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Feng ZX, Sriranganathan A, Lo C, Liu V, Maberley D, Etminan M. Risk of ocular adverse events with aromatase inhibitors. CANADIAN JOURNAL OF OPHTHALMOLOGY 2024; 59:e431-e434. [PMID: 37931898 DOI: 10.1016/j.jcjo.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/13/2023] [Accepted: 10/10/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVE Aromatase inhibitors (AIs) are a class of medications used for adjuvant treatment of breast cancer. Recent case reports suggest that AIs may be associated with various ocular adverse events (AEs). This study evaluates the risk of ocular AEs in patients who take AIs. METHOD Disproportionality analysis was performed using data from the U.S. Food and Drug Administration's Adverse Events Reporting System database from 2004 to 2022. All cases of vitreomacular traction, macular edema, retinal deposits, retinal artery occlusion, macular hole, retinal hemorrhage, uveitis, retinal tear, retinal detachment, dry eye disease, blepharitis, and optic neuropathy were searched for the 3 AIs anastrozole, letrozole, and exemestane. A search also was performed on trastuzumab as a control. Reported odds ratios (RORs) and corresponding 95% CIs were computed. RESULTS We identified 322 ocular AEs of interest for the 3 AIs and 55 for trastuzumab. Anastrozole had the most AEs (n = 163) and was found to have strong associations with vitreomacular traction (ROR = 665; 95% CI, 352-1255), macular edema (ROR = 37; 95% CI, 25-54), retinal deposits (ROR = 11; 95% CI, 2-77), and uveitis (ROR = 6; 95% CI, 4-9). Letrozole had strong associations with retinal deposits (ROR = 8, 95% CI, 1-57) and retinal artery occlusion (ROR = 6; 95% CI, 3-11). Exemestane had a strong association with macular holes (ROR = 10; 95% CI, 3-30). CONCLUSION Disproportionality analysis revealed an increased risk of ocular AEs with each of the AIs. This study calls for clinicians, especially oncologists and ophthalmologists, to be vigilant in patients who are on AI therapy, allowing them to provide prompt interventions to mitigate further ocular morbidities.
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Affiliation(s)
- Zhao Xun Feng
- Department of Ophthalmology, University of Ottawa, Ottawa, ON
| | | | - Cody Lo
- Department of Ophthalmology, University of Ottawa, Ottawa, ON
| | - Victoria Liu
- Department of Ophthalmology, University of Ottawa, Ottawa, ON
| | - David Maberley
- Department of Ophthalmology, University of Ottawa, Ottawa, ON
| | - Mahyar Etminan
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC..
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Ong NJ, Mackey Ao DA, Hunter M, Lee SSY. Exploring the Effects of Age at Menarche and Pregnancy on Myopia. Ophthalmic Epidemiol 2024:1-9. [PMID: 39241157 DOI: 10.1080/09286586.2024.2379973] [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: 03/24/2024] [Revised: 06/26/2024] [Accepted: 07/09/2024] [Indexed: 09/08/2024]
Abstract
PURPOSE Associations between age at menarche and myopia have been observed in studies that included older women. Furthermore, pregnancy-related hormone surges in young women are associated with short-term changes in refractive error, although the long-term effects are less known. This study explored associations of age at menarche and parity with refractive error and ocular biometry in young women, and the relationship between age at menarche and refractive error in middle-aged adults for comparison. METHODS Community-based young women underwent eye examinations at 20 and 28 years old. Information on age at menarche and parity were collected prospectively. The older cohort underwent an eye examination and information on age at menarche was self-reported retrospectively. Cross-sectional associations between age at menarche and myopia were explored in both cohorts. Associations between parity and 8-year longitudinal change in refractive error measures were explored in the young cohort. RESULTS The cross-sectional analyses comprised 429 young (age 18-22) and 1,818 older (age 46-69) women. No associations were found between age at menarche and myopia or ocular biometry measures in either cohort. The longitudinal analysis (n = 269 women) revealed that for each pregnancy carried to full term, there rate of lens thickening increased by 0.004 mm/year (95% CI = 0.002-0.007). No other associations between parity and refractive error or ocular biometry were found. CONCLUSION There is no association between age at menarche and myopia or its related measures. While pregnancy was associated with thicker lens in the long term, there is no lasting effect on refractive error.
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Affiliation(s)
| | - David A Mackey Ao
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, East Melbourne, Victoria, Australia
- School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
| | - Michael Hunter
- Busselton Health Study Centre, Busselton Population Medical Research Institute, Busselton, Western Australia, Australia
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Science (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
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Choi AJ, Hefley BS, Nicholas SE, Cunningham RL, Karamichos D. Novel Correlation between TGF-β1/-β3 and Hormone Receptors in the Human Corneal Stroma. Int J Mol Sci 2023; 24:13635. [PMID: 37686439 PMCID: PMC10487450 DOI: 10.3390/ijms241713635] [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: 07/15/2023] [Revised: 08/22/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
This study investigated the interplay between transforming growth factor beta (TGF-β1/T1 and TGF-β3/T3), and sex hormone receptors using our 3D in vitro cornea stroma model. Primary human corneal fibroblasts (HCFs) from healthy donors were plated in transwells at 106 cells/well and cultured for four weeks. HCFs were supplemented with stable vitamin C (VitC) and stimulated with T1 or T3. 3D construct proteins were analyzed for the androgen receptor (AR), progesterone receptor (PR), estrogen receptor alpha (ERα) and beta (ERβ), luteinizing hormone receptor (LHR), follicle-stimulating hormone receptor (FSHR), gonadotropin-releasing hormone receptor (GnRHR), KiSS1-derived peptide receptor (KiSS1R/GPR54), and follicle-stimulating hormone subunit beta (FSH-B). In female constructs, T1 significantly upregulated AR, PR, ERα, FSHR, GnRHR, and KiSS1R. In male constructs, T1 significantly downregulated FSHR and FSH-B and significantly upregulated ERα, ERβ, and GnRHR. T3 caused significant upregulation in expressions PR, ERα, ERβ, LHR, FSHR, and GNRHR in female constructs, and significant downregulation of AR, ERα, and FSHR in male constructs. Semi-quantitative Western blot findings present the interplay between sex hormone receptors and TGF-β isoforms in the corneal stroma, which is influenced by sex as a biological variable (SABV). Additional studies are warranted to fully delineate their interactions and signaling mechanisms.
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Affiliation(s)
- Alexander J. Choi
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA; (A.J.C.); (B.S.H.); (S.E.N.)
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, Fort Worth, TX 76107, USA;
| | - Brenna S. Hefley
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA; (A.J.C.); (B.S.H.); (S.E.N.)
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, Fort Worth, TX 76107, USA;
| | - Sarah E. Nicholas
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA; (A.J.C.); (B.S.H.); (S.E.N.)
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, Fort Worth, TX 76107, USA;
| | - Rebecca L. Cunningham
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, Fort Worth, TX 76107, USA;
| | - Dimitrios Karamichos
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA; (A.J.C.); (B.S.H.); (S.E.N.)
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, Fort Worth, TX 76107, USA;
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
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Celebi ARC, Aygun EG. A rare cause of recurrent subconjunctival hemorrhage: ocular vicarious menstruation. GMS OPHTHALMOLOGY CASES 2023; 13:Doc05. [PMID: 36875630 PMCID: PMC9979076 DOI: 10.3205/oc000213] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Purpose Vicarious menstruation is cyclical bleeding in extra-uterine locations that occurs during menstruation or within 48 h of its onset. We aim to present a 43-year-old female with ocular vicarious menstruation, its treatment, and a review of other published cases of ocular vicarious menstruation. Case description A 43-year-old Caucasian female presented with a 15-year history of recurrent monthly unilateral subconjunctival hemorrhage. The episodes were cyclical and coincided with the onset of menses, lasting for approximately 10 to 14 days. Slit-lamp examination of the right eye showed nasally located subconjunctival hemorrhage. Detailed laboratory findings, including parameters for various hematological disorders, were normal. A follow-up examination 2 weeks later showed that the subconjunctival hemorrhage in the right eye was completely resolved. The patient was prescribed the oral contraceptive levonorgestrel/ethinyl estradiol and marked improvement at the recurrences of subconjunctival hemorrhage was noted during subsequent menses. Conclusion Ocular vicarious menstruation is among the rarest causes of recurrent subconjunctival hemorrhage. A therapeutic trial of oral contraceptive should be considered in patients that present with ocular vicarious menstruation.
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Affiliation(s)
- Ali Riza Cenk Celebi
- Acibadem University School of Medicine, Department of Ophthalmology, Istanbul, Turkey
| | - Elif Ganime Aygun
- Acibadem Atakent Education and Research Hospital Department of Obstetrics and Gynecology, Istanbul, Turkey
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Ghosh S, Tale S, Handa N, Bhalla A. Rare case of red tears: ocular vicarious menstruation. BMJ Case Rep 2021; 14:e237294. [PMID: 33687932 PMCID: PMC7945043 DOI: 10.1136/bcr-2020-237294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 11/04/2022] Open
Abstract
Bloody tears or haemolacria is a rare clinical entity. It is caused by various ocular and systemic conditions. Haemolacria due to vicarious menstruation is even rarer. In this article, we presented a case of cyclical episodes of bloody tears coinciding with menstrual cycle in a 25-year-old married female patient. Extensive physical, ophthalmological and radiological evaluation failed to reveal other potential causes of her complaint. A diagnosis of ocular vicarious menstruation was made and she was treated with oral contraceptive pills. No such episode recurred during 3 months follow-up period.
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Affiliation(s)
- Soumitra Ghosh
- Internal Medicine, PGIMER, Chandigarh, Chandigarh, India
| | - Sudheer Tale
- Internal Medicine, PGIMER, Chandigarh, Chandigarh, India
| | - Neha Handa
- Internal Medicine, PGIMER, Chandigarh, Chandigarh, India
| | - Ashish Bhalla
- Internal Medicine, PGIMER, Chandigarh, Chandigarh, India
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Barrientez B, Nicholas SE, Whelchel A, Sharif R, Hjortdal J, Karamichos D. Corneal injury: Clinical and molecular aspects. Exp Eye Res 2019; 186:107709. [PMID: 31238077 DOI: 10.1016/j.exer.2019.107709] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/03/2019] [Accepted: 06/21/2019] [Indexed: 12/13/2022]
Abstract
Currently, over 10 million people worldwide are affected by corneal blindness. Corneal trauma and disease can cause irreversible distortions to the normal structure and physiology of the cornea often leading to corneal transplantation. However, donors are in short supply and risk of rejection is an ever-present concern. Although significant progress has been made in recent years, the wound healing cascade remains complex and not fully understood. Tissue engineering and regenerative medicine are currently at the apex of investigation in the pursuit of novel corneal therapeutics. This review uniquely integrates the clinical and cellular aspects of both corneal trauma and disease and provides a comprehensive view of the most recent findings and potential therapeutics aimed at restoring corneal homeostasis.
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Affiliation(s)
- Brayden Barrientez
- Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Sarah E Nicholas
- Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Amy Whelchel
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Rabab Sharif
- Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Jesper Hjortdal
- Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark
| | - Dimitrios Karamichos
- Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA; Department of Cell Biology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA.
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