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Ji J, Xiong C, Yang H, Jiang Z, Zhang Y, Wang X, Yu T, Li Q, Zhu S, Zhou Y. The aryl hydrocarbon receptor: A crucial mediator in ocular disease pathogenesis and therapeutic target. Exp Eye Res 2024; 249:110144. [PMID: 39486499 DOI: 10.1016/j.exer.2024.110144] [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: 07/08/2024] [Revised: 10/07/2024] [Accepted: 10/29/2024] [Indexed: 11/04/2024]
Abstract
The aryl hydrocarbon receptor (AHR) is a pivotal nuclear receptor involved in mediating cellular responses to a wide range of environmental pollutants and endogenous ligands. AHR plays a central role in regulating essential physiological processes, including xenobiotic metabolism, immune response modulation, cell cycle control, tumorigenesis, and developmental events. Recent studies have identified AHR as a critical mediator and a potential therapeutic target in the pathogenesis of ocular diseases. This review provides a thorough analysis of the various functions of AHR signalling in the ocular environment, with a specific emphasis on its effects on the retina, retinal pigment epithelium (RPE), choroid, and cornea. We provide a detailed discussion on the molecular mechanisms through which AHR integrates environmental and endogenous signals, influencing the development and progression of age-related macular degeneration (AMD), retinitis pigmentosa, uveitis, and other major ocular disorders. Furthermore, we evaluate the therapeutic potential of modulating AHR activity through novel ligands and agonists as a strategy for treating eye diseases. Understanding the molecular mechanisms of AHR in ocular tissues may facilitate the development of AHR-targeted therapies, which is crucial for addressing the pressing clinical demand for novel treatment strategies in ocular diseases.
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Affiliation(s)
- Juanjuan Ji
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Genome Sequencing Center, Department of Laboratory Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Chanyu Xiong
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Genome Sequencing Center, Department of Laboratory Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Huining Yang
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Genome Sequencing Center, Department of Laboratory Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhilin Jiang
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Genome Sequencing Center, Department of Laboratory Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yun Zhang
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Genome Sequencing Center, Department of Laboratory Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiao Wang
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Genome Sequencing Center, Department of Laboratory Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Tianshu Yu
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Genome Sequencing Center, Department of Laboratory Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiong Li
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Genome Sequencing Center, Department of Laboratory Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shikai Zhu
- Organ Transplant Center, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yu Zhou
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Genome Sequencing Center, Department of Laboratory Medicine, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
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Wu B, Zhu M, Zhang F, Cao J, Xie B, Zhu Z, Xiong W. Orbital decompression improves visual function and macular blood perfusion status in patients with thyroid-related eye disease. Front Med (Lausanne) 2024; 11:1455226. [PMID: 39529797 PMCID: PMC11552090 DOI: 10.3389/fmed.2024.1455226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 10/03/2024] [Indexed: 11/16/2024] Open
Abstract
Background Orbital decompression surgery is a treatment option for Thyroid-associated Ophthalmopathy (TAO). However, its effects on visual function and macular perfusion status remain unclear. This study examined how orbital decompression surgery affects visual acuity and macular blood flow in TAO patients and the variation between these two factors. Methods This study involved cross-sectional and longitudinal analyses of 54 TAO patients, who were categorized into a normal vision group (n = 40) and an impaired vision group (n = 14) based on the presence of visual impairment before surgery (LogMAR BCVA >0.097). Among the participants, 20 underwent orbital decompression surgery (normal vision group: n = 13, impaired vision group: n = 7). BCVA and IOP were assessed at baseline in patients with TAO, and macular retinal blood perfusion indices were measured using OCTA. One month post-operatively, changes in these indices were compared between the two groups, and the correlation between visual acuity and macular perfusion indices was analyzed. Results The LogMar BCVA in the visual impairment group was significantly worse than that in the normal vision group (p < 0.001), while the W-MVD was significantly lower (p = 0.01). In the visual impairment group, post-operative LogMar BCVA improved significantly (p = 0.038), and W-MVD increased significantly (p = 0.008) compared to baseline. However, there were no significant changes in LogMar BCVA, S-MVD, D-MVD, or W-MVD in the normal vision group from preoperative to postoperative assessments. A strong negative correlation was found between the changes in W-MVD and changes in LogMar BCVA in the eyes of the visual impairment group treated with orbital decompression (Pearson correlation coefficient, R = -0.812, p = 0.05). Conclusion This study found that TAO patients with visual impairment had lower macular blood flow perfusion than those with normal vision. Endoscopic orbital decompression surgery was found to improve both the best-corrected visual acuity and macular blood flow perfusion in TAO patients with visual impairment, and the improvement in visual acuity was correlated with the improvement in macular blood flow perfusion.
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Affiliation(s)
| | | | | | | | | | - Ziyi Zhu
- Department of Ophthalmology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Wei Xiong
- Department of Ophthalmology, The Third Xiangya Hospital, Central South University, Changsha, China
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Scarabosio A, Surico PL, Patanè L, Tambasco D, Kahale F, Zeppieri M, Parodi PC, Coassin M, Di Zazzo A. The Overlooked Floppy Eyelid Syndrome: From Diagnosis to Medical and Surgical Management. Diagnostics (Basel) 2024; 14:1828. [PMID: 39202316 PMCID: PMC11353443 DOI: 10.3390/diagnostics14161828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 08/13/2024] [Accepted: 08/20/2024] [Indexed: 09/03/2024] Open
Abstract
Floppy Eyelid Syndrome (FES) is an underdiagnosed ocular condition characterized by the abnormal laxity of the upper eyelids, often leading to chronic eye irritation and redness. This review provides an in-depth examination of FES, covering its pathophysiology, clinical presentation, and diagnostic and therapeutic approaches. We discuss the potential etiological factors, including genetic predispositions and associations with ocular and systemic conditions such as obesity, obstructive sleep apnea, keratoconus, and glaucoma. Diagnostic strategies are outlined, emphasizing the importance of thorough clinical examinations and specific tests for an efficacious grading and assessment of FES. Management of FES ranges from conservative medical treatments to surgical interventions for more severe cases and should be driven by a comprehensive and multidisciplinary approach. Herein, we illustrate the practical aspects of diagnosing and managing this condition. This comprehensive review aims to enhance the recognition and treatment of FES, ultimately improving the quality of life for affected patients.
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Affiliation(s)
- Anna Scarabosio
- Department of Plastic Surgery, Massachusetts General Hospital, Boston, MA 02114, USA;
- Department of Plastic Surgery, University Hospital of Udine, 33100 Udine, Italy;
| | - Pier Luigi Surico
- Department of Ophthalmology, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA;
- Department of Ophthalmology, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (M.C.); (A.D.Z.)
| | - Luca Patanè
- Department of Plastic Surgery, Sapienza University of Rome, 00185 Rome, Italy;
| | - Damiano Tambasco
- Department of Plastic Surgery, Hospital San Carlo di Nancy, 00165 Rome, Italy;
| | - Francesca Kahale
- Department of Ophthalmology, Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA;
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| | - Pier Camillo Parodi
- Department of Plastic Surgery, University Hospital of Udine, 33100 Udine, Italy;
| | - Marco Coassin
- Department of Ophthalmology, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (M.C.); (A.D.Z.)
| | - Antonio Di Zazzo
- Department of Ophthalmology, Campus Bio-Medico University Hospital, 00128 Rome, Italy; (M.C.); (A.D.Z.)
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Lixi F, Cuccu A, Giannaccare G, Onnis M, Timofte Zorila MM, Mariotti S, Vacca R, Meloni PE, Pisu M, Mura C, Boi F. Subclinical Ocular Motility Dysfunction and Extraocular Muscle Changes in Inactive Graves' Orbitopathy. J Pers Med 2024; 14:848. [PMID: 39202039 PMCID: PMC11355160 DOI: 10.3390/jpm14080848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/07/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
This study aimed to investigate the presence of structural and functional changes in extraocular muscles (EMs) among patients with inactive Graves' orbitopathy (GO) classified according to the Clinical Activity Score (CAS). Sixty-seven patients with Graves' disease (GD) and inactive GO were included. The data collected included clinical parameters, thyroid function, autoantibody levels, EOM morphology via orbital ultrasound (US), and ocular motility. Patients were stratified into Red Filter Test (RFT)-positive or RFT-negative groups based on the presence or absence of latent diplopia during the RFT examination. Thirty-three patients (49.25%) exhibited latent diplopia on the RFT, despite not reporting double vision during standard ocular motility tests. Significant differences were observed between the two groups in terms of age, disease duration, intraocular pressure (IOP) elevation in up-gaze, and medial rectus muscle thickness (p < 0.05). No significant differences were found in thyroid status, TRAb and ATA levels, CASs, exophthalmos, or lateral rectus thickness between the two groups. This study revealed that in inactive GO, subclinical EM dysfunction and morphological changes may be present, which might not be apparent through routine ocular examinations. The RFT is effective in detecting latent diplopia, highlighting its utility in identifying subtle ocular motility issues and subclinical muscle involvement. Comprehensive evaluations combining functional tests like the RFT and imaging are essential for early detection of GO-related abnormalities, enabling tailored and prompt management and improving patient outcomes.
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Affiliation(s)
- Filippo Lixi
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy; (F.L.); (A.C.); (M.O.)
| | - Alberto Cuccu
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy; (F.L.); (A.C.); (M.O.)
| | - Giuseppe Giannaccare
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy; (F.L.); (A.C.); (M.O.)
| | - Matteo Onnis
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, 09124 Cagliari, Italy; (F.L.); (A.C.); (M.O.)
| | - Mihaela Madalina Timofte Zorila
- Department of Ophthalmology, Cai Ferate Clinical Hospital, 1 Garabet Ibraileanu Street, 700506 Iasi, Romania;
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Stefano Mariotti
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (S.M.); (R.V.); (M.P.); (C.M.); (F.B.)
| | - Rosanna Vacca
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (S.M.); (R.V.); (M.P.); (C.M.); (F.B.)
| | - Paola Elisa Meloni
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (S.M.); (R.V.); (M.P.); (C.M.); (F.B.)
| | - Michela Pisu
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (S.M.); (R.V.); (M.P.); (C.M.); (F.B.)
| | - Chiara Mura
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (S.M.); (R.V.); (M.P.); (C.M.); (F.B.)
| | - Francesco Boi
- Endocrinology Unit, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; (S.M.); (R.V.); (M.P.); (C.M.); (F.B.)
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