RNA-seq analysis of human trabecular endothelial cells after treatment with timolol maleate.

PURPOSE: Timolol maleate (timolol), a ß-receptor blocker, reduces intraocular pressure by decreasing aqueous humor production. Timolol reportedly also protects ganglion cells, decreases aqueous humor outflow facility, and destroys the extracellular matrix in the trabecular meshwork. In this study, we investigated the effects of timolol on cultured human trabecular endothelial cells purchased from ScienCell using next-generation sequencing. STUDY DESIGN: Experimental investigation. METHODS: Total ribonucleic acid (RNA) was extracted after 24 h. More than 100 million RNAs in control and timolol-treated group were sequenced using a next-generation sequencer. The expression of 55,778 RNAs was analyzed. RESULTS: A total of 2,105 genes were significantly upregulated and 2,125 genes were downregulated, after the addition of timolol. VGF nerve growth factor inducible (VGF) (388-fold) had the maximum increase in expression, followed by amphiregulin (333-fold), a member of the epidermal growth factor family. Moreover, the expression of extracellular matrix-degrading enzymes, matrix metalloproteinases (MMPs) 1, 2, 3, 10, 12, and 14, increased. CONCLUSION: Timolol exerts various effects on human trabecular endothelial cells. The increase in MMP expression may contribute to the decrease in the aqueous humor outflow facility.

Comparison of objective and subjective sleep parameters in patients with bipolar disorder in both euthymic and residual symptomatic periods.

BACKGROUND: Sleep disturbance is a core feature of bipolar disorder; hence, sleep must be accurately assessed in patients with bipolar disorder. Subjective sleep assessment tools such as sleep diary and questionnaires are often used clinically for assessing sleep in these patients. However, the insight into whether these tools are as accurate as objective tools, such as actigraphy, remains controversial. METHODS: This cross-sectional study included 164 outpatients with a diagnosis of bipolar disorder, including patients who had euthymic and residual symptomatic periods. Objective sleep assessment was conducted prospectively using actigraphy for 7 consecutive days, whereas subjective sleep assessment was conducted prospectively using a sleep diary. RESULTS: The correlations were high and moderate between sleep diary and actigraphy when assessing the total sleep time and sleep onset latency, respectively (r = 0.81 and 0.47). These correlations remained significant after correction for multiple testing (both p < 0.001) and in both euthymic and residual symptomatic states (total sleep time: r = 0.86 and 0.77; sleep onset latency: r = 0.51 and 0.40, respectively). The median (interquartile ranges) of the percentage difference (sleep diary parameters minus actigraphy parameters divided by actigraphy parameter) in the total sleep time was relatively small (6.2% [-0.2% to 13.6%]). CONCLUSIONS: Total sleep time assessment using a sleep diary could be clinically useful in the absence of actigraphy or polysomnography.

Comparison of anterior segment and lens biometric measurements in patients with cataract.

PURPOSE: This study was performed to compare anterior ocular biometric measurements of deep-range swept-source anterior segment optical coherence tomography (AS-OCT) (CASIA2) versus short-range swept-source AS-OCT (CASIA SS-1000), ultrasonography (AL-4000), and Scheimpflug camera analysis (Pentacam and EAS-1000) in patients with cataract. METHODS: One hundred eighty-five eyes of 128 participants with mild refractive error or cataract were examined. The central corneal thickness (CCT), aqueous depth (AQD), and lens thickness were obtained. The repeatability of CASIA2 measurements was assessed. RESULTS: In patients with cataract, the CCT, AQD, lens thickness, and lens anterior curvature by CASIA2 showed high intraclass correlation coefficients (ICCs) of > 0.99. Conversely, measurements of the posterior part of the lens such as lens posterior curvature showed lower ICCs. The ICCs were higher in healthy young participants than in patients with cataract. The ICCs tended to be lower in patients with mild than dense cataract. There was no statistically significant difference in the CCT and AQD between the CASIA2 and CASIA SS-1000 or in the lens thickness measurements between the CASIA2 and AL-4000 and between the CASIA2 and EAS-1000. There was a significant linear correlation in the biometric measurements between the CASIA2 and the other instruments. CONCLUSION: We evaluated the biometric measurements of the anterior eye segment by the CASIA2. The CASIA2 yielded results comparable with those of the CASIA SS-1000, ultrasonography, and Scheimpflug camera. However, mild cataract decreased the repeatability of measurements of the posterior part of the lens.

Comparison of intensity, phase retardation, and local birefringence images for filtering blebs using polarization-sensitive optical coherence tomography.

Polarization-sensitive optical coherence tomography (PS-OCT) allows the recording of depth-resolved polarimetric measurements. It has been reported that phase retardation and local birefringence images can noninvasively detect fibrotic area in blebs after glaucoma surgery. Evaluation of scar fibrosis in blebs is important not only for predicting bleb function, but also for planning revision trabeculectomy. Herein, we characterize the intensity, phase retardation, and local birefringence images of blebs using PS-OCT. A total of 85 blebs from 85 patients who had undergone trabeculectomy were examined. Both phase retardation and local birefringence images detected fibrotic changes in blebs after glaucoma surgery. Phase retardation images detected slight fibrotic change during the early stage after surgery, whereas local birefringence images showed localized fibrotic tissue. There are two main patterns of local birefringence image changes in blebs: plate-like birefringence changes and diffuse changes. The area of plate-like birefringence change was significantly larger in poorly functioning blebs and is thus correlated with bleb function. These data suggest that the plate-like fibrotic change evaluation by PS-OCT may be useful not only for noninvasive evaluation of fibrotic scar tissue in blebs, but also for developing strategies for revision trabeculectomy.

Quantitative Evaluation of Phase Retardation in Filtering Blebs Using Polarization-Sensitive Optical Coherence Tomography.

PURPOSE: Polarization-sensitive optical coherence tomography (PS-OCT) can detect and evaluate scar fibrosis of the filtering blebs after glaucoma surgery. Although the change in phase retardation reportedly reflects bleb function, quantitative assessment of phase retardation in ocular tissues has not been conducted. We aimed to establish quantitative methods to investigate changes in phase retardation in the blebs after surgery using PS-OCT. METHODS: Twenty-two blebs of 22 patients who had undergone glaucoma filtration surgery were consecutively examined for 4 months. Phase retardation was measured by PS-OCT and quantitatively analyzed to evaluate its relationship with bleb function based on intraocular pressure and medication use. Cross-sectional re-evaluation was also performed for a previous data set of 153 blebs of 122 patients. RESULTS: In consecutive measurements, all blebs showed a low phase retardation value and good bleb function until 2 weeks. One month postoperatively, the phase retardation value was significantly increased, whereas bleb function was still good. The phase retardation value at 1 month postoperatively was significantly correlated with bleb function at 4 months postoperatively. While 55.6% of blebs with a high phase retardation value at 1 month subsequently lost function, only 7.7% with a low phase retardation value had bleb failure. In the cross-sectional re-evaluation, the quantitatively evaluated phase retardation value was highly correlated with bleb function (ß = 0.770, P < 0.001). CONCLUSIONS: An increase in phase retardation preceded deterioration of bleb function. The change in phase retardation may provide a prognostic metric for bleb function in the early stage after surgery.