Pseudoexfoliation Syndrome-Clinical Characteristics of Most Common Cause of Secondary Glaucoma.

Pseudoexfoliation syndrome (XFS) is a condition in which excess material builds up not only in the structures of the anterior chamber but also throughout the body. The frequency of the syndrome varies significantly (0.3-18%) depending on the region and the method of examination. Environmental risk factors for XFS include a large number of sunny days, proximity to the equator, dietary factors such as higher consumption of coffee and tea, long-term alcohol consumption, exposure to UV, and outdoor work. The pathognomonic sign of XFS is the presence of white material on the lens capsule and other anterior chamber components. In addition, a characteristic Sampaolesi line can be observed during gonioscopy. Systemic alterations indicative of XFS have been observed in the extracellular matrix of the eyelid skin, the heart, lungs, liver, kidneys, gallbladder, meninges, and endothelium of the blood vessels. XFS is the most common cause of secondary open-angle glaucoma, which is called pseudoexfoliative glaucoma and is more severe than primary open-angle glaucoma. It is plausible that a combination of environmental factors and genetic alterations promotes the onset of pseudoexfoliation syndrome, which requires additional research.

Advancements in Ocular Regenerative Therapies.

The use of stem cells (SCs) has emerged as a promising avenue in ophthalmology, offering potential therapeutic solutions for various vision impairments and degenerative eye diseases. SCs possess the unique ability to self-renew and differentiate into specialised cell types, making them valuable tools for repairing damaged tissues and restoring visual function. Stem cell-based therapies hold significant potential for addressing conditions such as age-related macular degeneration (AMD), retinitis pigmentosa (RP), corneal disorders, and optic nerve damage. Therefore, researchers have explored different sources of stem cells, including embryonic stem cells (ESC), induced pluripotent stem cells (iPSCs), and adult stem cells, for ocular tissue regeneration. Preclinical studies and early-phase clinical trials have demonstrated promising outcomes, with some patients experiencing improved vision following stem cell-based interventions. However, several challenges remain, including optimising the differentiation protocols, ensuring transplanted cells' safety and long-term viability, and developing effective delivery methods. The field of stem cell research in ophthalmology witnesses a constant influx of new reports and discoveries. To effectively navigate these tons of information, it becomes crucial to summarise and systematise these findings periodically. In light of recent discoveries, this paper demonstrates the potential applications of stem cells in ophthalmology, focusing on their use in various eye tissues, including the cornea, retina, conjunctiva, iris, trabecular meshwork, lens, ciliary body, sclera, and orbital fat.

The Importance of MicroRNA Expression in Pseudoexfoliation Syndrome.

Pseudoexfoliation syndrome (PEX) is an important systemic disorder of the extracellular matrix, in which granular amyloid-like protein fibers accumulate in the anterior segment of the eyeball as well as in other organs. PEX is currently considered to be a multifactorial systemic disorder with genetic and environmental risk factors. The aim of this manuscript was to analyze miR expression in PEX. In recent years, an attempt has been made to investigate and describe the level of expression of selected miRs in PEX. Four polymorphisms of genes isolated from the blood that may be related to PEX were identified and miR-122-5p was found to be upregulated in patient blood. Furthermore, 18 miRs were identified with a statistically different expression in the aqueous humor. A significantly elevated expression of miR-125b was found in the anterior lens capsule, and four miRs were described, which may have a significant impact on the development of PEX. Regulatory miR molecules are gaining more and more importance in research aimed at identifying and isolating molecular markers related to the pathogenesis and prognosis of PEX, but further studies are needed.

MicroRNA Expression in Pseudoexfoliation Syndrome with the Use of Next-Generation Sequencing.

Pseudoexfoliation syndrome (PEX) is a clinically important and biologically intriguing systemic disorder of the extracellular matrix. PEX etiopathogenesis was proved to be connected to multiple genes and other factors. However, the exact etiopathogenesis remains unknown. The aim of this study was to analyze miR expression in PEX using next-generation sequencing. An attempt was made to find the most commonly occurring miR in PEX, to evaluate miR that may have an essential role in the etiology of PEX syndrome. In addition, the correlation between the selected miRs' expressions and age was investigated. Anterior lens capsules were obtained during cataract surgery. Next-generation sequencing was conducted on Illumina MiSeq. The average age was 68.2 years (with standard deviation +/- 6.92 years). Ten miRs with the highest level of expression represent approx. 95% of all readings. Four miRs with statistically significant differences in expression between groups have been distinguished: miR-671-3p, miR374a-5p, miR-1307-5p and miR-708-5p. The relationship between the most frequent miRs' expressions and age has been evaluated and no correlation has been detected. In view of the above, it seems reasonable to examine the influence of miR on the biogenesis of PEX. Further studies on miR-671-3p, miR-374a-5p, miR-1307-5p and miR-708-5p expression in PEX are needed.

MicroRNA-125b overexpression in pseudoexfoliation syndrome.

BACKGROUND: MicroRNAs (miRs) are small non-coding RNAs. MiR-125b has been described as being downregulated in cataract tissue when compared to a transparent lens. OBJECTIVES: The aims of the study were: 1) to establish the expression of miR-125b in cataracts complicated by pseudoexfoliation syndrome (PEX), glaucoma or PEX glaucoma; and 2) to determine whether any environmental factors influence miR-125b expression. MATERIAL AND METHODS: Anterior lens capsules were obtained from 150 patients. The patients were subdivided into 1 of 4 groups: those with PEX (PEXg), those with primary open-angle glaucoma (Gg) and those with PEX glaucoma (PEXGg), plus gender-matched controls with cataracts alone (control group - Cg). Quantitative polymerase chain reaction (qPCR) expression of microRNA-125b was examined in every group. RESULTS: The mean age of the 150 patients was 75.18 years (standard deviation (SD) ±9.12 years). Our investigation indicated, for the first time, that miR-125b expression was increased 3.33 times in the PEXg (p = 0.015). The quantitative analysis of miR-125b expression conducted between combined groups of all the patients that have PEX syndrome (with or without glaucoma) and the Cg revealed a statistically significant difference (p = 0.04). Lower miR-125b expression was found in the patients who smoked compared to those who did not (p = 0.01). CONCLUSIONS: Our data revealed the possible role of miR-125b in PEX syndrome development. There are 2 possible interpretations of these results: either the co-existence of PEX acts as a moderator of miR-125b expression in the anterior lens capsule, or increased expression of miR-125b can play a role in the pathogenesis of PEX.

Clinical and immunological characteristics of Polish patients with systemic lupus erythematosus.

BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with varied clinical manifestations, which creates difficulties and delays in establishing a diagnosis. OBJECTIVES: The aim of this study was to evaluate the prevalence and nature of the clinical symptoms of SLE, both at the onset of the disease and in its further course. An attempt to assess the immunological characteristics of the patients and to analyze autoantibodies variability over time was also made. MATERIAL AND METHODS: This retrospective study included 71 Caucasian patients, 63 women and 8 men, meeting the criteria for diagnosis of SLE according to ACR. RESULTS: The ratio of women to men was approximately 7.9:1. The average age of the onset of SLE was 31.5 years. The average time from the onset of symptoms to diagnosis was 5 years. The most common first manifestation of SLE were joint and muscles symptoms - 71.8%, skin lesions - 69.0%, fever - 57.7%. The main symptoms in the further course of the disease were neurological disorders - 69.0%, joint and muscle changes - 67.7%, and general symptoms - 59.2%. There was an increase in the incidence of renal involvement and neurological symptoms throughout the disease course. The most commonly detected antibodies were anti-dsDNA - 47.9%, anti-Ro/SSA - 40.8%, anti-nucleosomal antibodies - 29.6%, and lupus anticoagulant - 22.5%. A panel of antibodies typically did not change. CONCLUSIONS: There is no typical clinical picture of SLE, the population suffering from this disease is very various. Therefore, early and accurate diagnosis can be a big challenge for any clinician, which justifies the need for this type of study to better characterize the disease.

Evaluation of the anterior chamber angle in pseudoexfoliation syndrome.

BACKGROUND: Pseudoexfoliation syndrome (PEX) is the most frequently identifiable cause of secondary open-angle glaucoma, known as pseudoexfoliation glaucoma. The exact pathophysiology and etiology of PEX and associated glaucoma remains obscure. OBJECTIVES: The purpose of this study was to determine the differences in the morphology of the anterior chamber angle in people with pseudoexfoliation syndrome and pseudoexfoliation glaucoma compared to a control group. We also evaluated the correlation between intraocular pressure (IOP) and pigmentation of the angle with the amount of exfoliated material in the anterior segment. MATERIAL AND METHODS: The study group was composed of 155 eyes from 103 patients aged between 43 and 86 years. Each patient underwent a complete ophthalmological examination. RESULTS: Some difference was found in intraocular pressure between the PEX group and the control group and between the pseudoexfoliation glaucoma group and the control group, but no significant difference was found between the 2 study groups. There was a significant difference in the incidence of some degree of pigmentation in the anterior chamber angle and no difference in the widths of the angle between each group. A significant positive relationship was observed between intraocular pressure and the degree of pigmentation of the anterior chamber angle in both the PEX group and the pseudoexfoliation glaucoma group. CONCLUSIONS: The results of this study indicate that the amount of pigmentation and exfoliation material in the anterior segment significantly correlates with the level of IOP and possibly with the degree of trabecular dysfunction. It seems that for clear identification of PEX and pseudoexfoliation glaucoma factors, clinical assessment appears to be insufficient.

A Novel Uveolymphatic Drainage Pathway-Possible New Target for Glaucoma Treatment.

Glaucoma is a heterogeneous group of ophthalmic diseases leading to irreversible damage to the optic nerve. While the overall mechanism responsible for glaucoma remains obscure, the most important risk factor is elevated intraocular pressure. The current therapies, whether pharmacological or surgical, are primarily symptomatic with the aim to lower the intraocular pressure (IOP). Poorer response to treatment is associated, for example, with pseudoexfoliation glaucoma, which is determined by blocking the trabecular meshwork (TM) both by pigment grains and the pseudoexfoliation material. It was thought that aqueous humor is drained from the eye by two main pathways: conventional outflow through the TM and Schlemm's canal; and unconventional outflow through the ciliary body through uveal tissue. In 2009 Yucel et al. described and proved the presence of a third pathway for aqueous humor drainage using two specific lymphatic markers: podoplanin, and lymphatic vessel endothelial hyaluronan receptor-1 to identify lymphatic channels in the human ciliary body. The discovery identifies a novel target for IOP-lowering therapies. The most promising group are prostaglandins, which are widely prescribed for glaucoma patients. An intriguing new possibility in glaucoma therapy is using ANGPT agonist. It is still not known if the lymphatic drainage in glaucoma is decreased or dysfunctional and whether lymphatic stimulation can help in removing the improperly accumulated substances, as is seen in pseudoexfoliation glaucoma. However, this new target for glaucoma treatment appears very promising.

Outbreak of Occupational Dermatitis Associated With Pyemotes ventricosus.

Importance: Although Pyemotes species have been known to cause dermatitis, recent reports are rare. During the past 30 years, only 3 outbreaks of dermatitis caused by Pyemotes ventricosus have been reported. Objective: To analyze the causative agent of skin changes in employees of a company that produced herbal medicines. Design, Setting, and Participants: This case series includes 18 patients (8 men, 10 women; mean age, 44 years) who contracted unusual dermatitis after an occupational exposure in July and August of 2012 while working for a company that produced herbal medicines. The patients were examined at the Lower Silesia Regional Centre of Occupational Medicine in Wroclaw, Poland. Exposures: Workers weighed and packed 1 part of the Helichrysum arenarium herb. Main Outcomes and Measures: We hypothesized the causative agent to be P ventricosus. An examination of the herbal specimens for ectoparasites confirmed the diagnosis. Results: Initially 16 employees developed pruritic skin changes. Skin lesions with pruritic vesicles on an erythematous base with surrounding swelling and edema were observed. Several employees also developed a flulike illness. After 44 days, 2 new employees presented with the same skin changes. The analysis of working conditions showed that the same part of the H arenarium herb was weighed and packed at that time. Conclusions and Relevance: We found that changing the time when the herbs were weighed and abandoning gas fumigation containing methyl bromide resulted in the recurrence of an almost forgotten disease.