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Hwang S, Choi S, Choi SH, Kim KY, Miller YI, Ju WK. Apolipoprotein A-I binding protein-mediated neuroprotection in glaucomatous neuroinflammation and neurodegeneration. Neural Regen Res 2025; 20:1414-1415. [PMID: 39075909 DOI: 10.4103/nrr.nrr-d-24-00221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/21/2024] [Indexed: 07/31/2024] Open
Affiliation(s)
- Sinwoo Hwang
- Hamilton Glaucoma Center and Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA (Hwang S, Choi S, Ju WK)
| | - Seunghwan Choi
- Hamilton Glaucoma Center and Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA (Hwang S, Choi S, Ju WK)
| | - Soo-Ho Choi
- Department of Medicine, University of California San Diego, La Jolla, CA, USA (Choi SH, Miller YI)
| | - Keun-Young Kim
- National Center for Microscopy and Imaging Research, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA (Kim KY)
| | - Yury I Miller
- Department of Medicine, University of California San Diego, La Jolla, CA, USA (Choi SH, Miller YI)
| | - Won-Kyu Ju
- Hamilton Glaucoma Center and Shiley Eye Institute, The Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA (Hwang S, Choi S, Ju WK)
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Yang Y, Qin B, Ng TK, Sun X, Cao W, Chen Y. Serum lipid and lipoprotein profiles and their association with intraocular pressure in primary open-angle glaucoma: an observational cross-sectional study in the Chinese population. Lipids Health Dis 2024; 23:323. [PMID: 39350087 PMCID: PMC11441088 DOI: 10.1186/s12944-024-02316-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 09/23/2024] [Indexed: 10/04/2024] Open
Abstract
BACKGROUND Glaucoma is a leading cause of vision impairment and permanent blindness. Primary open-angle glaucoma (POAG) is a prominent type of primary glaucoma; however, its cause is difficult to determine. This study aimed to analyze the serum lipid profile of Chinese POAG patients and assess its correlation with intraocular pressure (IOP). METHODS The study included 1,139, 1,248, and 356 Chinese individuals with POAG, primary angle closure glaucoma (PACG), and controls, respectively. Peripheral whole blood samples were collected at the time of diagnosis. Enzymatic colorimetry was used to determine serum levels of different lipids: high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides, cholesterol, and very low-density lipoproteins (VLDL). Additionally, immunoturbidimetry was used to quantify serum levels of apolipoproteins A (APOA), B (APOB), E (APOE), and lipoprotein A [Lp(a)], while intraocular pressure (IOP) was measured in all patients with POAG. RESULTS After adjusting for age and sex, patients with POAG exhibited elevated serum levels of VLDL, APOA, and APOE but mitigated cholesterol levels compared with the control participants. Significantly lower serum triglyceride, VLDL, and Lp(a) levels were found in patients with PACG than in control participants. Serum cholesterol (P = 0.019; β = -0.75, 95% confidence interval [CI]: -1.38 - -0.12) and HDL levels (P < 0.001; β = -2.91, 95% CI: -4.58 - -1.25) were inversely linked to IOP in patients with POAG, after adjusting for age, sex, and ocular metrics. In addition, serum Lp(a) levels were correlated with the average IOP (P = 0.023; β = -0.0039, 95% CI: -0.0073 - -0.006) and night peak (P = 0.027; β = -0.0061, 95% CI: -0.0113 - -0.0008) in patients with POAG. CONCLUSIONS Significantly different serum lipid and lipoprotein profiles were observed in POAG and PACG patients. This study highlighted the differences in serum lipid and lipoprotein levels among Chinese POAG patients and their relationship with IOP and IOP fluctuation. Serum lipid and lipoprotein profiles should be considered while evaluating glaucoma risk.
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Affiliation(s)
- Yaping Yang
- Department of Ophthalmology and Visual Science, Eye and Ear Nose Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Bo Qin
- Department of Ophthalmology and Visual Science, Eye and Ear Nose Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, China
| | - Tsz Kin Ng
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, Shantou, Guangdong, China
- Shantou University Medical College, Shantou, Guangdong, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Xinghuai Sun
- Department of Ophthalmology and Visual Science, Eye and Ear Nose Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Institutes of Brain Science and Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, China
| | - Wenjun Cao
- Department of Clinical Laboratory, Eye and Ear Nose Throat Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Yuhong Chen
- Department of Ophthalmology and Visual Science, Eye and Ear Nose Throat Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China.
- Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China.
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Zhu Y, Li SY, Zhang LJ, Lei B, Wang YC, Wang Z. Neuroprotection of the P2X7 receptor antagonist A740003 on retinal ganglion cells in experimental glaucoma. Neuroreport 2024; 35:822-831. [PMID: 38973496 DOI: 10.1097/wnr.0000000000002071] [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: 07/09/2024]
Abstract
The aim of this study was to explore the neuroprotective effects of the P2X7 receptor antagonist A740003 on retinal ganglion cells (RGCs) in chronic intraocular hypertension (COH) experimental glaucoma mouse model. Bioinformatics was used to analyze the glaucoma-related genes. Western blot, real-time fluorescence quantitative PCR, and immunofluorescence staining techniques were employed to explore the mechanisms underlying the neuroprotective effects of A740003 on RGCs in COH retinas. Bioinformatic analysis revealed that oxidative stress, neuroinflammation, and cell apoptosis were highly related to the pathogenesis of glaucoma. In COH retinas, intraocular pressure elevation significantly increased the levels of translocator protein, a marker of microglial activation, which could be reversed by intravitreal preinjection of A740003. A740003 also suppressed the increased mRNA levels of proinflammatory cytokines interleukin (IL) 1β and tumor necrosis factor α in COH retinas. In addition, although the mRNA levels of anti-inflammatory cytokine IL-4 and IL-10 were kept unchanged in COH retinas, administration of A740003 could increase their levels. The mRNA and protein levels of Bax and cleaved caspase-3 were increased in COH retinas, which could be partially reversed by A740003, while the levels of Bcl-2 kept unchanged in COH retinas with or without the injections of A740003. Furthermore, A740003 partially attenuated the reduction in the numbers of Brn-3a-positive RGCs in COH mice. A740003 could provide neuroprotective roles on RGCs by inhibiting the microglia activation, attenuating the retinal inflammatory response, reducing the apoptosis of RGCs, and enhancing the survival of RGCs in COH experimental glaucoma.
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Affiliation(s)
- Yan Zhu
- Institute of Neuroscience and Third Affiliated Hospital, Zhengzhou University
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou
| | - Shu-Ying Li
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai
| | - Lu-Jia Zhang
- Institute of Neuroscience and Third Affiliated Hospital, Zhengzhou University
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou
| | - Bo Lei
- Institute of Neuroscience and Third Affiliated Hospital, Zhengzhou University
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou
- Henan Eye Institute, Henan Eye Hospital, Henan Academy of Innovations in Medical Science, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Zhengzhou, China
| | - Yong-Chen Wang
- Institute of Neuroscience and Third Affiliated Hospital, Zhengzhou University
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou
| | - Zhongfeng Wang
- Institute of Neuroscience and Third Affiliated Hospital, Zhengzhou University
- Academy of Medical Sciences, Zhengzhou University, Zhengzhou
- State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai
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Kang T, Zhou Y, Fan C, Zhang Y, Yang Y, Jiang J. Genetic association of lipid traits and lipid-related drug targets with normal tension glaucoma: a Mendelian randomization study for predictive preventive and personalized medicine. EPMA J 2024; 15:511-524. [PMID: 39239107 PMCID: PMC11371969 DOI: 10.1007/s13167-024-00373-5] [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: 06/04/2024] [Accepted: 07/05/2024] [Indexed: 09/07/2024]
Abstract
Background Glaucoma is the leading cause of irreversible blindness worldwide. Normal tension glaucoma (NTG) is a distinct subtype characterized by intraocular pressures (IOP) within the normal range (< 21 mm Hg). Due to its insidious onset and optic nerve damage, patients often present with advanced conditions upon diagnosis. NTG poses an additional challenge as it is difficult to identify with normal IOP, complicating its prediction, prevention, and treatment. Observational studies suggest a potential association between NTG and abnormal lipid metabolism, yet conclusive evidence establishing a direct causal relationship is lacking. This study aims to explore the causal link between serum lipids and NTG, while identifying lipid-related therapeutic targets. From the perspective of predictive, preventive, and personalized medicine (PPPM), clarifying the role of dyslipidemia in the development of NTG could provide a new strategy for primary prediction, targeted prevention, and personalized treatment of the disease. Working hypothesis and methods In our study, we hypothesized that individuals with dyslipidemia may be more susceptible to NTG due to a dysregulation of microvasculature in optic nerve head. To verify the working hypothesis, univariable Mendelian randomization (UVMR) and multivariable Mendelian randomization (MVMR) were utilized to estimate the causal effects of lipid traits on NTG. Drug target MR was used to explore possible target genes for NTG treatment. Genetic variants associated with lipid traits and variants of genes encoding seven lipid-related drug targets were extracted from the Global Lipids Genetics Consortium genome-wide association study (GWAS). GWAS data for NTG, primary open angle glaucoma (POAG), and suspected glaucoma (GLAUSUSP) were obtained from FinnGen Consortium. For apolipoproteins, we used summary statistics from a GWAS study by Kettunen et al. in 2016. For metabolic syndrome, summary statistics were extracted from UK Biobank participants. In the end, these findings could help identify individuals at risk of NTG by screening for lipid dyslipidemia, potentially leading to new targeted prevention and personalized treatment approaches. Results Genetically assessed high-density cholesterol (HDL) was negatively associated with NTG risk (inverse-variance weighted [IVW] model: OR per SD change of HDL level = 0.64; 95% CI, 0.49-0.85; P = 1.84 × 10-3), and the causal effect was independent of apolipoproteins and metabolic syndrome (IVW model: OR = 0.29; 95% CI, 0.14-0.60; P = 0.001 adjusted by ApoB and ApoA1; OR = 0.70; 95% CI, 0.52-0.95; P = 0.023 adjusted by BMI, HTN, and T2DM). Triglyceride (TG) was positively associated with NTG risk (IVW model: OR = 1.62; 95% CI, 1.15-2.29; P = 6.31 × 10-3), and the causal effect was independent of metabolic syndrome (IVW model: OR = 1.66; 95% CI, 1.18-2.34; P = 0.003 adjusted by BMI, HTN, and T2DM), but not apolipoproteins (IVW model: OR = 1.71; 95% CI, 0.99-2.95; P = 0.050 adjusted by ApoB and ApoA1). Genetic mimicry of apolipoprotein B (APOB) enhancement was associated with lower NTG risks (IVW model: OR = 0.09; 95% CI, 0.03-0.26; P = 9.32 × 10-6). Conclusions Our findings supported dyslipidemia as a predictive causal factor for NTG, independent of other factors such as metabolic comorbidities. Among seven lipid-related drug targets, APOB is a potential candidate drug target for preventing NTG. Personalized health profiles can be developed by integrating lipid metabolism with life styles, visual quality of life such as reading, driving, and walking. This comprehensive approach will aid in shifting from reactive medical services to PPPM in the management of NTG. Supplementary Information The online version contains supplementary material available at 10.1007/s13167-024-00373-5.
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Affiliation(s)
- Tianyi Kang
- Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, 410008 Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
| | - Yi Zhou
- Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, 410008 Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
| | - Cong Fan
- Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, 410008 Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
| | - Yue Zhang
- Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, 410008 Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
| | - Yu Yang
- Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, 410008 Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
| | - Jian Jiang
- Eye Center of Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
- Hunan Key Laboratory of Ophthalmology, Central South University, Changsha, 410008 Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008 Hunan China
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Hsu AY, Shao YC, Lin CJ, Chen HS, Lin CL, Cho DY, Tsai YY. Evaluating the risk of new-onset glaucoma in chronic kidney disease patients: a nationwide cohort study. BMC Nephrol 2024; 25:263. [PMID: 39143548 PMCID: PMC11325696 DOI: 10.1186/s12882-024-03698-5] [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: 04/18/2024] [Accepted: 08/07/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND A better understanding of the association between chronic kidney disease (CKD) and glaucoma is required to optimize clinical outcomes. Therefore, this study aimed to investigate the association of chronic kidney disease (CKD) with new diagnoses of glaucoma over time from January 2009 to December 2019. METHOD This retrospective propensity-matched cohort study utilizing Taiwanese electronic health records examined the incidence of newly diagnosed glaucoma in patients with and without chronic kidney disease (CKD). The exposure variable was the diagnosis of CKD, identified through diagnostic codes. The primary outcome was the incidence of new-onset glaucoma. Subgroup analyses on glaucoma risk included age, gender, comorbidities, glaucoma subtypes, and dialysis status. Statistical analyses included Kaplan-Meier analysis, Cox proportional hazards models, and Poisson regression models, with the associated hazard ratios and confidence intervals reported. RESULTS Seven hundred twenty-three thousand two hundred sixteen patients with CKD (42.3% female; mean [SD] age at index, 66.3 [15.6] years) and 723,216 patients without CKD (42.3% female; mean [SD] age at index, 66.3 [15.7]) were recruited. We showed a significantly increased risk of glaucoma irrespective of subtypes in CKD patients compared to those without CKD (HR: 1.29 [CI: 1.26-1.32], p < 0.001). Kaplan-Meier curves revealed a significantly increased glaucoma risk in both the dialytic subtype and non-dialytic CKD patients when compared to their non-CKD counterparts (p < 0.001). We also showed that all genders (aHR 1.17 [CI: 1.13-1.21] for females vs. aHR 1.39 [CI:1.35-1.43] for males), all ages (< = 49: aHR 1.49 [CI: 1.37-1.62]; 50-59: aHR 1.48 [CI: 1.40-1.56]; 60-69: aHR 1.30 [CI: 1.25-1.6]; 70-79: aHR 1.21 [CI: 1.17-1.26]; > 80: aHR 1.29 [CI: 1.21-1.37]); all income brackets and all urbanization status were associated with significantly increased risk of glaucoma from among the CKD cohort when compared to their respective non-CKD cohort (p < 0.001). CONCLUSIONS Our cohort study spanning 12 years showed an elevated glaucoma risk following a CKD diagnosis compared to a frequency-matched non-CKD cohort. Our findings have relevance for the clinical practice of at-risk CKD patients. TRIAL REGISTRATION Due to the retrospective nature of the study, no registration was necessary.
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Affiliation(s)
- Alan Y Hsu
- Department of Ophthalmology, China Medical University Hospital, China Medical University, No. 29, Yude Rd., North Dist., Taichung, 40447, Taiwan
| | - Yi-Ching Shao
- Department of Ophthalmology, China Medical University Hospital, China Medical University, No. 29, Yude Rd., North Dist., Taichung, 40447, Taiwan.
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
| | - Chun-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, No. 29, Yude Rd., North Dist., Taichung, 40447, Taiwan.
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
- Department of Optometry, Asia University, Taichung, Taiwan.
| | - Huan-Sheng Chen
- An-Shin Dialysis Center, Excelsior Renal Service Co., Ltd., Taiwan Branch, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Der-Yang Cho
- Translational Cell Therapy Center, Department of Medical Research, China Medical University Hospital, Taichung, 40447, Taiwan
- Department of Neurosurgery, China Medical University Hospital, Taichung, 40447, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, 40447, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, No. 29, Yude Rd., North Dist., Taichung, 40447, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
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Choi JY, Yoo TK. Development of a novel scoring system for glaucoma risk based on demographic and laboratory factors using ChatGPT-4. Med Biol Eng Comput 2024:10.1007/s11517-024-03182-0. [PMID: 39129037 DOI: 10.1007/s11517-024-03182-0] [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: 06/19/2024] [Accepted: 08/01/2024] [Indexed: 08/13/2024]
Abstract
We developed a scoring system for assessing glaucoma risk using demographic and laboratory factors by employing a no-code approach (automated coding) using ChatGPT-4. Comprehensive health checkup data were collected from the Korea National Health and Nutrition Examination Survey. Using ChatGPT-4, logistic regression was conducted to predict glaucoma without coding or manual numerical processes, and the scoring system was developed based on the odds ratios (ORs). ChatGPT-4 also facilitated the no-code creation of an easy-to-use risk calculator for glaucoma. The ORs for the high-risk groups were calculated to measure performance. ChatGPT-4 automatically developed a scoring system based on demographic and laboratory factors, and successfully implemented a risk calculator tool. The predictive ability of the scoring system was comparable to that of traditional machine learning approaches. For high-risk groups with 1-2, 3-4, and 5 + points, the calculated ORs for glaucoma were 1.87, 2.72, and 15.36 in the validation set, respectively, compared with the group with 0 or fewer points. This study presented a novel no-code approach for developing a glaucoma risk assessment tool using ChatGPT-4, highlighting its potential for democratizing advanced predictive analytics, making them readily available for clinical use in glaucoma detection.
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Affiliation(s)
- Joon Yul Choi
- Department of Biomedical Engineering, Yonsei University, Wonju, South Korea
| | - Tae Keun Yoo
- Department of Ophthalmology, Hangil Eye Hospital, 35 Bupyeong-Daero, Bupyeong-Gu, Incheon, 21388, South Korea.
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Inouye K, Petrosyan A, Moskalensky L, Thankam FG. Artificial intelligence in therapeutic management of hyperlipidemic ocular pathology. Exp Eye Res 2024; 245:109954. [PMID: 38838975 DOI: 10.1016/j.exer.2024.109954] [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: 10/10/2023] [Revised: 04/09/2024] [Accepted: 06/02/2024] [Indexed: 06/07/2024]
Abstract
Hyperlipidemia has many ocular manifestations, the most prevalent being retinal vascular occlusion. Hyperlipidemic lesions and occlusions to the vessels supplying the retina result in permanent blindness, necessitating prompt detection and treatment. Retinal vascular occlusion is diagnosed using different imaging modalities, including optical coherence tomography angiography. These diagnostic techniques obtain images representing the blood flow through the retinal vessels, providing an opportunity for AI to utilize image recognition to detect blockages and abnormalities before patients present with symptoms. AI is already being used as a non-invasive method to detect retinal vascular occlusions and other vascular pathology, as well as predict treatment outcomes. As providers see an increase in patients presenting with new retinal vascular occlusions, the use of AI to detect and treat these conditions has the potential to improve patient outcomes and reduce the financial burden on the healthcare system. This article comprehends the implications of AI in the current management strategies of retinal vascular occlusion (RVO) in hyperlipidemia and the recent developments of AI technology in the management of ocular diseases.
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Affiliation(s)
- Keiko Inouye
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, USA
| | - Aelita Petrosyan
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, USA
| | - Liana Moskalensky
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, USA
| | - Finosh G Thankam
- Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, USA.
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Liu Y, Li T. Causal Association Between Lipid-Lowering Drugs and Glaucoma: A Drug-Targeted Mendelian Randomization Study. Invest Ophthalmol Vis Sci 2024; 65:23. [PMID: 39140962 PMCID: PMC11328884 DOI: 10.1167/iovs.65.10.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Affiliation(s)
- Yaqiong Liu
- Regenerative Medicine Institute (REMEDI), University of Galway, Galway, Ireland
| | - Tao Li
- Regenerative Medicine Institute (REMEDI), University of Galway, Galway, Ireland
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Manz KC, Mocek A, Höer A, Simantiri C, Heuck A, Eberhardt A, Mrosowsky T, Zander S, Fritz B, Schuster AK, Erb C. Epidemiology and Treatment of Patients With Primary Open Angle Glaucoma in Germany: A Health Claims Data Analysis. J Glaucoma 2024; 33:549-558. [PMID: 38752785 PMCID: PMC11319074 DOI: 10.1097/ijg.0000000000002420] [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: 04/24/2023] [Accepted: 05/02/2024] [Indexed: 08/15/2024]
Abstract
PRCIS Based on a large administrative database of German claims data, our study provides current estimates of the prevalence and incidence of primary open angle glaucoma (POAG) in Germany and describes selected outcomes for prevalent patients with POAG. PURPOSE To estimate the prevalence and incidence of POAG in Germany, to describe the patient population in terms of comorbidity burden, routine care, and overall healthcare resource utilization (HCRU) and associated costs, and to describe treatment patterns over time in patients undergoing relevant laser procedures. MATERIALS AND METHODS Based on anonymized German claims data, we carried out a retrospective, noninterventional study covering calendar years 2016-2021. RESULTS For the adult German population (≥18 y), we estimated a POAG 1-year prevalence of 1.70% and a 1-year incidence of 0.17% in 2018; both increased with age, peaking in 80- to 89-year-olds. Prevalence and incidence were lower in 2020 (1.65% and 0.16%, respectively), the first year of the SARS-CoV-2 pandemic. Most patients solely received topical treatment. Most surgically treated patients underwent laser trabeculoplasty, followed by laser iridotomy, trabeculectomy, and filtration operations with implant. In patients undergoing laser trabeculoplasty, the treatment regimen was nearly unchanged in the second year after, compared with 2 years before the procedure. Multimorbidity was commonly observed; 75.5% of patients had arterial hypertension and 50.0% had disorders of lipoprotein metabolism and other lipidemias, compared with 60.1% and 39.2%, respectively, in an age- and sex-matched control sample. CONCLUSIONS Our study provides insights into epidemiology and routine care of POAG in Germany and HCRU in prevalent patients. There was little change in treatment regimens in patients who underwent laser trabeculoplasty, 2 years after the procedure. Most patients were multimorbid highlighting the need for comprehensive care.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Alexander K. Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz
| | - Carl Erb
- Private Institute of Applied Ophthalmology Berlin, Berlin, Germany
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Yang Z, Zhang J, Zheng Y. Associations Between Life's Essential 8 and Major Ocular Diseases in the American Middle-Aged and Elderly Population. Am J Ophthalmol 2024; 268:76-85. [PMID: 39089359 DOI: 10.1016/j.ajo.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/15/2024] [Accepted: 07/21/2024] [Indexed: 08/03/2024]
Abstract
PURPOSE To explore the correlation between cardiovascular health (CVH) and ocular diseases, given their shared risk factors and biological mechanisms, this study utilizes the newly updated Life's Essential 8 (LE8) algorithm. DESIGN A cross-sectional study. METHODS This analysis, conducted from February 15 to April 1, 2024, in Changchun, includes data from 4146 participants aged 40 and above, drawn from the National Health and Nutrition Examination Survey database (2005-2008). It covers information on visual health status, dietary habits through interviews, and professional ophthalmological examinations. Participants' CVH status was assessed using the LE8 algorithm, and relationships with major ocular diseases such as retinopathy, cataracts, diabetic retinopathy, glaucoma, and age-related macular degeneration were explored through weighted logistic regression analysis, restricted cubic splines, stratified analysis, and sensitivity analysis. RESULTS After multivariable adjustment, lower LE8 scores showed a significant positive relationship with any ocular disease (odds ratio [OR]: 2.03, 95% confidence interval [CI]: 1.39-2.96, P = .001), any objectively determined ocular disease (OR: 2.24, 95% CI: 1.48-3.38, P < .001), retinopathy (OR: 2.88, 95% CI: 1.89-4.41, P < .001), diabetic retinopathy (OR: 10.23, 95% CI: 3.11-33.61, P < .001), and glaucoma (OR: 2.76, 95% CI: 1.47-5.21, P = .003), with all trends significant (all P < .01). Additionally, lower scores in the behavioral subdomain were significantly correlated with an elevated risk of cataracts (OR: 1.45, 95% CI: 1.03-2.04). Subgroup analyses revealed more pronounced negative correlations between LE8 and retinopathy among females and those suffering from chronic kidney disease. CONCLUSIONS A low CVH score was linked to an increased likelihood of ocular diseases in a US-populated-based study. This correlation supports the potential benefits of enhancing cardiovascular wellness to mitigate the development of ocular conditions.
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Affiliation(s)
- Ziling Yang
- From the Department of Ophthalmology (Z.Y., Y.Z.), The Second Hospital of Jilin University, Jilin University, Changchun, China
| | - Jinming Zhang
- The First Hospital of Jilin University, Jilin University (J.Z.), Changchun, China
| | - Yajuan Zheng
- From the Department of Ophthalmology (Z.Y., Y.Z.), The Second Hospital of Jilin University, Jilin University, Changchun, China.
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11
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Lee SY, Paul ME, Coleman AL, Kitayama K, Yu F, Pan D, Tseng VL. Associations between Statin Use and Glaucoma in the All of Us Research Program. Ophthalmol Glaucoma 2024:S2589-4196(24)00137-6. [PMID: 39094953 DOI: 10.1016/j.ogla.2024.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 05/29/2024] [Accepted: 07/26/2024] [Indexed: 08/04/2024]
Abstract
PURPOSE To investigate associations between statin use and glaucoma in the 2017 to 2022 All of Us (AoU) Research Program. DESIGN Cross-sectional, population-based. PARTICIPANTS 79 742 adult participants aged ≥40 years with hyperlipidemia and with electronic health record (EHR) data in the AoU database. METHODS Hyperlipidemia, glaucoma status, and statin use were defined by diagnoses and medication information in EHR data collected by AoU. Logistic regression analysis was performed to evaluate the association between statin use and glaucoma likelihood. Logistic regression modeling was used to examine associations between glaucoma and all covariates included in adjusted analysis. Serum low-density lipoprotein cholesterol (LDL-C) was used to assess hyperlipidemia severity. Analyses stratified by LDL-C level and age were performed. MAIN OUTCOME MEASURES Any glaucoma as defined by International Classification of Diseases codes found in EHR data. RESULTS Of 79 742 individuals with hyperlipidemia in AoU, there were 6365 (8.0%) statin users. Statin use was associated with increased glaucoma prevalence when compared with statin nonuse (adjusted odds ratio [aOR]: 1.13, 95% confidence interval [CI]: 1.01-1.26). Higher serum levels of LDL-C were associated with increased odds of glaucoma (aOR: 1.003, 95% CI: 1.003, 1.004). Statin users had significantly higher LDL-C levels compared to nonusers (144.9 mg/dL versus 136.3 mg/dL, P value < 0.001). Analysis stratified by LDL-C identified positive associations between statin use and prevalence of glaucoma among those with optimal (aOR = 1.39, 95% CI = 1.05-1.82) and high (aOR = 1.37, 95% CI = 1.09-1.70) LDL-C levels. Age-stratified analysis showed a positive association between statin use and prevalence of glaucoma in individuals aged 60 to 69 years (aOR = 1.28, 95% CI = 1.05-1.56). CONCLUSIONS Statin use was associated with increased glaucoma likelihood in the overall adult AoU population with hyperlipidemia, in individuals with optimal or high LDL-C levels, and in individuals 60 to 69 years old. Findings suggest that statin use may be an independent risk factor for glaucoma, which may furthermore be affected by one's lipid profile and age. 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)
- Samuel Y Lee
- Center for Community Outreach and Policy, Department of Ophthalmology, Stein & Doheny Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Megan E Paul
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anne L Coleman
- Center for Community Outreach and Policy, Department of Ophthalmology, Stein & Doheny Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California; Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California
| | - Ken Kitayama
- Center for Community Outreach and Policy, Department of Ophthalmology, Stein & Doheny Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Fei Yu
- Center for Community Outreach and Policy, Department of Ophthalmology, Stein & Doheny Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California; Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California
| | - Deyu Pan
- Center for Community Outreach and Policy, Department of Ophthalmology, Stein & Doheny Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Victoria L Tseng
- Center for Community Outreach and Policy, Department of Ophthalmology, Stein & Doheny Eye Institutes, David Geffen School of Medicine at UCLA, Los Angeles, California.
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12
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Abid A, Baxter SL. Breaking Barriers in Behavioral Change: The Potential of Artificial Intelligence-Driven Motivational Interviewing. J Glaucoma 2024; 33:473-477. [PMID: 38595151 DOI: 10.1097/ijg.0000000000002382] [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: 08/01/2023] [Accepted: 03/16/2024] [Indexed: 04/11/2024]
Abstract
Patient outcomes in ophthalmology are greatly influenced by adherence and patient participation, which can be particularly challenging in diseases like glaucoma, where medication regimens can be complex. A well-studied and evidence-based intervention for behavioral change is motivational interviewing (MI), a collaborative and patient-centered counseling approach that has been shown to improve medication adherence in glaucoma patients. However, there are many barriers to clinicians being able to provide motivational interviewing in-office, including short visit durations within high-volume ophthalmology clinics and inadequate billing structures for counseling. Recently, Large Language Models (LLMs), a type of artificial intelligence, have advanced such that they can follow instructions and carry coherent conversations, offering novel solutions to a wide range of clinical problems. In this paper, we discuss the potential of LLMs to provide chatbot-driven MI to improve adherence in glaucoma patients and provide an example conversation as a proof of concept. We discuss the advantages of AI-driven MI, such as demonstrated effectiveness, scalability, and accessibility. We also explore the risks and limitations, including issues of safety and privacy, as well as the factual inaccuracies and hallucinations to which LLMs are susceptible. Domain-specific training may be needed to ensure the accuracy and completeness of information provided in subspecialty areas such as glaucoma. Despite the current limitations, AI-driven motivational interviewing has the potential to offer significant improvements in adherence and should be further explored to maximally leverage the potential of artificial intelligence for our patients.
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Affiliation(s)
- Areeba Abid
- Emory University School of Medicine, Atlanta, GA
| | - Sally L Baxter
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego
- Divison of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA
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13
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Tseng YT, Huang ST, Wang CH, Wang LY, Kuo YC. Association of smoking cessation patterns and untreated smoking with glaucoma, cataract, and macular degeneration: a population-based retrospective study. Sci Rep 2024; 14:14788. [PMID: 38926484 PMCID: PMC11208419 DOI: 10.1038/s41598-024-65813-8] [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: 08/06/2023] [Accepted: 06/24/2024] [Indexed: 06/28/2024] Open
Abstract
This study aims to assess the association between nicotine replacement therapy (NRT), varenicline, and untreated smoking with the risk of developing eye disorders. We employed a new-user design to investigate the association between NRT use and the incidence of eye disorders by the Taiwan National Health Insurance program. This study included 8416 smokers who received NRT and 8416 smokers who did not receive NRT (control group) matched using propensity scores between 2007 and 2018. After adjustment for relevant factors, a multivariable Cox regression analysis revealed that compared with untreated smokers, NRT use was associated with a significantly reduced risk of macular degeneration (hazard ratio [HR]: 0.34; 95% confidence interval [CI]: 0.13-0.87, P = 0.024). When stratified by dose, short-term NRT use (8-28 defined daily doses) was associated with significantly lower risk of glaucoma (HR: 0.35; 95% CI: 0.16-0.80, P = 0.012) and a trend toward reduced risk of cataract (HR: 0.60; 95% CI: 0.36-1.01, P = 0.053) compared to no treatment. However, these associations were not observed with long-term NRT use. The results of this real-world observational study indicate that NRT use, particularly short-term use, was associated with a lower risk of certain eye disorders compared to no treatment for smoking cessation. Long-term NRT use did not demonstrate the same benefits. Thus, short-term NRT may be a beneficial treatment strategy for reducing the risk of eye disorders in smokers attempting to quit. However, further evidence is required to verify these findings and determine the optimal duration of NRT use.
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Affiliation(s)
- Yuan-Tsung Tseng
- Department of Medical Research, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan
- Department of Public Health, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Tang Huang
- Department of Ophthalmology, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan
| | - Chun-Hsiang Wang
- Department of Optometry, Chung Hwa Medical University, Tainan, Taiwan
- Department of Hepatogastroenterology, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan
| | - Ling-Yu Wang
- Department of Ophthalmology, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan
| | - Yi-Chun Kuo
- Department of Ophthalmology, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan.
- Department of Ophthalmology, Ministry of Health and Welfare, Sinying Hospital, No. 73, Xinyi St., Tainan, Taiwan.
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Ophthalmology, Yunlin Christian Hospital, Yunlin, Taiwan.
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14
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Ebrahimi M, Ebrahimi M, Vergroesen JE, Aschner M, Sillanpää M. Environmental exposures to cadmium and lead as potential causes of eye diseases. J Trace Elem Med Biol 2024; 82:127358. [PMID: 38113800 DOI: 10.1016/j.jtemb.2023.127358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
Humans are exposed to cadmium and lead in various regions of the world daily due to industrial development and climate change. Increasing numbers of preclinical and clinical studies indicate that heavy metals, such as cadmium and lead, play a role in the pathogenesis of eye diseases. Excessive exposure to heavy metals such as cadmium and lead can increase the risk of impaired vision. Therefore, it is essential to better characterize the role of these non-essential metals in disease etiology and progression. This article discusses the potential role of cadmium and lead in the development of age-related eye diseases, including age-related macular degeneration, cataracts, and glaucoma. Furthermore, we discuss how cadmium and lead affect ocular cells and provide an overview of putative pathological mechanisms associated with their propensity to damage the eye.
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Affiliation(s)
- Moein Ebrahimi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Network of Immunity in Infection, Malignancy, and Autoimmunity, Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Maryam Ebrahimi
- Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Joëlle E Vergroesen
- Department of Ophthalmology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands; Department of Epidemiology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands.
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Mika Sillanpää
- Department of Chemical Engineering, School of Mining, Metallurgy and Chemical Engineering, University of Johannesburg, P. O. Box 17011, Doornfontein 2028, South Africa; International Research Centre of Nanotechnology for Himalayan Sustainability (IRCNHS), Shoolini University, Solan 173212, Himachal Pradesh, India; Zhejiang Rongsheng Environmental Protection Paper Co. LTD, NO.588 East Zhennan Road, Pinghu Economic Development Zone, Zhejiang 314213, PR China; Department of Civil Engineering, University Centre for Research & Development, Chandigarh University, Gharuan, Mohali, Punjab, India
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15
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Weisser B, Erb C. Neuroprotective Effects of Anti-diabetic Drugs in the Treatment of Patients with Diabetes and Glaucoma or at High Risk for Glaucoma. Klin Monbl Augenheilkd 2024; 241:302-307. [PMID: 37336238 DOI: 10.1055/a-2066-3389] [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: 06/21/2023]
Abstract
There is an association between glaucoma and several risk factors and metabolic diseases, such as type 2 diabetes mellitus. Diabetes mellitus leads to neurodegenerative changes, both peripherally and in the brain. This might be a shared pathophysiology and etiology for both glaucoma and diabetes. It is interesting that drugs for the treatment of diabetes seem to have neuroprotective properties independent of their blood sugar reduction. Although prospective, randomized, clinical studies are still missing, particularly metformin and glucagon-like peptide receptor agonists (GLP 1 RA) seem to have neuroprotective effects. Sulphonylureas (e.g., glibenclamide, glimepiride) are still used. They frequently potently reduce blood pressure but may be less neuroprotective. In the present review, the evidence for neuroprotective effects of the different antidiabetic drugs is presented and a possible differential therapy for patients with diabetes and glaucoma, or at high risk of glaucoma, will be discussed.
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Affiliation(s)
| | - Carl Erb
- Augenklinik am Wittenbergplatz, Berlin, Deutschland
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16
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Wang T, Kimmel HRC, Park C, Ryoo H, Liu J, Underhill GH, Pattabiraman PP. Regulatory role of cholesterol in modulating actin dynamics and cell adhesive interactions in the trabecular meshwork. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.02.02.578717. [PMID: 38352310 PMCID: PMC10862777 DOI: 10.1101/2024.02.02.578717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
The trabecular meshwork (TM) tissue plays a crucial role in maintaining intraocular pressure (IOP) homeostasis. Increased TM contractility and stiffness are directly correlated with elevated IOP. Although cholesterol is known to be a determinant of glaucoma occurrence and elevated IOP, the underlying mechanisms remain elusive. In this study, we used human TM (HTM) cells to unravel the effects of cholesterol on TM stiffness. We achieved this by performing acute cholesterol depletion with Methyl-β-cyclodextrin (MβCD) and cholesterol enrichment/replenishment with MβCD cholesterol complex (CHOL). Interestingly, cholesterol depletion triggered notable actin depolymerization and decreased focal adhesion formation, while enrichment/replenishment promoted actin polymerization, requiring the presence of actin monomers. Using a specific reporter of phosphatidylinositol 4,5-bisphosphate (PIP2), we demonstrated that cholesterol depletion decreases PIP2 levels on the cell membrane, whereas enrichment increases them. Given the critical role of PIP2 in actin remodeling and focal adhesion formation, we postulate that cholesterol regulates actin dynamics by modulating PIP2 levels on the membrane. Furthermore, we showed that cholesterol levels regulate integrin α5β1 and αVβ3 distribution and activation, subsequently altering cell-extracellular matrix (ECM) interactions. Notably, the depletion of cholesterol, as a major lipid constituent of the cell membrane, led to a decrease in HTM cell membrane tension, which was reversed upon cholesterol replenishment. Overall, our systematic exploration of cholesterol modulation on TM stiffness highlights the critical importance of maintaining appropriate membrane and cellular cholesterol levels for achieving IOP homeostasis.
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Affiliation(s)
- Ting Wang
- Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, 1160 West Michigan Street, Indianapolis, Indiana, 46202, United States of America
- Stark Neuroscience Research Institute, Medical Neuroscience Graduate Program, Indiana University School of Medicine, 320 W. 15th Street, Indiana, 46202, United States of America
| | - Hannah R C Kimmel
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, 61801, United States of America
| | - Charles Park
- Deparment of Physics and Astronomy, Purdue University, 525 Northwestern Avenue, West Lafayette, Indiana, 47907, United States of America
| | - Hyeon Ryoo
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, 61801, United States of America
| | - Jing Liu
- Deparment of Physics and Astronomy, Purdue University, 525 Northwestern Avenue, West Lafayette, Indiana, 47907, United States of America
| | - Gregory H Underhill
- Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois, 61801, United States of America
| | - Padmanabhan P Pattabiraman
- Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, 1160 West Michigan Street, Indianapolis, Indiana, 46202, United States of America
- Stark Neuroscience Research Institute, Medical Neuroscience Graduate Program, Indiana University School of Medicine, 320 W. 15th Street, Indiana, 46202, United States of America
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17
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Braha A, Simion A, Timar R, Timar B. Factors Associated with Increased Intraocular Pressure in Type 2 Diabetes Patients. J Clin Med 2024; 13:676. [PMID: 38337370 PMCID: PMC10856384 DOI: 10.3390/jcm13030676] [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: 01/08/2024] [Revised: 01/21/2024] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Over one-third of patients living with diabetes will develop ocular disease during their lifetime. The present study analyzes the association between metabolic and anthropometric markers, associated comorbidities, and intraocular pressure (IOP) in patients with type 2 diabetes mellitus (DM). METHODS The retrospective study included 87 adult patients with type 2 DM who underwent routine eye examinations and blood/urine tests. RESULTS 67.9% of the patients had an IOP > 14.5 mmHg and only 41.3% had an HbA1c < 7%. In a multivariate regression analysis, the mean IOP was associated with diabetes duration in subjects with a disease duration < 15 years and an HbA1c < 7% (adjusted R2 = 0.29, p = 0.008). Also, patients with shorter diabetes duration and optimal glucose control had a lower mean IOP than patients with a higher HbA1c (mean IOP 15.1 mmHG vs. 18.9 mmHg, p = 0.04). The patient's age, anthropometric or metabolic markers, associated comorbidities like hypertension (HTN) or retinal angiosclerosis, and diabetes therapies were not associated with IOP in this study. CONCLUSION Diabetes progression is directly associated with increased IOP. Avoiding clinical inertia and optimizing glycemic control could prevent or delay the increase of IOP. Routine eye examination should include measuring IOP, not only diabetic retinopathy screening.
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Affiliation(s)
- Adina Braha
- Department of Second Internal Medicine—Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.B.); (R.T.); (B.T.)
- Department of Diabetes, Nutrition and Metabolic Diseases Clinic, “Pius Brînzeu” Emergency Clinical County University Hospital, 300723 Timisoara, Romania
| | - Amanda Simion
- Vista Vision Ophthalmology Clinic, 300367 Timisoara, Romania
| | - Romulus Timar
- Department of Second Internal Medicine—Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.B.); (R.T.); (B.T.)
- Department of Diabetes, Nutrition and Metabolic Diseases Clinic, “Pius Brînzeu” Emergency Clinical County University Hospital, 300723 Timisoara, Romania
| | - Bogdan Timar
- Department of Second Internal Medicine—Diabetes, Nutrition, Metabolic Diseases, and Systemic Rheumatology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (A.B.); (R.T.); (B.T.)
- Department of Diabetes, Nutrition and Metabolic Diseases Clinic, “Pius Brînzeu” Emergency Clinical County University Hospital, 300723 Timisoara, Romania
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18
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Li Y, Xie L, Song W, Chen S, Cheng Y, Gao Y, Huang M, Yan X, Yang S. Association between dyslipidaemia and dry eye disease: a systematic review and meta-analysis. BMJ Open 2023; 13:e069283. [PMID: 37989379 PMCID: PMC10668302 DOI: 10.1136/bmjopen-2022-069283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 08/25/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE To report a systematic review and meta-analysis of the association between dry eye disease (DED) and dyslipidaemia. METHODS PubMed, Embase, Web of Science and Cochrane Library were systematically searched from January 2000 to December 2021. We included observational studies to assess the correlation of DED with meibomian gland dysfunction and dyslipidaemia without any language restrictions. The pooled OR with 95% CI was calculated in Stata V.15. RESULTS Of 6727 identified studies, 18 studies (21 databases) with a total of 2 663 126 patients were analysed in our meta-analysis. The results showed that DED risk was associated with dyslipidaemia (OR=1.53, 95% CI: 1.41 to 1.66, p=0.001), especially elevated total cholesterol levels (OR=1.57, 95% CI: 1.25 to 1.99, p<0.001), elevated low-density lipoprotein cholesterol levels (OR=1.13, 95% CI: 1.06 to 1.20, p<0.001) and high-density lipoprotein cholesterol levels (OR=1.06, 95% CI: 1.01 to 1.11, p<0.001), but not with serum triglyceride levels. Moreover, having a history of lipid-lowering drug use (OR=1.41, 95% CI: 1.19 to 1.67, p<0.001) was also found to be positively associated with DED risk. CONCLUSIONS The findings suggested that dyslipidaemia and lipid-lowering drug use might be associated with an increased risk of DED. More evidence is needed to confirm the findings by prospective studies. PROSPERO REGISTRATION NUMBER CRD42022296664.
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Affiliation(s)
- Yingsi Li
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Luoying Xie
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Wenjing Song
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Shudi Chen
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Yu Cheng
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Yuan Gao
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Meiting Huang
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Xiaoming Yan
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Songlin Yang
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
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Wu Z, Huang C, Zheng Y, Yuan XL, Chen S, Xu Y, Chen LJ, Pang CP, Zhang M, Ng TK. Primary open-angle glaucoma risk prediction with ABCA1 and LOC102723944 variants and their genotype-phenotype correlations in southern Chinese population. Mol Genet Genomics 2023; 298:1343-1352. [PMID: 37516687 DOI: 10.1007/s00438-023-02058-6] [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: 07/09/2022] [Accepted: 07/19/2023] [Indexed: 07/31/2023]
Abstract
Glaucoma is a leading cause of irreversible visual impairment and blindness worldwide. Previous genome-wide association studies have identified caveolin-1 (CAV1), ATP-binding cassette A1 (ABCA1), and forkhead box C1 (FOXC1) loci associated with primary open angle glaucoma (POAG), a major subtype of glaucoma. This study aimed to fine map the association pattern of FOXC1 locus with POAG and determine the correlations of FOXC1, ABCA1, and CAV1 variants with ocular and lipidemic parameters in southern Chinese population. In total, 1291 unrelated Han Chinese subjects were recruited, including 301 high-tension glaucoma (HTG), 126 normal-tension glaucoma (NTG), and 864 control subjects. Twelve variants in FOXC1 locus, and two variants in ABCA1 and CAV1 genes, were genotyped by TaqMan assays. Genetic risk score and genotype-phenotype correlation analyses were conducted. In the FOXC1 locus, LOC102723944 rs6596830, rather than previously reported rs2745572, showed significant association with POAG (P = 8.61 × 10-4, odds ratio (OR) = 0.75) and HTG (P = 3.68 × 10-3, OR = 0.75). ABCA1 rs2487032 was also significantly associated with POAG (P = 3.00 × 10-5, OR = 0.70) and HTG (P = 2.08 × 10-4, OR = 0.70). Joint analysis showed that carriers of homozygous non-protective alleles of ABCA1 rs2487032 and LOC102723944 rs6596830 had 2.99-fold higher risk of POAG (P = 1.27 × 10-3) when compared to those carrying homozygous non-risk alleles. Patients with POAG carrying ABCA1 rs2487032 G allele had higher HDL cholesterol, and those with LOC102723944 rs6596830 A allele had lower LDL. This study revealed individual and joint association of ABCA1 and LOC102723944 variants with POAG in southern Chinese population. Subjects carrying non-protective alleles had increased risk to POAG, and corresponding genotypes would affect the lipid profiles.
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Affiliation(s)
- Zhenggen Wu
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Guangdong, Shantou, China
| | - Chukai Huang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Guangdong, Shantou, China
| | - Yuqian Zheng
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Guangdong, Shantou, China
| | - Xiang-Ling Yuan
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Guangdong, Shantou, China
- Shantou University Medical College, Shantou, Guangdong, China
| | - Shaowan Chen
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Guangdong, Shantou, China
| | - Yanxuan Xu
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Guangdong, Shantou, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Chi Pui Pang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Guangdong, Shantou, China.
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Guangdong, Shantou, China.
| | - Tsz Kin Ng
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Guangdong, Shantou, China.
- Shantou University Medical College, Shantou, Guangdong, China.
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
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20
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Bhandari G, Bhandari S, Byanju R, Pradhan S, Sah RK, Kandel RP, Thompson IJ, Rotchford AP, West SK, Muñoz B, Stevens VM, Oatts JT, Ou Y, Lietman TM, O’Brien KS, Keenan JD. Relationship Between Intraocular Pressure and Age: A Population-Based Study in Nepal. J Glaucoma 2023; 32:983-988. [PMID: 37670512 PMCID: PMC10840987 DOI: 10.1097/ijg.0000000000002291] [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: 03/02/2023] [Accepted: 06/02/2023] [Indexed: 09/07/2023]
Abstract
PRCIS Intraocular pressure (IOP) decreased with age in a population-based study in Nepal, from a mean of 14.1 mm Hg among those 60-64 years old to 13.0 mm Hg among those 80 years old or older. PURPOSE Few studies have assessed the distribution of IOP from the Indian subcontinent, despite its large population and high burden of glaucoma. The objective of this study was to assess the distribution of IOP measurements from adults living in a lowland region of Nepal. METHODS In a population-based cross-sectional study, all individuals aged 60 years and older from an area of lowland Nepal were invited for an IOP assessment with a rebound tonometer. RESULTS Of 160 communities (28,672 people aged ≥60 y) enrolled, 79 (13,808 people aged ≥60 y) were randomly selected for IOP testing. Of those eligible, 10,017 (72.5%) individuals underwent tonometry. Mean IOP decreased monotonically over 5-year age groups, from 14.1 mm Hg (SD: 3.6) among those aged 60-64 years to 13.0 mm Hg (SD: 4.2) among those 80 years or older. The 97.5th percentile IOP measurement was 21.0 mm Hg for all age groups. In adjusted analyses, younger age, self-reported diabetes, and higher population density were each associated with higher IOP, and self-reported cataract surgery was associated with lower IOP. CONCLUSIONS Mean IOP was lower among older individuals in Nepal, consistent with many studies from East Asia and in contrast to many studies from western populations. These results suggest that ethnic background might be a consideration when diagnosing ocular hypertension.
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Affiliation(s)
| | | | | | | | | | | | - Isabel J Thompson
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
| | - Alan P Rotchford
- Department of Ophthalmology, Tennent Institute of Ophthalmology, Gartnavel Hospital, Glasgow, UK
| | - Sheila K West
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Beatriz Muñoz
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Valerie M Stevens
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
| | - Julius T Oatts
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Yvonne Ou
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Thomas M Lietman
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, USA
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Kieran S O’Brien
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
| | - Jeremy D Keenan
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California San Francisco, San Francisco, CA, USA
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21
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Lee TE, Kim JS, Yeo CD, Yeom SW, Lee MG, Kang MG, Lee HJ, Lee EJ. Bidirectional Association Between Sudden Sensorineural Hearing Loss and Glaucoma: A Cohort Study. Laryngoscope 2023; 133:3169-3177. [PMID: 37036100 DOI: 10.1002/lary.30689] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/20/2023] [Accepted: 03/24/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVES To investigate the bidirectional association between sudden sensorineural hearing loss (SSNHL) and open-angle glaucoma (OAG) over a 12-year follow-up period using nationwide, population-based data. METHODS The study was conducted using the National Health Information Database of the National Health Insurance Service (NHIS-NHID), which covered 3.5 million individuals from 2008 to 2019. In Study 1, we evaluated the effect of OAG on SSNHL, and in Study 2, we evaluated the effect of SSNHL on OAG. Participants of the control group were enrolled through "greedy nearest-neighbor" 1:1 propensity score matching. RESULTS In Study 1, 26,777 people were included in each group. The hazard ratio (HR) for SSNHL of the OAG group was 1.27 (95% confidence interval [CI], 1.15-1.39). In subgroup analysis, there was significant HR value regarding (old age: 1.17, hyperlipidemia: 1.19). In Study 2, 15,433 people were included in each group. The HR for OAG of the SSNHL group was 1.18 (95% CI, 1.07-1.30). In subgroup analysis, the HRs were significant for old age (2.31), hypertension (1.17), diabetes (1.39), and hyperlipidemia (1.26). CONCLUSION Over the 12-year follow-up, we found a bidirectional association between SSNHL and OAG, suggesting a shared pathogenesis. LEVEL OF EVIDENCE N/A. Laryngoscope, 133:3169-3177, 2023.
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Affiliation(s)
- Tae-Eun Lee
- Department of Ophthalmology, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Jong Seung Kim
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Cha Dong Yeo
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Sang Woo Yeom
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Min Gyu Lee
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Min Gu Kang
- Department of Medical Informatics, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Haeng-Jin Lee
- Department of Ophthalmology, Jeonbuk National University Medical School, Jeonju, Republic of Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Eun Jung Lee
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Jeonbuk National University Medical School, Jeonju, Republic of Korea
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22
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Wang T, Soundararajan A, Rabinowitz J, Jaiswal A, Osborne T, Pattabiraman PP. Identification of the novel role of sterol regulatory element binding proteins (SREBPs) in mechanotransduction and intraocular pressure regulation. FASEB J 2023; 37:e23248. [PMID: 37823226 PMCID: PMC10826798 DOI: 10.1096/fj.202301185r] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023]
Abstract
Trabecular meshwork (TM) cells are contractile and mechanosensitive, and they aid in maintaining intraocular pressure (IOP) homeostasis. Lipids are attributed to modulating TM contractility, with poor mechanistic understanding. In this study using human TM cells, we identify the mechanosensing role of the transcription factors sterol regulatory element binding proteins (SREBPs) involved in lipogenesis. By constitutively activating SREBPs and pharmacologically inactivating SREBPs, we have mechanistically deciphered the attributes of SREBPs in regulating the contractile properties of TM. The pharmacological inhibition of SREBPs by fatostatin and molecular inactivation of SREBPs ex vivo and in vivo, respectively, results in significant IOP lowering. As a proof of concept, fatostatin significantly decreased the SREBPs responsive genes and enzymes involved in lipogenic pathways as well as the levels of the phospholipid, cholesterol, and triglyceride. Further, we show that fatostatin mitigated actin polymerization machinery and stabilization, and decreased ECM synthesis and secretion. We thus postulate that lowering lipogenesis in the TM outflow pathway can hold the key to lowering IOP by modifying the TM biomechanics.
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Affiliation(s)
- Ting Wang
- Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, 1160 West Michigan Street, Indianapolis, Indiana, 46202, United States of America
- Stark Neuroscience Research Institute, Medical Neuroscience Graduate Program, Indiana University School of Medicine, 320 W. 15th Street, Indiana, 46202, United States of America
| | - Avinash Soundararajan
- Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, 1160 West Michigan Street, Indianapolis, Indiana, 46202, United States of America
| | - Jeffrey Rabinowitz
- Department of Ophthalmology, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Anant Jaiswal
- Institute for Fundamental Biomedical Research, Department of Medicine and Biological Chemistry, Johns Hopkins University School of Medicine, St. Petersburg, Florida, 33701, United States of America
| | - Timothy Osborne
- Institute for Fundamental Biomedical Research, Department of Medicine and Biological Chemistry, Johns Hopkins University School of Medicine, St. Petersburg, Florida, 33701, United States of America
| | - Padmanabhan Paranji Pattabiraman
- Glick Eye Institute, Department of Ophthalmology, Indiana University School of Medicine, 1160 West Michigan Street, Indianapolis, Indiana, 46202, United States of America
- Stark Neuroscience Research Institute, Medical Neuroscience Graduate Program, Indiana University School of Medicine, 320 W. 15th Street, Indiana, 46202, United States of America
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23
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Xiong K, Mao H, Zhang Q, Lei C, Liang Y. Associations between vision impairment and multimorbidity among older Chinese adults: results from the China health and retirement longitudinal study. BMC Geriatr 2023; 23:688. [PMID: 37875816 PMCID: PMC10594768 DOI: 10.1186/s12877-023-04393-0] [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: 03/21/2023] [Accepted: 10/07/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Although several studies have reported the relationship between vision impairment (VI) and multimorbidity in high-income countries, this relationship has not been reported in low- and middle-income countries. This study aimed to explore the relationship between VI with multimorbidity and chronic conditions among the elderly Chinese population. METHODS The cross-sectional analysis was applied to data from the China Health and Retirement Longitudinal Study (CHARLS) in 2018. A total of 8,108 participants ≥ 60 years old were included, and 15 chronic conditions were used in this study. Logistic regression analysis was used to analyze the relationship between VI with multimorbidity and chronic conditions. RESULTS The prevalence of 15 chronic conditions and multimorbidity was higher among the elderly with VI than those without VI. After adjusting for demographic and socioeconomic confounders, 10 chronic conditions were associated with VI (all P < 0.05). Furthermore, positive association was observed between VI and one (odds ratio [OR]: 1.52; 95% confidence intervals [95%CI]: 1.16-2.00; P = 0.002), two (OR: 2.09; 95%CI: 1.61-2.71; P < 0.001), three (OR: 2.87; 95%CI: 2.22-3.72; P < 0.001), four (OR: 3.60; 95%CI: 2.77-4.69; P < 0.001), and five or more (OR: 5.53; 95%CI: 4.32-7.09; P < 0.001) chronic conditions, and the association increased as the number of chronic conditions (P for trend < 0.001). Sensitivity analysis stratified by gender, education, smoking status, and annual per capita household expenditure still found VI to be positively associated with multimorbidity. CONCLUSIONS For patients older than 60 years, VI was independently associated with multimorbidity and various chronic conditions. This result has important implications for healthcare resource plans and clinical practice, for example, increased diabetes and kidney function screening for patients with VI.
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Affiliation(s)
- Kun Xiong
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270, Xue Yuan Xi Road, Wenzhou, 325027, Zhejiang, China
| | - Huiyan Mao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270, Xue Yuan Xi Road, Wenzhou, 325027, Zhejiang, China
| | - Qi'ao Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270, Xue Yuan Xi Road, Wenzhou, 325027, Zhejiang, China
| | - Changrong Lei
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270, Xue Yuan Xi Road, Wenzhou, 325027, Zhejiang, China
| | - Yuanbo Liang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, No. 270, Xue Yuan Xi Road, Wenzhou, 325027, Zhejiang, China.
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24
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Zafar U, Hameed A, Amjad A, Javed MS, Afzal MI, Umer M, Al-Serwi RH, Batool Qaisarani T, Imran M, Hussain M, Anwar MJ, Siddique F, Suleman R, AL JBawi E. Potential of barley enriched yogurt to improve probiotic growth for the management of hypercholesterolemia. INTERNATIONAL JOURNAL OF FOOD PROPERTIES 2023; 26:1177-1189. [DOI: 10.1080/10942912.2023.2206064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/09/2023] [Indexed: 05/18/2024]
Affiliation(s)
- Umrah Zafar
- Department of Food Science and Technology, Faculty of Agriculture & Environmental Science, Muhammad Nawaz Shareef University of Agriculture, Multan, Pakistan
| | - Aneela Hameed
- Faculty of Food Science and Nutrition, Bahauddin Zakariya University, Multan, Punjab, Pakistan
| | - Adnan Amjad
- Faculty of Food Science and Nutrition, Bahauddin Zakariya University, Multan, Punjab, Pakistan
| | - Muhammad Sameem Javed
- Faculty of Food Science and Nutrition, Bahauddin Zakariya University, Multan, Punjab, Pakistan
| | - Muhammad Inam Afzal
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Muhammad Umer
- Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Rasha Hamed Al-Serwi
- Department of Basic Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Tahira Batool Qaisarani
- Department of Agriculture, Engineering and Technology, Ghazi University, Dera Ghazi Khan, Pakistan
| | - Muhammad Imran
- Department of Food Science and Technology, University of Narowal-Pakistan,Narowal, Pakistan
| | - Muzzamal Hussain
- Department of Food Sciences, Government College University Faisalabad, Faisalabad, Pakistan
| | - Muhammad Junaid Anwar
- Faculty of Food Science and Nutrition, Bahauddin Zakariya University, Multan, Punjab, Pakistan
| | - Farzana Siddique
- Institute of Food Science and Nutrition, Faculty of Agriculture, University of Sargodha, Sargodha, Punjab, Pakistan
| | - Raheel Suleman
- Institute of Food Science and Nutrition, Faculty of Agriculture, University of Sargodha, Sargodha, Punjab, Pakistan
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25
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Zhao J, Zou H, Xiao J. Chylous aqueous humor caused by hyperlipidemia: A case report and literature review. Medicine (Baltimore) 2023; 102:e34972. [PMID: 37682141 PMCID: PMC10489254 DOI: 10.1097/md.0000000000034972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023] Open
Abstract
RATIONALE Generally, there is no lipoprotein in aqueous humor, and chyle usually exists transiently in the body. Therefore, persistent chylous aqueous humor is rare. PATIENT CONCERNS We report a case of a 39-year-old man with persistent milky white appearance over the right eye. DIAGNOSES The patient had a history of poorly controlled diabetes for the past 2 years and central retinal vein occlusion of the same eye for the past 2 weeks. The patient's right eye had a uniform milky appearance in the anterior chamber, transparent cornea, and no keratic precipitate in the posterior cornea. Color Doppler ultrasound of the affected eye showed no obvious inflammation in the vitreous cavity. Laboratory tests revealed severe chylemia. The patient was finally diagnosed as chylous aqueous humor. INTERVENTIONS AND OUTCOMES After conventional hypolipidemia and hypoglycemia treatment and locally glucocorticoid treatment. The milky white changes in the anterior chamber improved considerably and finally disappeared. LESSONS Although the impact of hyperlipidemia on the cardiovascular system and digestive system is well known, its impact on the eyes is often overlooked. We report a rare case of unilateral chylous aqueous humor caused by hyperlipidemia. Through the analysis of this special case, we recommend that ophthalmologists should pay attention to the impact of blood lipid change on eyes.
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Affiliation(s)
- Jing Zhao
- Department of Ophthalmology, The Second Hospital of Jilin University, Jilin University, Changchun, Jilin, P.R. China
| | - He Zou
- Department of Ophthalmology, The Second Hospital of Jilin University, Jilin University, Changchun, Jilin, P.R. China
| | - Jun Xiao
- Department of Ophthalmology, The Second Hospital of Jilin University, Jilin University, Changchun, Jilin, P.R. China
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26
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Wang Y, Dong XX, Hou XW, Pan CW. Risk Factors for Primary Angle-closure Glaucoma: A Systematic Review and Meta-analysis of 45 Studies. Optom Vis Sci 2023; 100:606-613. [PMID: 37747945 DOI: 10.1097/opx.0000000000002050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Abstract
SIGNIFICANCE This study summarized primary angle-closure glaucoma (PACG)-related factors across different dimensions. OBJECTIVES This review aimed at systematically summarizing the associated factors of PACG in published literatures. METHODS A systematic review and meta-analysis were conducted by searching the electronic databases including PubMed, EMBASE, and Web of Science from their inception to November 2021. The pooled risk estimates of continuous and categorical variables were calculated using weighted mean difference (WMD) and odds ratio (OR; 95% confidence intervals [CIs]), respectively. RESULTS We included 45 studies in this review. In the meta-analysis, intraocular pressure (WMD, 3.13; 95% CI, 2.37 to 3.89), anterior chamber depth (WMD, -0.52; 95% CI, -0.70 to -0.34), axial length (WMD, -0.77; 95% CI, -1.26 to -0.28), retinal nerve fiber layer (WMD, -21.23; 95% CI, -30.21 to -12.25), and spherical equivalent (WMD, 1.02; 95% CI, 0.66 to 1.38) were the most common ophthalmic anatomic factors, and lower body weight (WMD, -3.65; 95% CI, -6.48 to -0.82) was the most significant general morphological indicators. The presence of cataract (OR, 3.77; 95% CI, 3.46 to 4.11) and hyperlipidemia (OR, 1.10; 95% CI, 1.02 to 1.20) were significantly associated with PACG. Increased level of triglyceride (WMD, 0.17; 95% CI, 0.06 to 0.27) was associated with PACG. In addition, an association between short-term antidepressant exposure (OR, 1.36; 95% CI, 1.08 to 1.70) and acute angle-closure glaucoma was observed. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS This review identified a few consistent factors related to PACG, providing important information for primary care physicians, general ophthalmologists, and public health professionals to counsel their patients on PACG risks.
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Affiliation(s)
- Ying Wang
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Xing-Xuan Dong
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Xiao-Wen Hou
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
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27
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Wang X, Wang M, Liu H, Mercieca K, Prinz J, Feng Y, Prokosch V. The Association between Vascular Abnormalities and Glaucoma-What Comes First? Int J Mol Sci 2023; 24:13211. [PMID: 37686017 PMCID: PMC10487550 DOI: 10.3390/ijms241713211] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Glaucoma is a leading cause of irreversible blindness worldwide. While intraocular pressure (IOP) presents a major risk factor, the underlying pathophysiology still remains largely unclear. The correlation between vascular abnormalities and glaucoma has been deliberated for decades. Evidence for a role played by vascular factors in the pathogenesis of glaucomatous neurodegeneration has already been postulated. In addition, the fact that glaucoma causes both structural and functional changes to retinal blood vessels has been described. This review aims to investigate the published evidence concerning the relationship between vascular abnormalities and glaucoma, and to provide an overview of the "chicken or egg" dilemma in glaucoma. In this study, several biomarkers of glaucoma progression from a vascular perspective, including endothelin-1 (ET-1), nitric oxide, vascular endothelial growth factor (VEGF), and matrix metalloproteinases (MMPs), were identified and subsequently assessed for their potential as pharmacological intervention targets.
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Affiliation(s)
- Xiaosha Wang
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
| | - Maoren Wang
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
- Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Hanhan Liu
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
| | - Karl Mercieca
- Glaucoma Section, University Hospital Eye Clinic, 53127 Bonn, Germany;
- Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester M13 9WH, UK
| | - Julia Prinz
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
- Department of Ophthalmology, RWTH Aachen University, 52074 Aachen, Germany
| | - Yuan Feng
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
| | - Verena Prokosch
- Department of Ophthalmology, University of Cologne, Kerpener Str. 62, 50937 Cologne, Germany; (X.W.); (M.W.); (H.L.); (J.P.); (Y.F.)
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
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28
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Yoo H, Singh A, Li H, Strat AN, Bagué T, Ganapathy PS, Herberg S. Simvastatin Attenuates Glucocorticoid-Induced Human Trabecular Meshwork Cell Dysfunction via YAP/TAZ Inactivation. Curr Eye Res 2023; 48:736-749. [PMID: 37083467 PMCID: PMC10524554 DOI: 10.1080/02713683.2023.2206067] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/22/2023] [Accepted: 04/18/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE Impairment of the trabecular meshwork (TM) is the principal cause of increased outflow resistance in the glaucomatous eye. Yes-associated protein (YAP) and transcriptional coactivator with PDZ binding motif (TAZ) are emerging as potential mediators of TM cell/tissue dysfunction. Furthermore, YAP/TAZ activity was recently found to be controlled by the mevalonate pathway in non-ocular cells. Clinically used statins block the mevalonate cascade and were shown to improve TM cell pathobiology; yet, the link to YAP/TAZ signaling was not investigated. In this study, we hypothesized that simvastatin attenuates glucocorticoid-induced human TM (HTM) cell dysfunction via YAP/TAZ inactivation. METHODS Primary HTM cells were seeded atop or encapsulated within bioengineered extracellular matrix (ECM) hydrogels. Dexamethasone was used to induce a pathologic phenotype in HTM cells in the absence or presence of simvastatin. Changes in YAP/TAZ activity, actin cytoskeletal organization, phospho-myosin light chain levels, hydrogel contraction/stiffness, and fibronectin deposition were assessed. RESULTS Simvastatin potently blocked pathologic YAP/TAZ nuclear localization/activity, actin stress fiber formation, and myosin light chain phosphorylation in HTM cells. Importantly, simvastatin co-treatment significantly attenuated dexamethasone-induced ECM contraction/stiffening and fibronectin mRNA and protein levels. Sequential treatment was similarly effective but did not match clinically-used Rho kinase inhibition. CONCLUSIONS YAP/TAZ inactivation with simvastatin attenuates HTM cell pathobiology in a tissue-mimetic ECM microenvironment. Our data may help explain the association of statin use with a reduced risk of developing glaucoma via indirect YAP/TAZ inhibition as a proposed regulatory mechanism.
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Affiliation(s)
- Hannah Yoo
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Ayushi Singh
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- Department of Cell and Developmental Biology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- BioInspired Institute, Syracuse University, Syracuse, NY 13244, USA
| | - Haiyan Li
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- Department of Cell and Developmental Biology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- BioInspired Institute, Syracuse University, Syracuse, NY 13244, USA
| | - Ana N. Strat
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- BioInspired Institute, Syracuse University, Syracuse, NY 13244, USA
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Tyler Bagué
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Preethi S. Ganapathy
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- BioInspired Institute, Syracuse University, Syracuse, NY 13244, USA
- Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
| | - Samuel Herberg
- Department of Ophthalmology and Visual Sciences, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- Department of Cell and Developmental Biology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- BioInspired Institute, Syracuse University, Syracuse, NY 13244, USA
- Department of Biochemistry and Molecular Biology, SUNY Upstate Medical University, Syracuse, NY 13210, USA
- Department of Biomedical and Chemical Engineering, Syracuse University, Syracuse, NY 13244, USA
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29
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Pasquale LR, Khawaja AP, Wiggs JL, Kim J, Hysi P, Elze T, Lasky-Su J, Kang JH, Zeleznik O. Metabolite and Lipid Biomarkers Associated With Intraocular Pressure and Inner Retinal Morphology: 1H NMR Spectroscopy Results From the UK Biobank. Invest Ophthalmol Vis Sci 2023; 64:11. [PMID: 37552033 PMCID: PMC10411643 DOI: 10.1167/iovs.64.11.11] [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: 01/25/2023] [Accepted: 07/17/2023] [Indexed: 08/09/2023] Open
Abstract
Purpose The purpose of this study was to assess metabolites associated with intraocular pressure (IOP) and inner retina structure. Methods We cross-sectionally assessed 168 non-fasting plasma metabolites measured by nuclear magnetic resonance (NMR) spectroscopy with IOP (n = 28,195), macular retinal nerve fiber layer thickness (mRNFL; n = 10,584), and macular ganglion cell inner plexiform layer thickness (mGCIPL; n = 10,554) in the UK Biobank. We used multiple linear regression models adjusting for various covariates with probit-transformed metabolite levels as predictors for each outcome. Each estimate represents the difference in outcome variable per standard deviation increase in the probit-transformed metabolite values. We used the number of effective (NEF) tests and false discovery rate (FDR) to adjust for multiple comparisons for metabolites and metabolite classes, respectively. Results In individual metabolite analysis, multiple amino acids, especially branched-chain amino acids, were associated with lower IOP (-0.12 mm Hg; 95% confidence interval = -0.16 to -0.07; NEF = 2.7E-05). Albumin, 3 hydroxybutyrate, lactate, and several lipids were associated with higher IOP (range = 0.07 to 0.18 mm Hg, NEF = ≤ 0.039). In IOP-adjusted analyses, five HDL-related metabolites were associated with thinner mRNFL (-0.15 microns for all metabolites, NEF = ≤ 0.027), whereas five LDL-related metabolites were associated with thicker mGCIPL (range = 0.17 to 0.20 microns; NEF = ≤ 0.044). In metabolite class analysis, the lipid components of lipoproteins (cholesterol, triglycerides, etc.) were not associated with our outcomes (FDR > 0.2 for all); yet multiple lipoproteins were significantly (FDR < 0.05) associated with all outcomes. Conclusions Branched-chain amino acids were associated with lower IOP, HDL metabolites were associated with thinner mRNFL, and LDL metabolites were associated with thicker mGCIPL.
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Affiliation(s)
- Louis R. Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Anthony P. Khawaja
- NIHR Biomedical Research Centre at Moorfields Eye Hospital & UCL Institute of Ophthalmology, London, United Kingdom
| | - Janey L. Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Jihye Kim
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Pirro Hysi
- Department of Ophthalmology, King's College London, St. Thomas’ Hospital, London, United Kingdom
- Department of Twin Research & Genetic Epidemiology, King's College London, St. Thomas’ Hospital, London, United Kingdom
| | - Tobias Elze
- Department of Ophthalmology, Schepens Research Eye Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Jae H. Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - Oana Zeleznik
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
| | - for the UK Biobank Eye and Vision Consortium
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- NIHR Biomedical Research Centre at Moorfields Eye Hospital & UCL Institute of Ophthalmology, London, United Kingdom
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States
- Department of Ophthalmology, King's College London, St. Thomas’ Hospital, London, United Kingdom
- Department of Twin Research & Genetic Epidemiology, King's College London, St. Thomas’ Hospital, London, United Kingdom
- Department of Ophthalmology, Schepens Research Eye Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, United States
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States
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Yokoyama S, Nakagawa C, Hosomi K. Association between statin use and open-angle glaucoma: a nested case-control study using the Japanese claims database. Sci Rep 2023; 13:11677. [PMID: 37468563 DOI: 10.1038/s41598-023-38957-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 07/18/2023] [Indexed: 07/21/2023] Open
Abstract
The association between statins and open-angle glaucoma (OAG) remains controversial. This study investigated the relationship between statins and OAG in Japanese patients with dyslipidemia using the Japanese administrative claims database. A nested case-control study using two models was conducted using the JMDC claims database (01/2005-01/2020). The onset of OAG: index date was defined as the diagnosis of glaucoma, prescription of anti-glaucoma drugs, or surgery of glaucoma. For each case, a maximum of 10 age-, sex-, and calendar year/month-matched controls were randomly selected by risk-set sampling with replacement. The number of statin prescriptions during the exposure assessment period, which was identified as the 12-month (model 1) or 24-month (model 2) periods prior to the index date, was used as an indicator for statin exposure. Adjusted odds ratios (aORs) and 95% confidence interval (CI) were estimated using conditional logistic regression analyses. We identified 375,373 patients with newly diagnosed dyslipidemia. Of these, 6180 cases and 61,792 controls (model 1) and 4153 cases and 41,522 controls (model 2) were selected. Statin use was not identified as a significant risk factor for OAG (model 1: aOR 0.98, 95% CI 0.93-1.03, model 2: aOR 0.97, 95% CI 0.91-1.04). Compared with nonexposure, short-term exposure (< 2 years) to statins was not related to an increased risk of OAG in the Japanese working-age population with dyslipidemia.
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Affiliation(s)
- Satoshi Yokoyama
- Division of Drug Informatics, School of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashiōsaka City, Osaka, 577-8502, Japan.
| | - Chihiro Nakagawa
- Division of Drug Informatics, School of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashiōsaka City, Osaka, 577-8502, Japan
| | - Kouichi Hosomi
- Division of Drug Informatics, School of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashiōsaka City, Osaka, 577-8502, Japan
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Noreen S, Rehman H, Tufail T, Badar Ul Ain H, Awuchi CG. Secoisolariciresinol diglucoside and anethole ameliorate lipid abnormalities, oxidative injury, hypercholesterolemia, heart, and liver conditions. Food Sci Nutr 2023; 11:2620-2630. [PMID: 37324915 PMCID: PMC10261738 DOI: 10.1002/fsn3.3250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 02/20/2023] Open
Abstract
Fennel seeds and flaxseed have been traditionally used against many medical ailments due to their medicinal characteristics. The aim of the study was to investigate the health properties of secoisolariciresinol diglucoside (SDG) and anethole from flaxseed and fennel seeds in rats fed with high-fat diet. Histopathological changes in the heart and liver were also examined. Sixty rats were divided into two main groups. Group I (10 rats) was used as a negative control group and fed on the basal diet only. Group II (50 rats) was fed a hypercholesterolemic diet but not given any drugs during the trial for 2 weeks. This group was further divided into five subgroups (10 rats each). One of them was fed on the basal diet and used as a positive control group. However, the other four subgroups were fed on basal diets and anethole (20 mg/kg/day, orally), SDG (20 mg/kg/day, orally), a mixture of anethole + SDG (10 + 10 mg/kg/day, orally), and atorvastatin (10 mg/kg/day, orally) for 6 weeks. Compared to control, treatment with a combination of anethole + SDG showed a significant (p ≤ .05) improvement in serum levels of triglyceride (TG) (137.88 ± 1.61 mg/dL), total cholesterol-(TC) (180.12 ± 8.99 mg/dL), LDL-C (46.40 ± 6.67 mg/dL), VLDL-C (11.81 ± 1.07 mg/dL), aspartate aminotransferase (AST) (75.97 ± 6.92 U/L), alanine aminotransferase (ALT) (34.83 ± 2.17 U/L), alkaline phosphatase (ALP) (130.65 ± 1.05 U/L), and malondialdehyde (MDA) (30.12 ± 1.89 mmol/g), and improved activities of catalase (70.99 ± 3.29 U/g) and superoxide dismutase (SOD) (35.13 ± 2.53 U/dL) enzymes while SDG and anethole group had relatively less impact. Atorvastatin also improved serum levels of triglyceride, total cholesterol, LDL-C, and VLDL-C significantly and rose serum high-density lipoprotein cholesterol (HDL-C) levels considerably meanwhile it had a minor but negative impact on AST, ALT, and ALP, and negligible impact on activities of MDA, CAT, and SOD enzymes compared to the positive control group. The study revealed that combining anethole and SDG may improve dyslipidemia, improve lipid profile, decrease risks of chronic heart diseases, increase HDL-C, and enhance antioxidant enzymes' activities.
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Affiliation(s)
- Sana Noreen
- University Institute of Diet and Nutritional SciencesUniversity of LahoreLahorePakistan
| | - Habib‐ur Rehman
- University Institute of Diet and Nutritional SciencesUniversity of LahoreLahorePakistan
| | - Tabussam Tufail
- University Institute of Diet and Nutritional SciencesUniversity of LahoreLahorePakistan
| | - Huma Badar Ul Ain
- University Institute of Diet and Nutritional SciencesUniversity of LahoreLahorePakistan
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Zeleznik OA, Kang JH, Lasky-Su J, Eliassen AH, Frueh L, Clish CB, Rosner BA, Elze T, Hysi P, Khawaja A, Wiggs JL, Pasquale LR. Plasma metabolite profile for primary open-angle glaucoma in three US cohorts and the UK Biobank. Nat Commun 2023; 14:2860. [PMID: 37208353 PMCID: PMC10199010 DOI: 10.1038/s41467-023-38466-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 05/04/2023] [Indexed: 05/21/2023] Open
Abstract
Glaucoma is a progressive optic neuropathy and a leading cause of irreversible blindness worldwide. Primary open-angle glaucoma is the most common form, and yet the etiology of this multifactorial disease is poorly understood. We aimed to identify plasma metabolites associated with the risk of developing POAG in a case-control study (599 cases and 599 matched controls) nested within the Nurses' Health Studies, and Health Professionals' Follow-Up Study. Plasma metabolites were measured with LC-MS/MS at the Broad Institute (Cambridge, MA, USA); 369 metabolites from 18 metabolite classes passed quality control analyses. For comparison, in a cross-sectional study in the UK Biobank, 168 metabolites were measured in plasma samples from 2,238 prevalent glaucoma cases and 44,723 controls using NMR spectroscopy (Nightingale, Finland; version 2020). Here we show higher levels of diglycerides and triglycerides are adversely associated with glaucoma in all four cohorts, suggesting that they play an important role in glaucoma pathogenesis.
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Affiliation(s)
- Oana A Zeleznik
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
| | - Jae H Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jessica Lasky-Su
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Lisa Frueh
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Clary B Clish
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tobias Elze
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Ophthalmology, Schepens Research Eye Institute of Massachusetts Eye and Ear, Boston, MA, USA
| | - Pirro Hysi
- Department of Ophthalmology, King's College London, London, UK
- Department of Twin Research & Genetic Epidemiology, King's College London, London, UK
- St. Thomas' Hospital, London, UK
| | - Anthony Khawaja
- National Institute for Health and Care Research Biomedical Research Centre, Moorfields Eye Hospital, London, UK
- National Institute for Health and Care Research Biomedical Research Centre, Institute of Ophthalmology, University College London, London, UK
| | - Janey L Wiggs
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Wang T, Soundararajan A, Rabinowitz J, Jaiswal A, Osborne T, Pattabiraman PP. Identification of the novel role of sterol regulatory element binding proteins (SREBPs) in mechanotransduction and intraocular pressure regulation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.05.527136. [PMID: 37214961 PMCID: PMC10197526 DOI: 10.1101/2023.02.05.527136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Trabecular meshwork (TM) cells are highly contractile and mechanosensitive to aid in maintaining intraocular pressure (IOP) homeostasis. Lipids are attributed to modulating TM contractility with poor mechanistic understanding. In this study using human TM cells, we identify the mechanosensing role of the transcription factors sterol regulatory element binding proteins (SREBPs) involved in lipogenesis. By constitutively activating SREBPs and pharmacologically inactivating SREBPs, we have mechanistically deciphered the attributes of SREBPs in regulating the contractile properties of TM. The pharmacological inhibition of SREBPs by fatostatin and molecular inactivation of SREBPs ex vivo and in vivo respectively results in significant IOP lowering. As a proof of concept, fatostatin significantly decreased the SREBPs responsive genes and enzymes involved in lipogenic pathways as well as the levels of the phospholipid, cholesterol, and triglyceride. Further, we show that fatostatin mitigated actin polymerization machinery and stabilization, and decreased ECM synthesis and secretion. We thus postulate that lowering lipogenesis in the TM outflow pathway can hold the key to lowering IOP by modifying the TM biomechanics. Synopsis In this study, we show the role of lipogenic transcription factors sterol regulatory element binding proteins (SREBPs) in the regulation of intraocular pressure (IOP). ( Synopsis Figure - Created using Biorender.com ) SREBPs are involved in the sensing of changes in mechanical stress on the trabecular meshwork (TM). SREBPs aid in transducing the mechanical signals to induce actin polymerization and filopodia/lamellipodia formation.SREBPs inactivation lowered genes and enzymes involved in lipogenesis and modified lipid levels in TM.SREBPs activity is a critical regulator of ECM engagement to the matrix sites.Inactivation of SCAP-SREBP pathway lowered IOP via actin relaxation and decreasing ECM production and deposition in TM outflow pathway signifying a novel relationship between SREBP activation status and achieving IOP homeostasis.
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Joshi RS, Adatiya VH. Study of the relationship between serum lipid levels and primary open-angle glaucoma. Indian J Ophthalmol 2023; 71:1948-1952. [PMID: 37203063 PMCID: PMC10391399 DOI: 10.4103/ijo.ijo_3233_22] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose To determine the association between serum lipid levels and primary open-angle glaucoma (POAG). Methods In this case-control study, 50 patients with POAG documented by clinical tests using standard ophthalmologic equipment and 50 age-matched controls were investigated. Twelve-hour fasting serum lipid profiles, including total cholesterol, serum triglycerides, low-density lipoproteins (LDLs), and high-density lipoproteins (HDLs), were compared between the cases and controls. Results The mean age of cases and controls was 62.84 ± 9.68 and 60.12 ± 8.65, respectively (P = 0.65). High total cholesterol levels (>200 mg/dl) were found in 23 cases (46%) and 8 controls (16%); high serum triglyceride levels (>150 mg/dl) were found in 24 cases (48%) and 7 controls (14%); high LDL levels (130 mg/dl) were found in 28 cases (56%) and 9 controls (18%); and low HDL levels (<40 mg/dl) were found in 38 cases (76%) and 30 controls (60%). The mean total cholesterol levels were 205.24 ± 36.90 mg/dl in cases and 177.68 ± 22.56 mg/dl in controls (P < 0.001); the mean serum triglyceride levels were 150.42 ± 49.55 mg/dl and 130.84 ± 23.16 mg/dl, respectively (P = 0.013); and the mean LDL levels were 139.50 ± 31.03 mg/dl and 114.96 ± 17.73 mg/dl, respectively (P < 0.001). The mean cholesterol, triglyceride, and LDL levels were significantly higher in cases than in controls (P < 0.05). Conclusion The present study shows that higher proportion of POAG patients have dyslipidemia compared to age-matched controls. Though these findings need to be replicated by others. This study opens new vistas for further studies, such as lowering dyslipidemia, lowering the intra-ocular pressure and incidence of POAG, and whether the use of statins to reduce dyslipidemia affects the progression of POAG.
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Affiliation(s)
- Rajesh Subhash Joshi
- Department of Ophthalmology, Government Medical College, Nagpur, Maharashtra, India
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Effect of Hypercholesterolemia, Systemic Arterial Hypertension and Diabetes Mellitus on Peripapillary and Macular Vessel Density on Superficial Vascular Plexus in Glaucoma. J Clin Med 2023; 12:jcm12052071. [PMID: 36902860 PMCID: PMC10004387 DOI: 10.3390/jcm12052071] [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: 02/06/2023] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND/AIMS Vascular factors are involved in the development of glaucoma, including diseases such as hypercholesterolemia (HC), systemic arterial hypertension (SAH), and diabetes mellitus (DM). The aim of this study was to determine the effect of glaucoma disease on peripapillary vessel density (sPVD) and macular vessel density (sMVD) on the superficial vascular plexus, controlling differences on comorbidities such as SAH, DM and HC between glaucoma patients and normal subjects. METHODS In this prospective, unicenter, observational cross-sectional study, sPVD and sMVD were measured in 155 glaucoma patients and 162 normal subjects. Differences between normal subjects and glaucoma patients' groups were analyzed. A linear regression model with 95% confidence and 80% statistical power was performed. RESULTS Parameters with greater effect on sPVD were glaucoma diagnosis, gender, pseudophakia and DM. Glaucoma patients had a sPVD 1.2% lower than healthy subjects (Beta slope 1.228; 95%CI 0.798-1.659, p < 0.0001). Women presented 1.19% more sPVD than men (Beta slope 1.190; 95%CI 0.750-1.631, p < 0.0001), and phakic patients presented 1.7% more sPVD than men (Beta slope 1.795; 95%CI 1.311-2.280, p < 0.0001). Furthermore, DM patients had 0.9% lower sPVD than non-diabetic patients (Beta slope 0.925; 95%CI 0.293-1.558, p = 0.004). SAH and HC did not affect most of the sPVD parameters. Patients with SAH and HC showed 1.5% lower sMVD in the outer circle than subjects without those comorbidities (Beta slope 1.513; 95%CI 0.216-2.858, p = 0.021 and 1.549; 95%CI 0.240-2.858, p = 0.022 respectively. CONCLUSIONS Glaucoma diagnosis, previous cataract surgery, age and gender seem to have greater influence than the presence of SAH, DM and HC on sPVD and sMVD, particularly sPVD.
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Yang J, Chen Y, Zou T, Xue B, Yang F, Wang X, Huo Y, Yan B, Xu Y, He S, Yin Y, Wang J, Zhu X, Zhang L, Zhou Y, Tai Z, Shuai P, Yu M, Luo Q, Cheng Y, Gong B, Zhu X, Zhang J, Sun X, Lin Y, Zhang H, Yang Z. Cholesterol homeostasis regulated by ABCA1 is critical for retinal ganglion cell survival. SCIENCE CHINA. LIFE SCIENCES 2023; 66:211-225. [PMID: 35829808 DOI: 10.1007/s11427-021-2126-2] [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: 11/04/2021] [Accepted: 06/17/2022] [Indexed: 10/17/2022]
Abstract
Genome-wide association studies have suggested a link between primary open-angle glaucoma and the function of ABCA1. ABCA1 is a key regulator of cholesterol efflux and the biogenesis of high-density lipoprotein (HDL) particles. Here, we showed that the POAG risk allele near ABCA1 attenuated ABCA1 expression in cultured cells. Consistently, POAG patients exhibited lower ABCA1 expression, reduced HDL, and higher cholesterol in white blood cells. Ablation of Abca1 in mice failed to form HDL, leading to elevated cholesterol levels in the retina. Counting retinal ganglion cells (RGCs) by using an artificial intelligence (AI) program revealed that Abca1-deficient mice progressively lost RGCs with age. Single-cell RNA sequencing (scRNA-seq) revealed aberrant oxidative phosphorylation in the Abca1-/- retina, as well as activation of the mTORC1 signaling pathway and suppression of autophagy. Treatment of Abca1-/- mice using atorvastatin reduced the cholesterol level in the retina, thereby improving metabolism and protecting RGCs from death. Collectively, we show that lower ABCA1 expression and lower HDL are risk factors for POAG. Accumulated cholesterol in the Abca1-/- retina causes profound aberrant metabolism, leading to a POAG-like phenotype that can be prevented by atorvastatin. Our findings establish statin use as a preventive treatment for POAG associated with lower ABCA1 expression.
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Affiliation(s)
- Jialiang Yang
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Yuhong Chen
- Department of Ophthalmology and Visual Science, Eye and Ear Nose Throat (ENT) Hospital, Fudan University, Shanghai, 200032, China
| | - Tongdan Zou
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Bai Xue
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Fang Yang
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Xiangzhou Wang
- School of Optoelectronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yibo Huo
- School of Optoelectronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Boyun Yan
- School of Optoelectronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yuxia Xu
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Shiyu He
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Yi Yin
- Institute of Chengdu Biology, Sichuan Translational Medicine Hospital, Chinese Academy of Sciences, Chengdu, 610093, China
| | - Jing Wang
- Institute of Chengdu Biology, Sichuan Translational Medicine Hospital, Chinese Academy of Sciences, Chengdu, 610093, China
| | - Xiong Zhu
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Lin Zhang
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Yu Zhou
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Zhengfu Tai
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Ping Shuai
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Man Yu
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Qian Luo
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Yilian Cheng
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Bo Gong
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
- Research Unit for Blindness Prevention of Chinese Academy of Medical Sciences, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Xianjun Zhu
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
- Research Unit for Blindness Prevention of Chinese Academy of Medical Sciences, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Jing Zhang
- School of Optoelectronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Xinghuai Sun
- Department of Ophthalmology and Visual Science, Eye and Ear Nose Throat (ENT) Hospital, Fudan University, Shanghai, 200032, China
| | - Ying Lin
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Houbin Zhang
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
| | - Zhenglin Yang
- Key Laboratory for Human Disease Gene Study of Sichuan Province and Institute of Laboratory Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China.
- Institute of Chengdu Biology, Sichuan Translational Medicine Hospital, Chinese Academy of Sciences, Chengdu, 610093, China.
- Research Unit for Blindness Prevention of Chinese Academy of Medical Sciences, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, 610072, China.
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Wang K, Yang F, Liu X, Lin X, Yin H, Tang Q, Jiang L, Yao K. Appraising the Effects of Metabolic Traits on the Risk of Glaucoma: A Mendelian Randomization Study. Metabolites 2023; 13:109. [PMID: 36677034 PMCID: PMC9867384 DOI: 10.3390/metabo13010109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/24/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
Metabolic traits are associated with the risk of developing glaucoma in observational studies. To assess whether theses associations reflect causality, we conducted a Mendelian randomization (MR) study. Our study included up to 20,906 glaucoma cases and 438,188 controls. Genetic instruments associated with the concerned 11 exposures at the genome-wide significance level were selected from corresponding genome-wide association studies. Summary-level data for glaucoma were obtained from the UK Biobank, the GERA study, and the FinnGen consortium. Univariable and multivariable MR analyses were conducted separately in two populations. Our results showed that higher genetic liability to type 2 diabetes (T2D) was causally and independently associated with an increased risk of glaucoma (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.06-1.16; p = 4.4 × 10-6). The association for T2D persisted after multivariable adjustment. In addition, higher genetically predicted systolic blood pressure (SBP), fasting glucose (FG), and HbA1c, were also suggestively associated with glaucoma risk. The OR was 1.08 (95% CI, 1.01-1.16; p = 0.035) for SBP, 1.24 (95% CI, 1.05-1.47; p = 0.011) for FG, and 1.28 (95% CI, 1.01-1.61; p = 0.039) for HbA1c. No evidence was observed to support the causal effects of body mass index and blood lipids for glaucoma. This study suggests a causal role for diabetes, as well as possible roles for higher SBP, FG, and HbA1c in the development of glaucoma. Further validation is needed to assess the potential of these risk factors as pharmacological targets for glaucoma prevention.
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Affiliation(s)
- Kai Wang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Fangkun Yang
- Department of Cardiology, Ningbo First Hospital, Ningbo 315010, China
| | - Xin Liu
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Xueqi Lin
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Houfa Yin
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Qiaomei Tang
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Li Jiang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Hangzhou Normal University, Hangzhou 311121, China
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
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Yuan Y, Wang W, Shang X, Xiong R, Ha J, Zhang L, Zhu Z, He M. Association between statin use and the risks of glaucoma in Australia: a 10-year cohort study. Br J Ophthalmol 2023; 107:66-71. [PMID: 34348924 DOI: 10.1136/bjophthalmol-2021-318789] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 07/01/2021] [Indexed: 11/04/2022]
Abstract
SYNOPSIS In a cohort of middle-aged and elderly Australians, we found that long-term statin use was associated with a higher risk of glaucoma onset. As to subtypes of statins, the increased risk was only found in rosuvastatin users. PURPOSE To investigate the relationship between statin use and glaucoma onset in a 10-year longitudinal study. METHODS This nested case-control study was based on data from a large-scale cohort of Australians aged over 45 years old. Medication exposure was identified by claims records from the Pharmaceutical Benefits Scheme during the follow-up period (2009-2016). The onset of glaucoma was defined as the people with at least three claims of antiglaucoma medications. Controls matched by age, gender and cardiovascular diseases were selected from participants without prescription of antiglaucoma medications. A conditional logistic regression model was used to assess the association between statin use and glaucoma onset. RESULTS The proportion of statin users was higher in the case group (40.5%) than that in the control group (38.4%). After adjusting for baseline characteristics and longitudinal claims records, statin use was not associated with glaucoma onset (OR 1.04, 95% CI 0.97 to 1.11). However, an increased risk of glaucoma onset was observed in participants with a longer duration of statin use (>3 years vs <1 year: OR 1.12, 95% CI 1.04 to 1.21). With respect to specific types of statins, participants taking rosuvastatin were more likely to suffer from glaucoma (OR 1.11, 95%CI 1.01 to 1.22). The use of other statins was not significantly associated with glaucoma onset. CONCLUSIONS Long-term statin use was found to be associated with a higher risk of glaucoma onset in this study. Regarding specific types of statins, the increased risk of glaucoma onset was only observed in users of rosuvastatin.
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Affiliation(s)
- Yixiong Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xianwen Shang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ruilin Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jason Ha
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Lei Zhang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.,Artificial Intelligence and Modelling in Epidemiology Program, Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.,Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Zhuoting Zhu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China .,Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
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Li J, Li C, Huang Y, Guan P, Huang D, Yu H, Yang X, Liu L. Mendelian randomization analyses in ocular disease: a powerful approach to causal inference with human genetic data. J Transl Med 2022; 20:621. [PMID: 36572895 PMCID: PMC9793675 DOI: 10.1186/s12967-022-03822-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 12/11/2022] [Indexed: 12/27/2022] Open
Abstract
Ophthalmic epidemiology is concerned with the prevalence, distribution and other factors relating to human eye disease. While observational studies cannot avoid confounding factors from interventions, human eye composition and structure are unique, thus, eye disease pathogenesis, which greatly impairs quality of life and visual health, remains to be fully explored. Notwithstanding, inheritance has had a vital role in ophthalmic disease. Mendelian randomization (MR) is an emerging method that uses genetic variations as instrumental variables (IVs) to avoid confounders and reverse causality issues; it reveals causal relationships between exposure and a range of eyes disorders. Thus far, many MR studies have identified potentially causal associations between lifestyles or biological exposures and eye diseases, thus providing opportunities for further mechanistic research, and interventional development. However, MR results/data must be interpreted based on comprehensive evidence, whereas MR applications in ophthalmic epidemiology have some limitations worth exploring. Here, we review key principles, assumptions and MR methods, summarise contemporary evidence from MR studies on eye disease and provide new ideas uncovering aetiology in ophthalmology.
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Affiliation(s)
- Jiaxin Li
- grid.412449.e0000 0000 9678 1884Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning China
| | - Cong Li
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China
| | - Yu Huang
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China ,grid.413405.70000 0004 1808 0686Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Peng Guan
- grid.412449.e0000 0000 9678 1884Department of Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning China
| | - Desheng Huang
- grid.412449.e0000 0000 9678 1884Department of Mathematics, School of Fundamental Sciences, China Medical University, Shenyang, Liaoning China
| | - Honghua Yu
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China
| | - Xiaohong Yang
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China
| | - Lei Liu
- grid.413405.70000 0004 1808 0686Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080 China
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Lu XR, Liu XW, Li SH, Qin Z, Bai LX, Ge WB, Li JY, Yang YJ. Untargeted lipidomics and metagenomics reveal the mechanism of aspirin eugenol ester relieving hyperlipidemia in ApoE-/- mice. Front Nutr 2022; 9:1030528. [PMID: 36618709 PMCID: PMC9815714 DOI: 10.3389/fnut.2022.1030528] [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: 08/29/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022] Open
Abstract
Hyperlipidemia is induced by abnormal lipid metabolism, which can cause the occurrence of cardiovascular diseases and lead to grievous injury to health. Studies showed that AEE had a significant therapeutic effect on hyperlipidemia and is likely to be associated with the up-regulation of cholesterol 7-alpha hydroxylase (CYP7A1), the key enzyme for cholesterol conversion to bile acids, but no research confirmed whether the effect of AEE on hyperlipidemia was related to the gut microbiota and liver lipids. At the same time, more and more studies have shown that gut microbiota and lipids are closely related to hyperlipidemia. Hence, in this study, we investigated the effects of AEE on liver lipids through LC-MS-based untargeted lipidomics and the effects of AEE on gut microbiota based on cecal contents metagenomics by Illumina sequencing in HFD-induced hyperlipidemia ApoE-/- mice at the overall level. The results of lipidomics showed that AEE relieved hyperlipidemia by decreasing the concentration of 10 PEs and 12 SMs in the liver and regulating the pathways of glycerophospholipid metabolic pathway, sphingolipid signaling pathway, and NF-kB signaling pathway. The results of metagenomics concluded that AEE treatment changed the composition of gut microbiota and regulated the functions of lipid transport and metabolism, as well as the metabolism of bile acids and secondary bile acids. The results of the joint analysis between lipidomics and metagenomics showed that the abundance of Verrucomicrobia, Verrucomicrobiales, Candidatus_Gastranaerophilales, and Candidatus_Melainabacteria was significantly positively correlated with the concentration of SM (d18:1/18:0) and PE (16:0/18:1) in the process of AEE alleviating hyperlipidemia in mice. In conclusion, these results suggested that the effect of AEE on hyperlipidemia was closely related to the gut microbiota by the change of bile acids and liver lipids.
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Zhang G, Sun B, Zhang Z, Wu S, Zhuo G, Rong H, Liu Y, Yang W. Hypermixed Convolutional Neural Network for Retinal Vein Occlusion Classification. DISEASE MARKERS 2022; 2022:1730501. [PMID: 36408465 PMCID: PMC9674409 DOI: 10.1155/2022/1730501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/30/2022] [Indexed: 01/22/2024]
Abstract
Retinal vein occlusion (RVO) is one of the most common retinal vascular diseases leading to vision loss if not diagnosed and treated in time. RVO can be classified into two types: CRVO (blockage of the main retinal veins) and BRVO (blockage of one of the smaller branch veins). Automated diagnosis of RVO can improve clinical workflow and optimize treatment strategies. However, to the best of our knowledge, there are few reported methods for automated identification of different RVO types. In this study, we propose a new hypermixed convolutional neural network (CNN) model, namely, the VGG-CAM network, that can classify the two types of RVOs based on retinal fundus images and detect lesion areas using an unsupervised learning method. The image data used in this study is collected and labeled by three senior ophthalmologists in Shanxi Eye Hospital, China. The proposed network is validated to accurately classify RVO diseases and detect lesions. It can potentially assist in further investigating the association between RVO and brain vascular diseases and evaluating the optimal treatments for RVO.
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Affiliation(s)
- Guanghua Zhang
- Department of Intelligence and Automation, Taiyuan University, Taiyuan 030000, China
- Graphics and Imaging Laboratory, University of Girona, Spain
| | - Bin Sun
- Shanxi Eye Hospital, Taiyuan 030002, China
| | | | - Shiyu Wu
- Department of Computer, Taiyuan Normal University, Jinzhong 030619, China
| | - Guangping Zhuo
- Department of Computer, Taiyuan Normal University, Jinzhong 030619, China
| | - Huifang Rong
- Department of Intelligence and Automation, Taiyuan University, Taiyuan 030000, China
| | - Yunfang Liu
- The First Affiliated Hospital of Huzhou University, Huzhou 313000, China
| | - Weihua Yang
- Shenzhen Eye Hospital, Jinan University, Shenzhen 518040, China
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Soundararajan A, Wang T, Sundararajan R, Wijeratne A, Mosley A, Harvey FC, Bhattacharya S, Pattabiraman PP. Multiomics analysis reveals the mechanical stress-dependent changes in trabecular meshwork cytoskeletal-extracellular matrix interactions. Front Cell Dev Biol 2022; 10:874828. [PMID: 36176278 PMCID: PMC9513235 DOI: 10.3389/fcell.2022.874828] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 08/12/2022] [Indexed: 11/29/2022] Open
Abstract
Trabecular meshwork (TM) tissue is subjected to constant mechanical stress due to the ocular pulse created by the cardiac cycle. This brings about alterations in the membrane lipids and associated cell-cell adhesion and cell-extracellular matrix (ECM) interactions, triggering intracellular signaling responses to counter mechanical insults. A loss of such response can lead to elevated intraocular pressure (IOP), a major risk factor for primary open-angle glaucoma. This study is aimed to understand the changes in signaling responses by TM subjected to mechanical stretch. We utilized multiomics to perform an unbiased mRNA sequencing to identify changes in transcripts, mass spectrometry- (MS-) based quantitative proteomics for protein changes, and multiple reaction monitoring (MRM) profiling-based MS and high-performance liquid chromatography (HPLC-) based MS to characterize the lipid changes. We performed pathway analysis to obtain an integrated map of TM response to mechanical stretch. The human TM cells subjected to mechanical stretch demonstrated an upregulation of protein quality control, oxidative damage response, pro-autophagic signal, induction of anti-apoptotic, and survival signaling. We propose that mechanical stretch-induced lipid signaling via increased ceramide and sphingomyelin potentially contributes to increased TM stiffness through actin-cytoskeleton reorganization and profibrotic response. Interestingly, increased phospholipids and diacylglycerol due to mechanical stretch potentially enable cell membrane remodeling and changes in signaling pathways to alter cellular contractility. Overall, we propose the mechanistic interplay of macromolecules to bring about a concerted cellular response in TM cells to achieve mechanotransduction and IOP regulation when TM cells undergo mechanical stretch.
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Affiliation(s)
- Avinash Soundararajan
- Department of Ophthalmology, Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Ting Wang
- Department of Ophthalmology, Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, United States
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Rekha Sundararajan
- Department of Ophthalmology, Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Aruna Wijeratne
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, United States
- Center for Proteome Analysis, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Amber Mosley
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, United States
- Center for Proteome Analysis, Indiana University School of Medicine, Indianapolis, IN, United States
- Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Faith Christine Harvey
- Bascom Palmer Eye Institute, Miller School of Medicine at University of Miami, Miami, FL, United States
- Miami Integrative Metabolomics Research Center, Miami, FL, United States
| | - Sanjoy Bhattacharya
- Bascom Palmer Eye Institute, Miller School of Medicine at University of Miami, Miami, FL, United States
- Miami Integrative Metabolomics Research Center, Miami, FL, United States
| | - Padmanabhan Paranji Pattabiraman
- Department of Ophthalmology, Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, United States
- Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, United States
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Madjedi KM, Stuart KV, Chua SYL, Luben RN, Warwick A, Pasquale LR, Kang JH, Wiggs JL, Lentjes MAH, Aschard H, Sattar N, Foster PJ, Khawaja AP. The Association between Serum Lipids and Intraocular Pressure in 2 Large United Kingdom Cohorts. Ophthalmology 2022; 129:986-996. [PMID: 35500606 PMCID: PMC10444694 DOI: 10.1016/j.ophtha.2022.04.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Serum lipids are modifiable, routinely collected blood test features associated with cardiovascular health. We examined the association of commonly collected serum lipid measures (total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], and triglycerides) with intraocular pressure (IOP). DESIGN Cross-sectional study in the UK Biobank and European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohorts. PARTICIPANTS We included 94 323 participants from the UK Biobank (mean age, 57 years) and 6230 participants from the EPIC-Norfolk (mean age, 68 years) cohorts with data on TC, HDL-C, LDL-C, and triglycerides collected between 2006 and 2009. METHODS Multivariate linear regression adjusting for demographic, lifestyle, anthropometric, medical, and ophthalmic covariables was used to examine the associations of serum lipids with corneal-compensated IOP (IOPcc). MAIN OUTCOME MEASURES Corneal-compensated IOP. RESULTS Higher levels of TC, HDL-C, and LDL-C were associated independently with higher IOPcc in both cohorts after adjustment for key demographic, medical, and lifestyle factors. For each 1-standard deviation increase in TC, HDL-C, and LDL-C, IOPcc was higher by 0.09 mmHg (95% confidence interval [CI], 0.06-0.11 mmHg; P < 0.001), 0.11 mmHg (95% CI, 0.08-0.13 mmHg; P < 0.001), and 0.07 mmHg (95% CI, 0.05-0.09 mmHg; P < 0.001), respectively, in the UK Biobank cohort. In the EPIC-Norfolk cohort, each 1-standard deviation increase in TC, HDL-C, and LDL-C was associated with a higher IOPcc by 0.19 mmHg (95% CI, 0.07-0.31 mmHg; P = 0.001), 0.14 mmHg (95% CI, 0.03-0.25 mmHg; P = 0.016), and 0.17 mmHg (95% CI, 0.06-0.29 mmHg; P = 0.003). An inverse association between triglyceride levels and IOP in the UK Biobank (-0.05 mmHg; 95% CI, -0.08 to -0.03; P < 0.001) was not replicated in the EPIC-Norfolk cohort (P = 0.30). CONCLUSIONS Our findings suggest that serum TC, HDL-C, and LDL-C are associated positively with IOP in 2 United Kingdom cohorts and that triglyceride levels may be associated negatively. Future research is required to assess whether these associations are causal in nature.
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Affiliation(s)
- Kian M Madjedi
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; Department of Ophthalmology, University of Calgary, Calgary, Canada.
| | - Kelsey V Stuart
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
| | - Sharon Y L Chua
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
| | - Robert N Luben
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Alasdair Warwick
- UCL Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jae H Kang
- Brigham and Women's Hospital / Harvard Medical School, Boston, Massachusetts
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Marleen A H Lentjes
- Clinical Epidemiology and Biostatistics/Nutrient Gut-Brain Interaction, Örebro University, Örebro, Sweden
| | | | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom; MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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Daytime Lipid Metabolism Modulated by CLOCK Gene Is Linked to Retinal Ganglion Cells Damage in Glaucoma. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12136374] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Lipid metabolism is intimately linked to circadian mechanisms and light signaling. Deteriorated photic transduction because of retinal ganglion cell (RGC) loss occurring with glaucoma progression reduces perceived light amplitude, causing circadian disruption. To investigate associations with RGCs, total cholesterol (TC), its low-density (LDL-C) and high-density (HDL-C) fractions, and triglycerides (TG) were measured, under a controlled meal regimen, during daytime hours in 114 patients diagnosed with primary open-angle glaucoma (POAG). RGC damage was assessed by high-definition optical coherence tomography (HD-OCT). Analysis of eight clock, clock-related, and melatonin receptor gene polymorphisms was performed on 19 patients. RGC loss was associated with changes in lipid metabolism in a time-dependent manner. Morning (08:00) values of HDL-C (r = 0.613, p < 0.0001) and TG (r = 0.568, p < 0.0001) correlated positively with RGC global loss, while LDL-C at 08:00 had a weak correlation (r = 0.235; p = 0.012) but showed a strong correlation in the evening (20:00) (r = 0.533, p < 0.0001). The morning–evening gradients (MEGs, changes at 20:00 versus 08:00) in TC and LDL-C changed sign from a negative to a positive association in patients exceeding the 15% two-eye mean GLV threshold. MEG (LDL-C higher in the evening than in the morning) was positive only in POAG patients with the CLOCK_3111 TT genotype.
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Kim J, Kennedy Neary MT, Aschard H, Palakkamanil MM, Do R, Wiggs JL, Khawaja AP, Pasquale LR, Kang JH. Statin Use in Relation to Intraocular Pressure, Glaucoma, and Ocular Coherence Tomography Parameters in the UK Biobank. Invest Ophthalmol Vis Sci 2022; 63:31. [PMID: 35612836 PMCID: PMC9150836 DOI: 10.1167/iovs.63.5.31] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/26/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the relationship between statin use and glaucoma-related traits. Methods In a cross-sectional study, we included 118,153 UK Biobank participants with data on statin use and corneal-compensated IOP. In addition, we included 192,283 participants (8982 cases) with data on glaucoma status. After excluding participants with neurodegenerative diseases, 41,638 participants with macular retinal nerve fiber layer thickness (mRNFL) and 41,547 participants with macular ganglion cell inner plexiform layer thickness (mGCIPL) were available for analysis. We examined associations of statin use with IOP, mRNFL, mGCIPL, and glaucoma status utilizing multivariable-adjusted regression models. We assessed whether a glaucoma polygenic risk score (PRS) modified associations. We performed Mendelian randomization (MR) experiments to investigate associations with various glaucoma-related outcomes. Results Statin users had higher unadjusted mean IOP ± SD than nonusers, but in a multivariable-adjusted model, IOP did not differ by statin use (difference = 0.05 mm Hg, 95% confidence interval [CI] = -0.02 to 0.13, P = 0.17). Similarly, statin use was not associated with prevalent glaucoma (odds ratio [OR] = 1.05, 95% CI = 0.98 to 1.13). Statin use was weakly associated with thinner mRNFL (difference = -0.15 microns, 95% CI = -0.28 to -0.01, P = 0.03) but not with mGCIPL thickness (difference = -0.12 microns, 95% CI = -0.29 to 0.05, P = 0.17). No association was modified by the glaucoma PRS (Pinteraction≥ 0.16). MR experiments showed no evidence for a causal association between the cholesterol-altering effect of statins and several glaucoma traits (inverse weighted variance P ≥ 0.14). Conclusions We found no evidence of a protective association between statin use and glaucoma or related traits after adjusting for key confounders.
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Affiliation(s)
- Jihye Kim
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States
| | | | - Hugues Aschard
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States
- Institut Pasteur, Université de Paris, Department of Computational Biology, Paris, France
| | - Mathew M. Palakkamanil
- Department of Ophthalmology and Visual Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ron Do
- Charles Bronfman Institute for Personalized Medicine, Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Janey L. Wiggs
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
| | - Anthony P. Khawaja
- NIHR Biomedical Research Centre at Moorfields Eye Hospital & UCL Institute of Ophthalmology, London, United Kingdom
| | - Louis R. Pasquale
- Department of Ophthalmology, Icahn School of Medicine, Mount Sinai, New York, New York, United States
| | - Jae H. Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
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Haring B, Hovey K, LaMonte M, Andrews C, Saquib N, Manson JE, Shimbo D, Ritch R, De Moraes CG, Wassertheil-Smoller S. Blood pressure control and glaucoma risk in postmenopausal women: an analysis from the Women's Health Initiative. Menopause 2022; 29:531-536. [PMID: 35486945 PMCID: PMC9060363 DOI: 10.1097/gme.0000000000001952] [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] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Individuals with elevated systolic blood pressure (BP) or low diastolic BP, whether or not on antihypertensive treatment, may be at higher risk for developing glaucoma. We aimed to investigate BP levels in relation to glaucoma risk in a large cohort of postmenopausal women. METHODS Prospective follow-up of 101,447 postmenopausal women without prior history of glaucoma enrolled in the Women's Health Initiative Study. BP was measured in-clinic at baseline and after 3 years using standardized procedures. Antihypertensive medication use was determined by drug inventory at baseline and year 3. Women self-reported incident newly diagnosed glaucoma annually. Hazard ratios (HRs) and 95% confidence intervals were estimated using Cox proportional hazards analyses adjusting for demographic, medical history, and lifestyle covariates. RESULTS During a mean follow-up of 4.7 years, we documented 7,514 glaucoma cases. Among women not on antihypertensive treatment, those with systolic BP ≥ 140 mm Hg or diastolic BP ≥80 mm Hg were not at higher risk of developing glaucoma (HR 0.97, 95% confidence intervals 0.88-1.08 and HR 1.00 [0.93-1.08], respectively), compared with women with a systolic BP < 120 mm Hg or a diastolic BP 60 to <80 mm Hg. Among women on antihypertensive treatment, neither systolic BP ≥ 140 mm Hg nor diastolic BP ≥80 mm Hg was associated with an increased glaucoma risk (HR 0.89 [0.79-1.00] and HR 0.97 [0.90-1.05], respectively). A diastolic BP <60 mm Hg was not associated with a higher risk compared with a diastolic BP 60 to <80 mm Hg. CONCLUSIONS BP control is not associated with an increased or decreased glaucoma risk in postmenopausal women.
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Affiliation(s)
- Bernhard Haring
- Department of Medicine III, Saarland University Hospital, Homburg, Saarland, Germany
- Department of Medicine I, University of Würzburg, Würzburg, Bavaria, Germany
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kathleen Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo – SUNY, Buffalo, NY, USA
| | - Mike LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo – SUNY, Buffalo, NY, USA
| | - Chris Andrews
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo – SUNY, Buffalo, NY, USA
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi University, Saudi Arabia
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Daichi Shimbo
- Department of Medicine, Columbia University Irving Medical Center, NYC, NY, USA
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye & Ear Infirmary New York, NYC, NY USA
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Yuan Y, Xiong R, Wu Y, Ha J, Wang W, Han X, He M. Associations of statin use with the onset and progression of open-angle glaucoma: A systematic review and meta-analysis. EClinicalMedicine 2022; 46:101364. [PMID: 35399812 PMCID: PMC8987630 DOI: 10.1016/j.eclinm.2022.101364] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 02/23/2022] [Accepted: 03/07/2022] [Indexed: 12/12/2022] Open
Abstract
Background Statins, the first-line therapy for hyperlipidemia, have received considerable attention as candidates for glaucoma treatments given its neuroprotective effects. In this systematic review and meta-analysis, we intended to assess the association of statin use with the onset and progression of open-angle glaucoma (OAG). Methods Databases including PubMed, Embase and Web of Science Core Collection were searched for longitudinal studies reporting the association between statin use and OAG onset or progression on Feb 3, 2021. A meta-analysis was performed for the association between statin use and OAG onset. Relative risks (RRs) with 95% confidential intervals (CIs) were retrieved from included studies and pooled using random-effects models. Potential risks of bias were evaluated by the Newcastle-Ottawa Quality Assessment Scale for all eligible studies. This study had been registered on PROSPERO (CRD 42021232172). Findings 515,788 participants (mean age 68.7 years, 62.3% female) from ten studies were included in the systematic review of the association between statin use and OAG onset, and 26,347 OAG patients (mean age 67.3 years, 52.2% female) from seven studies were included for the association between statin use and OAG progression. Potential risks of bias were detected in 12 studies, which were mainly attributed to selection and confounding bias. In addition, 515,600 participants from eight studies were included in the meta-analysis which collectively showed that statin use was associated with a reduced risk of OAG onset (Pooled RR: 0.95; 95%CI: 0.93-0.98; I2=0.199;). No significant heterogeneity or publication bias was found for studies included in the meta-analysis. There were inconsistent evidences for the association between statin use and OAG progression. Interpretation Statin use is associated with a slightly lower risk of OAG onset based on existing evidences from longitudinal observational studies, the association between statin use and OAG progression remains inconclusive. The included evidences were typically weak due to poor study design and under-powered studies. Current findings should be interpreted cautiously and still need to be validated in further research. Funding The National Key R&D Program of China (2018YFC0116500), Science and Technology Planning Project of Guangdong Province (2013B20400003), the China Postdoctoral Science Foundation (2019TQ0365), the National Natural Science Foundation of China (82000901 and 82101171).
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Key Words
- 3‑hydroxy‑3-methyl glutaryl coenzyme a (hmg-coa) reductase inhibitors
- CIS, confidential intervals
- HMG-COA, 3‑hydroxy‑3-methyl glutaryl coenzyme a
- HRS, hazard ratios
- ICD, international classification of diseases
- IOP, intraocular pressure
- NSLCM, non-statin lipid-controlling medications
- OAG, open-angle glaucoma
- ORS, odds ratios
- Open-angle glaucoma
- PRS, relative risks
- RGC, retinal ganglion cell
- VF, visual field
- WOS, web of science core collection
- meta-analysis
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Affiliation(s)
- Yixiong Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Ruilin Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yi Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Jason Ha
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaotong Han
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- Department of Surgery, Ophthalmology, University of Melbourne, Melbourne, Australia
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Marshall H, Mullany S, Han X, Berry EC, Hassall MM, Qassim A, Nguyen T, Hollitt GL, Knight LS, Ridge B, Schmidt J, Crowley C, Schulz A, Mills RA, Agar A, Galanopoulos A, Landers J, Healey PR, Graham SL, Hewitt AW, Casson RJ, MacGregor S, Siggs OM, Craig JE. Genetic Risk of Cardiovascular Disease Is Associated with Macular Ganglion Cell-Inner Plexiform Layer Thinning in an Early Glaucoma Cohort. OPHTHALMOLOGY SCIENCE 2022; 2:100108. [PMID: 36246177 PMCID: PMC9559075 DOI: 10.1016/j.xops.2021.100108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/05/2021] [Accepted: 12/16/2021] [Indexed: 06/16/2023]
Abstract
PURPOSE To evaluate the association between genetic risk for cardiovascular disease and retinal thinning in early glaucoma. DESIGN Prospective, observational genetic association study. PARTICIPANTS Multicohort study combining a cohort of patients with suspect and early manifest primary open-angle glaucoma (POAG), a cohort of patients with perimetric POAG, and an external normative control cohort. METHODS A cardiovascular disease genetic risk score was calculated for 828 participants from the Progression Risk of Glaucoma: Relevant SNPs [single nucleotide polymorphisms] with Significant Association (PROGRESSA) study. Participants were characterized as showing either predominantly macular ganglion cell-inner plexiform layer (GCIPL), predominantly peripapillary retinal nerve fiber layer (pRNFL) or equivalent macular GCIPL and pRNFL spectral-domain OCT thinning. The cardiovascular disease genetic risk scores for these groups were compared to an internal reference group of stable suspected glaucoma and of an external normative population. Replication was undertaken by comparing the phenotypes of participants from the Australia New Zealand Registry of Advanced Glaucoma (ANZRAG) with the normative control group. MAIN OUTCOME MEASURES Spectral-domain OCT and Humphrey Visual Field (HVF) change. RESULTS After accounting for age, sex, and intraocular pressure (IOP), participants with predominantly macular GCIPL thinning showed a higher cardiovascular disease genetic risk score than reference participants (odds ratio [OR], 1.76/standard deviation [SD]; 95% confidence interval [CI], 1.18-2.62; P = 0.005) and than normative participants (OR, 1.32/SD; 95% CI, 1.12-1.54; P = 0.002). This finding was replicated by comparing ANZRAG participants with predominantly macular GCIPL change with the normative population (OR, 1.39/SD; 95% CI, 1.05-1.83; P = 0.022). Review of HVF data identified that participants with paracentral visual field defects also demonstrated a higher cardiovascular disease genetic risk score than reference participants (OR, 1.85/SD; 95% CI, 1.16-2.97; P = 0.010). Participants with predominantly macular GCIPL thinning exhibited a higher vertical cup-to-disc ratio genetic risk score (OR, 1.48/SD; 95% CI, 1.24-1.76; P < 0.001), but an IOP genetic risk score (OR, 1.12/SD; 95% CI, 0.95-1.33; P = 0.179) comparable with that of the normative population. CONCLUSIONS This study highlighted the relationship between cardiovascular disease and retinal thinning in suspect and manifest glaucoma cases.
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Key Words
- ANOVA, analysis of variance
- ANZRAG, Australia New Zealand Registry of Advanced Glaucoma
- CI, confidence interval
- Cardiovascular disease
- DDLS, Disc Damage Likelihood Scale
- GCIPL, ganglion cell–inner plexiform layer
- Glaucoma
- HVF, Humphrey Visual Field
- IOP, intraocular pressure
- Macular GCIPL
- OR, odds ratio
- POAG, primary open-angle glaucoma
- PROGRESSA, Progression Risk of Glaucoma: Relevant SNPs with Significant Association
- Paracentral visual field
- Retinal thinning
- SNP, single nucleotide polymorphism
- VCDR, vertical cup-to-disc ratio
- pRNFL, peripapillary retinal nerve fiber layer
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Affiliation(s)
- Henry Marshall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Sean Mullany
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Xikun Han
- Statistical Genetics Laboratory, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Australia
| | - Ella C. Berry
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Mark M. Hassall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Thi Nguyen
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Georgina L. Hollitt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Lachlan S.W. Knight
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Bronwyn Ridge
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Joshua Schmidt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Caroline Crowley
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Angela Schulz
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia
| | - Richard A. Mills
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Ashish Agar
- Department of Ophthalmology, University of New South Wales, Sydney, Australia
| | - Anna Galanopoulos
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia
| | - John Landers
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Paul R. Healey
- Centre for Vision Research, University of Sydney, Sydney, Australia
| | - Stuart L. Graham
- Department of Ophthalmology, University of New South Wales, Sydney, Australia
| | - Alex W. Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Robert J. Casson
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, Australia
| | - Stuart MacGregor
- Statistical Genetics Laboratory, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Australia
| | - Owen M. Siggs
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
- Garvan Institute of Medical Research, Sydney, Australia
| | - Jamie E. Craig
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
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Tsai YE, Chen YH, Sun CA, Chung CH, Chien WC, Chien KH. Relationship between Using Fibrate and Open-Angle Glaucoma in Hyperlipidemic Patients: A Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042415. [PMID: 35206602 PMCID: PMC8872131 DOI: 10.3390/ijerph19042415] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/12/2022] [Accepted: 02/18/2022] [Indexed: 02/01/2023]
Abstract
Background: This study aimed to investigate the associated risk between using fibrate and open-angle glaucoma (OAG) in hyperlipidemic patients from the National Health Insurance Research Database (NHIRD). Methods: We collected data over a 16-year period from the NHIRD, and used the Fisher’s exact test and Pearson chi-square test to analyze variables. Adjusted hazard ratios (aHR) were used to examine the risk factors for disease development. We applied Kaplan–Meier analysis to compare the cumulative incidence of OAG. Results: A total of 10,011 patients using fibrate were enrolled in the study cohort, and 40,044 patients not using fibrate were enrolled in the control cohort. The incidence of OAG was lower in the study cohort than in the control cohort (aHR = 0.624, p = 0.007). The overall incidence of OAG was 463.02 per 100,000 person-years in the study cohort and 573.65 per 100,000 person-years in the control cohort. We used the Kaplan–Meier method to calculate the cumulative risk of developing OAG. The results revealed that after using fibrate for over seven years, the study cohort had a greatly lower rate of developing OAG than the control cohort (log-rank test p = 0.050). Conclusions: Our studies showed that using fibrate for over seven years may lead to a lower risk of OAG in patients with hyperlipidemia. Nevertheless, further prospective studies that comprehensively investigate the relationship between using fibrate and OAG are needed.
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Affiliation(s)
- Yung-En Tsai
- Department of Ophthalmology, Kaohsiung Armed Forces General Hospital, Kaohsiung 802, Taiwan;
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
| | - Chien-An Sun
- Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan;
- Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City 242, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
- School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei 114, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
- School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114, Taiwan
- Correspondence: (W.-C.C.); (K.-H.C.); Tel.: +886-2-8792-3311 (W.-C.C. & K.-H.C.); Fax: +886-2-8792-7235 (W.-C.C.); +886-2-8792-7104 (K.-H.C.)
| | - Ke-Hung Chien
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan;
- Correspondence: (W.-C.C.); (K.-H.C.); Tel.: +886-2-8792-3311 (W.-C.C. & K.-H.C.); Fax: +886-2-8792-7235 (W.-C.C.); +886-2-8792-7104 (K.-H.C.)
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50
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Imperato JS, Zou KH, Li JZ, Hassan TA. Clinical Practice Management of Primary Open-Angle Glaucoma in the United States: An Analysis of Real-World Evidence. Patient Prefer Adherence 2022; 16:2213-2227. [PMID: 36003802 PMCID: PMC9394656 DOI: 10.2147/ppa.s367443] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 08/05/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate clinical management of primary open-angle glaucoma (POAG) in the United States using real-world evidence and to examine healthcare resource utilization (HCRU), medication adherence/persistence, and procedure use. DESIGN A cross-sectional, retrospective analysis of Optum's de-identified Market Clarity Dataset (July 1, 2013-December 31, 2019). PATIENTS AND METHODS Patients ≥18 years with POAG diagnosis and continuous enrollment for 1-year pre- and post-index were eligible and categorized into four mutually exclusive cohorts: CH1, treated with antiglaucoma medication(s) only; CH2, underwent glaucoma procedure(s) only; CH3, treated with antiglaucoma medication(s) and underwent procedure(s); and CH4, received no treatment for POAG. Adherence and persistence with antiglaucoma medications, and disease-specific HCRU were analyzed. Pairwise two-sample comparisons and multivariate regressions were conducted. RESULTS Examined 232,572 eligible patients (CH1=60,895; CH2=4330; CH3=6027; CH4=161,320). Prostaglandin analogs were most prescribed antiglaucoma medications (CH1: 69.7%; CH3: 62.7%), of which latanoprost was most common (CH1: 51.3%; CH3: 46.1%). Disease-specific office visits occurred in 26.3%, 78.2%, 75.0%, 23.8%, and surgical services visits occurred in 3.8%, 36.3%, 42.5%, 3.3%, in CH1-CH4, respectively. Adherence was higher (medication possession ratio: 47.1% vs 39.4%; P<0.0001), and more patients remained persistent across 1-year post-index period in CH1 vs CH3 (25.4% vs 16.1%; P<0.0001). Positive predictors of medication persistence included being female, ≥55 years, and history of dyslipidemia or thyroid disease (all P≤0.0003). CONCLUSION Overall, 70% POAG patients might not have received antiglaucoma treatment. Since POAG is a slowly progressive blinding disease, the lack of antiglaucoma treatment and suboptimal adherence/persistence with medications are of major concerns. Targeted screening and educational approaches are needed to improve POAG management.
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Affiliation(s)
- Joseph S Imperato
- Global Medical Analytics and Real-World Evidence, Viatris Inc., Canonsburg, PA, USA
| | - Kelly H Zou
- Global Medical Analytics and Real-World Evidence, Viatris Inc., Canonsburg, PA, USA
| | - Jim Z Li
- Global Medical Analytics and Real-World Evidence, Viatris Inc., Canonsburg, PA, USA
| | - Tarek A Hassan
- Global Medical Affairs, Ophthalmology, Viatris Inc, Canonsburg, PA, USA
- Correspondence: Tarek A Hassan, Global Medical Affairs, Ophthalmology, Viatris Inc, 1000 Mylan Boulevard, Canonsburg, PA, 15317, USA, Tel +1 347 443 2850, Email
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