/2024]
Abstract
PRCIS In the largest clinic-based study to date, our review of 588 patients presenting with glaucoma in Northern Ghana revealed 36% of these had primary angle closure glaucoma (PACG). OBJECTIVE Glaucoma is the second leading cause of blindness worldwide. In Africa, glaucoma is an established public health problem, and PACG is not commonly discussed. Recognizing it is important because of its negative impact on visual morbidity, and also because its treatment is different from primary open angle glaucoma. In response to the observation of many PACG cases at the Northern Community Eye Hospital in Tamale, Ghana, we investigated the proportion of those attending with a first diagnosis of glaucoma who had PACG. PATIENTS AND METHODS Using the electronic records, we identified 976 patients who attended with a first diagnosis of glaucoma between January 2021 and October 2022. Of these, 588 met the inclusion criterion of a clear glaucoma subtype diagnosis. RESULTS Of these 316 (53.7%) had primary open angle glaucoma, 210 (35.7%) PACG, and 62 (10.5%) secondary glaucoma. Thus, over a third of presenting glaucomas had PACG. CONCLUSION This study highlights that PACG is present in about a third of patients presenting to our clinic in North Ghana. Our study demonstrates the importance of a clear diagnostic pathway including gonioscopy in the assessment of glaucoma patients and the consideration of wider training on angle closure glaucoma diagnosis and management.
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Affiliation(s)
- Catherine K Liu
- Wills Eye Hospital Center for Academic Global Ophthalmology, Thomas Jefferson University, Philadelphia, PA
| | - Omair Ali
- Wills Eye Hospital Center for Academic Global Ophthalmology, Thomas Jefferson University, Philadelphia, PA
| | - Ian Murdoch
- Moorfields Eye Hospital, Department of Glaucoma, London, UK
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Wu SM, Pang JJ. Effects of elevated intraocular pressure on alpha ganglion cells in experimental glaucoma mice. Vision Res 2024; 224:108475. [PMID: 39217910 DOI: 10.1016/j.visres.2024.108475] [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: 06/28/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024]
Abstract
Glaucoma is a leading cause of blindness worldwide and glaucoma patients exhibit an early diffuse loss of retinal sensitivity followed by focal loss of RGCs. Combining some previous published results and some new data, this paper provides our current view on how high IOP (H-IOP) affects the light response sensitivity of a subset of RGCs, the alpha-ganglion cells (αGCs), as well as their presynaptic bipolar cells (DBCs and HBCs) and A2 amacrine cells (AIIACs) in dark-adapted mouse retinas. Our data demonstrate that H-IOP in experimental glaucoma mice significantly decreases light-evoked spike response sensitivity of sONαGCs and sOFFαGCs (i.e., raises thresholds by 1.5-2.5 log units), but not that of the tONαGCs and tOFFαGCs. The sensitivity loss in sONαGCs and sOFFαGCs is mediated by a H-IOP induced suppression of AIIAC response which is caused by a decrease of transmission efficacy of the DBCR→AIIAC synapse. We also provide evidence supporting the hypothesis that BK channels in the A17AC→DBCR feedback synapse are the H-IOP sensor that regulates the DBCR→AIIAC synaptic efficacy, as BK channel blocker IBTX mimics the action of H-IOP. Our results provide useful information for designing strategies for early detection and possible treatments of glaucoma as physiological changes occur before irreversible structural damage.
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Affiliation(s)
- Samuel M Wu
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, United States.
| | - Ji-Jie Pang
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, United States
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Lee JS, Park HJ, Kang SO, Lee SH, Lee CK. The effects of light emitting diodes on mitochondrial function and cellular viability of M-1 cell and mouse CD1 brain cortex neurons. PLoS One 2024; 19:e0306656. [PMID: 39213294 PMCID: PMC11364243 DOI: 10.1371/journal.pone.0306656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 06/20/2024] [Indexed: 09/04/2024] Open
Abstract
The invention of Light Emitting Diode (LED) revolutionized energy-efficient illumination, but concerns persist regarding the potential harm of blue light to our eyes. In this study, we scrutinized the impact of LED light characteristics on eyes using two cell types: M-1 (rich in mitochondria) and CD-1 (neuronal). Variations in color rendering index (CRI) and correlated color temperature (CCT) were investigated, alongside exposure durations ranging from 0 to 24 hours. The findings illuminated the potential benefits of high-quality LED lighting, characterized by a high CRI and low CCT, which emits a greater proportion of red light. This form of lighting was associated with enhanced cell proliferation, elevated ATP levels, and reduced oxidative stress. In contrast, LEDs with low CRI and high CCT exhibited adverse effects, diminishing cell viability and increasing oxidative stress. These results suggest that high-quality LED lighting may have neuroprotective potential as a treatment option, such as for retinal ganglion cells.
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Affiliation(s)
- Jong Soo Lee
- Department of Ophthalmology, Pusan National University College of Medicine, Busan, Korea
| | - Hyun Jin Park
- Biomedical Research Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Sang Ook Kang
- Department of Advanced Materials Chemistry, Korea University, Sejong, Korea
| | - Sang Hak Lee
- Department of Chemistry, Pusan National University, Busan, Korea
| | - Chang Kyu Lee
- Biomedical Research Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- Department of Ophthalmology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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Su CC, Liu C, Adi V, Chan KC, Tseng HC. Age-related effects of optineurin deficiency in the mouse eye. Vision Res 2024; 224:108463. [PMID: 39208752 DOI: 10.1016/j.visres.2024.108463] [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: 06/01/2024] [Revised: 07/30/2024] [Accepted: 07/30/2024] [Indexed: 09/04/2024]
Abstract
Optineurin (OPTN) is a gene associated with familial normal tension glaucoma (NTG). While NTG involves intraocular pressure (IOP)-independent neurodegeneration of the visual pathway that progresses with age, how OPTN dysfunction leads to NTG remains unclear. Here, we generated an OPTN knockout mouse (Optn-/-) model to test the hypothesis that a loss-of-function mechanism induces structural and functional eye deterioration with aging. Eye anatomy, visual function, IOP, retinal histology, and retinal ganglion cell survival were compared to littermate wild-type (WT) control mice. Consistent with OPTN's role in NTG, loss of OPTN did not increase IOP or alter gross eye anatomy in young (2-3 months) or aged (12 months) mice. When retinal layers were quantitated, young Optn-/- mice had thinner retina in the peripheral regions than young WT mice, primarily due to thinner ganglion cell-inner plexiform layers. Despite this, visual function in Optn-/- mice was not severely impaired, even with aging. We also assessed relative abundance of retinal cell subtypes, including amacrine cells, bipolar cells, cone photoreceptors, microglia, and astrocytes. While many of these cellular subtypes were unaffected by Optn deletion, more dopaminergic amacrine cells were observed in aged Optn-/- mice. Taken together, our findings showed that complete loss of Optn resulted in mild retinal changes and less visual function impairment, supporting the possibility that OPTN-associated glaucoma does not result from a loss-of-function disease mechanism. Further research using these Optn mice will elucidate detailed molecular pathways involved in NTG and identify clinical or environmental risk factors that can be targeted for glaucoma treatment.
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Affiliation(s)
- Chien-Chia Su
- Duke Eye Center, Department of Ophthalmology, Duke University Medical Center, Durham, NC 27710, USA; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan
| | - Crystal Liu
- Departments of Ophthalmology and Radiology, Neuroscience Institute, and Tech4Health Institute, New York University Grossman School of Medicine, New York, NY 10017, USA
| | - Vishnu Adi
- Departments of Ophthalmology and Radiology, Neuroscience Institute, and Tech4Health Institute, New York University Grossman School of Medicine, New York, NY 10017, USA
| | - Kevin C Chan
- Departments of Ophthalmology and Radiology, Neuroscience Institute, and Tech4Health Institute, New York University Grossman School of Medicine, New York, NY 10017, USA; Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY 11201, USA
| | - Henry C Tseng
- Duke Eye Center, Department of Ophthalmology, Duke University Medical Center, Durham, NC 27710, USA.
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Erb C, Erb C, Kazakov A, Kapanova G, Weisser B. Lifestyle Changes in Aging and their Potential Impact on POAG. Klin Monbl Augenheilkd 2024. [PMID: 39191386 DOI: 10.1055/a-2372-3505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
Primary open angle glaucoma is a primary mitochondrial disease with oxidative stress triggering neuroinflammation, eventually resulting in neurodegeneration. This affects many other areas of the brain in addition to the visual system. Aging also leads to inflammaging - a low-grade chronic inflammatory reaction in mitochondrial dysfunction, so these inflammatory processes overlap in the aging process and intensify pathophysiological processes associated with glaucoma. Actively counteracting these inflammatory events involves optimising treatment for any manifest systemic diseases while maintaining chronobiology and improving the microbiome. Physical and mental activity also provides support. This requires a holistic approach towards optimising neurodegeneration treatment in primary open angle glaucoma in addition to reducing intraocular pressure according personalised patient targets.
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Affiliation(s)
- Carl Erb
- Augenklinik am Wittenbergplatz, Berlin, Deutschland
| | | | - Avaz Kazakov
- External Relations and Development, Salymbekov University, Bishkek, Kyrgyzstan
| | - Gulnara Kapanova
- Medical Faculty of Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
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Li M, Li Z, Xiang F, Li C, Zhang Y, Li S. Correlation between choroidal parameters and primary angle-closure suspect in different age groups. BMJ Open Ophthalmol 2024; 9:e001772. [PMID: 39179254 PMCID: PMC11344506 DOI: 10.1136/bmjophth-2024-001772] [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: 05/13/2024] [Accepted: 07/27/2024] [Indexed: 08/26/2024] Open
Abstract
OBJECTIVE To investigate the correlations between choroidal parameters and primary angle-closure suspect (PACS) in different age subgroups. METHODS AND ANALYSIS Participants aged 50 years or older in a rural area of Daxing District, Beijing, were recruited. Swept-source optical coherence tomography was used to measure the choroidal parameters. Demographic, ocular biometry parameters and choroidal parameters were compared between the PACS and non-PACS (NPACS) eyes. Logistic analysis was performed to explore the association between the choroidal parameters and PACS. RESULTS 192 (26.89%) subjects with PACS and 509 (71.29%) with PACS were analysed. Subjects were divided into two groups: group 1 (50-60 years, n=286) and group 2 (>60 years, n=415). In group 1, the mean subfoveal choroidal thickness of PACS eyes was 341.82±88.23 µm and thicker than NPACS eyes (315.07±83.53 µm, p=0.035). The choroidal volume was greater in PACS eyes (10.61±2.78 mm3) compared with NPACS eyes (9.66±2.49 mm3, p=0.013). In group 2, no significant difference in any choroidal parameters between PACS and NPACS was found. Multivariate regression demonstrated that increased choroidal volume was associated with PACS (OR 1.298, 95% CI 1.117 to 1.510, p<0.001) in group 1. CONCLUSIONS In the age group of 50-60 years, PACS eyes had greater choroidal thickness and volume than NPACS eyes, and the increased total choroidal volume was a predisposing factor for PACS. TRIAL REGISTRATION NUMBER ChiCTR2000037944.
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Affiliation(s)
- Mengyang Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Zhi Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Fei Xiang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Caixia Li
- Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, Shaanxi, China
| | - Ye Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
| | - Shuning Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing, China
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Lai JY, Mclarnon P, Sheridan C, Vallabh NA. Evaluating the impact of caloric restriction, body mass index and exercise on primary open-angle glaucoma: A review. Eur J Ophthalmol 2024:11206721241274445. [PMID: 39169764 DOI: 10.1177/11206721241274445] [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: 08/23/2024]
Abstract
This literature review evaluates any possible links between primary open-angle glaucoma (POAG) and caloric restriction (CR), body mass index (BMI), and exercise, aiming to map the extent of the literature. Its primary objective is to recognise the nature and breadth of research evidence, identify possible gaps in these topics and develop future studies. The databases searched were MEDLINE (PudMed), Scopus and ScienceDirect, in April 2023 for articles published in English, with no date restriction. A total of 447 search results were retrieved. Of these, 73 were related to CR, 249 to BMI, and 125 to exercise. Records identified included systematic reviews, meta-analyses, randomised controlled trials, cohort studies and animal studies. CR has been shown to halt the degeneration of retinal ganglion cells and protect against various glaucomatous processes in animal models. Low BMI has been shown to be associated with an increased risk of POAG and a faster rate of visual field deterioration in POAG. However, the association between high BMI and POAG is not consistent. Exercise has been shown to cause mechanical, vascular, and neurobiological changes affecting the pathophysiology of POAG. The present review helps identify key characteristics and factors relating to the impacts of CR, BMI, or exercise on POAG.
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Affiliation(s)
- Jonathan Ym Lai
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Patrick Mclarnon
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Carl Sheridan
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Neeru A Vallabh
- St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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Yuan W, Li J, Gao S, Sun W, Zhao F. Novel therapeutic targets for primary open-angle glaucoma identified through multicenter proteome-wide mendelian randomization. Front Pharmacol 2024; 15:1428472. [PMID: 39221148 PMCID: PMC11362091 DOI: 10.3389/fphar.2024.1428472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024] Open
Abstract
Background This study aimed to identify novel therapeutic targets for primary open-angle glaucoma (POAG). Methods The summary-data-based Mendelian randomization (SMR) method was used to evaluate the genetic association between plasma proteins and POAG. Two sets of plasma protein quantitative trait loci (pQTLs) data considered exposures were obtained from the Icelandic Decoding Genetics Study and UK Biobank Pharma Proteomics Project. The summary-level genome-wide association studies data for POAG were extracted from the latest Round 10 release of the FinnGen consortium (8,530 cases and 391,275 controls) and the UK Biobank (4,737 cases and 458,196 controls). Colocalization analysis was used to screen out pQTLs that share the same variant with POAG as drug targets identified. The two-sample Mendelian randomization, reverse causality testing and phenotype scanning were performed to further validate the main findings. Protein-protein interaction, pathway enrichment analysis and druggability assessment were conducted to determine whether the identified plasma proteins have potential as drug targets. Results After systematic analysis, this study identified eight circulating proteins as potential therapeutic targets for POAG. Three causal proteins with strong evidence of colocalization, ROBO1 (OR = 1.38, p = 1.48 × 10-4, PPH4 = 0.865), FOXO3 (OR = 0.35, p = 4.34 × 10-3, PPH4 = 0.796), ITIH3 (OR = 0.89, p = 2.76 × 10-4, PPH4 = 0.767), were considered tier one targets. Five proteins with medium support evidence of colocalization, NCR1 (OR = 1.25, p = 4.18 × 10-4, PPH4 = 0.682), NID1 (OR = 1.38, p = 1.54 × 10-3, PPH4 = 0.664), TIMP3 (OR = 0.91, p = 4.01 × 10-5, PPH4 = 0.659), SERPINF1 (OR = 0.81, p = 2.77 × 10-4, PPH4 = 0.59), OXT (OR = 1.17, p = 9.51 × 10-4, PPH4 = 0.526), were classified as tier two targets. Additional sensitivity analyses further validated the robustness and directionality of these findings. According to druggability assessment, Pimagedine, Resveratrol, Syringaresinol and Clozapine may potentially be important in the development of new anti-glaucoma agents. Conclusion Our integrated study identified eight potential associated proteins for POAG. These proteins play important roles in neuroprotection, extracellular matrix regulation and oxidative stress. Therefore, they have promising potential as therapeutic targets to combat POAG.
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Affiliation(s)
- Weichen Yuan
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
- Key Lens Research Laboratory of Liaoning Province, Shenyang, China
| | - Jun Li
- Department of Ultrasonography, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shang Gao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
- Key Lens Research Laboratory of Liaoning Province, Shenyang, China
| | - Wei Sun
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
- Key Lens Research Laboratory of Liaoning Province, Shenyang, China
| | - Fangkun Zhao
- Department of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
- Key Lens Research Laboratory of Liaoning Province, Shenyang, China
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Millington-Ward S, Palfi A, Shortall C, Finnegan LK, Bargroff E, Post IJM, Maguire J, Irnaten M, O′Brien C, Kenna PF, Chadderton N, Farrar GJ. AAV-NDI1 Therapy Provides Significant Benefit to Murine and Cellular Models of Glaucoma. Int J Mol Sci 2024; 25:8876. [PMID: 39201561 PMCID: PMC11354491 DOI: 10.3390/ijms25168876] [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: 07/09/2024] [Revised: 08/02/2024] [Accepted: 08/04/2024] [Indexed: 09/02/2024] Open
Abstract
Glaucoma, a leading cause of blindness, is a multifactorial condition that leads to progressive loss of retinal ganglion cells (RGCs) and vision. Therapeutic interventions based on reducing ocular hypertension are not always successful. Emerging features of glaucoma include mitochondrial dysfunction and oxidative stress. In the current study, NDI1-based gene therapy, which improves mitochondrial function and reduces reactive oxygen species, was delivered intraocularly via an adeno-associated viral vector (AAV). This AAV-NDI1 therapy protected RGCs from cell death in treated (1552.4 ± 994.0 RGCs/mm2) versus control eyes (1184.4 ± 978.4 RGCs/mm2, p < 0.05) in aged DBA/2J mice, a murine model of glaucoma. The photonegative responses (PhNRs) of RGCs were also improved in treated (6.4 ± 3.3 µV) versus control eyes (5.0 ± 3.1 µV, p < 0.05) in these mice. AAV-NDI1 also provided benefits in glaucomatous human lamina cribrosa (LC) cells by significantly increasing basal and maximal oxygen consumption rates and ATP production in these cells. Similarly, NDI1 therapy significantly protected H2O2-insulted primary porcine LC cells from oxidative stress. This study highlights the potential utility of NDI1 therapies and the benefits of improving mitochondrial function in the treatment of glaucoma.
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Affiliation(s)
- Sophia Millington-Ward
- The School of Genetics and Microbiology, Smurfit Institute of Genetics, Trinity College Dublin, Dublin 2, D02VF25 Dublin, Ireland; (A.P.); (C.S.); (L.K.F.); (E.B.); (I.J.M.P.); (P.F.K.); (G.J.F.)
| | - Arpad Palfi
- The School of Genetics and Microbiology, Smurfit Institute of Genetics, Trinity College Dublin, Dublin 2, D02VF25 Dublin, Ireland; (A.P.); (C.S.); (L.K.F.); (E.B.); (I.J.M.P.); (P.F.K.); (G.J.F.)
| | - Ciara Shortall
- The School of Genetics and Microbiology, Smurfit Institute of Genetics, Trinity College Dublin, Dublin 2, D02VF25 Dublin, Ireland; (A.P.); (C.S.); (L.K.F.); (E.B.); (I.J.M.P.); (P.F.K.); (G.J.F.)
| | - Laura K. Finnegan
- The School of Genetics and Microbiology, Smurfit Institute of Genetics, Trinity College Dublin, Dublin 2, D02VF25 Dublin, Ireland; (A.P.); (C.S.); (L.K.F.); (E.B.); (I.J.M.P.); (P.F.K.); (G.J.F.)
| | - Ethan Bargroff
- The School of Genetics and Microbiology, Smurfit Institute of Genetics, Trinity College Dublin, Dublin 2, D02VF25 Dublin, Ireland; (A.P.); (C.S.); (L.K.F.); (E.B.); (I.J.M.P.); (P.F.K.); (G.J.F.)
| | - Iris J. M. Post
- The School of Genetics and Microbiology, Smurfit Institute of Genetics, Trinity College Dublin, Dublin 2, D02VF25 Dublin, Ireland; (A.P.); (C.S.); (L.K.F.); (E.B.); (I.J.M.P.); (P.F.K.); (G.J.F.)
| | - John Maguire
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin 2, D02XK51 Dublin, Ireland;
| | - Mustapha Irnaten
- UCD Clinical Research Centre, Mater Misericordiae University Hospital, Dublin 7, D07K201 Dublin, Ireland; (M.I.); (C.O.)
| | - Colm O′Brien
- UCD Clinical Research Centre, Mater Misericordiae University Hospital, Dublin 7, D07K201 Dublin, Ireland; (M.I.); (C.O.)
| | - Paul F. Kenna
- The School of Genetics and Microbiology, Smurfit Institute of Genetics, Trinity College Dublin, Dublin 2, D02VF25 Dublin, Ireland; (A.P.); (C.S.); (L.K.F.); (E.B.); (I.J.M.P.); (P.F.K.); (G.J.F.)
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin 2, D02XK51 Dublin, Ireland;
| | - Naomi Chadderton
- The School of Genetics and Microbiology, Smurfit Institute of Genetics, Trinity College Dublin, Dublin 2, D02VF25 Dublin, Ireland; (A.P.); (C.S.); (L.K.F.); (E.B.); (I.J.M.P.); (P.F.K.); (G.J.F.)
| | - G. Jane Farrar
- The School of Genetics and Microbiology, Smurfit Institute of Genetics, Trinity College Dublin, Dublin 2, D02VF25 Dublin, Ireland; (A.P.); (C.S.); (L.K.F.); (E.B.); (I.J.M.P.); (P.F.K.); (G.J.F.)
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Lin WY, Wang JJ, Chen CY, Liu CY, Lin MH, Yang YH, Lai CH. The Relationship Between Carotid Artery Stenosis and the Development of Open-Angle Glaucoma: A Long-term Cohort Study in Taiwan. Ophthalmic Epidemiol 2024:1-9. [PMID: 39146467 DOI: 10.1080/09286586.2024.2371467] [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: 11/21/2023] [Revised: 05/28/2024] [Accepted: 06/18/2024] [Indexed: 08/17/2024]
Abstract
PURPOSES To determine the relationship between carotid artery stenosis (CAS) and the development of open-angle glaucoma (OAG) in the Taiwanese population. METHODS This retrospective cohort study was conducted using Chang Gung Research Database. Cox-proportional hazards model was applied to calculate the hazard ratio for OAG between CAS and the control cohort. RESULTS Among 19,590 CAS patients, 17,238 had mild CAS (<50%), 1,895 had moderate CAS (50-69%), and 457 had severe CAS (≥70%). The CAS cohort had a higher proportion of several comorbidities. After adjusting for comorbidities, no significant difference in OAG development was found between CAS and control cohorts. Matching for key comorbidities, no significant differences in OAG incidence were found between matched cohorts (P = .869). Subdividing the matched CAS cohort by stenosis severity: mild (<50%), moderate (50-69%), and severe (≥70%), a statistically significantly lower OAG risk was observed in patients with mild CAS stenosis (HR: 1.12, 95% CI = 1.03-1.21, P = .006). Kaplan-Meier analysis revealed reduced OAG incidence in CAS patients who underwent surgical intervention, compared to the control cohort (P <.001). Subgroup analysis revealed that patients in the mild CAS stenosis group, those who underwent surgical intervention exhibited a reduced OAG risk (HR: 0.29, 95% CI = 0.15-0.58, P = .001). CONCLUSIONS No statistically significant differences in OAG risk were observed between patients with CAS and the control cohort. The severity of CAS appears to influence OAG risk, with surgical intervention potentially offering protective effects, particularly in patients with mild CAS stenosis (<50%), suggesting that enhanced ocular perfusion post-surgery may act as a protective factor against OAG development.
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Affiliation(s)
- Wen-Yun Lin
- Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Jin-Jhe Wang
- Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Ophthalmology, College of Medicine, Chang Gung University, Linkuo, Taiwan
| | - Chauyin-Yin Chen
- Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Ophthalmology, College of Medicine, Chang Gung University, Linkuo, Taiwan
| | - Chia-Yen Liu
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Meng-Hung Lin
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Hsu Yang
- Health Information and Epidemiology Laboratory, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chien-Hsiung Lai
- Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Ophthalmology, College of Medicine, Chang Gung University, Linkuo, Taiwan
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Zhang Y, Zhang X, Zhang Q, Lv B, Hu M, Lv C, Ni Y, Xie G, Li S, Zebardast N, Shweikh Y, Wang N. Automated classification of angle-closure mechanisms based on anterior segment optical coherence tomography images via deep learning. Heliyon 2024; 10:e35236. [PMID: 39166052 PMCID: PMC11334645 DOI: 10.1016/j.heliyon.2024.e35236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/22/2024] Open
Abstract
Purpose To develop and validate deep learning algorithms that can identify and classify angle-closure (AC) mechanisms using anterior segment optical coherence tomography (AS-OCT) images. Methods This cross-sectional study included participants of the Handan Eye Study aged ≥35 years with AC detected via gonioscopy or on the AS-OCT images. These images were classified by human experts into the following to indicate the predominant AC mechanism (ground truth): pupillary block, plateau iris configuration, or thick peripheral iris roll. A deep learning architecture, known as comprehensive mechanism decision net (CMD-Net), was developed to simulate the identification of image-level AC mechanisms by human experts. Cross-validation was performed to optimize and evaluate the model. Human-machine comparisons were conducted using a held-out and separate test sets to establish generalizability. Results In total, 11,035 AS-OCT images of 1455 participants (2833 eyes) were included. Among these, 8828 and 2.207 images were included in the cross-validation and held-out test sets, respectively. A separate test was formed comprising 228 images of 35 consecutive patients with AC detected via gonioscopy at our eye center. In the classification of AC mechanisms, CMD-Net achieved a mean area under the receiver operating characteristic curve (AUC) of 0.980, 0.977, and 0.988 in the cross-validation, held-out, and separate test sets, respectively. The best-performing ophthalmologist achieved an AUC of 0.903 and 0.891 in the held-out and separate test sets, respectively. And CMD-Net outperformed glaucoma specialists, achieving an accuracy of 89.9 % and 93.0 % compared to 87.0 % and 86.8 % for the best-performing ophthalmologist in the held-out and separate test sets, respectively. Conclusions Our study suggests that CMD-Net has the potential to classify AC mechanisms using AS-OCT images, though further validation is needed.
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Affiliation(s)
- Ye Zhang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology & Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | | | - Qing Zhang
- Beijing Institute of Ophthalmology, Beijing, China
| | - Bin Lv
- Ping an Healthcare Technology, Beijing, China
| | - Man Hu
- National Key Discipline of Pediatrics, Ministry of Education, Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, China
| | | | - Yuan Ni
- Ping an Healthcare Technology, Beijing, China
| | - Guotong Xie
- Ping an Healthcare Technology, Beijing, China
- Ping an Health Cloud Company Limited, Shenzhen, China
- Ping an International Smart City Technology Company Limited, Shenzhen, China
| | - Shuning Li
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology & Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Nazlee Zebardast
- Massachusetts Eye and Ear Infirmary, Harvard Medical School Department of Ophthalmology, Boston, MA, USA
| | - Yusrah Shweikh
- Massachusetts Eye and Ear Infirmary, Harvard Medical School Department of Ophthalmology, Boston, MA, USA
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Sussex, UK
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology & Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing, China
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48
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de Vries VA, Hanyuda A, Vergroesen JE, Do R, Friedman DS, Kraft P, Turman C, Luo YL, Tran JH, Liefers B, Wong SH, Lee RH, Zebardast N, Klaver CCW, Segrè AV, Pasquale LR, Wiggs JL, Kang JH, Ramdas WD. The Clinical Usefulness of a Glaucoma Polygenic Risk Score in 4 Population-Based European Ancestry Cohorts. Ophthalmology 2024:S0161-6420(24)00464-0. [PMID: 39128550 DOI: 10.1016/j.ophtha.2024.08.005] [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: 04/19/2024] [Revised: 07/19/2024] [Accepted: 08/05/2024] [Indexed: 08/13/2024] Open
Abstract
PURPOSE We used a polygenic risk score (PRS) to identify high-risk groups for primary open-angle glaucoma (POAG) within population-based cohorts. DESIGN Secondary analysis of 4 prospective population-based studies. PARTICIPANTS We included four European-ancestry cohorts: the United States-based Nurses' Health Study, Nurses' Health Study 2, and the Health Professionals Follow-up Study and the Rotterdam Study (RS) in The Netherlands. The United States cohorts included female nurses and male health professionals ≤ 55 years of age. The RS included residents ≤ 45 years of age living in Rotterdam, The Netherlands. METHODS Polygenic risk score weights were estimated by applying the lassosum method on imputed genotype and phenotype data from the UK Biobank. This resulted in 144 020 variants, single nucleotide polymorphism and insertions or deletions, with nonzero βs that we used to calculate a PRS in the target populations. Using multivariable Cox proportional hazard models, we estimated the relationship between the standardized PRS and relative risk for POAG. Additionally, POAG prediction was tested by calculating these models' concordance (Harrell's C statistic). Finally, we assessed the association between PRS tertiles and glaucoma-related traits. MAIN OUTCOME MEASURES The relative risk for POAG and Harrell's C statistic. RESULTS Among 1046 patients and 38 809 control participants, the relative risk (95% confidence interval) for POAG for participants in the highest PRS quintile was 3.99 (3.08-5.18) times higher in the United States cohorts and 4.89 (2.93-8.17) times higher in the RS, compared with participants with median genetic risk (third quintile). Combining age, sex, intraocular pressure of more than 25 mmHg, and family history resulted in a meta-analyzed concordance of 0.75 (95% CI, 0.73-0.75). Adding the PRS to this model improved the concordance to 0.82 (95% CI, 0.80-0.84). In a meta-analysis of all cohorts, patients in the highest tertile showed a larger cup-to-disc ratio at diagnosis, by 0.10 (95% CI, 0.06 0.14), and a 2.07-fold increased risk of requiring glaucoma surgery (95% CI, 1.19-3.60). CONCLUSIONS Incorporating a PRS into a POAG predictive model improves identification concordance from 0.75 up to 0.82, supporting its potential for guiding more cost-effective screening strategies. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Victor A de Vries
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Joëlle E Vergroesen
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Ron Do
- Department of Genetics and Genomics Science, Icahn School of Medicine at Mount Sinai, New York, New York
| | - David S Friedman
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Peter Kraft
- National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Constance Turman
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
| | - Yuyang Leo Luo
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Jessica H Tran
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Bart Liefers
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Sze H Wong
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Rachel H Lee
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Nazlee Zebardast
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands; Institute of Molecular and Clinical Ophthalmology, University of Basel, Basel, Switzerland
| | - Ayellet V Segrè
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Jae H Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Wishal D Ramdas
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.
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Yokoyama H, Takata M, Kanda H, Okita Y, Gomi F. Assessment of silent reading ability among glaucoma patients using an eye tracking system with horizontally scrolling text. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06537-3. [PMID: 39141117 DOI: 10.1007/s00417-024-06537-3] [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: 01/11/2024] [Revised: 05/11/2024] [Accepted: 05/27/2024] [Indexed: 08/15/2024] Open
Abstract
PURPOSE There have been many reports suggesting that glaucoma patients with visual field defects may have decreased silent reading ability compared with individuals without glaucoma. This study used an eye tracking system to assess the ability of glaucoma patients to silently read horizontally scrolling text. METHODS Glaucoma patients who met the following criteria were recruited: age of ≤ 70 years, at least one eye with a 10 - 2 threshold on standard automated perimetry, a mean deviation value of n 4.0 dB or less, and corrected decimal visual acuity of 0.7 or better in both eyes. Using heat map images created from data from an eye tracking system operating during presentation of a video in which a sentence scrolled horizontally from right to left, reading time, average gaze position, and average fixation time (AFT) were compared between normal eyes (23 individuals, 46 eyes) and glaucomatous eyes (25 patients, 45 eyes). Four styles of sentences (large slow, large fast, small slow, and small fast) were scrolled in the top or bottom sections of the screen. RESULTS Primary open-angle glaucoma was the most common type of glaucoma in 34 eyes (75.6%), followed by secondary glaucoma in six eyes (13.3%). In comparison with normal eyes, the reading time among right eyes was significantly longer in glaucomatous eyes when reading large fast text that was shown in the bottom area and left glaucomatous eyes showed a leftward shift in gaze position in the top, bottom, or both sections with all four sentence types. There was no significant difference in AFT between glaucomatous and normal eyes across the four sentence styles. In the left eye with inferior visual field loss, text presented at the top consistently showed a correlation with leftward shift of the gaze position across all scenarios. CONCLUSION Glaucoma patients with central visual field defects in their left eyes may experience greater difficulty reading horizontally scrolling text than individuals with normal eyes.
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Affiliation(s)
- Hiroshi Yokoyama
- Department of Ophthalmology, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Hyogo, Japan.
| | - Masashi Takata
- Department of Ophthalmology, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Hyogo, Japan
| | - Hiroyuki Kanda
- Department of Ophthalmology, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Hyogo, Japan
| | - Yoichi Okita
- Department of Ophthalmology, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Hyogo, Japan
| | - Fumi Gomi
- Department of Ophthalmology, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Hyogo, Japan
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Vizzari G, Ceruti P. Effectiveness and safety of istent inject as an interventional glaucoma approach for uncontrolled open-angle glaucoma. Eur J Ophthalmol 2024:11206721241272224. [PMID: 39105221 DOI: 10.1177/11206721241272224] [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: 08/07/2024]
Abstract
INTRODUCTION To describe the results of iStent inject implantation as a standalone procedure in early-stage uncontrolled glaucoma, with results up to 24 months. METHODS A retrospective, single-center case series that recruited patients with open-angle glaucoma (OAG), uncontrolled IOP (defined as ≥18 mmHg), and who are receiving 1-4 glaucoma medications were implanted the iStent inject as a standalone procedure. Exclusion criteria were the contraindications of iStent inject implantation. Primary outcome measures were IOP at 6, 12, 18, and 24 months compared to baseline, and the number of medications at baseline and 24 months. RESULTS Eighty-eight eyes from 88 patients, aged 57.6 ± 9.8 years, were included. Ten eyes underwent a subsequent glaucoma procedure during follow-up and were excluded from the analysis. The mean IOP (mmHg) was reduced from 20.54 ± 1.42 at baseline to 15.99 ± 1.98 and 16.15 ± 2.21 (n = 78, p < 0.001) at the 12- and 24-month follow-up, respectively, and the mean number of medications was reduced from 2.35 ± 0.70 to 1.31 ± 0.80 (p < 0.001) at 24 months. Of those eyes, 59% had ≥20% reduction in IOP at 24 months, 91% had an IOP ≤18 mmHg at 24 months, and 71.8% were receiving fewer medications. At 24 months, 14.1% of eyes were medication-free, compared to none at baseline. No serious intraoperative or postoperative adverse events occurred. DISCUSSION iStent inject can effectively control intraocular pressure in mild glaucoma, reducing medication reliance and improving patient quality of life.
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Affiliation(s)
- Gabriele Vizzari
- Department of Ophthalmology, Hospital Mater Salutis Legnago, Legnago, Verona, Italy
| | - Piero Ceruti
- Department of Ophthalmology, Hospital Mater Salutis Legnago, Legnago, Verona, Italy
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