Clinical research of fenofibrate and spironolactone for acute central serous chorioretinopathy

AIM

To compare the effectiveness of combined fenofibrate and spironolactone with fenofibrate alone for treatment of central serous chorioretinopathy (CSCR).

METHODS

Totally 60 patients (60 eyes) with a history of acute CSCR were randomed into two groups: group A with combination of fenofibrate (200 mg) and spironolactone (100 mg), and group B with only fenofibrate (200 mg). They were taken half an hour before meals and once per day for 8wk. The changes of the visual acuity, subjective symptom, ocular surface disease index (OSDI), the tear film and optical coherence tomography were observed at 2, 4, 6, and 8wk before and after treatment.

RESULTS

The best corrected visual acuity (BCVA, logMAR) was improved to 0.22 and 0.27 after treatment from baseline of 0.35 and 0.36 in groups A and B (P<0.05), respectively. After 8wk treatment, the central subfield thickness (CST), and subretinal fluid volumn (SFV) decreased significantly to 49.5% and 78.8% in group A and 37.0% and 57.2% in group B. There were significant differences of CST and SFV in both groups (all P<0.05).

CONCLUSION

Fenofibrate combined with spironolactone may have more clinical efficacy in the treatment of CSCR than fenofibrate only.

Clinical correlates of common corneal neovascular diseases: a literature review

A large subset of corneal pathologies involves the formation of new blood and lymph vessels (neovascularization), leading to compromised visual acuity. This article aims to review the clinical causes and presentations of corneal neovascularization (CNV) by examining the mechanisms behind common CNV-related corneal pathologies, with a particular focus on herpes simplex stromal keratitis, contact lenses-induced keratitis and CNV secondary to keratoplasty. Moreover, we reviewed CNV in the context of different types of corneal transplantation and keratoprosthesis, and summarized the most relevant treatments available so far.

Roles of IL-10 in ocular inflammations: a review

INTRODUCTION

This review represents the current in vitro, in vivo, animal and human investigations on the roles of IL-10 in ocular inflammatory conditions.

MATERIALS AND METHODS

The data sources were literature reviews, including Pub Med, Medline, and ISI databases (since 1989 to mid-2012). Search items were, IL-10, chemokines, cytokines, alone or in combination with, serum, aqueous, vitreous eye, ocular, ocular tissues, ophthalmic, and review.

RESULTS

Ocular effects of IL-10 depend on the sources of the secretion and sites of the action. IL-10 plays important anti-inflammatory and especially anti-angiogenic activities in ocular tissues such as the conjunctiva, cornea, retina, choroid, and orbit.

CONCLUSION

IL-10 plays major anti-inflammatory and anti-angiogenic roles in most of the ocular inflammations. Also, IL-10 plays a role in development of anterior chamber-associated immune deviation (ACAID). Any manipulation of IL-10 for treatment purposes should be considered very cautiously due to its potential hazards to the immune system.

Delayed neovascularization in inflammation-induced corneal neovascularization in interleukin-10-deficient mice

PURPOSE

To investigate the potential modulatory role of interleukin-10 (IL-10) in the suture model for corneal neovascularization.

METHODS

Neovascularized areas were measured on corneal flat-mounts in IL-10(-/-) and wild-type C57BL6 mice. The inflammatory cellular response was characterized with immunohistochemistry. Gene expression was measured by real-time polymerase chain reaction.

RESULTS

IL-10(-/-) mice showed a delayed neovascular response compared to wild-type animals at day 6 after suture, when approximately half of the cornea was neovascularized. No apparent differences in inflammatory responses or in messenger RNA (mRNA) expression for proangiogenic factors were detected in IL-10(-/-) versus wild-type mice.

CONCLUSION

IL-10 appears to have a proangiogenic effect in the suture model for corneal neovascularization that cannot be explained by either IL-10's anti-inflammatory effect or apparent cross-talk with the angiogenic factors vascular endothelial growth factor (VEGF)-A, metalloproteinase (MMP)-2 and MMP-9, angiopoietin (Ang)-1 and Ang-2.

Novel aspects of corneal angiogenic and lymphangiogenic privilege

In this article, we provide the results of experimental studies demonstrating that corneal avascularity is an active process involving the production of anti-angiogenic factors, which counterbalance the pro-angiogenic/lymphangiogenic factors that are upregulated during wound healing. We also summarize pertinent published reports regarding corneal neovascularization (NV), corneal lymphangiogenesis and corneal angiogenic/lymphangiogenic privilege. We outline the clinical causes of corneal NV, and discuss the angiogenic proteins (VEGF and bFGF) and angiogenesis regulatory proteins. We also describe the role of matrix metalloproteinases MMP-2, -7, and MT1-MMP, anti-angiogenic factors, and lymphangiogenic regulatory proteins during corneal wound healing. Established and potential new therapies for the treatment of corneal neovascularization are also discussed.