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Schultheiss M, Haritoglou C, Boneva S, Binder S, Sebag J. [Vitreous body in the treatment of exudative age-related macular degeneration : The medium is the message]. DIE OPHTHALMOLOGIE 2023; 120:999-1003. [PMID: 37819604 DOI: 10.1007/s00347-023-01940-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/15/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Intravitreal anti-vascular endothelial growth factor (VEGF) is the standard treatment for exudative age-related macular degeneration (AMD). The constitution of the vitreomacular interface varies greatly in cases of attached (with or without traction) or detached vitreous body, which can impact the effectiveness of the anti-VEGF treatment. OBJECTIVE Based on the current literature this article displays the current state of the science on whether the constitution of the vitreous body has an effect on the anti-VEGF treatment. MATERIAL AND METHODS The published data extracted from current trials and post hoc analyses concerning this topic are presented and put into the clinical context. RESULTS The presence of a vitreomacular adhesion reduces the efficacy of anti-VEGF treatment of exudative AMD. Posterior vitreous body detachment represents a positive prognostic factor concerning the efficacy of anti-VEGF treatment but not necessarily the prognosis for visual acuity. CONCLUSION Patients with attached vitreous body need a more intensive treatment monitoring compared to patients with detached vitreous body. Therefore, in eyes with initial posterior vitreous body detachment receiving a treat and extend regimen, the interval between anti-VEGF injections can be extended to 4 instead of 2 weeks without endangering the success of treatment.
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Affiliation(s)
- Maximilian Schultheiss
- Augenklinik Herzog Carl Theodor, Nymphenburger Str. 43, 80335, München, Deutschland.
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
| | - Christos Haritoglou
- Augenklinik Herzog Carl Theodor, Nymphenburger Str. 43, 80335, München, Deutschland
| | - Stefaniya Boneva
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | | | - Jerry Sebag
- Doheny Eye Institute, UCLA, Pasadena, USA
- Stein Eye Institute, UCLA, Los Angeles, USA
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Tram NK, Maxwell CJ, Swindle-Reilly KE. Macro- and Microscale Properties of the Vitreous Humor to Inform Substitute Design and Intravitreal Biotransport. Curr Eye Res 2020; 46:429-444. [PMID: 33040616 DOI: 10.1080/02713683.2020.1826977] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Research on the vitreous humor and development of hydrogel vitreous substitutes have gained a rapid increase in interest within the past two decades. However, the properties of the vitreous humor and vitreous substitutes have yet to be consolidated. In this paper, the mechanical properties of the vitreous humor and hydrogel vitreous substitutes were systematically reviewed. The number of publications on the vitreous humor and vitreous substitutes over the years, as well as their respective testing conditions and testing techniques were analyzed. The mechanical properties of the human vitreous were found to be most similar to the vitreous of pigs and rabbits. The storage and loss moduli of the hydrogel vitreous substitutes developed were found to be orders of magnitude higher in comparison to the native human vitreous. However, the reported modulus for human vitreous, which was most commonly tested in vitro, has been hypothesized to be different in vivo. Future studies should focus on testing the mechanical properties of the vitreous in situ or in vivo. In addition to its mechanical properties, the vitreous humor has other biotransport mechanisms and biochemical functions that establish a redox balance and maintain an oxygen gradient inside the vitreous chamber to protect intraocular tissues from oxidative damage. Biomimetic hydrogel vitreous substitutes have the potential to provide ophthalmologists with additional avenues for treating and controlling vitreoretinal diseases while preventing complications after vitrectomy. Due to the proximity and interconnectedness of the vitreous humor to other ocular tissues, particularly the lens and the retina, more interest has been placed on understanding the properties of the vitreous humor in recent years. A better understanding of the properties of the vitreous humor will aid in improving the design of biomimetic vitreous substitutes and enhancing intravitreal biotransport.
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Affiliation(s)
- Nguyen K Tram
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Courtney J Maxwell
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Katelyn E Swindle-Reilly
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA.,William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, USA.,Department of Ophthalmology & Visual Science, The Ohio State University, Columbus, OH, USA
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Sebag J. Vitreous and Vision Degrading Myodesopsia. Prog Retin Eye Res 2020; 79:100847. [PMID: 32151758 DOI: 10.1016/j.preteyeres.2020.100847] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 03/01/2020] [Accepted: 03/03/2020] [Indexed: 12/16/2022]
Abstract
Macromolecules comprise only 2% of vitreous, yet are responsible for its gel state, transparency, and physiologic function(s) within the eye. Myopia and aging alter collagen and hyaluronan association causing concurrent gel liquefaction and fibrous degeneration. The resulting vitreous opacities and collapse of the vitreous body during posterior vitreous detachment are the most common causes for the visual phenomenon of vitreous floaters. Previously considered innocuous, the vitreous opacities that cause floaters sometimes impact vision by profoundly degrading contrast sensitivity function and impairing quality-of-life. While many people adapt to vitreous floaters, clinically significant cases can be diagnosed with Vision Degrading Myodesopsia based upon echographic assessment of vitreous structure and by measuring contrast sensitivity function. Perhaps due to the ubiquity of floaters, the medical profession has to date largely ignored the plight of those with Vision Degrading Myodesopsia. Improved diagnostics will enable better disease staging and more accurate identification of severe cases that merit therapy. YAG laser treatments may occasionally be slightly effective, but vitrectomy is currently the definitive cure. Future developments will usher in more informative diagnostic approaches as well as safer and more effective therapeutic strategies. Improved laser treatments, new pharmacotherapies, and possibly non-invasive optical corrections are exciting new approaches to pursue. Ultimately, enhanced understanding of the underlying pathogenesis of Vision Degrading Myodesopsia should result in prevention, the ultimate goal of modern Medicine.
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Affiliation(s)
- J Sebag
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA; Doheny Eye Institute, Pasadena, CA, USA; Department of Ophthalmology, Geffen School of Medicine, University of California, Los Angeles, CA, USA.
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Kim NY, Goddard TN, Sohn S, Spiegel DA, Crawford JM. Biocatalytic Reversal of Advanced Glycation End Product Modification. Chembiochem 2019; 20:2402-2410. [PMID: 31013547 DOI: 10.1002/cbic.201900158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Indexed: 01/01/2023]
Abstract
Advanced glycation end products (AGEs) are a heterogeneous group of molecules that emerge from the condensation of sugars and proteins through the Maillard reaction. Despite a significant number of studies showing strong associations between AGEs and the pathologies of aging-related illnesses, it has been a challenge to establish AGEs as causal agents primarily due to the lack of tools in reversing AGE modifications at the molecular level. Herein, we show that MnmC, an enzyme involved in a bacterial tRNA-modification pathway, is capable of reversing the AGEs carboxyethyl-lysine (CEL) and carboxymethyl-lysine (CML) back to their native lysine structure. Combining structural homology analysis, site-directed mutagenesis, and protein domain dissection studies, we generated a variant of MnmC with improved catalytic properties against CEL in its free amino acid form. We show that this enzyme variant is also active on a CEL-modified peptidomimetic and an AGE-containing peptide that has been established as an authentic ligand of the receptor for AGEs (RAGE). Our data demonstrate that MnmC variants are promising lead catalysts toward the development of AGE-reversal tools and a better understanding of AGE biology.
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Affiliation(s)
- Nam Y Kim
- Department of Chemistry, Yale University, 225 Prospect Street, New Haven, CT, 06511, USA.,Chemical Biology Institute, Yale University, 600 West Campus Drive, West Haven, CT, 06516, USA
| | - Tyler N Goddard
- Department of Chemistry, Yale University, 225 Prospect Street, New Haven, CT, 06511, USA.,Chemical Biology Institute, Yale University, 600 West Campus Drive, West Haven, CT, 06516, USA
| | - Seungjung Sohn
- Department of Chemistry, Yale University, 225 Prospect Street, New Haven, CT, 06511, USA
| | - David A Spiegel
- Department of Chemistry, Yale University, 225 Prospect Street, New Haven, CT, 06511, USA.,Department of Pharmacology, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06520, USA
| | - Jason M Crawford
- Department of Chemistry, Yale University, 225 Prospect Street, New Haven, CT, 06511, USA.,Chemical Biology Institute, Yale University, 600 West Campus Drive, West Haven, CT, 06516, USA.,Department of Microbial Pathogenesis, Yale School of Medicine, 295 Congress Avenue, New Haven, CT, 06536, USA
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Bejarano E, Taylor A. Too sweet: Problems of protein glycation in the eye. Exp Eye Res 2018; 178:255-262. [PMID: 30145354 DOI: 10.1016/j.exer.2018.08.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/03/2018] [Accepted: 08/22/2018] [Indexed: 01/06/2023]
Abstract
Laboratory and epidemiological data indicate that high blood sugar levels and/or consuming high glycemia diets are linked to multiple age-related diseases, including age-related macular degeneration, cataract, Parkinson's disease, Alzheimer's disease, diabetic retinopathy, and, apparently glaucoma. High concentrations of blood sugar and perturbations of the systems that regulate blood sugar lead to the accumulation of advanced-glycation end products (AGEs). AGEs are toxic compounds that are formed from the combination of sugars and their metabolites with biomolecules in a non-enzymatic biochemical reaction called glycation. In vitro and in vivo data indicate that high sugar consumption is associated with accumulation of AGEs in a variety of human tissues. Hyperglycemia, along with an oxidative environment and limited cell proliferation in many ocular tissues, encourages formation and precludes dilution of AGEs and associated damage by cell division. These circumstances make many eye tissues vulnerable to glycation-derived damage. Here, we summarize research regarding glycation-induced ocular tissue dysfunction and its contribution to the onset and development of eye disorders. We also discuss how management of carbohydrate nutrition may provide a low-cost way to ameliorate the progression of AGEs-related diseases, including age related macular degeneration and some cataracts, as they do for cardiovascular disease and diabetes.
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Affiliation(s)
- Eloy Bejarano
- Laboratory for Nutrition and Vision Research, USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington St, Boston, MA, 02111, USA.
| | - Allen Taylor
- Laboratory for Nutrition and Vision Research, USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington St, Boston, MA, 02111, USA.
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Prestes ADS, dos Santos MM, Ecker A, Zanini D, Schetinger MRC, Rosemberg DB, da Rocha JBT, Barbosa NV. Evaluation of methylglyoxal toxicity in human erythrocytes, leukocytes and platelets. Toxicol Mech Methods 2017; 27:307-317. [DOI: 10.1080/15376516.2017.1285971] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
| | - Matheus Mülling dos Santos
- Department of Biochemistry and Molecular Biology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Assis Ecker
- Department of Biochemistry and Molecular Biology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Daniela Zanini
- Department of Biochemistry and Molecular Biology, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Denis Broock Rosemberg
- Department of Biochemistry and Molecular Biology, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Nilda Vargas Barbosa
- Department of Biochemistry and Molecular Biology, Federal University of Santa Maria, Santa Maria, Brazil
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