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Spurlock M, An W, Reshetnikova G, Wen R, Wang H, Braha M, Solis G, Kurtenbach S, Galindez OJ, de Rivero Vaccari JP, Chou TH, Porciatti V, Shestopalov VI. The Inflammasome-Dependent Dysfunction and Death of Retinal Ganglion Cells after Repetitive Intraocular Pressure Spikes. Cells 2023; 12:2626. [PMID: 37998361 PMCID: PMC10670000 DOI: 10.3390/cells12222626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/25/2023] Open
Abstract
The dysfunction and selective loss of retinal ganglion cells (RGCs) is a known cause of vision loss in glaucoma and other neuropathies, where ocular hypertension (OHT) is the major risk factor. We investigated the impact of transient non-ischemic OHT spikes (spOHT) on RGC function and viability in vivo to identify cellular pathways linking low-grade repetitive mechanical stress to RGC pathology. We found that repetitive spOHT had an unexpectedly high impact on intraocular homeostasis and RGC viability, while exposure to steady OHT (stOHT) of a similar intensity and duration failed to induce pathology. The repetitive spOHT induced the rapid activation of the inflammasome, marked by the upregulation of NLRP1, NLRP3, AIM2, caspases -1, -3/7, -8, and Gasdermin D (GSDMD), and the release of interleukin-1β (IL-1β) and other cytokines into the vitreous. Similar effects were also detected after 5 weeks of exposure to chronic OHT in an induced glaucoma model. The onset of these immune responses in both spOHT and glaucoma models preceded a 50% deficit in pattern electroretinogram (PERG) amplitude and a significant loss of RGCs 7 days post-injury. The inactivation of inflammasome complexes in Nlrp1-/-, Casp1-/-, and GsdmD-/- knockout animals significantly suppressed the spOHT-induced inflammatory response and protected RGCs. Our results demonstrate that mechanical stress produced by acute repetitive spOHT or chronic OHT is mechanistically linked to inflammasome activation, which leads to RGC dysfunction and death.
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Affiliation(s)
- Markus Spurlock
- Bascom Palmer Eye Institute Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.S.); (W.A.); (G.R.); (R.W.); (H.W.); (M.B.); (G.S.); (S.K.); (V.P.)
- Neuroscience Graduate Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
| | - Weijun An
- Bascom Palmer Eye Institute Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.S.); (W.A.); (G.R.); (R.W.); (H.W.); (M.B.); (G.S.); (S.K.); (V.P.)
| | - Galina Reshetnikova
- Bascom Palmer Eye Institute Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.S.); (W.A.); (G.R.); (R.W.); (H.W.); (M.B.); (G.S.); (S.K.); (V.P.)
| | - Rong Wen
- Bascom Palmer Eye Institute Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.S.); (W.A.); (G.R.); (R.W.); (H.W.); (M.B.); (G.S.); (S.K.); (V.P.)
| | - Hua Wang
- Bascom Palmer Eye Institute Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.S.); (W.A.); (G.R.); (R.W.); (H.W.); (M.B.); (G.S.); (S.K.); (V.P.)
| | - Michelle Braha
- Bascom Palmer Eye Institute Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.S.); (W.A.); (G.R.); (R.W.); (H.W.); (M.B.); (G.S.); (S.K.); (V.P.)
| | - Gabriela Solis
- Bascom Palmer Eye Institute Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.S.); (W.A.); (G.R.); (R.W.); (H.W.); (M.B.); (G.S.); (S.K.); (V.P.)
| | - Stefan Kurtenbach
- Bascom Palmer Eye Institute Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.S.); (W.A.); (G.R.); (R.W.); (H.W.); (M.B.); (G.S.); (S.K.); (V.P.)
| | - Orlando J. Galindez
- Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
| | - Juan Pablo de Rivero Vaccari
- Neuroscience Graduate Program, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
- Department of Neurological Surgery and The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA;
| | - Tsung-Han Chou
- Bascom Palmer Eye Institute Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.S.); (W.A.); (G.R.); (R.W.); (H.W.); (M.B.); (G.S.); (S.K.); (V.P.)
| | - Vittorio Porciatti
- Bascom Palmer Eye Institute Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.S.); (W.A.); (G.R.); (R.W.); (H.W.); (M.B.); (G.S.); (S.K.); (V.P.)
| | - Valery I. Shestopalov
- Bascom Palmer Eye Institute Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (M.S.); (W.A.); (G.R.); (R.W.); (H.W.); (M.B.); (G.S.); (S.K.); (V.P.)
- Department of Cell Biology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
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Holm JL, Bach‐Holm D, Holm LM, Vestergaard AH. Prophylactic treatment of intraocular pressure elevation after uncomplicated cataract surgery in nonglaucomatous eyes - a systematic review. Acta Ophthalmol 2019; 97:545-557. [PMID: 30941916 DOI: 10.1111/aos.14092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 03/03/2019] [Indexed: 01/22/2023]
Abstract
The purpose of this systematic review was to evaluate the literature regarding prophylactic treatment of intraocular pressure (IOP) elevation after uncomplicated cataract surgery to provide an evidence-based guideline for cataract surgeons. The relevant literature was identified in EMBASE and PubMed. The risk of bias was assessed according to the 'Cochrane Handbook for Systematic Reviews of Interventions' and the ROBINS-I tool. The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) criteria were used to rate the quality of evidence, and relevant data were systematically extracted to evaluate the pressure-lowering effect of the active substances. The primary outcomes for this systematic review were the absolute and relative pressure-lowering effect of the different drugs after 3-8 hr and 1 day after surgery. In total, 23 randomized controlled trials and one nonrandomized controlled study consisting of 45 treatment arms with 14 different active substances were included in the qualitative synthesis. According to the GRADE criteria, nine trials were graded as 'high' quality of evidence, 12 trials as 'moderate', while three trials were given the grade 'low' quality of evidence. The primary outcomes showed most consistency between the trials, which studied the effect of timolol, and presented a relative effect from 18.6% to 29.6% at 3-8 hr and 9.8% to 23.6% at day 1. This systematic review indicates that timolol, latanoprost and travoprost alone or medications containing timolol as an additive active substance, such as dorzolamide + timolol, brinzolamide + timolol and brimonidine + timolol, are characterized by a good relative IOP-lowering effect, which can be gained by a single dose postoperatively.
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Affiliation(s)
- Jakob Lysholk Holm
- Department of Ophthalmology Odense University Hospital Odense Denmark
- Research Unit of Ophthalmology University of Southern Denmark Odense Denmark
| | - Daniella Bach‐Holm
- Department of Ophthalmology Rigshospitalet‐Glostrup Copenhagen Denmark
- Faculty of Health Sciences Institute of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Lars Morten Holm
- Department of Ophthalmology Rigshospitalet‐Glostrup Copenhagen Denmark
- Faculty of Health Sciences Institute of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Anders Højslet Vestergaard
- Department of Ophthalmology Odense University Hospital Odense Denmark
- Research Unit of Ophthalmology University of Southern Denmark Odense Denmark
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Hayashi K, Yoshida M, Sato T, Manabe SI. Effect of Topical Hypotensive Medications for Preventing Intraocular Pressure Increase after Cataract Surgery in Eyes with Glaucoma. Am J Ophthalmol 2019; 205:91-98. [PMID: 30902694 DOI: 10.1016/j.ajo.2019.03.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/07/2019] [Accepted: 03/07/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE To compare the effects of a topical intraocular pressure (IOP)-lowering medication for preventing an IOP increase after cataract surgery in eyes with glaucoma. DESIGN Randomized clinical study. METHODS A total of 165 eyes of 165 patients with primary open-angle glaucoma or pseudoexfoliation glaucoma scheduled for phacoemulsification were randomly assigned to 1 of 3 groups to receive each medication immediately postoperatively: 1) prostaglandin F2α analog (travoprost), 2) β-blocker (timolol maleate), or 3) carbonic anhydrase inhibitor (brinzolamide). Intraocular pressure (IOP) was measured using a rebound tonometer at 1 hour preoperatively, at the end of surgery, and at 2, 4, 6, 8, and 24 hours postoperatively. The incidence of eyes exhibiting a marked IOP increase to greater than 25 mm Hg was compared among the groups. RESULTS At 1 hour preoperatively and at the end of surgery, mean IOP did not differ significantly among the groups. Mean IOP increased significantly between 4 and 8 hours postoperatively and then decreased at 24 hours postoperatively in all groups (P < .0001). Mean IOP was significantly lower in the brinzolamide group than in the travoprost or timolol group at 4, 6, and 8 hours postoperatively (P ≤ .0374) and did not differ significantly among groups at 2 and 24 hours postoperatively. The incidence of an IOP spike was significantly lower in the brinzolamide group than in the travoprost and timolol groups (P = .0029). CONCLUSIONS Brinzolamide reduces the short-term IOP increase after cataract surgery more effectively than travoprost or timolol in eyes with glaucoma, suggesting that brinzolamide is preferable for preventing an IOP spike.
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Abstract
PURPOSE OF REVIEW The aim of this review was to assess the risk factors and course of postoperative intraocular pressure (IOP) increase in order to determine the optimal the treatment. RECENT FINDINGS Early postoperative IOP elevation following cataract surgery is a frequent adverse event, and might represent 88% early postoperative complications. The risk factors for IOP elevation following phacoemulsification cataract surgery include residual viscoelastic material, resident performed surgery, glaucoma, pseudoexfoliation syndrome, axial length over 25 mm, tamsulosin intake, topical steroid application in steroid responders. A day-1 postoperative follow-up might be questioned, even in glaucoma patients, as in IOP spikes the topmost IOP elevation occurs 3-4 h postoperatively. SUMMARY Several IOP-lowering agents have been evaluated, but none has completely prevented the occurrence of IOP spikes. We recommend applying a combination of dorzolamide/timolol and brinzolamide topically in high-risk patients, particularly with preexisting optic nerve damage. Corticosteroid cessation usually results in a reduction of the IOP to normal levels in steroid responders. Additional studies are required to assess the optimal treatment, especially in glaucoma patients.
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Grzybowski A, Kanclerz P. Do we need day-1 postoperative follow-up after cataract surgery? Graefes Arch Clin Exp Ophthalmol 2018; 257:855-861. [DOI: 10.1007/s00417-018-04210-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 11/21/2018] [Accepted: 12/04/2018] [Indexed: 12/18/2022] Open
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Topical Curcumin Nanocarriers are Neuroprotective in Eye Disease. Sci Rep 2018; 8:11066. [PMID: 30038334 PMCID: PMC6056418 DOI: 10.1038/s41598-018-29393-8] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 03/14/2018] [Indexed: 11/11/2022] Open
Abstract
Curcumin (1,7-bis-(4-hydroxy-3-methoxyphenyl)-1,6-heptadiene-3,5dione) is a polyphenol extracted from turmeric that has long been advocated for the treatment of a variety of conditions including neurodegenerative and inflammatory disorders. Despite this promise, the clinical use of curcumin has been limited by the poor solubility and low bioavailability of this molecule. In this article, we describe a novel nanocarrier formulation comprising Pluronic-F127 stabilised D-α-Tocopherol polyethene glycol 1000 succinate nanoparticles, which were used to successfully solubilize high concentrations (4.3 mg/mL) of curcumin. Characterisation with x-ray diffraction and in vitro release assays localise curcumin to the nanocarrier interior, with each particle measuring <20 nm diameter. Curcumin-loaded nanocarriers (CN) were found to significantly protect against cobalt chloride induced hypoxia and glutamate induced toxicity in vitro, with CN treatment significantly increasing R28 cell viability. Using established glaucoma-related in vivo models of ocular hypertension (OHT) and partial optic nerve transection (pONT), topical application of CN twice-daily for three weeks significantly reduced retinal ganglion cell loss compared to controls. Collectively, these results suggest that our novel topical CN formulation has potential as an effective neuroprotective therapy in glaucoma and other eye diseases with neuronal pathology.
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Turk A, Ceylan OM, Gokce G, Borazan M, Kola M. Comparison of brimonidine-timolol and dorzolamide-timolol in the management of intraocular pressure increase after phacoemulsification. Int J Ophthalmol 2015; 8:945-9. [PMID: 26558206 DOI: 10.3980/j.issn.2222-3959.2015.05.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 03/02/2015] [Indexed: 11/02/2022] Open
Abstract
AIM To compare the effectiveness of brimonidine/timolol fixed combination (BTFC) and dorzolamide/timolol fixed combination (DTFC) in the management of short-term intraocular pressure (IOP) increase after phacoemulsification surgery. METHODS Eighty eyes of 80 patients undergoing phacoemulsification and intraocular lens (IOL) implantation were randomly assigned into three groups. Group 1 consisted of 28 eyes and represented the control group. Group 2 consisted of 25 eyes undergoing phacoemulsification surgery and BTFC was instilled at the end of surgery. Group 3 consisted of 27 eyes undergoing phacoemulsification surgery and DTFC was instilled at the end of surgery. IOP was measured preoperatively and 6, 24h and 1wk postoperatively. RESULTS There was no statistically significant difference in preoperative baseline IOP among the three groups (P=0.84). However, IOP was significantly lower in groups 2 and 3 compared to the control group (P<0.05 for all comparisons) at all postoperative visits. There was no significant difference between groups 2 and 3 at any visit. Eight eyes (28.6%) in the control group, two (8%) in Group 2 and one (3.7%) in Group 3 had IOP >25 mm Hg at 6h after surgery (P=0.008). However, IOP decreased and was >25 mm Hg in only one eye in each group at 24h after surgery. CONCLUSION BTFC and DTFC have similar effects in reducing increases in IOP after phacoemulsification surgery and can both be recommended for preventing IOP spikes after such surgery.
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Affiliation(s)
- Adem Turk
- Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey
| | - Osman Melih Ceylan
- Department of Ophthalmology, Medical Park Hospital, Ankara 06370, Turkey
| | - Gokcen Gokce
- Department of Ophthalmology, Kayseri Military Hospital, Kayseri 38100, Turkey
| | - Mehmet Borazan
- Department of Ophthalmology, Faculty of Medicine, Mevlana University, Konya 42003, Turkey
| | - Mehmet Kola
- Department of Ophthalmology, Faculty of Medicine, Karadeniz Technical University, Trabzon 61080, Turkey
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Legrand M, Blumen-Ohana E, Laplace O, Adam R, Akesbi J, Colas E, Nordmann J. Pression intraoculaire en postopératoire précoce de phakoémulsification chez le sujet normal et glaucomateux. J Fr Ophtalmol 2015; 38:633-8. [DOI: 10.1016/j.jfo.2015.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 01/20/2015] [Accepted: 02/02/2015] [Indexed: 10/23/2022]
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Gupta A, Vernon SA. Is the 1-day postoperative IOP check needed post uncomplicated phacoemulsification in patients with glaucoma and ocular hypertension? Eye (Lond) 2015; 29:1299-307. [PMID: 25697456 DOI: 10.1038/eye.2014.331] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 12/07/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To determine whether the 1-day postoperative intraocular pressure (IOP) check following routine uncomplicated phacoemulsification is necessary in patients with pre-existing glaucoma and ocular hypertension (OHT), if acetazolamide prophylaxis is used. To investigate the practice of U.K. glaucoma specialists in IOP rise prophylaxis and follow-up regimes. PATIENTS AND METHODS The IOP 1-day postoperatively was analysed against the last recorded IOP before phacoemulsification in a cohort of patients with glaucoma or OHT who underwent uncomplicated phacoemulsification cataract surgery between December 2009 and September 2012, where it was routine practice to give acetazolamide postoperatively. U.K. and Eire Glaucoma Society members were surveyed via an online questionnaire to analyse practice among U.K. glaucoma specialists. RESULTS One hundred and seven eyes were studied: 99 with glaucoma and 8 with OHT. The mean IOP change was -0.8 mm Hg with only two eyes measuring >30 mm Hg postoperatively (2%). Both these eyes received 750 mg acetazolamide. Eighteen (17%) eyes had an IOP rise of at least 30%. In the survey of practice there were 65 respondents. Twenty-one (32%) respondents did not use IOP prophylaxis. Only 17 (26%) of respondents routinely reviewed their patients 1-day postoperatively. CONCLUSION Our prophylactic acetazolamide regime does not completely eliminate the risk of an IOP >30 mm Hg on day 1 post routine phacoemulsification in glaucoma/OHT patients. Patients with pre-existing glaucoma, despite acetazolamide prophylaxis, will require IOP management decisions on the first postoperative day after uncomplicated phacoemulsification surgery. U.K. expert practice is non-uniform with regard to IOP prophylaxis, and the 1-day review, and further discussion and formulation of consensus appears necessary.
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Affiliation(s)
- A Gupta
- Ophthalmology Department, Queen's Medical Centre, Nottingham, UK
| | - S A Vernon
- Ophthalmology Department, Queen's Medical Centre, Nottingham, UK
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Erdogan H, Ozec AV, Caner C, Toker MI, Arici MK, Topalkara A. Effect of latanoprost/timolol and dorzolamide/tiomolol on intraocular pressure after phacoemulsification surgery. Int J Ophthalmol 2011; 4:190-4. [PMID: 22553640 DOI: 10.3980/j.issn.2222-3959.2011.02.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Accepted: 03/11/2011] [Indexed: 11/02/2022] Open
Abstract
AIM To evalaute the effect of fixed-combination latanoprost 0.005%/timolol maleate 0.5% and dorzolamide hydrochloride 2%/timolol maleate 0.5% on postoperative intraocular pressure after phacoemulsification cataract surgery. METHODS This study is a prospective, randomized, double-masked and placebo-controlled. The study included 90 eyes of 90 patients which were scheduled to have phacoemulsification surgery. Patients were randomly assigned preoperatively to 1 of 3 groups (30 eyes of 30 patients). Two hour before surgery, the patients received one drop latanoprost/timolol (group 1), dorzolamide/timolol (group 2) and placebo (group 3, control group). The IOPs were measured at preoperative and postoperative 4, 8, and 24 hours. RESULTS The preoperative mean intraocular pressure was not statistically significant between both drug groups and control group. In group 1 and 2, the postoperative mean IOP [group1: (14.03±3.15)mmHg and group 2: (14.16±4.43)mmHg] at 24 hours were significantly lower than the control group [(16.93±3.70)mmHg, (P<0.05)]. In addition, the postoperative mean IOP of group 1 [(14.90±3.69)mmHg] at 8 hours was significantly lower than the control group [(17.70±3.89)mmHg, (P<0.05)], but there was no significant difference between group 2 [(16.16±5.23)mmHg] and control group at 8 hours (P>0.05). CONCLUSION When compared with placebo, the use of preoperative fixed combination of latanoprost/timolol and dorzolamide/timolol is an effective method for preventing intraocular pressure elevation in 24 hours after phacoemulsification surgery, but did not completely prevent IOP spikes.
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Affiliation(s)
- Haydar Erdogan
- Departments of Ophthalmology, School of Medicine, University of Cumhuriyet, Sivas-Turkey
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