1
|
Safa BN, Fraticelli Guzmán NS, Li G, Stamer WD, Feola AJ, Ethier CR. A Histomorphometric and Computational Investigation of the Stabilizing Role of Pectinate Ligaments in the Aqueous Outflow Pathway. J Biomech Eng 2024; 146:081011. [PMID: 38529724 DOI: 10.1115/1.4065164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/22/2024] [Indexed: 03/27/2024]
Abstract
Murine models are commonly used to study glaucoma, the leading cause of irreversible blindness. Glaucoma is associated with elevated intra-ocular pressure (IOP), which is regulated by the tissues of the aqueous outflow pathway. In particular, pectinate ligaments (PLs) connect the iris and trabecular meshwork (TM) at the anterior chamber angle, with an unknown role in maintenance of the biomechanical stability of the aqueous outflow pathway, thus motivating this study. We conducted histomorphometric analysis and optical coherence tomography-based finite element (FE) modeling on three cohorts of C57BL/6 mice: "young" (2-6 months), "middle-aged" (11-16 months), and "elderly" (25-32 months). We evaluated the age-specific morphology of the outflow pathway tissues. Further, because of the known pressure-dependent Schlemm's canal (SC) narrowing, we assessed the dependence of the SC lumen area on varying IOPs in age-specific FE models over a physiological range of TM/PL stiffness values. We found age-dependent changes in morphology of outflow tissues; notably, the PLs were more developed in older mice compared to younger ones. In addition, FE modeling demonstrated that murine SC patency is highly dependent on the presence of PLs and that increased IOP caused SC collapse only with sufficiently low TM/PL stiffness values. Moreover, the elderly model showed more susceptibility to SC collapse compared to the younger models. In conclusion, our study elucidated the previously unexplored role of PLs in the aqueous outflow pathway, indicating their function in supporting TM and SC under elevated IOP.
Collapse
Affiliation(s)
- Babak N Safa
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332
| | - Nina Sara Fraticelli Guzmán
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30318; Department of Ophthalmology, Emory University, Atlanta, GA 30332
- Georgia Institute of Technology
| | - Guorong Li
- Department of Ophthalmology, Duke University, Durham, NC 27705
- Duke University
| | - W Daniel Stamer
- Department of Ophthalmology, Duke University, Durham, NC 27705
- Duke University
| | - Andrew J Feola
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332; Department of Ophthalmology, Emory University, Atlanta, GA 30322; Atlanta VA Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affair Healthcare System, Decatur, GA 30033
- Emory University
| | - C Ross Ethier
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Emory University, Atlanta, GA 30332; George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30318; Department of Ophthalmology, Emory University, Atlanta, GA 30332
| |
Collapse
|
2
|
Horie Y, Sawada A, Dorcas U, Ramaswamy BR, Iguchi T. Iopanoic acid alters thyroid hormone-related gene expression, thyroid hormone levels, swim bladder inflation, and swimming performance in Japanese medaka. Comp Biochem Physiol C Toxicol Pharmacol 2024; 281:109930. [PMID: 38663833 DOI: 10.1016/j.cbpc.2024.109930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/30/2024] [Accepted: 04/22/2024] [Indexed: 04/30/2024]
Abstract
Disruption of the thyroid hormone system by synthetic chemicals is gaining attention owing to its potential negative effects on organisms. In this study, the effects of the dio-inhibitor iopanoic acid (IOP) on the levels of thyroid hormone and related gene expression, swim bladder inflation, and swimming performance were investigated in Japanese medaka. Iopanoic acid exposure suppressed thyroid-stimulating hormone β (tshβ), tshβ-like, iodotyronin deiodinase 1 (dio1), and dio2 expression, and increased T4 and T3 levels. In addition, IOP exposure inhibited swim bladder inflation, reducing swimming performance. Although adverse outcome pathways of thyroid hormone disruption have been developed using zebrafish, no adverse outcome pathways have been developed using Japanese medaka. This study confirmed that IOP inhibits dio expression (a molecular initiating event), affects T3 and T4 levels (a key event), and reduces swim bladder inflation (a key event) and swimming performance (an adverse outcome) in Japanese medaka.
Collapse
Affiliation(s)
- Yoshifumi Horie
- Research Center for Inland Seas (KURCIS), Kobe University, Fukaeminami-machi, Higashinada-ku, Kobe 658-0022, Japan.
| | - Ayaka Sawada
- Graduate School of Maritime Science, Kobe University, Fukaeminami-machi, Higashinada-ku, Kobe 658-0022, Japan
| | - Uaciquete Dorcas
- Research Center for Inland Seas (KURCIS), Kobe University, Fukaeminami-machi, Higashinada-ku, Kobe 658-0022, Japan
| | - Babu Rajendran Ramaswamy
- Department of Environmental Biotechnology, School of Environmental Sciences, Bharathidasan University, Tiruchirappalli 620024, India
| | - Taisen Iguchi
- Graduate School of Nanobioscience, Yokohama City University, 22-2 Seto, Kanazawa-ku, Yokohama 236-0027, Japan
| |
Collapse
|
3
|
Elhusseiny AM, Aref AA. Sustained Release Therapies with the Prostaglandin Analogues Intracameral Implants. Ophthalmol Ther 2024:10.1007/s40123-024-00965-4. [PMID: 38761359 DOI: 10.1007/s40123-024-00965-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 05/01/2024] [Indexed: 05/20/2024] Open
Abstract
The travoprost intracameral implant was recently approved by the US Food and Drug Administration for sustained release medical treatment of open-angle glaucoma in the USA. The approval represents a substantial and progressive step forward in the area of sustained-release glaucoma therapy. Topical intraocular pressure-lowering medications for the treatment of glaucoma are faced with a host of challenges for long-term and usually lifelong care. A changing paradigm in glaucoma management involves first-line interventions with laser modalities, micro-invasive surgeries, and sustained-release treatment platforms. Future needs in the area of sustained-release therapy include a non-prostaglandin drug delivery platform and longer-term treatments that do not require surgical reintervention.
Collapse
Affiliation(s)
- Abdelrahman M Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ahmad A Aref
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, 1009 S Wood St, Chicago, IL, 60612, USA.
| |
Collapse
|
4
|
Da Silva F, Linhares JMM, Lira M. The influence of the tear film on the intraocular pressure and the corneal biomechanical properties analyzed with the Ocular Response Analyzer. J Optom 2024; 17:100488. [PMID: 37918060 PMCID: PMC10641536 DOI: 10.1016/j.optom.2023.100488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/11/2023] [Accepted: 07/25/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE As ocular dryness and glaucoma are more prevalent with increasing age, understanding how the tear film affects tonometry is important. The present study aims to understand the impact that changes in the tear film have on intraocular pressure (IOP), corneal hysteresis, and corneal resistance factor measurements. METHODS Cross-sectional research was conducted and 37 patients were assessed. The tear film lipid layer and the non-invasive break-up time (NIBUT) were evaluated using the Tearscope Plus (Keeler, Windsor, UK). Dry eye symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. IOP was measured using rebound tonometry and the Ocular Response Analyzer (ORA, Reichert). Corneal biomechanical properties were measured using ORA. RESULTS It was found that an increase in the IOP measured with the iCare was directly correlated with the subclass that evaluated symptomatology associated with environmental factors (r = 0.414, p<0.05, Spearman). Goldmann-correlated IOP (IOPg) and Corneal-compensated IOP (IOPcc) values were statistically significantly different between the various interferometric patterns (p<0.05). It was also found that an increase in the corneal biomechanical properties measured with ORA was directly correlated with the overall scores obtained when using the OSDI and some of its subclasses. CONCLUSIONS Tear film interferometric patterns were shown to have some impact on the IOP measured using ORA. The IOP measured with iCare seems to be related to the symptomatology obtained from OSDI. Corneal biomechanical properties were related to the OSDI total score and some of its subclasses. An increase in symptomatology was associated with an increase in the measured biomechanical properties of the cornea.
Collapse
Affiliation(s)
- Filipe Da Silva
- Physics Center of Minho and Porto Universities (CF-UM-UP), School of Sciences, University of Minho, Braga, Portugal.
| | - João M M Linhares
- Physics Center of Minho and Porto Universities (CF-UM-UP), School of Sciences, University of Minho, Braga, Portugal
| | - Madalena Lira
- Physics Center of Minho and Porto Universities (CF-UM-UP), School of Sciences, University of Minho, Braga, Portugal
| |
Collapse
|
5
|
Safa BN, Guzmán NSF, Li G, Daniel Stamer W, Feola AJ, Ross Ethier C. A Histomorphometric and Computational Investigation of the Stabilizing Role of Pectinate Ligaments in the Aqueous Outflow Pathway. bioRxiv 2024:2023.10.17.562754. [PMID: 37905127 PMCID: PMC10614930 DOI: 10.1101/2023.10.17.562754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Murine models are commonly used to study glaucoma, the leading cause of irreversible blindness. Glaucoma is associated with elevated intraocular pressure (IOP), which is regulated by the tissues of the aqueous outflow pathway. In particular, pectinate ligaments (PLs) connect the iris and trabecular meshwork (TM) at the anterior chamber angle, with an unknown role in maintenance of the biomechanical stability of the aqueous outflow pathway, thus motivating this study. We conducted histomorphometric analysis and optical coherence tomography-based finite element (FE) modeling on three cohorts of C57BL/6 mice: 'young' (2-6 months), 'middle-aged' (11-16 months), and 'elderly' (25-32 months). We evaluated the age-specific morphology of the outflow pathway tissues. Further, because of the known pressure-dependent Schlemm's canal (SC) narrowing, we assessed the dependence of the SC lumen area to varying IOPs in age-specific FE models over a physiological range of TM/PL stiffness values. We found age-dependent changes in morphology of outflow tissues; notably, the PLs were more developed in older mice compared to younger ones. In addition, FE modeling demonstrated that murine SC patency is highly dependent on the presence of PLs, and that increased IOP caused SC collapse only with sufficiently low TM/PL stiffness values. Moreover, the elderly model showed more susceptibility to SC collapse compared to the younger models. In conclusion, our study elucidated the previously unexplored role of PLs in the aqueous outflow pathway, indicating their function in supporting TM and SC under elevated IOP.
Collapse
Affiliation(s)
- Babak N. Safa
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA
| | - Nina Sara Fraticelli Guzmán
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Department of Ophthalmology, Emory University, Atlanta, GA, USA
| | - Guorong Li
- Department of Ophthalmology, Duke University, Durham, NC, USA
| | | | - Andrew J. Feola
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA
- Department of Ophthalmology, Emory University, Atlanta, GA, USA
- Atlanta VA Center for Visual and Neurocognitive Rehabilitation, Atlanta Veterans Affair Healthcare System, Decatur, GA, USA
| | - C. Ross Ethier
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Department of Ophthalmology, Emory University, Atlanta, GA, USA
| |
Collapse
|
6
|
Steger JS, Durai I, Odayappan A, Raman R, Sruthi T, Song AJ, Puthuran G, Venkatesh R, Colantuoni E, Robin AL. An Evaluation of the Efficacy and Safety of Timolol Maleate 0.5% Microdrops Administered with the Nanodropper. Ophthalmology 2024:S0161-6420(24)00189-1. [PMID: 38492865 DOI: 10.1016/j.ophtha.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
PURPOSE To examine if 12.5 μl timolol maleate 0.5% microdrops dispensed with the Nanodropper Adaptor provide noninferior intraocular pressure (IOP) reduction compared with conventional 28 μl drops in patients with open-angle glaucoma (OAG) and ocular hypertension (OHT). DESIGN Prospective, noninferiority, parallel, multicenter, single-masked, active-controlled, randomized trial. PARTICIPANTS Treatment-naïve subjects who were recently diagnosed with OAG and OHT at the Aravind Eye Care System. METHODS Both eyes of subjects received 1 commercially available drop or both eyes of subjects received 1 microdrop of timolol maleate 0.5%. We measured IOP, resting heart rate (HR), and blood pressure (BP) at baseline and 1, 2, 5, and 8 hours after timolol administration. MAIN OUTCOME MEASURES The IOP was the primary outcome measure. Secondary outcomes were resting HR, systolic BP (sBP), and diastolic BP (dBP). RESULTS Adaptor-mediated microdrops and conventional drops of timolol significantly decreased IOP compared with baseline at all timepoints. Noninferiority was established at 3 of 4 timepoints. Heart rate decreases with Nanodropper were approximately 3 beats per minute (bpm) less than with conventional drops. CONCLUSIONS Timolol microdrops appear to be as effective in ocular hypotensive action as conventional drops with a slightly attenuated effect on resting HR and BP. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
Collapse
Affiliation(s)
| | | | | | | | | | - Allisa J Song
- Nanodropper, Inc., Rochester, Minnesota; Mayo Clinic Alix School of Medicine, Rochester, Minnesota
| | | | | | | | - Alan L Robin
- Johns Hopkins University, Baltimore, Maryland; University of Michigan, Ann Arbor, Michigan.
| |
Collapse
|
7
|
Martínez-de-la-Casa JM, Marcos-Parra MT, Millá-Griñó E, Laborda T, Giménez-Gomez R, Larrosa JM, Urcola A, Teus MÁ, Perucho-Martínez S. Effectiveness and safety of XEN63 in patients with primary-open-angle glaucoma. Sci Rep 2024; 14:4561. [PMID: 38402310 PMCID: PMC10894194 DOI: 10.1038/s41598-024-55287-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 02/22/2024] [Indexed: 02/26/2024] Open
Abstract
This paper evaluates the effectiveness and safety of XEN63 stent, either standalone or in combination with phacoemulsification, in patients with primary open-angle glaucoma (POAG). Eighty eyes from 80 patients with medically uncontrolled POAG were assigned to undergo XEN63 implant. The primary outcome was the surgical success, defined as an intraocular pressure (IOP) lowering from preoperative values ≥ 20% and an IOP absolute value between 6 and 18 mmHg, with or without antiglaucoma medications. Forty-three (53.7%) eyes underwent XEN63-standalone and 37(46.2%) eyes a XEN63 + Phacoemulsification procedure. Success rate was 68.8% (55/80) eyes in the overall study sample, 69.8% (30/43) eyes in the XEN63-standalone group; and 67.6% (25/37) eyes in the XEN63 + Phaco group (p = 0.6133). Preoperative IOP was significantly lowered from 22.1 ± 4.9 mmHg and 19.8 ± 3.7 mmHg to 14.7 ± 5.3 mmHg and 13.8 ± 3.4 mmHg in the XEN63-standalone and XEN63 + Phaco groups, respectively (p < 0.0001 each, respectively); without significant differences between them at any of the time-points measured. Preoperative number of ocular-hypotensive drugs was significantly reduced from 2.3 ± 0.8 to 0.3 ± 0.7 drugs, from 2.5 ± 0.7 to 0.3 ± 0.7 drugs; and from 2.0 ± 0.8 to 0.3 ± 0.7 drugs, in the overall, XEN63-standalone, and XEN63 + Phaco groups, respectively. Regarding safety, 3(42.5%) eyes had transient hypotony at some point during the study, although only in one (1.2%) eye was clinically significant. Four (5.0%) eyes underwent a needling, 4 (5.0%) eyes underwent surgical-bleb-revision, 1 (1.2%) eye required a device replacement and 1 (1.2%) eye a device removal due to maculopathy. XEN63, either alone or in combination with phacoemulsification, significantly lowered IOP and reduced the number of ocular hypotensive medications. The rate of ocular hypotony was relatively high, although it was clinically relevant only in one eye.
Collapse
Affiliation(s)
- José María Martínez-de-la-Casa
- Ophthalmology Unit, Department of Ophthalmology and ORL, Faculty of Medicine, Hospital Clinico San-Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San-Carlos (IdISSC), Universidad Complutense de Madrid, Calle del Prof Martín Lagos, s/n, 28040, Madrid, Spain.
| | | | | | - Teresa Laborda
- Glaucoma Department. Hospital La Arruzafa, Córdoba, Spain
| | | | | | - Aritz Urcola
- Ophthalmology Department, Araba University Hospital, Álava, Spain
| | | | | |
Collapse
|
8
|
Okeke CO, Cothran NL, Brinkley DA, Rahmatnejad K, Rodiño FJ, Deom JE. Latanoprostene Bunod 0.024% in Patients with Open-Angle Glaucoma Switched from Prior Pharmacotherapy: A Retrospective Chart Review. Clin Ophthalmol 2024; 18:409-422. [PMID: 38348139 PMCID: PMC10859762 DOI: 10.2147/opth.s442940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/15/2024] [Indexed: 02/15/2024] Open
Abstract
Introduction Latanoprostene bunod 0.024% (LBN, Vyzulta®) is a nitric oxide-donating prostaglandin analog (PGA). We investigated the real-world efficacy and safety of LBN in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT) who switched their existing intraocular pressure (IOP)-lowering treatment(s) to LBN. Methods This non-interventional, multicenter (United States), retrospective chart review included patients aged ≥18 years with OHT and/or mild-to-moderate OAG diagnoses taking 1-2 IOP-lowering treatments at the time of switch to LBN (index visit). Chart-extracted data included demographics, diagnoses, IOP and ocular assessments, other IOP-lowering treatments, adverse events (AEs), and reasons for discontinuation. The main study outcome was IOP change from the index visit to each of the next 2 chart-recorded follow-up visits. Analysis groups included the overall dataset and 2 subgroups of patients switched from PGA therapy to LBN: "PGA-all" subgroup [all patients previously on a PGA with/without another IOP-lowering product] and "PGA-monotherapy" subgroup [patients previously on a PGA alone]). Additional ocular outcomes (eg, visual acuity) were examined, if available. Results The overall dataset included 49 patients (46 had OAD alone, 2 had OHT alone, and 1 had both). The PGA-all subgroup and PGA-monotherapy subgroups had 41 and 32 patients, respectively. Switching to LBN led to a ~25% IOP reduction from the index visit to Visit 1 that was sustained at Visit 2. IOP findings in the PGA-all and PGA-monotherapy subgroups were consistent with the overall dataset. No meaningful changes in other ocular outcomes were found. Of 14 ocular AEs, 3 were recorded as such (mild in severity, considered unrelated to treatment), and 11 were identified through review of interval ocular histories (no severity/relatedness information); none led to discontinuation. Conclusion In this short-term retrospective chart review of mild-to-moderate OAG/OHT, switching prior IOP-lowering therapy to LBN produced an additional ~25% IOP reduction and appeared to be well tolerated.
Collapse
Affiliation(s)
| | | | | | | | | | - James E Deom
- Hazleton Eye Specialists, Hazle Township, PA, USA
| |
Collapse
|
9
|
Wang XF, Zhang XW, Liu YJ, Zheng XY, Su MR, Sun XH, Jiang F, Liu ZN. The causal effect of hypertension, intraocular pressure, and diabetic retinopathy: a Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 15:1304512. [PMID: 38379860 PMCID: PMC10877050 DOI: 10.3389/fendo.2024.1304512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/17/2024] [Indexed: 02/22/2024] Open
Abstract
Background Previous research has indicated a vital association between hypertension, intraocular pressure (IOP), and diabetic retinopathy (DR); however, the relationship has not been elucidated. In this study, we aim to investigate the causal association of hypertension, IOP, and DR. Methods The genome-wide association study (GWAS) IDs for DR, hypertension, and IOP were identified from the Integrative Epidemiology Unit (IEU) Open GWAS database. There were 33,519,037 single-nucleotide polymorphisms (SNPs) and a sample size of 1,030,836 for DR. There were 16,380,466 SNPs and 218,754 participants in the hypertension experiment. There were 9,851,867 SNPs and a sample size of 97,465 for IOP. Univariable, multivariable, and bidirectional Mendelian randomization (MR) studies were conducted to estimate the risk of hypertension and IOP in DR. Moreover, causality was examined using the inverse variance weighted method, and MR results were verified by numerous sensitivity analyses. Results A total of 62 SNPs at the genome-wide significance level were selected as instrumental variables (IVs) for hypertension-DR. The results of univariable MR analysis suggested a causal relationship between hypertension and DR and regarded hypertension as a risk factor for DR [p = 0.006, odds ratio (OR) = 1.080]. A total of 95 SNPs at the genome-wide significance level were selected as IVs for IOP-DR. Similarly, IOP was causally associated with DR and was a risk factor for DR (p = 0.029, OR = 1.090). The results of reverse MR analysis showed that DR was a risk factor for hypertension (p = 1.27×10-10, OR = 1.119), but there was no causal relationship between DR and IOP (p > 0.05). The results of multivariate MR analysis revealed that hypertension and IOP were risk factors for DR, which exhibited higher risk scores (p = 0.001, OR = 1.121 and p = 0.030, OR = 1.124, respectively) than those in univariable MR analysis. Therefore, hypertension remained a risk factor for DR after excluding the interference of IOP, and IOP was still a risk factor for DR after excluding the interference of hypertension. Conclusion This study validated the potential causal relationship between hypertension, IOP, and DR using MR analysis, providing a reference for the targeted prevention of DR.
Collapse
Affiliation(s)
- Xiao-Fang Wang
- Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xiao-Wen Zhang
- Department of Endocrinology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Ya-Jun Liu
- Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xin-Yu Zheng
- Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Meng-Ru Su
- Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xing-Hong Sun
- Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Feng Jiang
- Department of Ophthalmology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhi-Nan Liu
- Department of Ophthalmology, Changzhou Third People’s Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, China
| |
Collapse
|
10
|
Nicou CM, Passaglia CL. Characterization of intraocular pressure variability in conscious rats. Exp Eye Res 2024; 239:109757. [PMID: 38123009 PMCID: PMC10922224 DOI: 10.1016/j.exer.2023.109757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/10/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023]
Abstract
Elevation of mean intraocular pressure (IOP) has long been recognized as a leading risk factor for glaucoma. Less is known about the possible contribution of moment-to-moment variations in IOP to disease development and progression due to limitations of tonometry, the prevailing method of IOP measurement. Tonometry provides good estimates of mean IOP but not IOP variance. The aim of this study was to quantitatively characterize IOP variability via round-the-clock IOP telemetry in conscious unrestrained rats. The anterior chamber of one eye was implanted with a microcannula connected to a wireless backpack telemetry system, and IOP data were collected every 4 s for one week. The cannula was then repositioned under the conjunctiva, and control data were collected for an additional week. IOP statistics were computed in 30-min intervals over a 24-h period and averaged across days. All animals exhibited a diurnal variation in mean IOP, while deviations about the mean were independent of time of day. Correlation analysis of the deviations revealed transient and sustained components, which were respectively extracted from IOP records using an event detection algorithm. The amplitude and interval distributions of transient and sustained events were characterized, and their energy content was estimated based on outflow tissue resistance of rat eyes. Transient IOP events occurred ∼231 times per day and were typically ≤5 mmHg in amplitude and 2-8 min in duration, while sustained IOP events occurred ∼16 times per day and were typically ≤5 mmHg in amplitude and 20-60 min in duration. Both persisted but were greatly reduced in control recordings, implying minor contamination of IOP data by motion-induced telemetry noise. Sustained events were also often synchronous across implanted animals, indicating that they were driven by autonomic startle and stress responses or other physiological processes activated by sensory signals in the animal housing environment. Not surprisingly, the total daily fluidic energy applied to resistive outflow pathways was determined primarily by basal IOP level. Nevertheless, transient and sustained fluctuations collectively contributed 6% and diurnal fluctuations contributed 9% to daily IOP energy. It is therefore important to consider the cumulative impact of biomechanical stress that IOP fluctuations apply over time to ocular tissues.
Collapse
Affiliation(s)
- Christina M Nicou
- Medical Engineering Department, University of South Florida, Tampa, FL, 33620, USA
| | - Christopher L Passaglia
- Medical Engineering Department, University of South Florida, Tampa, FL, 33620, USA; Ophthalmology Department, University of South Florida, Tampa, FL, 33620, USA.
| |
Collapse
|
11
|
Lidder AK, Vanner EA, Chang TC, Lum F, Rothman AL. Intraocular Pressure Spike Following Stand-Alone Phacoemulsification in the IRIS® Registry (Intelligent Research in Sight). Ophthalmology 2024:S0161-6420(24)00081-2. [PMID: 38246424 DOI: 10.1016/j.ophtha.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/09/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024] Open
Abstract
PURPOSE To evaluate risk factors for intraocular pressure (IOP) spike after cataract surgery using the IRIS® Registry (Intelligent Research in Sight). DESIGN Retrospective clinical cohort study. PARTICIPANTS Adults with IRIS Registry data who underwent stand-alone phacoemulsification from January 1, 2013, through September 30, 2019. METHODS Intraocular pressure spike was defined as postoperative IOP of > 30 mmHg and > 10 mmHg from the baseline within the first postoperative week. Odds ratios (ORs) for demographic and clinical characteristics were calculated with univariable and multivariable logistic regression analyses. MAIN OUTCOME MEASURES Incidence and OR of IOP spike. RESULTS We analyzed data from 1 191 034 eyes (patient mean age, 71.3 years; 61.2% female sex; and 24.8% with glaucoma). An IOP spike occurred in 3.7% of all eyes, 5.2% of eyes with glaucoma, and 3.2% of eyes without glaucoma (P < 0.0001). Multivariable analyses of all eyes indicated a greater risk of IOP spike with higher baseline IOP (OR, 1.57 per 3 mmHg), male sex (OR, 1.79), glaucoma (OR, 1.20), Black race (OR, 1.39 vs. Asian and 1.21 vs. Hispanic), older age (OR, 1.07 per 10 years), and complex surgery coding (OR, 1.22; all P < 0.0001). Diabetes (OR, 0.90) and aphakia after surgery (OR, 0.60) seemed to be protective against IOP spike (both P < 0.0001). Compared with glaucoma suspects, ocular hypertension (OR, 1.55), pigmentary glaucoma (OR, 1.56), and pseudoexfoliative glaucoma (OR, 1.52) showed a greater risk of IOP spike and normal-tension glaucoma (OR, 0.55), suspected primary angle closure (PAC; OR, 0.67), and PAC glaucoma (OR, 0.81) showed less risk (all P < 0.0001). Using more baseline glaucoma medications was associated with IOP spike (OR, 1.18 per medication), whereas topical β-blocker use (OR, 0.68) was protective (both P < 0.0001). CONCLUSIONS Higher baseline IOP, male sex, glaucoma, Black race, older age, and complex cataract coding were associated with early postoperative IOP spike, whereas diabetes and postoperative aphakia were protective against a spike after stand-alone phacoemulsification. Glaucomatous eyes demonstrated different risk profiles dependent on glaucoma subtype. The findings may help surgeons to stratify and mitigate the risk of IOP spike after cataract surgery. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Collapse
Affiliation(s)
- Alcina K Lidder
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Elizabeth A Vanner
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Ta Chen Chang
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Flora Lum
- American Academy of Ophthalmology, San Francisco, California
| | - Adam L Rothman
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
| |
Collapse
|
12
|
Zeng L, Ying Q, Lou H, Wang F, Pang Y, Hu H, Zhang Z, Song Y, Liu P, Zhang X. Protective effect of the natural flavonoid naringenin in mouse models of retinal injury. Eur J Pharmacol 2024; 962:176231. [PMID: 38052414 DOI: 10.1016/j.ejphar.2023.176231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023]
Abstract
Glaucoma is an eye disease with a high rate of blindness and a complex pathogenesis. Ocular hypertension (OHT) is a critical risk factor, and retinal ischemia/reperfusion (I/R) is an important pathophysiological basis. This study was designed to investigate the retinal neuroprotective effect of oral naringenin in an acute retinal I/R model and a chronic OHT model and the possible mechanism involved. After the I/R and OHT models were established, mice were given vehicle or naringenin (100 mg/kg or 300 mg/kg). Hematoxylin-eosin (HE) staining and immunostaining of RBPMS and glial fibrillary acidic protein (GFAP) were used to evaluate retinal injury. GFAP, CD38, Sirtuin1 (SIRT1), and NOD-like receptor protein 3 (NLRP3) expression levels were measured by Western blotting. In the OHT model, intraocular pressure (IOP) was dynamically maintained at approximately 20-25 mmHg after injury. The retinal structure was damaged, and retinal ganglion cells (RGCs) were lost in both models. Naringenin ameliorated the abovementioned indications but also demonstrated that high concentrations of naringenin significantly inhibited retinal astrocyte activation and inhibited damage-induced increases in the expression of GFAP, NLRP3, and CD38 proteins, while SIRT1 protein expression was upregulated. This study showed for the first time that naringenin can reduce microbead-induced IOP elevation in the OHT model, providing new evidence for the application of naringenin in glaucoma. Naringenin may mediate the CD38/SIRT1 signaling pathway, inhibit astrocyte activation, and ultimately exert an anti-inflammatory effect to achieve retinal neuroprotection.
Collapse
Affiliation(s)
- Ling Zeng
- Affiliated Eye Hospital of Nanchang University, Jiangxi Research Institute of Ophthalmology and Visual Science, Jiangxi Provincial Key Laboratory for Ophthalmology, Nanchang, Jiangxi, China
| | - Qian Ying
- Affiliated Eye Hospital of Nanchang University, Jiangxi Research Institute of Ophthalmology and Visual Science, Jiangxi Provincial Key Laboratory for Ophthalmology, Nanchang, Jiangxi, China
| | - Hongdou Lou
- Affiliated Eye Hospital of Nanchang University, Jiangxi Research Institute of Ophthalmology and Visual Science, Jiangxi Provincial Key Laboratory for Ophthalmology, Nanchang, Jiangxi, China
| | - Feifei Wang
- Affiliated Eye Hospital of Nanchang University, Jiangxi Research Institute of Ophthalmology and Visual Science, Jiangxi Provincial Key Laboratory for Ophthalmology, Nanchang, Jiangxi, China
| | - Yulian Pang
- Affiliated Eye Hospital of Nanchang University, Jiangxi Research Institute of Ophthalmology and Visual Science, Jiangxi Provincial Key Laboratory for Ophthalmology, Nanchang, Jiangxi, China
| | - Haijian Hu
- Affiliated Eye Hospital of Nanchang University, Jiangxi Research Institute of Ophthalmology and Visual Science, Jiangxi Provincial Key Laboratory for Ophthalmology, Nanchang, Jiangxi, China
| | - Ziqiao Zhang
- Queen Mary School, Nanchang University, Nanchang, 330006, Jiangxi Province, China
| | - Yuning Song
- Affiliated Eye Hospital of Nanchang University, Jiangxi Research Institute of Ophthalmology and Visual Science, Jiangxi Provincial Key Laboratory for Ophthalmology, Nanchang, Jiangxi, China
| | - Peiyu Liu
- Affiliated Eye Hospital of Nanchang University, Jiangxi Research Institute of Ophthalmology and Visual Science, Jiangxi Provincial Key Laboratory for Ophthalmology, Nanchang, Jiangxi, China
| | - Xu Zhang
- Affiliated Eye Hospital of Nanchang University, Jiangxi Research Institute of Ophthalmology and Visual Science, Jiangxi Provincial Key Laboratory for Ophthalmology, Nanchang, Jiangxi, China.
| |
Collapse
|
13
|
Wang J, Chun LY, Qiu M. Baerveldt-350 with 3-0 Prolene Ripcord to Minimize Hypotony-Associated Complications after Spontaneous Ligature Dissolution. Ophthalmol Glaucoma 2024; 7:93-100. [PMID: 37454973 DOI: 10.1016/j.ogla.2023.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/10/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE To describe the technique and demonstrate the utility and outcomes of using a thick 3-0 Prolene ripcord in the lumen of a Baerveldt-350 aqueous shunt until after the ligature suture dissolves. DESIGN Single-center, noncontrolled, retrospective case series. PARTICIPANTS A total of 50 eyes from 50 patients with glaucoma undergoing placement of Baerveldt-350 aqueous shunts with 3-0 Prolene ripcords. METHODS A retrospective chart review was performed for all eyes of adult patients that had undergone a Baerveldt-350 aqueous shunt placement by a single surgeon at a single academic center between October 1, 2019 and June 30, 2022. MAIN OUTCOME MEASURES Data collected included demographic and clinical characteristics of the patients, preoperative and postoperative clinical data including intraocular pressure (IOP) and glaucoma medications, postoperative timepoints of ligature suture dissolution, and timepoints of 3-0 Prolene ripcord removal or whether they were permanently left in place. RESULTS In total, 50 eyes from 50 patients were included; mean age was 69.5 years, 54.0% of patients were female, 92% of patients were Black, and 66% of eyes had primary open-angle glaucoma. Twenty-six of 50 (52%) eyes had ripcord removal at the soonest postoperative visit after spontaneous ligature dissolution, 19/50 (38%) eyes had delayed ripcord removal, and 5/50 (10%) eyes had no ripcord removal. There were no cases of hypotony-associated complications (shallow anterior chamber, hypotony maculopathy, choroidal effusion, suprachoroidal hemorrhage) in this subgroup of eyes that underwent no ripcord removal. CONCLUSIONS Our results demonstrate that routine use of a 3-0 Prolene ripcord to partially occlude the lumen of a Baerveldt-350 is a useful strategy to minimize sudden hypotony-associated complications when the ligature suture dissolves. This strategy allows for a more controlled postoperative course and a safe 2-step decrease in IOP (1: when the ligature dissolves, and 2: when the ripcord is removed). FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Collapse
Affiliation(s)
- Jessie Wang
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, Illinois
| | - Lindsay Y Chun
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, Illinois
| | - Mary Qiu
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, Illinois.
| |
Collapse
|
14
|
Antonov AA, Klinicheva EA, Volzhanin AV, Makarova AS. [Effect of refractive surgery on Maklakov tonometry results]. Vestn Oftalmol 2024; 140:51-59. [PMID: 38739131 DOI: 10.17116/oftalma202414002251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
PURPOSE The study investigates the influence of changes in keratometric parameters after refractive surgery on the results of Maklakov tonometry. MATERIAL AND METHODS The study examined a total of 61 people (121 eyes). The patients were divided into a control group with no history of surgery (16 people, 31 eyes), a LASIK group (13 people, 26 eyes), a femtosecond-assisted LASIK (FS-LASIK) group (16 people, 32 eyes), and a photorefractive keratectomy (PRK) group (16 people, 32 eyes). The patients underwent standard examination, keratometry (Km), Maklakov tonometry with a 10 g weight, and elastotonometry with 5, 7.5, and 15 g weights. RESULTS In the LASIK group, the indentation diameter with 5 and 7.5 g weights correlated with Km in the central and near-paracentral zone (r=0.3-0.5). Tonometry with a 10 g weight did not correlate with anything. Tonometry with a 15 g weight inversely correlated with Km in the paracentral points (4 mm) of the strong meridian (r= -0.5 ... -0.7). In the FS-LASIK group, a significant inverse correlation with Km was observed only for the indentation diameter with a 10 g weight in the paracentral (3-4 mm) zone (r= -0.4 ... -0.5). In the PRK group, weak (r<0.4) correlations were found between Km and the indentation diameter of the 7.5 and 10 g weights for the central zone (1-2 mm). No significant correlations were found for 5 and 15 g weights. In the control group, there were practically no correlations for 5 and 7.5 g weights. The indentation diameter of the 10 g weight evenly correlated with Km at all points (r= -0.38 ... -0.60), the indentation of the 15 g weight correlated mainly with the curvature of the horizontal meridian (r= -0.37 ... -0.49). CONCLUSION Tonometry readings with the 10 g weight are the most dependent on Km in different groups, and the readings with the 5 g weight are the least dependent. LASIK is characterized by the largest scatter of dependencies for weights of different masses, FS-LASIK - by the smallest. Tonometry readings with the 5 g weight correlated with Km only in the LASIK group, and this was the only direct correlation. Considering the inverse nature of most correlations, higher Km may be associated with an overestimation of tonometry results, and lower Km - with its underestimation.
Collapse
Affiliation(s)
- A A Antonov
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | - E A Klinicheva
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | - A V Volzhanin
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | - A S Makarova
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| |
Collapse
|
15
|
Storp JJ, Schatten H, Vietmeier FE, Merté RL, Lahme L, Zimmermann JA, Englmaier VA, Eter N, Brücher VC. The Preserflo MicroShunt Affects Microvascular Flow Density in Optical Coherence Tomography Angiography. Biomedicines 2023; 11:3254. [PMID: 38137475 PMCID: PMC10741543 DOI: 10.3390/biomedicines11123254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/28/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Intraocular pressure (IOP) lowering surgery has been shown to alter microvascular density in glaucoma patients. The aim of this study is to report changes in retinal flow density (FD) over the course of treatment with the Preserflo MicroShunt, using optical coherence tomography angiography (OCTA). 34 eyes from 34 patients who underwent Preserflo MicroShunt implantation were prospectively enrolled in this study. OCTA imaging was conducted at the superficial (SCP), deep (DCP) and radial peripapillary plexus (RPC) levels. The progression of FD and IOP was assessed at different time points from baseline to six months postoperatively for the entire patient population, as well as disease severity subgroups. The Preserflo MicroShunt achieved a significant reduction in IOP over the course of six months (median: 8 mmHg; p < 0.01). FD values of the SCP and DCP did not show significant fluctuations, even after adjusting for disease severity. FD of the RPC decreased significantly over the course of six months postoperatively from 42.31 at baseline to 39.59 at six months postoperatively (p < 0.01). The decrease in peripapillary FD was strongest in patients with advanced glaucoma (median: -3.58). These observations hint towards dysfunctional autoregulatory mechanisms in capillaries surrounding the optic nerve head in advanced glaucoma. In comparison, the microvascular structure of the macula appeared more resilient to changes in IOP.
Collapse
Affiliation(s)
- Jens Julian Storp
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Hannah Schatten
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
- Augenklinik Roth am St. Josef-Hospital, 53225 Bonn, Germany
| | - Friederike Elisabeth Vietmeier
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Ralph-Laurent Merté
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Larissa Lahme
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Julian Alexander Zimmermann
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Verena Anna Englmaier
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| | - Viktoria Constanze Brücher
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany (F.E.V.); (R.-L.M.); (L.L.); (J.A.Z.); (V.A.E.); (N.E.); (V.C.B.)
| |
Collapse
|
16
|
Kuo HT, Yeh CY, Hsu AY, Ho JHC, Lin CJ, Tsai YY. Clinical Efficacy of Omidenepag Isopropyl for Primary Open-Angle Glaucoma, Normal Tension Glaucoma, or Ocular Hypertension: A Meta-Analysis. J Ocul Pharmacol Ther 2023; 39:705-715. [PMID: 37579061 DOI: 10.1089/jop.2023.0058] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
Purpose: To investigate the clinical efficacy of omidenepag isopropyl (OMDI) among glaucoma patients in terms of increased intraocular pressure (IOP) changes through a meta-analysis. Methods: Studies investigating the clinical efficacy of OMDI toward glaucoma patients were systemically searched. Inclusion criteria include recruiting studies that consisted of glaucoma or normal tension glaucoma patients who received OMDI treatment at least 4 weeks in duration. The primary outcome was to compare changes in IOP levels at baseline before OMDI treatment and after OMDI treatment. Results: Six studies were included with a total of 358 eyes. Our results showed OMDI monotherapy resulted in significant decreased IOP among patients with ocular hypertension, with weighted mean difference post-OMDI treatment being -4.684 (95% confidence interval: -6.010 to -3.358) and I2 of 91.092%. Separate subgroup analyses also showed initial IOP greater than 21 mmHg and those within the age group greater than 65 years old to be correlated with significant reduction in IOP post-OMDI. Randomized control trial (RCTs) design was also found to be superior compared with non-RCT in terms of investigating IOP changes after OMDI. The country of origin of the recruited studies and OMDI dosage frequencies were also found to have no effect on overall IOP changes after OMDI treatment. Conclusions: The current meta-analysis indicates OMDI to be a clinically effective treatment for glaucoma patients in terms of lowering IOP levels.
Collapse
Affiliation(s)
- Hou-Ting Kuo
- Department of General Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cyuan-Yi Yeh
- Department of General Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Alan Y Hsu
- Department of General Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Jennifer Hui-Chun Ho
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Center for Translational Genomics and Regenerative Medicine Research, China Medical University Hospital, Taichung, Taiwan
- Department of Medical Research, Eye Center, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Chun-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
| |
Collapse
|
17
|
Gliske K, Ballard J, Berry KR, Killian M, Kroll E, Fenkel C. Reduction of Mental Health-Related Emergency Department Admissions for Youth and Young Adults Following a Remote Intensive Outpatient Program: Quality Improvement Analysis. JMIR Form Res 2023; 7:e47895. [PMID: 37943600 PMCID: PMC10667974 DOI: 10.2196/47895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 09/12/2023] [Accepted: 10/03/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Pediatric mental health emergency department (ED) visits are increasing at 6% to 10% per year, at substantial cost, while 13% of youth with psychiatric hospitalizations are readmitted in the following weeks. Hospitals do not have the resources to meet escalating youth's mental health needs. Intensive outpatient (IOP) programs, which provide multiple hours of care each week, have the power to reduce the number of patients in need of hospitalized care and provide a step-down option for patients discharging from ED's in order to prevent readmissions. OBJECTIVE The purpose of this program evaluation was to assess (1) whether youth and young adult ED admission rates decreased following participation in a remote IOP program and (2) whether there were differences in readmission rates between youth and young adults by gender identity, sexual orientation, race, or ethnicity. METHODS Data were collected from intake and 3-month postdischarge surveys for 735 clients who attended at least 6 sessions of a remote IOP program for youth and young adults. Patients reported if they had been admitted to an ED within the previous 30 days and the admission reason. Over half (407/707, 57.6%) of clients were adolescents and the rest were young adults (300/707, 42.4%; mean age 18.25, SD 4.94 years). The sample was diverse in gender identity (329/687, 47.9% female; 196/687, 28.5% male; and 65/669, 9.7% nonbinary) and sexual orientation (248/635, 39.1% heterosexual; 137/635, 21.6% bisexual; 80/635, 10.9% pansexual; and 170/635, 26.8% other sexual orientation) and represented several racial (9/481, 1.9% Asian; 48/481, 10% Black; 9/481, 1.9% Indigenous; 380/481, 79% White; and 35/481, 7.2% other) and ethnic identities (112/455, 24.6% Hispanic and 28/455, 6.2% other ethnic identity). RESULTS Mental health-related ED admissions significantly decreased between intake and 3 months after discharge, such that 94% (65/69) of clients with a recent history of mental health-related ED admissions at IOP intake reported no mental health-related ED admissions at 3 months after discharge from treatment (χ21=38.8, P<.001). There were no differences in ED admissions at intake or in improvement at 3 months after discharge by age, gender, sexuality, race, or ethnicity. CONCLUSIONS This study documents a decrease in ED admissions between intake and 3 months after discharge among both youth and young adults who engage in IOP care following ED visits. The similar outcomes across demographic groups indicate that youth and young adults experience similar decreases after the current tracks of programming. Future research could conduct a full return-on-investment analysis for intensive mental health services for youth and young adults.
Collapse
Affiliation(s)
- Kate Gliske
- Charlie Health Inc, Bozeman, MT, United States
| | - Jaime Ballard
- Center For Applied Research and Educational Improvement, University of Minnesota, Saint Paul, MN, United States
| | | | - Michael Killian
- College of Social Work, Florida State University, Tallahassee, FL, United States
| | | | | |
Collapse
|
18
|
Zhuang H, Zheng NX, Lin L. Watching intense movies increase IOP of primary open angle glaucoma patients: A prospective study. J Fr Ophtalmol 2023; 46:882-895. [PMID: 37085357 DOI: 10.1016/j.jfo.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 04/23/2023]
Abstract
PURPOSE To investigate intraocular pressure (IOP) changes while viewing smartphone movies under artificial intelligence (AI) monitoring. METHODS In all, 48 subjects were recruited from the glaucoma clinic of Xianyou maternal and child health hospital from January 2018 to March 2020. The research consisted of three parts. In part 1, movies rated by the Motion Picture Association of America (MPAA) were viewed via smartphones of various screen sizes under AI supervision for 90minutes, at a distance of 40cm. IOP and biological parameters including anterior chamber angle, Schlemm's canal (SC) cross-sectional area, heart rate, systolic and diastolic blood pressures (SBP and DBP) were measured and analyzed. In part 2, blue-blocking glasses (BB glasses) were worn to repeat the above experiments. In part 3, the efficacy of AI in decreasing attention loss was analyzed. In addition, results were analyzed to determine whether interval breaks, prompted by AI, prevented IOP from rising. RESULTS In part 1, the mean IOP of primary open angle glaucoma (POAG) subjects' right eyes significantly increased by 4.828 and 4.974mmHg after watching R and NC-17 movies, respectively. In their left eyes, it increased by 2.876 and 5.767 after watching R and NC-17 movies, respectively. The maximum IOP difference was also increased by 4.782 and 4.510 on right and left eyes, respectively, after viewing NC-17 movies on a 6.1-inch screen. Furthermore, the SC became narrower, whereas heart rate, DBP and SBP increased in the POAG group. In addition, maximum IOP difference was significantly correlated with SC cross-sectional area, DBP and SBP in the POAG group. In part 2, symptom scores were improved by BB glasses; however, IOP was not decreased. In part 3, attention loss was significantly decreased by AI monitoring. On the contrary, AI also prevented IOP from rising via promoting interval rest. CONCLUSION Watching adult movies (NC-17) can significantly increase the IOP of POAG patients. AI can prevent IOP from rising by promoting interval rest when viewing NC-17 movies.
Collapse
Affiliation(s)
- H Zhuang
- Department of Ophthalmology, Maternal and Child Health Hospital of Xianyou County, 351200 Putian City, Fujian Province, China.
| | - N-X Zheng
- Fujian Center for Disease Control and Prevention, 350000 Fuzhou city, Fujian Province, China.
| | - L Lin
- Department of Ophthalmology, Women and Children's Hospital, School of Medicine, Xiamen University, 361000 Xiamen city, Fujian Province, China.
| |
Collapse
|
19
|
Serino F, Bernardi E, Franco F. Efficacy and safety of combined Xen Gel Stent-45 implantation and 25-gauge Pars Plana Vitrectomy: a case series. Rom J Ophthalmol 2023; 67:362-367. [PMID: 38239415 PMCID: PMC10793369 DOI: 10.22336/rjo.2023.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2023] [Indexed: 01/22/2024] Open
Abstract
Purpose: To report outcomes in terms of efficacy and safety of patients affected with Primary Open Angle Glaucoma (POAG) and Vitreoretinal Disease, who have undergone Pars Plana Vitrectomy (PPV) and ab-interno XEN gel 45 (Abbvie) implantations. Methods: This is a retrospective, observational, case series on five patients who underwent combined Pars Plana Vitrectomy and XEN gel Stent 45 implantation at "Careggi Hospital" Eye Clinic of Florence. Best-corrected visual acuity (BCVA) evaluation, intraocular pressure (IOP) measurements with Goldmann applanation tonometer (GAT), and several glaucoma medications were evaluated at the baseline and at one, three, six, and twelve months after surgery. Complications were recorded up to 1 year after surgery. Results: 5 eyes in five patients were enrolled. IOP dropped from an average of 21,2 ± 3,3 mmHg preoperatively to 14,6 ± 1,1 mmHg at the end of the follow-up period (month 12), with a mean percentage reduction of 58%. One patient needed a needling procedure (20%). None needed reintervention. We did not register any case of hypotony (IOP < 6,5 mmHg), hypotony maculopathy and choroidal detachment. The postoperative number of anti-glaucomatous molecules was on average 0,2 ± 0,4. Conclusion: Our results suggested that combined Pars Plana Vitrectomy and XEN gel stent 45 implantation is safe and effective for patients affected by visually significant vitreoretinal diseases and POAG. Abbreviations: AC = anterior chamber, BCVA = Best-corrected visual acuity, ERM = epiretinal membrane, FTMH = full-thickness macular holes, FU = fluorouracil, GAT = Goldmann applanation tonometer, IOP = intraocular pressure, MIGS = minimally invasive glaucoma surgery, MMC = mitomycin C, NVG = neovascular glaucoma, OCT = optical coherence tomography, POAG = Primary Open Angle Glaucoma, PPV = Pars Plana Vitrectomy, SD = standard deviation, TB = Trabeculectomy, VF = visual field, VMI = Vitreomacular Interface, VMA = vitreomacular adhesion, VMT = vitreomacular traction.
Collapse
Affiliation(s)
| | - Enrico Bernardi
- Department of Ophthalmology, Inselspital, University Hospital Bern, Switzerland
| | | |
Collapse
|
20
|
De Bernardo M, Pilone V, Di Paola I, Cione F, Cembalo G, Calabrese P, Rosa N. Intraocular Pressure Variations in Postural Changes: Comparison between Obese and Non-Obese Controls. J Clin Med 2023; 12:5883. [PMID: 37762825 PMCID: PMC10531973 DOI: 10.3390/jcm12185883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/31/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Comparing intraocular pressure (IOP) changes (ΔIOP) between obese subjects and non-obese controls in relation to different positions: standing, sitting, supine. METHODS the IOP was measured in both obese patients and non-obese controls groups with Tono-Pen AVIA in different positions following this sequence: after 5 min (5') in the standing position, sitting, supine, supine after 5 min (supine 5') and immediately after standing. ΔIOP values obtained comparing all positions were, therefore, evaluated. RESULTS 92 eyes of 46 obese subjects aged between 18 and 59 years (mean 38.07 ± 11.51 years) and of a Body Mass Index (BMI) between 31.84 and 60.65 (mean 41.84 ± 7.05) were evaluated. A total of 48 eyes of 24 non-obese controls aged between 23 and 55 (mean 35.21 ± 11.96 years) and of a BMI between 18.20 and 26.79 (mean 21.04 ± 2.36) were also recruited. In obese subjects, there were statistically significant differences between the IOP in the supine position and the supine positions 5' with all other IOP measurements (p < 0.05). There were statistically significant differences between ΔIOP in both supine positions and prolonged standing positions obtained by obese subjects and non-obese controls (p < 0.05). CONCLUSIONS In obese subjects, there is a statistically significant increase in IOP in the supine positions that is significantly greater than the non-obese population. BMI is weakly correlated with IOP and ΔIOP in postural changes.
Collapse
Affiliation(s)
- Maddalena De Bernardo
- Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Salerno, Italy; (M.D.B.); (N.R.)
| | - Vincenzo Pilone
- Unit of General, Emergency and Bariatric Surgery, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Salerno, Italy; (V.P.)
| | - Ilenia Di Paola
- Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Salerno, Italy; (M.D.B.); (N.R.)
| | - Ferdinando Cione
- Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Salerno, Italy; (M.D.B.); (N.R.)
| | - Giovanni Cembalo
- Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Salerno, Italy; (M.D.B.); (N.R.)
| | - Pietro Calabrese
- Unit of General, Emergency and Bariatric Surgery, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Salerno, Italy; (V.P.)
| | - Nicola Rosa
- Eye Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84084 Salerno, Italy; (M.D.B.); (N.R.)
| |
Collapse
|
21
|
Bahrani Fard MR, Chan J, Sanchez Rodriguez G, Yonk M, Kuturu SR, Read AT, Emelianov SY, Kuehn MH, Ethier CR. Improved magnetic delivery of cells to the trabecular meshwork in mice. Exp Eye Res 2023; 234:109602. [PMID: 37488007 PMCID: PMC10530071 DOI: 10.1016/j.exer.2023.109602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/22/2023] [Indexed: 07/26/2023]
Abstract
Glaucoma is the leading cause of irreversible blindness worldwide and its most prevalent subtype is primary open angle glaucoma (POAG). One pathological change in POAG is loss of cells in the trabecular meshwork (TM), which is thought to contribute to ocular hypertension and has thus motivated development of cell-based therapies to refunctionalize the TM. TM cell therapy has shown promise in intraocular pressure (IOP) control, but existing cell delivery techniques suffer from poor delivery efficiency. We employed a novel magnetic delivery technique to reduce the unwanted side effects of off-target cell delivery. Mesenchymal stem cells (MSCs) were labeled with superparamagnetic iron oxide nanoparticles (SPIONs) and after intracameral injection were magnetically steered towards the TM using a focused magnetic apparatus ("point magnet"). This technique delivered the cells significantly closer to the TM at higher quantities and with more circumferential uniformity compared to either unlabeled cells or those delivered using a "ring magnet" technique. We conclude that our point magnet cell delivery technique can improve the efficiency of TM cell therapy and in doing so, potentially increase the therapeutic benefits and lower the risk of complications such as tumorigenicity and immunogenicity.
Collapse
Affiliation(s)
- M Reza Bahrani Fard
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Jessica Chan
- School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, GA, USA
| | | | - Marybeth Yonk
- College of Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Shreya R Kuturu
- Department of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - A Thomas Read
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA
| | - Stanislav Y Emelianov
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA
| | - Markus H Kuehn
- Departments of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, IA, USA; Veterans Administration Center for the Prevention and Treatment of Visual Loss, Iowa City VA Healthcare System, Iowa City, IA, USA
| | - C Ross Ethier
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology/Emory University, Atlanta, GA, USA.
| |
Collapse
|
22
|
Rajkumar SVPB, Sivakumar R. Analysis of bio-optical active constituents for lentic ecosystem through spectral-spatial and in-vitro observation. Environ Sci Pollut Res Int 2023; 30:99605-99619. [PMID: 37620697 DOI: 10.1007/s11356-023-29239-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023]
Abstract
The neural network algorithm approach was adopted in Kolavai Lake to retrieve the inherent optical properties (IOP) of active constituents. The retrieval of IOP by absorption and the scattering of optically active constituents (OAC) through employing Sentinel-2 MSI reflectance and field measured the salinity and temperature. The result illustrates the relationship between the IOP and measured OAC's concentrations and its sensitivity towards spectral wavelength. It shows that the phytoplankton absorption ap is highly related with chlorophyll-a concentration and has an R2 value of 0.808. Furthermore, at the total absorption of water has high correlation with chl-a which indicates the significant dominance in the lentic water. Also, the pigment constituents are showing an R2 value of 0.754. The total backscattering of water (btot) is strongly related to the total suspended matter with R value > 0.73. The spatial distribution of OAC in Kolavai Lake helps monitor the lake water quality. This approach is well-performed in estimating the inherent optical properties of optically active constituents that gives insight for assessing the relationship between IOP and water quality. The research has proved to be a good potential for monitoring lentic water quality through Sentinel-2 MSI.
Collapse
Affiliation(s)
- Sri Vishnu Prasanth Balachandran Rajkumar
- Department of Civil Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, 603203, India
| | - Ramamoorthy Sivakumar
- Department of Civil Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamil Nadu, 603203, India.
| |
Collapse
|
23
|
Wang X, Tan S, Yang S, Liu X, Lei J, Li H. Activation of Sonic Hedgehog Signaling Pathway Regulates Human Trabecular Meshwork Cell Function. J Ocul Pharmacol Ther 2023; 39:430-438. [PMID: 37307020 DOI: 10.1089/jop.2023.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
Purpose: To investigate the effects of Sonic hedgehog (Shh) signaling on primary human trabecular meshwork (HTM) cells. Methods: Primary HTM cells were isolated from healthy donors and cultured. Recombinant Shh (rShh) protein and cyclopamine were used to activate and inhibit the Shh signaling pathway, respectively. A cell viability assay was performed to assess the effects of rShh on the activity of primary HTM cells. Functional assessment of cell adhesion and phagocytosis was also performed. The proportion of apoptotic cells was examined using flow cytometry. Fibronectin (FN) and transforming growth factor beta2 (TGF-β2) protein were detected to assess the influence of rShh on the metabolism of the extracellular matrix (ECM). Real-time polymerase chain reaction (RT-PCR) and western blot analyses were used to examine mRNA and protein expression of Shh signaling pathway-associated factors GLI Family Zinc Finger 1 (GLI1) and Suppressor of Fused (SUFU). Results: rShh significantly enhanced primary HTM cell viability at a concentration of 0.5 μg/mL. rShh increased the adhesion and phagocytic abilities of primary HTM cells, and decreased cell apoptosis. FN and TGF-β2 protein expression increased in primary HTM cells treated with rShh. rShh upregulated the transcriptional activity and protein levels of GLI1, and downregulated those of SUFU. Correspondingly, the rShh-induced GLI1 upexpression was partially blocked by pretreatment with the Shh pathway inhibitor cyclopamine at a concentration of 10 μM. Conclusions: Activation of Shh signaling can regulate the function of primary HTM cells through GLI1. Regulation of Shh signaling may be a potential target for attenuating cell damage in glaucoma.
Collapse
Affiliation(s)
- Xiaochen Wang
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Sisi Tan
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Shuang Yang
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Xianmao Liu
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Junqin Lei
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| | - Hong Li
- Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Lab of Ophthalmology, Chongqing Eye Institute, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing, China
| |
Collapse
|
24
|
Storp JJ, Vietmeier FE, Merté RL, Koch R, Zimmermann JA, Eter N, Brücher VC. Long-Term Outcomes of the PRESERFLO MicroShunt Implant in a Heterogeneous Glaucoma Cohort. J Clin Med 2023; 12:4474. [PMID: 37445509 DOI: 10.3390/jcm12134474] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/14/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
The Preserflo MicroShunt represents a novel glaucoma treatment device, necessitating long-term follow-up data to accurately assess its efficacy. The aim of this study is to report real-world data of a heterogenous glaucoma cohort who received Preserflo implantation at a specialized glaucoma clinic. A total of 160 eyes of 160 patients who underwent Preserflo MicroShunt implantation were retrospectively enrolled in this study. Patient characteristics, as well as success and failure rates, were assessed. The numbers of adverse events and revision procedures were recorded, along with any reduction in supplementary medication. The progression of intraocular pressure (IOP) was assessed over the course of 12 months, and fluctuations were analyzed. The overall success rate was 61.9% (complete success: 51.3%, qualified success: 10.6%). Revision surgery was performed in 25% of cases. Excessive hypotony occurred postoperatively in 54.4% of patients and regressed after 7 days in 88.8% of all cases. Median IOP decreased from 22 (interquartile range (IQR): 17-27) mmHg preoperatively to 14 (IQR 12-16) mmHg at 12 months postoperatively (p < 0.01). The median number of antiglaucomatous agents decreased from three to zero at latest follow-up. The Preserflo MicroShunt achieved a noticeable reduction in IOP over the course of 12 months in glaucoma patients, irrespective of disease severity or disease subtype. The frequency of postoperative adverse events and number for revision surgeries over the course of the follow-up period were low.
Collapse
Affiliation(s)
- Jens Julian Storp
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | | | - Ralph-Laurent Merté
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Raphael Koch
- Institute of Biostatistics and Clinical Research, University of Muenster, 48149 Muenster, Germany
| | | | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | | |
Collapse
|
25
|
Al-Qaysi ZK, Beadham IG, Schwikkard SL, Bear JC, Al-Kinani AA, Alany RG. Sustained release ocular drug delivery systems for glaucoma therapy. Expert Opin Drug Deliv 2023; 20:905-919. [PMID: 37249548 DOI: 10.1080/17425247.2023.2219053] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 05/24/2023] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Glaucoma is a group of progressive optic neuropathies resulting in irreversible blindness. It is associated with an elevation of intraocular pressure (>21 mm Hg) and optic nerve damage. Reduction of the intraocular pressure (IOP) through the administration of ocular hypotensive eye drops is one of the most common therapeutic strategies. Patient adherence to conventional eye drops remains a major obstacle in preventing glaucoma progression. Additional problems emerge from inadequate patient education as well as local and systemic side effects associated with adminstering ocular hypotensive drugs. AREAS COVERED Sustained-release drug delivery systems for glaucoma treatment are classified into extraocular systems including wearable ocular surface devices or multi-use (immediate-release) eye formulations (such as aqueous solutions, gels; ocular inserts, contact lenses, periocular rings, or punctual plugs) and intraocular drug delivery systems (such as intraocular implants, and microspheres for supraciliary drug delivery). EXPERT OPINION Sustained release platforms for the delivery of ocular hypotensive drugs (small molecules and biologics) may improve patient adherence and prevent vision loss. Such innovations will only be widely adopted when efficacy and safety has been established through large-scale trials. Sustained release drug delivery can improve glaucoma treatment adherence and reverse/prevent vision deterioration. It is expected that these approaches will improve clinical management and prognosis of glaucoma.
Collapse
Affiliation(s)
- Zinah K Al-Qaysi
- Drug Discovery, Delivery and Patient Care (DDDPC) Theme, Department of Pharmacy, Kingston University London, Kingston Upon Thames, UK
| | - Ian G Beadham
- Drug Discovery, Delivery and Patient Care (DDDPC) Theme, Department of Pharmacy, Kingston University London, Kingston Upon Thames, UK
| | - Sianne L Schwikkard
- Department of Chemical and Pharmaceutical Sciences, Kingston University, Kingston Upon Thames, UK
| | - Joseph C Bear
- Department of Chemical and Pharmaceutical Sciences, Kingston University, Kingston Upon Thames, UK
| | - Ali A Al-Kinani
- Drug Discovery, Delivery and Patient Care (DDDPC) Theme, Department of Pharmacy, Kingston University London, Kingston Upon Thames, UK
| | - Raid G Alany
- Drug Discovery, Delivery and Patient Care (DDDPC) Theme, Department of Pharmacy, Kingston University London, Kingston Upon Thames, UK
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
26
|
Mędrzycka J, Szabelska P, Rerych M, Różycki R, Gołębiewska J. Multimodal Imaging Techniques in Monitoring a Patient with Ocular Decompression Retinopathy. Diagnostics (Basel) 2023; 13:1992. [PMID: 37370887 DOI: 10.3390/diagnostics13121992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/21/2023] [Accepted: 06/04/2023] [Indexed: 06/29/2023] Open
Abstract
Ocular decompression retinopathy (ODR) is characterized by multiple retinal hemorrhages. It is a rare complication associated with rapid decrease of intraocular pressure (IOP). The course of ODR is usually asymptomatic and self-limiting, which was confirmed by the observation of our patient. In this study, we present a 5-month follow up of a 77-year-old woman with acute right eye (RE) filtration angle closure who developed symptoms of ODR. Clinical examination and multimodal imaging modalities, including color fundus photography, optical coherence tomography (OCT), OCT angiography (OCTA) and fluorescein angiography (FA), were used to confirm the diagnosis and performed regularly in monitoring the course of the disease. Fundus lesions in the RE included diffuse intraretinal hemorrhages in the posterior pole, which gradually resolved during follow-up time. The fundus of the left eye (LE) was normal. The patient underwent conservative therapy, laser therapy and surgery, achieving stabilization of the IOP and improvement of the local condition in the RE. Of the various multimodal imaging techniques, color fundus photography and OCT seemed to be the most specific and helpful in monitoring the patient with ODR.
Collapse
Affiliation(s)
- Justyna Mędrzycka
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland
| | - Paulina Szabelska
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland
| | - Magdalena Rerych
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland
| | - Radosław Różycki
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland
| | - Joanna Gołębiewska
- Department of Ophthalmology, Military Institute of Aviation Medicine, 01-755 Warsaw, Poland
| |
Collapse
|
27
|
Mathur MC, Ratnam PV, Saikumar S, John M, Ravishankar S, Dinesh M, Chandil P, Pahuja K, Cherlikar V, Wadhwani S, Bendale P, Hazari A, Mishra R, Deshmukh S, Achlerkar RR, Shah DT, Hingorani C, Shah K, Topiwala P, Jani S, Rana VG, Majumdar NK, Chakrabarti D, Dey R, Halder D, Choudhury S, Kumar A, Das S, Nanda AK, Kumar VB, Dubey R, Kamdar GA, Pandey A, Kishanpuria S, Srivastava RM, Singh P, Verma SK, Sharma N, Gupta R. Netarsudil monotherapy as the initial treatment for open-angle glaucoma and ocular hypertension in Indian patients: A real-world evaluation of efficacy and safety. Indian J Ophthalmol 2023; 71:2500-2503. [PMID: 37322670 PMCID: PMC10418014 DOI: 10.4103/ijo.ijo_25_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/13/2023] [Accepted: 03/21/2023] [Indexed: 06/17/2023] Open
Abstract
Purpose Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40-80. The best way to manage primary open-angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods An open-label, real-world, multicentric, observation-based 3-month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first-line therapy. Diurnal IOP measurements, best-corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day-1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results Four hundred and sixty-nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once-daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion We found that netarsudil 0.02% w/v solution monotherapy when used as the first-line treatment in primary open-angle glaucoma and ocular hypertension was both safe and effective.
Collapse
Affiliation(s)
| | | | | | - Manuel John
- Holy Ghost Mission Hospital, Kottayam, Kerala, India
| | | | - M.B Dinesh
- Uma Eye Clinic, Chennai, Tamil Nadu, India
| | | | - Kishore Pahuja
- Natasha Eye Care and Research Centre, Pune, Maharashtra, India
| | | | | | - Pankaj Bendale
- Dr. Bendale’s Eye Care, Pimpri-Chinchwad, Maharashtra, India
| | - Ajit Hazari
- Hazari Nursing Home, Aurangabad, Maharashtra, India
| | - Rajesh Mishra
- Advanced Eye Hospital, A Unit of Dr Agarwals Eye Hospital, Vashi, Navi Mumbai, Maharashtra, India
| | - Susheel Deshmukh
- Sudrishti Eye Care and Goregaon Glaucoma Centre, Mumbai, Maharashtra, India
| | | | | | | | - Kaivan Shah
- Bhavna Super Speciality Eye Care, Surat, Gujarat, India
| | | | - Sheetal Jani
- Netralaya Superspecialty Eye Hospital, Ahmedabad, Gujarat, India
| | - Viral G. Rana
- Shree Bidada Survoday Trust- Laxmi Jyot Eye Hospital, Bidada, Gujarat, India
| | | | | | - Rituparna Dey
- Citizen’s Eye and Healthcare, Hooghly, West Bengal, India
| | | | | | - Ajeet Kumar
- Sharda Eye and Dental Hospital, Patna, Bihar, India
| | - Sasmita Das
- Kar Vision Eye Hospital, Bhubaneshwar, Odisha, India
| | | | | | - Rama Dubey
- Rama Eye Hospital, Jaipur, Rajasthan, India
| | | | | | | | | | - Parul Singh
- GSVM Medical College, Kanpur,Uttar Pradesh, India
| | | | - Neha Sharma
- P.C. Sharma Eye Hospital, Ambala, Haryana, India
| | | |
Collapse
|
28
|
Wiggins SV, Schreiner R, Ferreira J, Marmorstein AD, Levin LR, Buck J. Carbonic Anhydrase Inhibitor Modulation of Intraocular Pressure Is Independent of Soluble Adenylyl Cyclase. J Ocul Pharmacol Ther 2023. [PMID: 37097314 PMCID: PMC10398745 DOI: 10.1089/jop.2022.0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
Purpose: We investigated whether a clinically used carbonic anhydrase inhibitor (CAIs) can modulate intraocular pressure (IOP) through soluble adenylyl cyclase (sAC) signaling. Methods: IOP was measured 1 h after topical treatment with brinzolamide, a topically applied and clinically used CAIs, using direct cannulation of the anterior chamber in sAC knockout (KO) mice or C57BL/6J mice in the presence or absence of the sAC inhibitor (TDI-10229). Results: Mice treated with the sAC inhibitor TDI-10229 had elevated IOP. CAIs treatment significantly decreased increased intraocular pressure (IOP) in wild-type, sAC KO mice, as well as TDI-10229-treated mice. Conclusions: Inhibiting carbonic anhydrase reduces IOP independently from sAC in mice. Our studies suggest that the signaling cascade by which brinzolamide regulates IOP does not involve sAC.
Collapse
Affiliation(s)
- Shakarr V Wiggins
- Department of Pharmacology, Weill Cornell Medicine, New York, New York, USA
- Graduate Program in Neuroscience, Weill Cornell Medicine, New York, New York, USA
| | - Ryan Schreiner
- Division of Regenerative Medicine, Department of Medicine, Ansary Stem Cell Institute, Weill Cornell Medicine, New York, New York, USA
| | - Jacob Ferreira
- Department of Pharmacology, Weill Cornell Medicine, New York, New York, USA
| | | | - Lonny R Levin
- Department of Pharmacology, Weill Cornell Medicine, New York, New York, USA
| | - Jochen Buck
- Department of Pharmacology, Weill Cornell Medicine, New York, New York, USA
| |
Collapse
|
29
|
Evans-Chase M, Solomon P, Peralta B, Kornmann R, Fenkel C. Treating Depression in Adolescents and Young Adults Using Remote Intensive Outpatient Programs: Quality Improvement Assessment. JMIR Form Res 2023; 7:e44756. [PMID: 37040155 PMCID: PMC10131586 DOI: 10.2196/44756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 03/13/2023] [Accepted: 03/21/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Youth and young adults face barriers to mental health care, including a shortage of programs that accept youth and a lack of developmentally sensitive programming among those that do. This shortage, along with the associated geographically limited options, has contributed to the health disparities experienced by youth in general and by those with higher acuity mental health needs in particular. Although intensive outpatient programs can be an effective option for youth with more complex mental health needs, place-based intensive outpatient programming locations are still limited to clients who have the ability to travel to the clinical setting several days per week. OBJECTIVE The objective of the analysis reported here was to assess changes in depression between intake and discharge among youth and young adults diagnosed with depression attending remote intensive outpatient programming treatment. Analysis of outcomes and the application of findings to programmatic decisions are regular parts of ongoing quality improvement efforts of the program whose results are reported here. METHODS Outcomes data are collected for all clients at intake and discharge. The Patient Health Questionnaire (PHQ) adapted for adolescents is used to measure depression, with changes between intake and discharge regularly assessed for quality improvement purposes using repeated measures t tests. Changes in clinical symptoms are assessed using McNamar chi-square analyses. One-way ANOVA is used to test for differences among age, gender, and sexual orientation groups. For this analysis, 1062 cases were selected using criteria that included a diagnosis of depression and a minimum of 18 hours of treatment over a minimum of 2 weeks of care. RESULTS Clients ranged in age from 11 to 25 years, with an average of 16 years. Almost one-quarter (23%) identified as nongender binary and 60% identified as members of the lesbian, gay, bisexual, transgender, queer (LGBTQ+) community. Significant decreases (mean difference -6.06) were seen in depression between intake and discharge (t967=-24.68; P<.001), with the symptoms of a significant number of clients (P<.001) crossing below the clinical cutoff for major depressive disorder between intake and discharge (388/732, 53%). No significant differences were found across subgroups defined by age (F2,958=0.47; P=.63), gender identity (F7,886=1.20; P=.30), or sexual orientation (F7,872=0.47; P=.86). CONCLUSIONS Findings support the use of remote intensive outpatient programming to treat depression among youth and young adults, suggesting that it may be a modality that is an effective alternative to place-based mental health treatment. Additionally, findings suggest that the remote intensive outpatient program model may be an effective treatment approach for youth from marginalized groups defined by gender and sexual orientation. This is important given that youth from these groups tend to have poorer outcomes and greater barriers to treatment compared to cisgender, heterosexual youth.
Collapse
Affiliation(s)
- Michelle Evans-Chase
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, United States
| | - Phyllis Solomon
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, United States
| | | | - Rachel Kornmann
- Department of Behavioral Health, Rutgers University, New Brunswick, NJ, United States
| | | |
Collapse
|
30
|
Oluwaniyi AT, Olawoye O, Sarimiye TF, Ajayi BGK. Comparison of Ocular Biomery in Primary Open Angle Glaucoma and Non-glaucoma in South West Nigeria. J West Afr Coll Surg 2023; 13:37-44. [PMID: 37228875 PMCID: PMC10204919 DOI: 10.4103/jwas.jwas_264_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 12/05/2022] [Indexed: 05/27/2023]
Abstract
Background Glaucoma is a public health problem in Nigeria. The number of individuals affected by glaucoma in Nigeria is much higher than the individuals known to have the disease. Ocular parameters such as intraocular pressure, central cornea thickness, axial length and refractive error have all been documented as risk factors of glaucoma especially among Caucasians and African Americans, with little documentation in Africa where there's an alarming rate of blindness. Aim and Objectives To compare central cornea thickness (CCT), intraocular pressure (IOP), axial length (AL) and refractive state in participants with primary open angle glaucoma (POAG) and non-glaucoma in South-West Nigeria. Materials and Methods This hospital-based case-control study was carried out among 184 newly diagnosed POAG and non-glaucoma adult participants attending the outpatient clinic of Eleta eye institute. The CCT, IOP, AL and refractive state were measured in each participant. Test of significance between proportions in categorical variables were assessed using chi square test (χ2) in both groups. The means were compared using independent t-test while correlation between parameters were analyzed using Pearson correlation coefficient. Results The mean age of the POAG participants was 57.16 + 13.3 years and the mean age of the non-glaucoma participants was 54.15 + 13.4 years. The mean IOP in the POAG group was 30.2 + 8.9mmHg while non- glaucoma group was 14.2 + 2.6mmHg (P < 0.001), other ocular parameters were not significantly different in both groups. In the POAG group, decreased spherical equivalent refractive error (i.e increasing myopia) was significantly associated with increased axial length (r= -0.252, P = 0.01), but not significant in the non- glaucoma group. However, in the non-glaucoma group, central cornea thickness increased with increasing intraocular pressure (r= 0.305, P = 0.003), which was not significant in the glaucoma group. Conclusion Patients with POAG had much higher IOP and thus, IOP remains a significant risk factor in its development. There was a significant relationship between refractive state and axial length in the POAG group while a significant relationship was identified between central cornea thickness and intraocular pressure in the non- glaucoma group.
Collapse
Affiliation(s)
| | - Olusola Olawoye
- Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - B. G. K. Ajayi
- Eleta Eye Institute, Olomi Academy, Ibadan, Oyo State, Nigeria
| |
Collapse
|
31
|
Bigdeli A, Makhmalzadeh BS, Feghhi M, SoleimaniBiatiani E. Cationic liposomes as promising vehicles for timolol/brimonidine combination ocular delivery in glaucoma: formulation development and in vitro/in vivo evaluation. Drug Deliv Transl Res 2023; 13:1035-1047. [PMID: 36477776 DOI: 10.1007/s13346-022-01266-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2022] [Indexed: 12/12/2022]
Abstract
Glaucoma is a chronic eye disease in which the pressure inside the eye increases and leads to damage to the optic nerve, and eventually causes blindness. In this disease, it is often necessary to use a multi-drug treatment system. There is a fixed combination of timolol maleate and brimonidine tartrate among the combination drugs in glaucoma treatment. Liposomes are one of the most important targeted drug delivery systems to eye tissue, which leads to improved drug permeability and durability in ocular tissue. In this study, thin layer hydration was used to make liposomal formulations containing timolol maleate (TM) and brimonidine tartrate (BT). After the necessary evaluations, one of the eight initial formulations was selected as an optimization formulation. Then, characteristics such as drug loading percentage, particle size, pH, zeta potential, and drug release were performed on the optimized formulation. The study of reducing intraocular pressure was performed on the optimized formulation. This study in total was performed on 18 rabbits in three groups. Hydroxypropyl methylcellulose (HPMC) polymer was injected into the anterior chamber to experimental induce glaucoma. The selected formulation was within the acceptable range of ocular products in terms of physical properties. HPMC polymer injection successfully induced glaucoma in the animal model, resulting in a 79% increase in intraocular pressure. The results showed that the liposomal formulation significantly reduced the intraocular pressure compared to the simple formulation of the aqueous solution, and both formulations were able to significantly reduce the intraocular pressure compared to the control group (P < 0.001). The results also showed that liposomal formulation has a therapeutic effect in reducing intraocular pressure. It seems that the selected liposomal formulation made by thin layer hydration can act as a suitable drug carrier to increase the effectiveness of the fixed combination of timolol maleate and brimonidine tartrate and be proposed as a new drug formulation for targeted and controlled drug delivery in the treatment of glaucoma.
Collapse
Affiliation(s)
- Ali Bigdeli
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Ahvaz Jundishapur University of Medical Sciences, Golestan avenue, Ahvaz, Iran
| | - Behzad Sharif Makhmalzadeh
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Ahvaz Jundishapur University of Medical Sciences, Golestan avenue, Ahvaz, Iran.
- Nanotechnology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mostafa Feghhi
- Department of Ophthalmology, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Emad SoleimaniBiatiani
- Department of Ophthalmology, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
32
|
Spini A, Giometto S, Donnini S, Posarelli M, Dotta F, Ziche M, Tosi GM, Girardi A, Lucenteforte E, Gini R, Etminan M, Virgili G. Risk of Intraocular Pressure Increase With Intravitreal Injections of Vascular Endothelial Growth Factor Inhibitors: A Cohort Study. Am J Ophthalmol 2023; 248:45-50. [PMID: 36410468 DOI: 10.1016/j.ajo.2022.11.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/12/2022] [Accepted: 11/13/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE Intraocular pressure increase (IOPi) after intravitreal injections of vascular endothelial growth factor inhibitors (VEGFis) might be different among different VEGFis (bevacizumab, aflibercept, ranibizumab). The purpose of this study was to evaluate the risk of IOPi among new users of bevacizumab, ranibizumab, and aflibercept in nondiabetic patients in Tuscany, Italy. DESIGN Retrospective cohort study. METHODS Tuscan regional administrative database was used to identify subjects with a first VEGFi intravitreal injection between 2011 and 2020, followed to first incidence of IOPi. Diabetic subjects, those with pre-existing IOPi, or previous use of dexamethasone implants were excluded. Multivariable Cox regression analyses (intention-to-treat and as treated) were conducted to evaluate risk of IOPi among aflibercept, bevacizumab, and ranibizumab, adjusting for potential confounding variables. IOPi was defined as the first record of International Classification of Diseases, Ninth Revision (ICD-9-CM) code 365 or use of 2 glaucoma drugs dispensations within 180 days of each other. RESULTS We identified 6585 new users of VEGFis: 1749 aflibercept, 1112 bevacizumab, and 3724 ranibizumab. Women made up 60% of the cohort, with a mean age of 73.6 years. In the intention-to-treat analysis, the adjusted hazard ratio (HR) for incident IOPi, compared with aflibercept, was higher for bevacizumab (HR = 2.20, 95% CI = 1.64-2.95) and ranibizumab users (HR = 1.88, 95% CI = 1.46-2.42), respectively. The HRs remained robust after exclusion of patients with proxy of retinal vascular occlusion. As treated analysis confirmed such results (bevacizumab: HR = 3.76, 95% CI = 2.30-6.17; ranibizumab: HR = 2.49, 95% CI = 1.62-3.82). CONCLUSIONS This study found an increased risk of IOPi among nondiabetic patients with ranibizumab and bevacizumab compared with aflibercept. Future studies are needed to validate these findings.
Collapse
Affiliation(s)
- Andrea Spini
- From the Department of Medicine, Surgery and Neuroscience (A.S., F.D., M.Z., G.M.T.), University of Siena, Siena, Italy; Azienda Ospedaliera Universitaria Senese (A.S., M.P., F.D., G.M.T.), Siena, Italy
| | - Sabrina Giometto
- Department of Clinical and Experimental Medicine (S.G., E.L.), University of Pisa, Pisa, Italy
| | - Sandra Donnini
- Department of Life Sciences (S.D.), University of Siena, Siena, Italy
| | - Matteo Posarelli
- Azienda Ospedaliera Universitaria Senese (A.S., M.P., F.D., G.M.T.), Siena, Italy
| | - Francesco Dotta
- From the Department of Medicine, Surgery and Neuroscience (A.S., F.D., M.Z., G.M.T.), University of Siena, Siena, Italy; Azienda Ospedaliera Universitaria Senese (A.S., M.P., F.D., G.M.T.), Siena, Italy
| | - Marina Ziche
- From the Department of Medicine, Surgery and Neuroscience (A.S., F.D., M.Z., G.M.T.), University of Siena, Siena, Italy; Azienda Ospedaliera Universitaria Senese (A.S., M.P., F.D., G.M.T.), Siena, Italy
| | - Gian Marco Tosi
- From the Department of Medicine, Surgery and Neuroscience (A.S., F.D., M.Z., G.M.T.), University of Siena, Siena, Italy
| | - Anna Girardi
- Agenzia Regionale di Sanità della Toscana (A.G., R.G.), Firenze, Italy
| | - Ersilia Lucenteforte
- Department of Clinical and Experimental Medicine (S.G., E.L.), University of Pisa, Pisa, Italy
| | - Rosa Gini
- Agenzia Regionale di Sanità della Toscana (A.G., R.G.), Firenze, Italy
| | - Mahyar Etminan
- Departments of Ophthalmology and Visual Sciences and Medicine (M.E.), University of British Columbia, Vancouver, British Columbia, Canada
| | - Gianni Virgili
- Centre for Public Health (G.V.), Queen's University, Belfast, UK; Department NEUROFARBA (G.V.), University of Florence, Florence Italy.
| |
Collapse
|
33
|
Sun MT, Tran M, Singh K, Chang R, Wang H, Sun Y. Glaucoma and Myopia: Diagnostic Challenges. Biomolecules 2023; 13:biom13030562. [PMID: 36979497 PMCID: PMC10046607 DOI: 10.3390/biom13030562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/06/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
The rising global prevalence of myopia is a growing concern for clinicians, as it predisposes patients to severe ocular pathologies including glaucoma. High myopia can be associated with clinical features that resemble glaucomatous damage, which make an accurate glaucoma diagnosis challenging, particularly among patients with normal intraocular pressures. These patients may also present with established visual field defects which can mimic glaucoma, and standard imaging technology is less useful in disease detection and monitoring due to the lack of normative data for these anatomically unique eyes. Progression over time remains the most critical factor in facilitating the detection of early glaucomatous changes, and thus careful longitudinal follow-up of high-risk myopic patients is the most important aspect of management. Here, we review our current understanding of the complex relationship between myopia and glaucoma, and the diagnostic challenges and limitations of current testing protocols including visual field, intraocular pressure, and imaging. Furthermore, we discuss the clinical findings of two highly myopic patients with suspected glaucoma.
Collapse
Affiliation(s)
- Michelle T Sun
- Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA
| | - Matthew Tran
- Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA
- School of Medicine, University of Nevada, Reno, NV 89557, USA
| | - Kuldev Singh
- Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA
| | - Robert Chang
- Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA
| | - Huaizhou Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Yang Sun
- Department of Ophthalmology, School of Medicine, Stanford University, Palo Alto, CA 94305, USA
- Palo Alto Veterans Administration, Palo Alto, CA 94304, USA
| |
Collapse
|
34
|
Dinh P. Analyzing Longitudinal Data from Glaucoma Trials. Ther Innov Regul Sci 2023; 57:365-71. [PMID: 36352342 DOI: 10.1007/s43441-022-00474-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/14/2022] [Indexed: 11/11/2022]
Abstract
In glaucoma trials, patients often come in for multiple visits, and at each visit, intraocular pressures are taken at multiple timepoints throughout the day. A mixed model for repeated measures is often used to model the data from such trials. One modeling approach is to jointly model all visits and timepoints together. Another modeling approach is to model data across all visits at each timepoint separately. I conducted a simulation study to compare the two modeling approaches. The results suggest that modeling each timepoint separately across all visits is superior, especially when missing data are low. This approach is recommended over jointly modeling all visits and timepoints together.
Collapse
|
35
|
Szurman P, Gillmann K, Seuthe AM, Dick HB, Hoffmann EM, Mermoud A, Mackert MJ, Weinreb RN, Rao HL, Mansouri K; EYEMATE-SC Study Group. EYEMATE-SC Trial: Twelve-Month Safety, Performance, and Accuracy of a Suprachoroidal Sensor for Telemetric Measurement of Intraocular Pressure. Ophthalmology 2023; 130:304-12. [PMID: 36202141 DOI: 10.1016/j.ophtha.2022.09.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Measuring and controlling intraocular pressure (IOP) provide the foundation for glaucoma treatment. Self-tonometry has been proposed as an alternative to measure IOP throughout the entire day better. The novel EYEMATE-SC sensor (Implandata) is implanted in the suprachoroidal space to enable contactless continual IOP monitoring. The aim of the present study was to investigate the 1-year safety, performance, and accuracy of the EYEMATE-SC in patients with primary open-angle glaucoma undergoing simultaneous nonpenetrating glaucoma surgery (NPGS). DESIGN Prospective, multicenter, open-label, single-arm, interventional clinical trial. PARTICIPANTS Twenty-four eyes of 24 patients with primary open-angle glaucoma who were due to undergo NPGS (canaloplasty or deep sclerectomy). METHODS An EYEMATE-SC sensor was implanted during NPGS. Goldmann applanation tonometry (GAT) measurements were compared with the sensors' IOP measurements at all postoperative visits through 12 months. MAIN OUTCOME MEASURES Device position and adverse events. RESULTS Fifteen eyes underwent canaloplasty, and 9 underwent deep sclerectomy. Successful implantation of the sensor was achieved in all eyes with no reported intraoperative difficulties. Through the 12-month follow-up, no device migration, dislocation, or serious device-related complications were recorded. A total of 536 EYEMATE-SC measurements were pairwise included in the IOP agreement analysis. The overall mean difference between GAT and EYEMATE-SC measurements was 0.8 mmHg (95% confidence interval [CI] of the limits of agreement [LoA], -5.1 to 6.7 mmHg). The agreement gradually improved, and from 3 months after surgery until the end of the follow-up, the mean difference was -0.2 mmHg (95% CI of LoA, -4.6 to 4.2 mmHg) over a total of 264 EYEMATE-SC measurements, and 100% of measurements were within ±5 mmHg of GAT. CONCLUSIONS The EYEMATE-SC sensor was safe and well tolerated through 12 months. Moreover, it allowed accurate, continuous IOP monitoring. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found after the references.
Collapse
|
36
|
Khodeiry MM, Liu X, Sayed MS, Lee RK. Outcomes of primary surgical treatment of medically recalcitrant post-keratoplasty glaucoma with transscleral cyclophotocoagulation. Eur J Ophthalmol 2023:11206721221149514. [PMID: 36648194 DOI: 10.1177/11206721221149514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE To report the outcomes of slow-coagulation continuous-wave transscleral cyclophotocoagulation (CW-TSCPC) in post-keratoplasty glaucoma refractory to medical therapy. METHODS Medical records of 47 patients (mean age of 70.7 ± 15.7 years and follow-up of 13.9 ± 7.1 months) were retrospectively enrolled. All patients had the diagnosis of secondary glaucoma after penetrating keratoplasty (PKP; n = 28) or Descemet's stripping automated endothelial keratoplasty (DSAEK; n = 19) with no previous history of incisional glaucoma or TSCPC surgeries. Study participants underwent slow-coagulation CW-TSCPC (1250-milliwatt power and 4-second duration). RESULTS A statically significant reduction of IOP from 31.8 ± 8.0 mmHg preoperatively to 16.9 ± 9.0 mmHg postoperatively was noted (p < 0.001). Similarly, the number of glaucoma medications decreased from 4.0 ± 1.0 to 2.7 ± 1.4 (p < 0.001). The overall success rates at 12 and 24 months were 68.1% and 66.0%, respectively, with no difference in success rates between post-PKP and post-DSAEK subgroups (p = 0.836). No significant changes in VA or central corneal thickness (CCT) were observed (p = 0.345 and 0.311, respectively). One (3.3%) patient had a graft rejection. The majority of the complications noted during this study were mild and transient. CONCLUSIONS Our study suggests that slow-coagulation TSCPC may be a safe and efficient surgical glaucoma treatment modality in patients with medically uncontrolled post-keratoplasty glaucoma.
Collapse
Affiliation(s)
- Mohamed M Khodeiry
- Department of Ophthalmology, Bascom Palmer Eye Institute, 22130University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Xiangxiang Liu
- Department of Ophthalmology, Bascom Palmer Eye Institute, 22130University of Miami Miller School of Medicine, Miami, Florida, USA.,Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Mohamed S Sayed
- Department of Ophthalmology, Bascom Palmer Eye Institute, 22130University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Richard K Lee
- Department of Ophthalmology, Bascom Palmer Eye Institute, 22130University of Miami Miller School of Medicine, Miami, Florida, USA
| |
Collapse
|
37
|
Cantor L, Lindfield D, Ghinelli F, Świder AW, Torelli F, Steeds C, Dickerson Jr JE, Nguyen DQ. Systematic Literature Review of Clinical, Economic, and Humanistic Outcomes Following Minimally Invasive Glaucoma Surgery or Selective Laser Trabeculoplasty for the Treatment of Open-Angle Glaucoma with or Without Cataract Extraction. Clin Ophthalmol 2023; 17:85-101. [PMID: 36636619 PMCID: PMC9831079 DOI: 10.2147/opth.s389406] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/23/2022] [Indexed: 01/07/2023] Open
Abstract
Introduction Selective laser trabeculoplasty (SLT) and minimally invasive glaucoma surgery (MIGS) are increasingly used options for mild-to-moderate open-angle glaucoma (OAG) care. While most MIGS devices are indicated for use in combination with cataract surgery only, with phacoemulsification playing a role in lowering IOP, newer technologies can also be used as standalone glaucoma surgery. Methods This systematic literature review (SLR) aimed to assess the clinical, economic, and humanistic outcomes of MIGS and SLT for the treatment of OAG and was conducted according to PRISMA guidelines. Studies that assessed MIGS or SLT in at least one treatment arm versus any other glaucoma treatment in adults with mild-to-moderate OAG were included. Clinical, humanistic (health-related quality of life [HRQoL] and patient burden), and economic data were extracted, and the methodological quality of included studies was evaluated. Results A total of 2720 articles were screened, and 81 publications were included. Fifty-eight reported clinical outcomes. The majority assessed iStent or iStent inject (n=41), followed by OMNI (n=9), gonioscopy-assisted transluminal trabeculotomy (GATT) or the Kahook Dual Blade (KDB) (n=7), Hydrus (n=6), SLT (n=5), Xen Gel Stent (n=2), PreserFlo (n=1), and iTrack (n=1). IOP reduction was observed across prospective studies, varying from -31% to -13.7% at month 6 and from -39% to -11.4% at year 1 versus baseline. Most adverse events were transient and non-serious. Limited humanistic and economic data were identified. Conclusion Given their established efficacy and safety, there is a rationale for wider use of MIGS in mild-to-moderate OAG. Of the MIGS devices, iStent and OMNI have the largest clinical evidence base supporting their sustained effectiveness.
Collapse
Affiliation(s)
- Louis Cantor
- Eugene and Marilyn Glick Eye Institute, Indiana School of Medicine, Indianapolis, IN, USA
| | - Dan Lindfield
- Royal Surrey County Hospital, Guildford, England, UK
| | | | | | - Francesca Torelli
- Valid Insight, Macclesfield, England, UK,Correspondence: Francesca Torelli, Valid Insight, Ropewalks, Newton St, Macclesfield, SK11 6QJ, UK, Tel +44 203 750 9833 Ext 703, Email
| | | | - Jaime E Dickerson Jr
- Sight Sciences, Menlo Park, CA, USA,North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Dan Q Nguyen
- Mid-Cheshire Hospitals NHS Foundation Trust, Crewe, UK
| |
Collapse
|
38
|
Shinozaki Y, Saito K, Kashiwagi K, Koizumi S. Ocular P2 receptors and glaucoma. Neuropharmacology 2023; 222:109302. [PMID: 36341810 DOI: 10.1016/j.neuropharm.2022.109302] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/08/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
Adenosine triphosphate (ATP), an energy source currency in cells, is released or leaked to the extracellular space under both physiological and pathological conditions. Extracellular ATP functions as an intercellular signaling molecule through activation of purinergic P2 receptors. Ocular tissue and cells release ATP in response to physiological stimuli such as intraocular pressure (IOP), and P2 receptor activation regulates IOP elevation or reduction. Dysregulated purinergic signaling may cause abnormally elevated IOP, which is one of the major risk factors for glaucoma. Glaucoma, a leading cause of blindness worldwide, is characterized by progressive degeneration of optic nerves and retinal ganglion cells (RGCs), which are essential retinal neurons that transduce visual information to the brain. An elevation in IOP may stress RGCs and increase the risk for glaucoma pathogenesis. In the aqueous humor of human patients with glaucoma, the ATP level is significantly elevated. Such excess amount of ATP may directly cause RGC death via a specific subtype of P2 receptors. Dysregulated purinergic signaling may also trigger inflammation, oxidative stress, and excitotoxicity via activating non-neuronal cell types such as glial cells. In this review, we discussed the physiological roles of extracellular nucleotides in the ocular tissue and their potential role in the pathogenesis of glaucoma. This article is part of the Special Issue on 'Purinergic Signaling: 50 years'.
Collapse
Affiliation(s)
- Youichi Shinozaki
- Department of Neuropharmacology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan; Interdisciplinary Brain-Immune Research Center, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Kozo Saito
- Department of Neuropharmacology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Kenji Kashiwagi
- Department of Ophthalmology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Schuichi Koizumi
- Department of Neuropharmacology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan; Interdisciplinary Brain-Immune Research Center, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan.
| |
Collapse
|
39
|
Ang RET, Rixon A, Kilgore K, Schweitzer J. Goldmann and modified Goldmann tonometry measuring intraocular pressure changes in eyes which underwent myopic laser in situ Keratomileusis and photorefractive keratectomy. BMC Ophthalmol 2022; 22:503. [PMID: 36539706 PMCID: PMC9768993 DOI: 10.1186/s12886-022-02741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Compare intraocular pressure (IOP) measured by a standard Goldmann applanation tonometer prism (IOPg) and a modified correcting applanation tonometer surface Goldmann prism (IOPc) before and after laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). METHODS Goldmann tonometry was analyzed in a retrospective, cross-sectional study, using both GAT and modified-GAT prisms pre-operatively and at the 3 month post-operative appointment on 120 eyes (64 patients) who received LASIK (n = 58) or PRK (n = 62). Demographics, central corneal thickness (CCT), manifest refraction and corneal curvature (CC) data was collected at each visit as well as surgical parameters, including maximum ablation depth. RESULTS Mean paired IOP following LASIK decreased by - 3.28 ± 3.2 mmHg measured by IOPg and - 1.93 ± 3.3 mmHg by IOPc (p ≤ 0.0001). Mean paired IOP following PRK reduced by - 1.92 ± 3.6 mmHg measured by IOPg and - 1.06 ± 3.6 mmHg by IOPc (p ≤ 0.0001). Increased LASIK ablation depth and post-procedural change in CCT trended toward a statistically significant reduction in IOPg (p = 0.07,p = 0.12), but not IOPc (p = 0.18,p = 0.32). PRK ablation depth was not associated with a reduction in IOPg or IOPc. DISCUSSION The modified Goldmann (IOPc) prism measured less of an IOP reduction following LASIK and PRK compared to the standard (IOPg) prism, and the IOP reduction with both prisms was associated with the degree of myopic correction. WHAT IS ALREADY KNOWN AND THE RESIDUAL QUERY Corneal refractive surgery generally demonstrates significant postoperative Goldmann IOP reductions. Presumably, this is due to corneal biomechanical changes for which a newer method of Goldmann IOP measurement may be able to compensate. WHAT THIS STUDY ADDS A modified, corneal conforming Goldmann prism demonstrates significantly less IOP reduction following myopic LASIK and PRK compared to the standard flat Goldmann prism. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY A newer, modified Goldmann prism may help detect glaucoma and OHT at an earlier stage in patients which have undergone LASIK or PRK. The findings corroborate predicted corneal biomechanical changes following the most common corneal refractive procedures.
Collapse
Affiliation(s)
- Robert Edward T. Ang
- Department of Ophthalmology, Cardinal Santos Medical Center, City, Metro Manila, San Juan, Philippines ,grid.476917.a0000 0004 9154 7342Cornea and Refractive Surgery Service, Asian Eye Institute, City, Metro Manila, Makati, Philippines ,grid.476917.a0000 0004 9154 7342Glaucoma Service, Asian Eye Institute, City, Metro Manila, Makati, Philippines
| | - Andrew Rixon
- grid.413847.d0000 0004 0420 4721Veterans Administration, Memphis, TN U.S.A.
| | | | | |
Collapse
|
40
|
Xu Q, Rydz C, Nguyen Huu VA, Rocha L, Palomino La Torre C, Lee I, Cho W, Jabari M, Donello J, Lyon DC, Brooke RT, Horvath S, Weinreb RN, Ju W, Foik A, Skowronska‐Krawczyk D. Stress induced aging in mouse eye. Aging Cell 2022; 21:e13737. [PMID: 36397653 PMCID: PMC9741506 DOI: 10.1111/acel.13737] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/17/2022] [Accepted: 10/23/2022] [Indexed: 11/21/2022] Open
Abstract
Aging, a universal process that affects all cells in an organism, is a major risk factor for a group of neuropathies called glaucoma, where elevated intraocular pressure is one of the known stresses affecting the tissue. Our understanding of molecular impact of aging on response to stress in retina is very limited; therefore, we developed a new mouse model to approach this question experimentally. Here we show that susceptibility to response to stress increases with age and is primed on chromatin level. We demonstrate that ocular hypertension activates a stress response that is similar to natural aging and involves activation of inflammation and senescence. We show that multiple instances of pressure elevation cause aging of young retina as measured on transcriptional and DNA methylation level and are accompanied by local histone modification changes. Our data show that repeated stress accelerates appearance of aging features in tissues and suggest chromatin modifications as the key molecular components of aging. Lastly, our work further emphasizes the importance of early diagnosis and prevention as well as age-specific management of age-related diseases, including glaucoma.
Collapse
Affiliation(s)
- Qianlan Xu
- Department of Physiology and Biophysics, Center for Translational Vision Research, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
| | - Cezary Rydz
- Department of Physiology and Biophysics, Center for Translational Vision Research, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
| | - Viet Anh Nguyen Huu
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Lorena Rocha
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Claudia Palomino La Torre
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Irene Lee
- Department of Physiology and Biophysics, Center for Translational Vision Research, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
| | - William Cho
- Department of Physiology and Biophysics, Center for Translational Vision Research, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
| | - Mary Jabari
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - John Donello
- Department of Physiology and Biophysics, Center for Translational Vision Research, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
| | - David C. Lyon
- Department of Anatomy and Neurobiology, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA
| | | | - Steve Horvath
- Epigenetic Clock Development FoundationTorranceCaliforniaUSA
| | - Robert N. Weinreb
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Won‐Kyu Ju
- Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center and Shiley Eye Institute, School of MedicineUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Andrzej Foik
- Department of Anatomy and Neurobiology, School of MedicineUniversity of California, IrvineIrvineCaliforniaUSA,International Centre for Translational Eye Research, Institute of Physical ChemistryPolish Academy of SciencesWarsawPoland
| | - Dorota Skowronska‐Krawczyk
- Department of Physiology and Biophysics, Department of Ophthalmology, Center for Translational Vision Research, School of MedicineUniversity of California, IrvineCaliforniaUSA
| |
Collapse
|
41
|
Mavlyutov TA, Kuhn MS, Bilal SE, De Ieso ML, Chauhan AK, Stamer WD, McDowell CM. Decreased outflow facility and Schlemm's canal defects in a mouse model of glaucoma. Exp Eye Res 2022; 225:109249. [PMID: 36152913 PMCID: PMC9722577 DOI: 10.1016/j.exer.2022.109249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/24/2022] [Accepted: 09/12/2022] [Indexed: 12/29/2022]
Abstract
Previously we identified B6.EDA+/+ mice as a novel mouse model that presents with elevated IOP and trabecular meshwork damage. Here, we expand on our previous findings by measuring aqueous humor outflow facility and analyzing the integrity of the inner wall of Schlemm's canal. As expected, intraocular pressure (IOP) was increased, and outflow facility was decreased compared to C57BL/6J controls. B6.EDA+/+ mice had significantly increased expression of the adherens junction protein, VE-cadherin by the inner wall endothelium of Schlemm's canal. These data suggest that in addition to trabecular meshwork damage, there are changes in Schlemm's canal in B6.EDA+/+ mice that lead to aqueous outflow dysfunction and ocular hypertension.
Collapse
Affiliation(s)
- Timur A Mavlyutov
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53575, USA
| | - Megan S Kuhn
- Duke Eye Center, Duke University, Durham, NC, USA
| | - Samer E Bilal
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53575, USA
| | | | - Anil K Chauhan
- Department of Internal Medicine, Division of Hematology/Oncology, University of Iowa, Iowa City, IA, USA
| | | | - Colleen M McDowell
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53575, USA.
| |
Collapse
|
42
|
Senapati S, Youssef AAA, Sweeney C, Cai C, Dudhipala N, Majumdar S. Cannabidiol Loaded Topical Ophthalmic Nanoemulsion Lowers Intraocular Pressure in Normotensive Dutch-Belted Rabbits. Pharmaceutics 2022; 14. [PMID: 36559077 DOI: 10.3390/pharmaceutics14122585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
Cannabidiol (CBD) is the major non-psychoactive and most widely studied of the cannabinoid constituents and has great therapeutic potential in a variety of diseases. However, contradictory reports in the literature with respect to CBD's effect on intraocular pressure (IOP) have raised concerns and halted research exploring its use in ocular therapeutics. Therefore, the current investigation aimed to further evaluate CBD's impact on the IOP in the rabbit model. CBD nanoemulsions, containing Carbopol® 940 NF as a mucoadhesive agent (CBD-NEC), were prepared using hot-homogenization followed by probe sonication. The stability of the formulations post-moist-heat sterilization, in terms of physical and chemical characteristics, was studied for three different storage conditions. The effect of the formulation on the intraocular pressure (IOP) profile in normotensive Dutch Belted male rabbits was then examined. The lead CBD-NEC formulation (1% w/v CBD) exhibited a globule size of 259 ± 2.0 nm, 0.27 ± 0.01 PDI, and 23.2 ± 0.4 cP viscosity, and was physically and chemically stable for one month (last time point tested) at 4 °C, 25 °C, and 40 °C. CBD-NEC significantly lowered the IOP in the treated eyes for up to 360 min, with a peak drop in IOP of 4.5 mmHg observed at the 150 min time point, post-topical application. The IOP of the contralateral eye (untreated) was also observed to be lowered significantly, but the effect lasted up to the 180 min time point only. Overall, topically administered CBD, formulated in a mucoadhesive nanoemulsion formulation, reduced the IOP in the animal model studied. The results support further exploration of CBD as a therapeutic option for various inflammation-based ocular diseases.
Collapse
|
43
|
Madjedi KM, Stuart KV, Chua SYL, Foster PJ, Strouthidis NG, Luben RN, Warwick AN, Kang JH, Wiggs JL, Pasquale LR, Khawaja AP. The Association of Female Reproductive Factors with Glaucoma and Related Traits: A Systematic Review. Ophthalmol Glaucoma 2022; 5:628-647. [PMID: 35691565 PMCID: PMC10051419 DOI: 10.1016/j.ogla.2022.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 05/20/2022] [Accepted: 06/03/2022] [Indexed: 11/25/2022]
Abstract
TOPIC This systematic review summarizes evidence for associations between female reproductive factors (age at menarche, parity, oral contraceptive [OC] use, age at menopause, and postmenopausal hormone [PMH] use) and intraocular pressure (IOP) or open-angle glaucoma (OAG). CLINICAL RELEVANCE Understanding the associations between female reproductive factors and glaucoma may shed light on the disease pathogenesis and aid clinical prediction and personalized treatment strategies. Importantly, some factors are modifiable, which may lead to new therapies. METHODS Two reviewers independently extracted articles in MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials databases to identify relevant studies. Eligibility criteria included studies with human subjects aged > 18 years; a measured outcome of either IOP or OAG; a cohort, case-control, cross-sectional, or randomized controlled trial design; a reported measure of association, such as the hazard ratio, relative risk, odds ratio, or mean difference, with an associated confidence interval; and a measured exposure of at least 1 of the following variables: age at menarche, parity, OC use, age at menopause, or PMH use. RESULTS We included a total of 27 studies. Substantial differences in study designs, exposure and treatment levels, treatment durations, and variable reporting precluded a meaningful quantitative synthesis of the identified studies. Overall, relatively consistent associations between PMH use and a lower IOP were identified. Estrogen-only PMH use may be associated with lower OAG risk, which may be modified by race. No significant associations were found with combined estrogen-and-progesterone PMH use. No strong associations between parity or age at menarche and glaucoma were found, but a younger age at menopause was associated with an increased glaucoma risk, and adverse associations were identified with a longer duration of OC use, though no overall association with OC use was found. CONCLUSIONS The association between PMH use and lower IOP or OAG risk is a potentially clinically relevant and modifiable risk factor and should be investigated further, although this needs to be interpreted in the context of a high risk of bias across included studies. Future research should examine associations with IOP specifically and how the relationship between genetic factors and OAG risks may be influenced by female reproductive factors.
Collapse
Affiliation(s)
- Kian M Madjedi
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom; Department of Ophthalmology, University of Calgary, Alberta, Canada.
| | - Kelsey V Stuart
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom
| | - Sharon Y L Chua
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom
| | - Paul J Foster
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom
| | - Nicholas G Strouthidis
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom
| | - Robert N Luben
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom; Medical Research Council, Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Jae H Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary Boston, Massachusetts
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Anthony P Khawaja
- National Institute for Health Research, Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & University College London, Institute of Ophthalmology, London, United Kingdom
| |
Collapse
|
44
|
Kamalipour A, Moghimi S, Inpirom VR, Mahmoudinezhad G, Weinreb RN. Multipressure Dial Goggle Effects on Circumpapillary Structure and Microvasculature in Glaucoma Patients. Ophthalmol Glaucoma 2022; 5:572-580. [PMID: 35605936 PMCID: PMC10566504 DOI: 10.1016/j.ogla.2022.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/25/2022] [Accepted: 05/16/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the effects of pressure changes induced by a multipressure dial (MPD) on circumpapillary retinal nerve fiber layer (RNFL) and capillary density (CD) measurements in patients with glaucoma using OCT angiography (OCTA). DESIGN Prospective interventional study. PARTICIPANTS Twenty-four patients with primary open-angle glaucoma. METHODS One eye of each patient underwent negative pressure application with the MPD. The MPD alters intraocular pressure (IOP) relative to atmospheric pressure by generating a negative pressure vacuum within a goggle chamber that is placed over the eye. Each participant underwent serial high density OCTA imaging (AngioVue) of the optic nerve head at different negative pressure increments of -5 mmHg, starting from 0 mmHg, ending at -20 mmHg, and then returning to baseline. Images were acquired after 2 minutes of sustained negative pressure at each target pressure to allow for stabilization of the retinal structures and microvasculature. The RNFL thickness and CD measurements were automatically calculated using the native AngioVue software, and then exported for analysis. MAIN OUTCOME MEASURES The influence of different levels of negative pressure on circumpapillary RNFL thickness and CD measurements, assessed by a linear mixed-effects model with repeated measures. RESULTS The mean (± SD) age was 71.0 years (± 7.8 years), the baseline IOP was 17.5 mmHg (± 3.6 mmHg), and there was a mean 24-2 mean deviation of -2.80 dB (± 2.55 dB). Serial circumpapillary CD measurements showed a statistically significant dose-dependent increase from baseline, without negative pressure application, to the maximum negative pressure application of -20 mmHg (difference, 2.27%; P = 0.010). Capillary density measurements then decreased symmetrically when lowering the negative pressure to baseline. Circumpapillary CD measurements at target negative pressures of -10 mmHg, -15 mmHg, and -20 mmHg were significantly higher than the baseline measurements (all P values < 0.05). Circumpapillary RNFL thickness remained the same throughout different levels of negative pressure. CONCLUSIONS Circumpapillary CD measurements showed a dose-dependent increase with the induction of negative pressure, while RNFL thickness measurements remained unchanged.
Collapse
Affiliation(s)
- Alireza Kamalipour
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Sasan Moghimi
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Veronica R Inpirom
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Golnoush Mahmoudinezhad
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA.
| |
Collapse
|
45
|
Dubey S, Bansal T, Garg P, Hegde A, Das R, Rekha PD. Outcomes of ab-interno irrigating goniectomy with trabectome in primary and secondary glaucoma from a single center in India. Indian J Ophthalmol 2022; 70:3569-3574. [PMID: 36190048 PMCID: PMC9789827 DOI: 10.4103/ijo.ijo_656_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose This study was done to report intermediate-term outcomes of irrigating goniectomy with trabectome (trabectome) surgery among different types of glaucoma eyes from a single center in India using a cross-sectional, longitudinal, observational study design. Methods Fifty-three patients (58 eyes) with glaucoma who underwent irrigating goniectomy with trabectome between January 2019 and February 2020 were included. Pre-operative data included age, gender, eye laterality, specific diagnosis, number of anti-glaucoma medications (AGMs), prior glaucoma surgeries, visual acuity, and intraocular pressure (IOP) on medical treatment. Post-operative data included IOP changes during the follow-up till 1-year, number of AGMs, any complications, or additional surgical intervention required. Success was defined as IOP ≤ 21 mmHg and ≥ 20% reduction of IOP from pre-operative IOP with no additional glaucoma surgery. Results The cohort included 58 eyes (male 53.4% and female 46.6%) ranging from 0.6 to 81 years of age. The average baseline IOP was 23.4 ± 10.2 mmHg and reduced significantly with surgery to 14.1 ± 5.3 mmHg at 1-year follow-up. The AGMs reduced from 2.4 ± 1.4 pre-surgery to 1.6 ± 1.4 at 1-year follow-up. Four eyes required additional glaucoma surgeries for IOP control. The success rate of trabectome with phacoemulsification (88%) was discernibly higher than with trabectome alone (67%). Intra-operatively, significant blood reflux was noticed in 27 eyes, of which only one required tamponading with a viscoelastic agent. Conclusion This study concludes that irrigating goniectomy with trabectome has good efficacy and safety in both pediatric and adult cases of glaucoma in terms of IOP control, reduction in AGMs, and low incidence of complications in the Indian population.
Collapse
Affiliation(s)
- Suneeta Dubey
- Department of Glaucoma, Dr. Shroff’s Charity Eye Hospital, New Delhi, India,Correspondence to: Dr. Suneeta Dubey, Department of Glaucoma, Dr. Shroff’s Charity Eye Hospital, New Delhi, India. E-mail: ;
Dr. Rekha PD, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore, Karnataka, India. E-mail:
| | - Tanima Bansal
- Department of Glaucoma, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | - Prerna Garg
- Department of Glaucoma, Dr. Shroff’s Charity Eye Hospital, New Delhi, India
| | - Aparna Hegde
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Derlakatte, Mangalore, Karnataka, India
| | - Ranajit Das
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Derlakatte, Mangalore, Karnataka, India
| | - PD Rekha
- Yenepoya Research Centre, Yenepoya (Deemed to be University), Derlakatte, Mangalore, Karnataka, India,Correspondence to: Dr. Suneeta Dubey, Department of Glaucoma, Dr. Shroff’s Charity Eye Hospital, New Delhi, India. E-mail: ;
Dr. Rekha PD, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore, Karnataka, India. E-mail:
| |
Collapse
|
46
|
Bharathi RB, Poojary RG, Prabhu GK, Ve RS. Finite element method for estimation of applanation force and to study the influence of intraocular pressure of eye on tonometry. Int Ophthalmol 2022; 42:1997-2005. [PMID: 35665874 PMCID: PMC9287227 DOI: 10.1007/s10792-021-02157-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 12/18/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Discover the associations of force of applanation on the eye with the plunging depth of the cornea and quantify them. The results will be utilized as the feedback parameter in the new prototype development of eye care instruments as additional force may damage the internal structure of the eye or may result in erroneous output. METHOD A finite element-based eye model is designed utilizing the actual dimensions of the human eye. A standardized tonometer is designed and the simulation is carried out at predetermined deformation of the cornea to find the force of applanation on the cornea during tonometry. Adding on, the influence of IOP during tonometry is analyzed for a range of plunging depths of the cornea. RESULTS The graphical results inferred the linear relation between the force of applanation with the deformation of the cornea and the results are quantified. The resulting deformation and stress plot of FEM based simulation approach is analyzed and observations regarding deformations and stress are made. CONCLUSION The human eye is successfully developed and also computed force on the cornea during tonometry is validated. The inference drawn from the deformation plot and stress plot is that the junction of cornea-sclera along with cornea-tonometer periphery undergo maximum deformation and experiences the highest stress compared to other areas of the eye while during tonometry.
Collapse
Affiliation(s)
- R B Bharathi
- Department of Electrical and Electronics Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India.
| | - Rakshath G Poojary
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Gopalakrishna K Prabhu
- Department of Electronics and Communication Engineering, Manipal Academy of Higher Education, Manipal University Jaipur, Jaipur, India
| | - Ramesh S Ve
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
47
|
Bradley C, Manchip K, Sansom PG, Carter WJ. Prophylactic efficacy of intravenous paracetamol administration to reduce the incidence of post-operative ocular hypertension in dogs undergoing phacoemulsification: A pilot study. Vet Ophthalmol 2022; 25:350-359. [PMID: 35512023 DOI: 10.1111/vop.12990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 04/03/2022] [Accepted: 04/11/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine whether intravenous administration of paracetamol can prevent postoperative ocular hypertension (POH) in dogs following routine phacoemulsification. METHODS Diabetic and non-diabetic patients (total 54 dogs) undergoing unilateral or bilateral phacoemulsification were recruited to this placebo-controlled, prospective study. The control group received 1 ml/kg saline via intravenous infusion while the treatment group received 10 mg/kg paracetamol via intravenous infusion. Infusions were administered 30 min prior to surgery and repeated 12 h following initial administration. All patients received topical latanoprost at the conclusion of surgery. Intraocular pressure (IOP) was measured before premedication (baseline), and at 1 h, 3 h, 5 h and 18 h following extubation. POH was defined as an IOP above 25 mmHg (POH25). In addition, the number of patients with an IOP exceeding 20 mmHg was analyzed (POH20). RESULTS POH20 occurred in 33 of 54 animals (61.1%), including 19 of 25 animals (76.0%) in the control group and 14 of 29 animals (55.2%) in the treatment group. POH25 occurred in 23 of 44 animals (52.3%), including 13 of 25 animals (52.0%) in the control group and 10 of 29 animals (34.5%) in the treatment group. Paracetamol administration showed a significant positive effect on reducing the incidence of POH20 (p = .048), but not POH25 (p = .221). CONCLUSIONS When comparing groups, treatment with paracetamol showed a statistically significant reduction in the incidence of POH20, although no differences were observed in the incidence of POH25 between groups. Further studies are warranted to explore whether alternative drug regimes or routes of administration can provide enhanced efficacy in the prevention of POH25.
Collapse
Affiliation(s)
| | | | - Philip G Sansom
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
| | | |
Collapse
|
48
|
Boskovic I, Akca AYE, Giromini L. Symptom coaching and symptom validity tests: An analog study using the structured inventory of malingered symptomatology, Self-Report Symptom Inventory, and Inventory of Problems-29. Appl Neuropsychol Adult 2022:1-13. [PMID: 35414324 DOI: 10.1080/23279095.2022.2057856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In this pilot and exploratory study, we tested the robustness of three self-report symptom validity tests (SVTs) to symptom coaching for depression, with and without additional information available on the Internet. Specifically, we divided our sample (N = 193) so that each subject received either the Structured Inventory of Malingered Symptomatology (SIMS; n = 64), the Self-Report Symptom Inventory (SRSI; n = 66), or the Inventory of Problems-29 (IOP-29; n = 63). Within each of the three subgroups, approximately one third of participants were instructed to respond honestly (Genuine Condition, nSIMS = 21; nSRSI = 24; nIOP-29 = 26) and approximately two-thirds were instructed to feign depression. One half of the feigners were presented with a vignette to increase their compliance with instructions and were given information about symptoms of depression (Coached Feigning, nSIMS = 25; nSRSI = 18; nIOP-29 = 21), and the other half were given the same vignette and information about symptoms of depression, plus two Internet links to review before completing the test (Internet-Coached Feigning, nSIMS = 18; nSRSI = 24; nIOP-29 = 16). Overall, the results showed that the genuine conditions yielded the lowest total scores on all three measures, while the two feigning conditions did not significantly differ from each other. Looking at the detection rates for all feigning participants, all three measures showed satisfactory results, with IOP-29 performing slightly better than SIMS and SIMS performing slightly better than SRSI. Internet-Coached Feigners scored slightly lower on all three measures than feigners who were coached without the Internet links. Taken together, the results of this preliminary and exploratory study suggest that all three SVTs examined are sensitive to feigned depression even in the presence of symptom coaching, both with and without additional Internet-based information.
Collapse
Affiliation(s)
- Irena Boskovic
- Forensic Psychology Section, Clinical Psychology Department, Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Forensic Psychology Section, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | | | | |
Collapse
|
49
|
Sweeney C, Dudhipala N, Thakkar R, Mehraj T, Marathe S, Gul W, ElSohly MA, Murphy B, Majumdar S. Impact of mucoadhesive agent inclusion on the intraocular pressure lowering profile of Δ 9-tetrahydrocannabinol-valine-hemisuccinate loaded nanoemulsions in New Zealand white rabbits. Int J Pharm 2022; 616:121564. [PMID: 35151817 DOI: 10.1016/j.ijpharm.2022.121564] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/01/2022] [Accepted: 02/06/2022] [Indexed: 01/01/2023]
Abstract
The current study aimed to determine the effect of inclusion of a mucoadhesive agent on the intensity and duration of intraocular pressure (IOP) lowering activity of Δ9-tetrahydrocannabinol-valine-hemisuccinate (THC-VHS) loaded in a nanoemulsion (THC-VHS-NE) formulation. THC-VHS-NE formulation with Carbopol®940NF added as a mucoadhesive agent (THC-VHS-NEC) was prepared using hot-homogenization followed by probe sonication and characterized. A comparative evaluation of the IOP lowering activity of THC-VHS-NEC, THC-VHS-NE, THC-NEC, and commercial latanoprost ophthalmic solution, was undertaken in normotensive New Zealand white rabbits. The effect of pH, surfactant concentration, and autoclave process on the IOP lowering activity of THC-VHS-NEC was also studied. The formulation demonstrated desired viscosity, physicochemical properties, and autoclave process stability. The THC-VHS-NEC formulation showed a significant (p < 0.05) improvement in the duration of IOP lowering activity, compared to THC-NEC and THC-VHS-NE. Moreover, in this model, THC-VHS-NEC was more effective than commercially available latanoprost ophthalmic formulation, in terms of both duration and intensity of IOP lowering. A change in formulation pH, surfactant concentration, or sterilization process did not impact the IOP lowering activity of THC-VHS-NEC. Overall, inclusion of a mucoadhesive agent in THC-VHS-NE formulation, significantly increased the duration of activity, and could lead to a once- or twice- a day dosing regimen.
Collapse
Affiliation(s)
- Corinne Sweeney
- Department of Pharmaceutics and Drug Delivery, University of Mississippi, University, MS 38677, United States
| | - Narendar Dudhipala
- Department of Pharmaceutics and Drug Delivery, University of Mississippi, University, MS 38677, United States
| | - Ruchi Thakkar
- Department of Pharmaceutics and Drug Delivery, University of Mississippi, University, MS 38677, United States
| | - Tabish Mehraj
- Department of Pharmaceutics and Drug Delivery, University of Mississippi, University, MS 38677, United States
| | - Sushrut Marathe
- Department of Pharmaceutics and Drug Delivery, University of Mississippi, University, MS 38677, United States
| | - Waseem Gul
- ElSohly Laboratories Inc., Oxford, MS 38655, United States
| | - Mahmoud A ElSohly
- Department of Pharmaceutics and Drug Delivery, University of Mississippi, University, MS 38677, United States; ElSohly Laboratories Inc., Oxford, MS 38655, United States; National Center for Natural Products Research, University of Mississippi, Oxford, MS 38677, United States
| | - Brian Murphy
- Emerald Biosciences Inc., Long Beach, CA 90803, United States
| | - Soumyajit Majumdar
- Department of Pharmaceutics and Drug Delivery, University of Mississippi, University, MS 38677, United States; Research Institute of Pharmaceutical Sciences, University of Mississippi, University, MS 38677, United States.
| |
Collapse
|
50
|
Ibarz Barberá M, Morales Fernández L, Tañá Rivero P, Gómez de Liaño R, Teus MA. Anterior-segment optical coherence tomography of filtering blebs in the early postoperative period of ab externo SIBS microshunt implantation with mitomycin C: Morphological analysis and correlation with intraocular pressure reduction. Acta Ophthalmol 2022; 100:e192-e203. [PMID: 33838021 DOI: 10.1111/aos.14863] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 02/27/2021] [Accepted: 03/16/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE To analyse the morphological evolution of filtering blebs with anterior-segment OCT (AS-OCT) and its correlation with intraocular pressure after ab externo SIBS microshunt implantation with mitomycin C (MMC) during a 3-month follow-up period. METHODS Twenty-eight filtering blebs of 28 patients with open-angle glaucoma were measured horizontally and vertically in the sub-Tenon space with AS-OCT after ab externo SIBS microshunt implantation with MMC. The intraocular pressure (IOP) was monitored simultaneously at each visit. Maturation of and morphological changes in the blebs and correlations with the IOP were recorded. RESULTS The average median preoperative IOP of 20.7 (range, 12-30) mmHg decreased to 8.5 (range, 4-17), 8.9 (range, 5-17), 10.4 (range, 8-16) and 10.9 (range, 9-15) mmHg at 24 hr, 1 week, 1 month and 3 months, respectively (p < 0.001). A multiform morphology on AS-OCT prevailed at all time points, with a 3.5% rate of a uniform bleb morphology at the first week. The horizontal and vertical diameters of the blebs increased from baseline to the third month. The horizontal expansion (406 ± 127 μm on day 7, p = 0.04, 712 ± 211 μm on day 30, p = 0.02 and 952 ± 218 μm on day 90, p < 0.001) was greater than the vertical expansion (16 ± 18 μm, p = 0.3 on day 1, 63 ± 27 μm, p = 0.02 on day 30 and 137 ± 34 μm, p < 0.001 on day 90) without correlation with the IOP (r = -0.3, p = 0.2). CONCLUSION Anterior-segment OCT (AS-OCT) of the filtering blebs formed after ab externo SIBS microshunt implantation showed progressive horizontal and vertical expansion of the blebs in the sub-Tenon space, with a significant peak at the first month not significantly correlated with the decrease in the IOP.
Collapse
Affiliation(s)
| | | | | | | | - Miguel A. Teus
- Hospital Clínico Madrid Spain
- Clínica Novovisión Madrid Spain
- Hospital Universitario Príncipe de Asturias Alcalá de Henares, Madrid Spain
- Universidad de Alcalá Alcalá de Henares, Madrid Spain
| |
Collapse
|