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1.
Invest Ophthalmol Vis Sci ; 62(12): 6, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34499706

RESUMO

Purpose: To investigate whether retinal structural parameters, including positions of the optic disc and major retinal arteries, affect glaucomatous progression of the visual field (VF). Methods: In this cohort study, 116 eyes of 73 patients with primary open angle glaucoma (POAG) were included. VFs were measured using the Humphrey Field Analyzer 24-2 program and the VF was divided into seven sectors according to the corresponding optic disc angle. Average total deviation (TD) was calculated in each sector. Positions of major retinal arteries in the superotemporal and inferotemporal areas were decided by identifying the points where the retinal artery intersected the 3.4-mm-diameter circle around the optic disc. The relationship between sectorial TD VF progression rate and eight variables (age, mean and standard deviation of intraocular pressure during the observation period, baseline sectorial TD value, papillomacular bundle tilt angle, and axial length, along with superior/inferior arterial angle) was investigated. Results: The main outcome measures were the association between retinal structural parameters and glaucomatous progression of VF. The superior retinal artery angular position was positively associated with sectorial TD progression rates in two central sectors in the inferior hemifield, which suggests faster VF progression where superior retinal artery angles are narrow. Papillomacular bundle tilt was not associated with TD progression rate in any sector. Conclusions: Progression of the inferior VF was associated with the superior retinal artery angular position in this study of POAG.


Assuntos
Glaucoma de Ângulo Aberto/diagnóstico , Pressão Intraocular/fisiologia , Disco Óptico/patologia , Doenças do Nervo Óptico/fisiopatologia , Artéria Retiniana/patologia , Tomografia de Coerência Óptica/métodos , Campos Visuais/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Seguimentos , Glaucoma de Ângulo Aberto/complicações , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Doenças do Nervo Óptico/diagnóstico , Doenças do Nervo Óptico/etiologia , Células Ganglionares da Retina/patologia , Estudos Retrospectivos , Testes de Campo Visual
2.
Malawi Med J ; 33(1): 15-20, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-34422229

RESUMO

Purpose: To evaluate the clinical and socio-demographic profile of patients living with glaucoma and receiving care in a tertiary eye center in Zimbabwe. Method: A hospital-based retrospective study of clinical records of glaucoma patients from January 2014 to December 2018. The study involved collating demographic information of patients, visual acuities, (VA) intraocular pressure, (IOP), cup-to-disc ratios, (CDRs), average retinal nerve fibers thickness, (RNFL), cup volume, cup-to-disc area, vertical cup-to-disc ratio, (VCDR), rim area, disc area, glaucoma hemifield test, visual field indices and the management of glaucoma. Results: Nine thousand one hundred and eighty-five (9,185) folders were retrieved. Out of these, 432 (4.7%) qualified for the study and were analyzed. There were 267 (61.8%) males and 165 (38.2%) females. The mean age (± Standard deviation, SD) of the patients was 62.66 ± 15.94 years, (range 10 - 110 years). The means visual acuity (VA): OD =1.30 ± 1.06 Logarithm of the Minimum Angle of Resolution, (logMAR), OS = 1.33 ± 1.06 logMAR; IOP: OD = 29.51 ± 12.89 mmHg, OS: 29.17 ± 12.59 mmHg; CDRs: OD = 0.91 ± 0.14 D, OS = 0.92 ± 0.14 D; and the average RNFL thickness was 72.76 ± 18.26 µm and 71.24 ± 23.17 µm in the right and left eye respectively. The mainstay of treatment was medication only. Conclusion: There were more males than females receiving glaucoma care at the tertiary level. Glaucoma cases included juveniles but the mean age was mostly the elderly. It was characterized by high IOPs, large CDRs, and thin RNFL suggestive of late presentation.


Assuntos
Glaucoma/diagnóstico , Glaucoma/epidemiologia , Encaminhamento e Consulta/estatística & dados numéricos , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Glaucoma/terapia , Glaucoma de Ângulo Aberto/epidemiologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Retina/anatomia & histologia , Estudos Retrospectivos , Fatores Socioeconômicos , Campos Visuais/fisiologia , Adulto Jovem , Zimbábue/epidemiologia
3.
Invest Ophthalmol Vis Sci ; 62(10): 15, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34398197

RESUMO

Purpose: To compare the microvasculature of the optic nerve head (ONH) and peripapillary tissues in eyes with normal-tension glaucoma (NTG) and nonarteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography angiography (OCTA). Methods: Thirty-eight eyes with treatment-naïve NTG, 38 eyes with NAION matched for retinal nerve fiber layer (RNFL) thickness in each superior and inferior quadrant, and 38 healthy eyes matched by age were included. ONH and peripapillary retinal microvasculature was evaluated in en face images obtained using OCTA. Vessel density (VD) was calculated as the percent area occupied by vessels in the measured region in each layer segmented into the prelaminar tissue (PLT), lamina cribrosa (LC), and peripapillary retina (PR). Results: VDs in the PLT and LC were lower in NTG eyes than in both NAION and healthy eyes (P ≤ 0.008), and did not differ between the NAION and healthy eyes. VDs in the PR did not differ between the NTG and NAION eyes. In intersectoral comparisons, VDs in the PLT (P = 0.030) and LC (P = 0.028) were lower in the affected than in the unaffected sector of eyes with NTG, but the differences did not occur in eyes with NAION. VD in the PR was lower in the affected than in the unaffected sector in both NTG and NAION eyes (both P < 0.001). Conclusions: Despite similar degrees of RNFL loss and VD decreases in the PR, VDs in the ONH differed between eyes with NTG and NAION, indicating different mechanisms of vascular impairment and ONH damage in each condition.


Assuntos
Pressão Intraocular/fisiologia , Glaucoma de Baixa Tensão/diagnóstico , Microvasos/patologia , Disco Óptico/irrigação sanguínea , Neuropatia Óptica Isquêmica/diagnóstico , Células Ganglionares da Retina/patologia , Campos Visuais/fisiologia , Feminino , Angiofluoresceinografia/métodos , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
4.
Invest Ophthalmol Vis Sci ; 62(10): 12, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34398200

RESUMO

Purpose: To investigate the relationship between pulse wave velocity (PWV) and retinal vessel density (VD) measured by optical coherence tomography angiography (OCTA) in patients with normal-tension glaucoma (NTG). Methods: This retrospective study included 103 patients with NTG and 109 healthy controls who underwent glaucoma examination and PWV measurements. Each group was classified into two subgroups according to a brachial-ankle PWV of 1400 cm/s. NTG was diagnosed when the maximum untreated intraocular pressure was < 21 mmHg on three repeated measurements obtained at different times in the presence of glaucomatous optic discs (neuroretinal rim thinning and excavation), peripapillary retinal nerve fiber layer defects, and glaucomatous visual field defects. Healthy controls did not have glaucomatous optic discs or visual field defects and exhibited normal retinal nerve fiber layer thickness. The interval between glaucoma examination and PWV measurements did not exceed six months. Univariate and multivariate logistic regression analyses were performed to identify factors associated with high PWV. Results: PWV was higher in the NTG group than in the control group, while peripapillary VD and macular VD (mVD) were lower (all P < 0.05). Stepwise logistic regression analysis revealed that high PWV was significantly associated with age, mean arterial pressure (MAP), and mVD in the NTG group. Meanwhile, high PWV was significantly associated with age, MAP, and low-density lipoprotein cholesterol levels in healthy controls. Conclusions: High PWV is associated with decreased mVD in NTG patients, suggesting that systemic arterial stiffness might be involved in the pathogenesis of NTG.


Assuntos
Glaucoma de Baixa Tensão/diagnóstico , Macula Lutea/irrigação sanguínea , Células Ganglionares da Retina/patologia , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Estudos Transversais , Feminino , Angiofluoresceinografia/métodos , Seguimentos , Humanos , Pressão Intraocular , Glaucoma de Baixa Tensão/fisiopatologia , Masculino , Densidade Microvascular , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Disco Óptico/patologia , Análise de Onda de Pulso , Estudos Retrospectivos , Campos Visuais/fisiologia
5.
Invest Ophthalmol Vis Sci ; 62(10): 21, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34410298

RESUMO

Purpose: To characterize the visual pathway integrity of five glaucoma animal models using diffusion tensor imaging (DTI). Methods: Two experimentally induced and three genetically determined models of glaucoma were evaluated. For inducible models, chronic IOP elevation was achieved via intracameral injection of microbeads or laser photocoagulation of the trabecular meshwork in adult rodent eyes. For genetic models, the DBA/2J mouse model of pigmentary glaucoma, the LTBP2 mutant feline model of congenital glaucoma, and the transgenic TBK1 mouse model of normotensive glaucoma were compared with their respective genetically matched healthy controls. DTI parameters, including fractional anisotropy, axial diffusivity, and radial diffusivity, were evaluated along the optic nerve and optic tract. Results: Significantly elevated IOP relative to controls was observed in each animal model except for the transgenic TBK1 mice. Significantly lower fractional anisotropy and higher radial diffusivity were observed along the visual pathways of the microbead- and laser-induced rodent models, the DBA/2J mice, and the LTBP2-mutant cats compared with their respective healthy controls. The DBA/2J mice also exhibited lower axial diffusivity, which was not observed in the other models examined. No apparent DTI change was observed in the transgenic TBK1 mice compared with controls. Conclusions: Chronic IOP elevation was accompanied by decreased fractional anisotropy and increased radial diffusivity along the optic nerve or optic tract, suggestive of disrupted microstructural integrity in both inducible and genetic glaucoma animal models. The effects on axial diffusivity differed between models, indicating that this DTI metric may represent different aspects of pathological changes over time and with severity.


Assuntos
Imagem de Tensor de Difusão/métodos , Glaucoma de Ângulo Aberto/diagnóstico , Substância Cinzenta/patologia , Pressão Intraocular/fisiologia , Nervo Óptico/patologia , Vias Visuais/patologia , Animais , Anisotropia , Gatos , Modelos Animais de Doenças , Glaucoma de Ângulo Aberto/fisiopatologia , Camundongos , Camundongos Endogâmicos DBA , Fibras Nervosas/patologia , Ratos , Ratos Sprague-Dawley
6.
Invest Ophthalmol Vis Sci ; 62(9): 4, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34228087

RESUMO

Purpose: To investigate the relationship between intereye visual field defect (VFD) asymmetry and subsequent VF progression in primary open-angle glaucoma (POAG). Methods: Moderate-stage patients with POAG (226 eyes of 113 patients) with a single hemifield defect were followed for 8.7 years. Participants were categorized into three groups by initial VF pattern: (1) unilateral VFD, (2) bilateral VFD within same hemifield (superior-superior, inferior-inferior), (3) bilateral VFD within opposite hemifield (superior-inferior). The mean deviation (MD) difference between the intereye was defined as the intereye MD asymmetry index (iMAI). Intereye visual-sensitivity difference within the same hemifield was calculated as the intereye hemifield visual-sensitivity asymmetry index. Functional progression was detected by Glaucoma Progression Analysis. The overall rate of MD change and the association between new indices were evaluated by linear regression. A Kaplan-Meier survival analysis was performed and the factors associated with glaucoma progression were evaluated by Cox proportional hazard modeling. Results: Unilateral VFD eyes and bilateral VFD eyes within opposite VF hemifield showed significant progression and faster rate of MD change compared with bilateral VFD eyes within same VF hemifield (71.1% vs. 45.9% vs. 21.1% [P = 0.001]; -1.27 dB/y vs. -0.64 dB/y vs. -0.32 dB/y [P = 0.001]). Unilateral VFD eyes showed the fastest time to VF progression compared with other groups (P = 0.002). A faster rate of MD change was associated with greater intereye MD asymmetry index (P = 0.001) and greater intereye hemifield visual-sensitivity asymmetric index (P = 0.031), which were significant risk factors for glaucoma progression (all P < 0.001). Conclusions: Among POAG eyes with comparable hemifield VFDs, eyes without a corresponding hemifield defect in the fellow eye showed faster rates of progression compared with those with a corresponding hemifield defect.


Assuntos
Glaucoma de Ângulo Aberto/fisiopatologia , Disco Óptico/patologia , Tomografia de Coerência Óptica/métodos , Campos Visuais/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Seguimentos , Glaucoma de Ângulo Aberto/diagnóstico , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Prognóstico , Estudos Retrospectivos , Fatores de Tempo , Testes de Campo Visual
7.
Invest Ophthalmol Vis Sci ; 62(9): 6, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34232260

RESUMO

Purpose: Given the role of corneal sensory nerves during epithelial wound repair, we sought to examine the relationship between immune cells and polymodal nociceptors following corneal injury. Methods: Young C57BL/6J mice received a 2 mm corneal epithelial injury. One week later, corneal wholemounts were immunostained using ß-tubulin-488, TRPV1 (transient receptor potential ion channel subfamily V member-1, a nonselective cation channel) and immune cell (MHC-II, CD45 and CD68) antibodies. The sum length of TRPV1+ and TRPV1- nerve fibers, and their spatial association with immune cells, was quantified in intact and injured corneas. Results: TRPV1+ nerves account for ∼40% of the nerve fiber length in the intact corneal epithelium and ∼80% in the stroma. In the superficial epithelial layers, TRPV1+ nerve terminal length was similar in injured and intact corneas. In intact corneas, the density (sum length) of basal epithelial TRPV1+ and TRPV1- nerve fibers was similar, however, in injured corneas, TRPV1+ nerve density was higher compared to TRPV1- nerves. The degree of physical association between TRPV1+ nerves and intraepithelial CD45+ MHC-II+ CD11c+ cells was similar in intact and injured corneas. Stromal leukocytes co-expressed TRPV1, which was partially localized to CD68+ lysosomes, and this expression pattern was lower in injured corneas. Conclusions: TRPV1+ nerves accounted for a higher proportion of corneal nerves after injury, which may provide insights into the pathophysiology of neuropathic pain following corneal trauma. The close interactions of TRPV1+ nerves with intraepithelial immune cells and expression of TRPV1 by stromal macrophages provide evidence of neuroimmune interactions in the cornea.


Assuntos
Córnea/metabolismo , Lesões da Córnea/metabolismo , Homeostase/fisiologia , Imunidade Celular , Canais de Cátion TRPV/metabolismo , Animais , Contagem de Células , Córnea/imunologia , Córnea/patologia , Lesões da Córnea/imunologia , Modelos Animais de Doenças , Feminino , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Microscopia Confocal , Fibras Nervosas/patologia
8.
Optom Vis Sci ; 98(5): 531-541, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33973913

RESUMO

SIGNIFICANCE: Adaptive-optics scanning-laser-ophthalmoscopy (AOSLO) retinal imaging of the retinal nerve fiber layer (RNFL) helps predict the severity of perimetric damage based on absence of fibers and projection of the defects in en face images of the RNFL from spectral-domain optical coherence tomography (SD-OCT). PURPOSE: En face images of the RNFL reveal reflectance defects in patients with glaucoma and predict locations of perimetric defects. These defects could arise from either loss of retinal nerve fiber bundles or reduced bundle reflectance. This study used AOSLO to assess presence of bundles in areas with RNFL reflectance defects on SD-OCT. METHODS: Adaptive-optics scanning laser ophthalmoscopy was used to image a vertical strip of RNFL measuring approximately 30 × 3° between the optic disc and the fovea. Fifteen patients with glaucoma who had SD-OCT reflectance defects that passed through this region were chosen. Four patients had reflectance defects in both superior and inferior hemifields, so presence of bundles on AOSLO was assessed for 19 hemifields. Where bundles were present, the hemifield was scored for whether bundles seemed unusual (low contrast and/or low density). Perimetric defects were considered deep when sensitivity was below 15 dB. RESULTS: Ten hemifields had a region with no fibers present on AOSLO; all had a corresponding deep perimetric defect. The other nine hemifields had no region in the AOSLO image without fibers: four with normal fibers and five with unusual fibers. The only one of these nine hemifields with a deep perimetric defect was one with low-contrast fibers and overall thin RNFL. CONCLUSIONS: Retinal nerve fiber layer reflectance defects, which were associated with deep perimetric defects, usually had a region with absence of fibers on AOSLO images of RNFL. Ability to predict severity of perimetric damage from en face SD-OCT RNFL reflectance images could benefit from quantification that differentiated between absence of fibers and unusual fibers.


Assuntos
Glaucoma de Ângulo Aberto/diagnóstico por imagem , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Idoso , Interpretação Estatística de Dados , Feminino , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Oftalmoscopia/métodos , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Tomografia de Coerência Óptica/métodos , Testes de Campo Visual/métodos
9.
Optom Vis Sci ; 98(5): 518-530, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33973920

RESUMO

SIGNIFICANCE: Optical coherence tomography (OCT) summary measures have been suggested as a way to detect progression in eyes with advanced glaucoma. Here, we show that these measures have serious flaws largely due to segmentation errors. However, inspection of the images and thickness maps can be clinically useful. PURPOSE: This study aimed to test the hypothesis that recently suggested global OCT measures for detecting progression in eyes with advanced progression are seriously affected by segmentation mistakes and other errors that limit their clinical utility. METHODS: Forty-five eyes of 38 patients with a 24-2 mean deviation worse than -12 dB had at least two spectral domain OCT sessions (0.8 to 4.4 years apart) with 3.5-mm circle scans of the disc and cube scans centered on the fovea. Average (global) circumpapillary retinal nerve fiber layer thickness, GcRNFL, and ganglion cell plus inner plexiform layer thickness, GGCLP, were obtained from the circle and cube scan, respectively. To evaluate progression, ΔGcRNFL was calculated for each eye as the GcRNFL value at time 2 minus the value at time 1, and ΔGGCLP was calculated in a similar manner. The b-scans of the six eyes with the highest and lowest ΔGcRNFL and ΔGGCLP values were examined for progression as well as segmentation, alignment, and centering errors. RESULTS: Progression was a major factor in only 7 of the 12 eyes with the most negative values of either ΔGcRNFL or ΔGGCLP, whereas segmentation played a role in 8 eyes and was the major factor in all 12 eyes with the largest positive values. In addition, alignment (one eye) and other (three eyes) errors played a secondary role in four of the six eyes with the most negative ΔGcRNFL values. CONCLUSIONS: For detecting the progression of advanced glaucoma, common summary metrics have serious flaws largely due to segmentation errors, which limit their utility in clinical and research settings.


Assuntos
Glaucoma de Ângulo Aberto/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Benchmarking , Progressão da Doença , Feminino , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Células Ganglionares da Retina/patologia , Adulto Jovem
10.
Clin Exp Optom ; 104(6): 717-722, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34016010

RESUMO

CLINICAL RELEVANCE: The SARS-COV 2 virus, which is responsible for the COVID-19 pandemic, acts on the angiotensin converting enzyme 2 (ACE-2) receptor in the host cell. Ocular effects may occur because of the ACE-2 receptor in the retina. BACKGROUND: To investigate the impact of COVID-19 on the retinal layers and optic disc parameters in previously confirmed COVID-19 patients using spectral domain optical coherence tomography (SD-OCT). METHODS: This study included 60 eyes of 60 subjects; 35 of them were in the COVID-19 group and the remaining 25 were in the control group. Patients with the diagnosis of COVID-19 that had a negative result after treatment were included in the study. Macular and peripapillary retinal nerve fiber layer (RNFL) thickness measurements, each retinal layer thickness of all participants were done 14-30 days after COVID-19 symptom onset, following the negative result of real time reverse transcriptase-polymerase chain reaction test using SD-OCT. RESULTS: The mean value of central macular thickness was significantly higher in the COVID-19 group than the control group (p = 0.02). The mean values of the ganglion cell layer and inner nuclear layer thickness in the COVID-19 group were significantly thinner than control group (p = 0.04 and p = 0.04, respectively). Even though mean RNFL thickness measurements in all sections in the COVID-19 group was thinner than controls, there were no significant differences between groups (p > 0.05 for all). CONCLUSION: In the early recovery phase, changes in the macula, ganglion cell layer and inner nuclear layer could be seen. These patients should be followed up closely for the recognition of new pathologies that could be seen in the late recovery phase.


Assuntos
COVID-19/epidemiologia , Glaucoma/diagnóstico , Pandemias , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Adulto , Idoso , Comorbidade , Estudos Transversais , Feminino , Seguimentos , Glaucoma/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Estudos Prospectivos , SARS-CoV-2 , Adulto Jovem
11.
Invest Ophthalmol Vis Sci ; 62(6): 5, 2021 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-33944892

RESUMO

Purpose: Increased corneal and epidermal Langerhans cells (LCs) have been reported in patients with diabetic neuropathy. The aim of this study was to quantify the density of LCs in relation to corneal nerve morphology and the presence of diabetic neuropathy and to determine if this differed in patients with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and latent autoimmune diabetes of adults (LADA). Methods: Patients with T1DM (n = 25), T2DM (n = 36), or LADA (n = 23) and control subjects (n = 23) underwent detailed assessment of peripheral neuropathy and corneal confocal microscopy. Corneal nerve fiber density (CNFD), branch density (CNBD), length (CNFL) and total, immature and mature LC densities were quantified. Results: Lower CNFD (P < 0.001), CNBD (P < 0.0001), and CNFL (P < 0.0001) and higher LC density (P = 0.03) were detected in patients with T1DM, T2DM, and LADA compared to controls. CNBD was inversely correlated with mature (r = -0.5; P = 0.008), immature (r = -0.4; P = 0.02) and total (r = -0.5; P = 0.01) LC density, and CNFL was inversely correlated with immature LC density (r = -0.4; P = 0.03) in patients with T1DM but not in patients with T2DM and LADA. Conclusions: This study shows significant corneal nerve loss and an increase in LC density in patients with T1DM, T2DM, and LADA. Furthermore, increased LC density correlated with corneal nerve loss in patients with T1DM.


Assuntos
Córnea/inervação , Diabetes Mellitus Tipo 1/patologia , Diabetes Mellitus Tipo 2/patologia , Células de Langerhans/patologia , Diabetes Autoimune Latente em Adultos/patologia , Fibras Nervosas/patologia , Nervo Oftálmico/patologia , Adulto , Idoso , Contagem de Células , Feminino , Humanos , Masculino , Microscopia Confocal , Pessoa de Meia-Idade
12.
PLoS One ; 16(4): e0249556, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33852613

RESUMO

Autonomic nerve fibers in the liver are distributed along the portal tract, being involved in the regulation of blood flow, bile secretion and hepatic metabolism, thus contributing to systemic homeostasis. The present study investigated changes in hepatic nerve fibers in liver biopsy specimens from patients with normal liver, viral hepatitis and non-alcoholic steatohepatitis, in relation to clinical background. The areal ratio of nerve fibers to the total portal area was automatically calculated for each sample. The nerve fiber areal ratios (NFAR) for total nerve fibers and sympathetic nerve fibers were significantly lower in liver affected by chronic hepatitis, particularly viral hepatitis, and this was also the case for advanced liver fibrosis. However, the degree of inflammatory activity did not affect NFAR for either whole nerves or sympathetic nerves. Comparison of samples obtained before and after antiviral treatment for HCV demonstrated recovery of NFAR along with improvement of liver fibrosis.


Assuntos
Antivirais/uso terapêutico , Hepatite C/patologia , Hepatite Crônica/patologia , Fibras Nervosas/patologia , Hepatopatia Gordurosa não Alcoólica/patologia , Adulto , Idoso , Antivirais/farmacologia , Biópsia , Feminino , Hepatite C/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/efeitos dos fármacos
13.
Invest Ophthalmol Vis Sci ; 62(4): 12, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33844828

RESUMO

Purpose: The purpose of this study was to determine if the rate of change in the depth of the surface of the lamina cribrosa due to glaucomatous remodeling differs between glaucoma patients of African descent (AD) and European descent (ED). Methods: There were 1122 images taken longitudinally over an average of 3 years (range = 0.9-4.1 years) from 122 patients with glaucoma followed in the African Descent and Glaucoma Evaluation Study (ADAGES) and Diagnostic Intervention and Glaucoma Study (DIGS) were automatically segmented to compute anterior lamina cribrosa surface depth (ALCSD). The rate of ALCSD change was compared across racial groups after adjusting for baseline characteristics known to be associated with ALCSD or disease progression (visual field, ALCSD, corneal thickness, optic disk size, and age). Results: After adjusting for all other covariates, the ED group had significantly greater ALCSD posterior migration (deepening) than the AD group (difference = 2.57 µm/year, P = 0.035). There was a wider range of ALCSD change in the ED compared with the AD group, and more individuals had greater magnitude of both deepening and shallowing. No other covariates measured at baseline had independent effects on the longitudinal changes in ALCSD (baseline visual field severity, baseline ALCSD, corneal thickness, Bruch's membrane opening [BMO] area, or age). Conclusions: Glaucomatous remodeling of the lamina cribrosa differs between AD and ED patients with glaucoma. Unlike the cross-sectional associations seen with aging, in which a deeper ALCSD was seen with age in the ED group, glaucomatous remodeling in this longitudinal study resulted in more posterior migration of ALCSD in ED compared to AD patients.


Assuntos
Afro-Americanos , Lâmina Basilar da Corioide/patologia , Glaucoma/etnologia , Pressão Intraocular/fisiologia , Disco Óptico/patologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Idoso , Estudos Transversais , Europa (Continente)/etnologia , Feminino , Glaucoma/diagnóstico , Glaucoma/fisiopatologia , Humanos , Incidência , Masculino , Fibras Nervosas/patologia , Fatores Raciais , Estados Unidos/epidemiologia , Campos Visuais
14.
Invest Ophthalmol Vis Sci ; 62(4): 24, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33871570

RESUMO

Purpose: To study birefringence of the peripapillary retinal nerve fiber layer (RNFL) of diabetic eyes with no clinical signs of diabetic retinopathy (DR) or mild to moderate DR stages using spectral-domain polarization-sensitive (PS) optical coherence tomography (OCT). Methods: In this observational pilot study, circular PS-OCT scans centered on the optic nerve head were recorded in prospectively recruited diabetic and age-matched healthy eyes. From averaged circumpapillary intensity and retardation tomograms plots of RNFL birefringence were obtained by a linear fit of retardation versus depth within the RNFL tissue for each A-scan position and mean birefringence values for RNFL calculated. Spectral-domain OCT imaging (Heidelberg Engineering) was performed to assess peripapillary RNFL thickness and macular ganglion cell complex (GCC). Results: Out of 70 eyes of 43 diabetic patients (mean ± SD age: 50.86 ± 15.71) 36 showed no signs of DR, 17 mild and 17 moderate nonproliferative DR with no diabetic macular edema. Thirty-four eyes of 34 healthy subjects (53.21 ± 13.88 years) served as controls. Compared with healthy controls (0.143° ± 0.014°/µm) mean total birefringence of peripapillary RNFL was significantly reduced in subclinical diabetic eyes (0.131° ± 0.014°/µm; P = 0.0033), as well as in mild to moderate DR stages (0.125° ± 0.018°/µm, P < 0.0001) with borderline statistically significant differences between diabetic patients (P = 0.0049). Mean birefringence values were significantly lower in inferior compared with superior RNFL sectors (P < 0.0001) of diabetic eyes with no such difference detected in the healthy control group. Conclusions: We identified evidence of early neuroretinal alteration in diabetic eyes through reduced peripapillary RNFL birefringence assessed by PS-OCT occurring before appearance of clinical microvascular lesions or GCC alterations.


Assuntos
Retinopatia Diabética/diagnóstico , Fibras Nervosas/patologia , Disco Óptico/patologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Birrefringência , Retinopatia Diabética/fisiopatologia , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Fatores de Tempo
15.
Invest Ophthalmol Vis Sci ; 62(2): 9, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33733716

RESUMO

Purpose: The purpose of this study to identify the effects of prolonged type 2 diabetes (T2DM) on the peripapillary retinal nerve fiber layer (pRNFL) and peripapillary microvasculature in patients with prolonged T2DM without clinical diabetic retinopathy (DR). Methods: Subjects were divided into 3 groups: controls (control group; 153 eyes), patients with T2DM < 10 years (DM group 1; 136 eyes), and patients with T2DM ≥ 10 years (DM group 2; 74 eyes). The pRNFL thickness and peripapillary superficial vessel density (VD) were compared. Linear regression analyses were performed to identify factors associated with peripapillary VD in patients with T2DM. Results: The mean pRNFL thicknesses of the control group, DM group 1, and DM group 2 were 96.0 ± 7.9, 94.5 ± 0.9, and 92.2 ± 8.2 µm, respectively (P < 0.001). The VDs were 18.24 ± 0.62, 17.60 ± 1.47, and 17.15 ± 1.38 mm-1 in the control group, DM group 1, and DM group 2, respectively (P < 0.001). In multivariate linear regression analyses, visual acuity (B = -2.460, P = 0.001), axial length (B = -0.169, P = 0.008), T2DM duration (B = -0.056, P < 0.001), and pRNFL (B = 0.024, P = 0.001) were significant factors affecting the peripapillary VD in patients with T2DM. Conclusions: Patients with T2DM without clinical DR showed thinner pRNFL and lower peripapillary VD and perfusion density (PD) compared with normal controls, and such damage was more severe in patients with T2DM ≥ 10 years. Additionally, peripapillary VD was significantly associated with best-corrected visual acuity (BCVA), axial length, T2DM duration, and pRNFL thickness in patients with T2DM.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/diagnóstico , Microvasos/patologia , Disco Óptico/irrigação sanguínea , Células Ganglionares da Retina/patologia , Vasos Retinianos/patologia , Acuidade Visual , Estudos Transversais , Retinopatia Diabética/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Estudos Retrospectivos , Tomografia de Coerência Óptica
16.
Optom Vis Sci ; 98(3): 295-305, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33771958

RESUMO

SIGNIFICANCE: The macular ganglion cell-inner plexiform layer (mGCIPL) may serve as a quick and easily obtained measure of generalized neurodegeneration. Investigating factors associated with this thickness could help to understand neurodegenerative processes. PURPOSE: This study aimed to characterize and identify associated factors of the mGCIPL thickness in a Beaver Dam Offspring Study cohort of middle-aged U.S. adults. METHODS: Baseline examinations occurred from 2005 to 2008, with follow-up examinations every 5 years. Included participants had baseline data and measured mGCIPL at 10-year follow-up (N = 1848). The mGCIPL was measured using the Cirrus 5000 HD-OCT Macular Cube Scan. Associations between mean mGCIPL thickness and thin mGCIPL, defined as 1 standard deviation (SD) below the population mean, and baseline risk factors were investigated using generalized estimating equations. RESULTS: Participants (mean [SD] baseline age, 48.9 [9.3] years; 54.4% women) had mean (SD) mGCIPL thicknesses of 78.4 (8.1) µm in the right eye and 78.1 (8.5) µm in the left (correlation coefficient = 0.76). In multivariable models, age (-1.07 µm per 5 years; 95% confidence interval [CI], -1.28 to -0.86 µm), high alcohol consumption (-1.44 µm; 95% CI, -2.72 to -0.16 µm), higher interleukin 6 levels (50% increase in level: -0.23 µm; 95% CI, -0.45 to 0.00 µm), myopia (-2.55 µm; 95% CI, -3.17 to -1.94 µm), and glaucoma (-1.74 µm; 95% CI, -2.77 to -0.70 µm) were associated with thinner mGCIPL. Age (per 5 years: odds ratio [OR], 1.38; 95% CI, 1.24 to 1.53), diabetes (OR, 1.89, 95% CI, 1.09 to 3.27), myopia (OR, 2.11; 95% CI, 1.63 to 2.73), and increasing and long-term high C-reactive protein (ORs, 1.46 [95% CI, 1.01 to 2.11] and 1.74 [95% CI, 1.14 to 2.65], respectively) were associated with increased odds of thin mGCIPL. CONCLUSIONS: Factors associated cross-sectionally with mGCIPL thickness, older age, high alcohol consumption, inflammation, diabetes, myopia, and glaucoma may be important to neural retina structure and health and neuronal health system-wide.


Assuntos
Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Fatores de Risco , Tomografia de Coerência Óptica , Adulto Jovem
17.
Invest Ophthalmol Vis Sci ; 62(3): 35, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33760040

RESUMO

Purpose: To provide structural and functional evidence of inner retinal loss in diabetes prior to vascular changes and interpret the structure-function relationship in the context of an established neural model. Methods: Data from one eye of 505 participants (134 with diabetes and no clinically evident vascular alterations of the retina) were included in this analysis. The data were collected as part of a large population-based study. Functional tests included best-corrected visual acuity, Pelli-Robson contrast sensitivity, mesopic microperimetry, and frequency doubling technology perimetry (FDT). Macular optical coherence tomography volume scans were collected for all participants. To interpret the structure-function relationship in the context of a neural model, ganglion cell layer (GCL) thickness was converted to local ganglion cell (GC) counts. Results: The GCL and inner plexiform layer were significantly thinner in participants with diabetes (P < 0.05), with no significant differences in the macular retinal nerve fiber layer or the outer retina. All functional tests except microperimetry showed a significant loss in diabetic patients (P < 0.05). Both FDT and microperimetry showed a significant relationship with the GC count (P < 0.05), consistent with predictions from a neural model for partial summation conditions. However, the FDT captured additional significant damage (P = 0.03) unexplained by the structural loss. Conclusions: Functional and structural measurements support early neuronal loss in diabetes. The structure-function relationship follows the predictions from an established neural model. Functional tests could be improved to operate in total summation conditions in the macula, becoming more sensitive to early loss.


Assuntos
Retinopatia Diabética/fisiopatologia , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia , Idoso , Sensibilidades de Contraste/fisiologia , Retinopatia Diabética/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia de Coerência Óptica , Acuidade Visual/fisiologia , Testes de Campo Visual , Campos Visuais/fisiologia
18.
Sci Rep ; 11(1): 6344, 2021 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-33737516

RESUMO

The current study evaluated retinal function using electroretinography (ERG) in cognitively healthy (CH) participants with preclinical Alzheimer's disease (AD), as classified by cerebral spinal fluid (CSF) Aß42/Tau ratio. Individuals with normal retinal morphology ascertained by spectral-domain optical coherence tomography were enrolled. Full-field ERG, pattern PERG, and photopic negative response (PhNR) were performed in 29 adult participants (58 eyes). Amplitude and implicit times of the ERG wave components were analyzed. Preclinical AD participants showed marked retinal ganglion cell dysfunction relative to controls. The PhNR was significantly diminished in preclinical AD relative to controls. PhNR amplitude and N95 implicit time differentiated CH individuals with CSF biomarkers of AD pathology with 87% sensitivity and 82% specificity. These quantitative electrophysiologic findings expand our understanding of early retinal functional changes that precede cognitive decline in AD. Retinal ganglion cell dysfunction, as detected by ERG, may be a clinically useful, non-invasive in vivo biomarker for early disease detection, which is necessary for ultimately pursuing early intervention.


Assuntos
Doença de Alzheimer/diagnóstico por imagem , Peptídeos beta-Amiloides/líquido cefalorraquidiano , Fragmentos de Peptídeos/líquido cefalorraquidiano , Retina/diagnóstico por imagem , Doenças Retinianas/diagnóstico por imagem , Proteínas tau/líquido cefalorraquidiano , Idoso , Doença de Alzheimer/líquido cefalorraquidiano , Doença de Alzheimer/complicações , Doença de Alzheimer/patologia , Biomarcadores/líquido cefalorraquidiano , Fenômenos Eletrofisiológicos , Eletrorretinografia , Humanos , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Testes Neuropsicológicos , Estimulação Luminosa , Retina/metabolismo , Retina/patologia , Doenças Retinianas/líquido cefalorraquidiano , Doenças Retinianas/complicações , Doenças Retinianas/patologia , Células Ganglionares da Retina/patologia , Tomografia de Coerência Óptica , Campos Visuais
19.
Int J Mol Sci ; 22(5)2021 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-33669048

RESUMO

Diabetic neuropathy is one of the most common complications of diabetes. This complication is peripheral neuropathy with predominant sensory impairment, and its symptoms begin with hyperesthesia and pain and gradually become hypoesthesia with the loss of nerve fibers. In some cases, lower limb amputation occurs when hypoalgesia makes it impossible to be aware of trauma or mechanical stimuli. On the other hand, up to 50% of these complications are asymptomatic and tend to delay early detection. Therefore, sensitive and reliable biomarkers for diabetic neuropathy are needed for an early diagnosis of this condition. This review focuses on systemic biomarkers that may be useful at this time. It also describes research on the relationship between target gene polymorphisms and pathological conditions. Finally, we also introduce current information on regenerative therapy, which is expected to be a therapeutic approach when the pathological condition has progressed and nerve degeneration has been completed.


Assuntos
Citocinas/uso terapêutico , Neuropatias Diabéticas/terapia , Neurônios/efeitos dos fármacos , Medicina Regenerativa/métodos , Animais , Biomarcadores/sangue , Citocinas/farmacologia , Neuropatias Diabéticas/tratamento farmacológico , Neuropatias Diabéticas/genética , Neuropatias Diabéticas/fisiopatologia , Exossomos/metabolismo , Glioxal/sangue , Humanos , Inflamação/imunologia , Inflamação/metabolismo , Lactoilglutationa Liase/sangue , MicroRNAs/genética , MicroRNAs/metabolismo , Fibras Nervosas/efeitos dos fármacos , Fibras Nervosas/patologia , Neurônios/metabolismo , Polimorfismo Genético , Aldeído Pirúvico/sangue , Receptores Toll-Like/sangue , Receptores Toll-Like/genética , Receptores Toll-Like/metabolismo
20.
PLoS One ; 16(2): e0247401, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33630899

RESUMO

Glaucoma is a chronic neurodegenerative disease of the optic nerve and a leading cause of irreversible blindness, worldwide. While the experimental research using animal models provides growing information about cellular and molecular processes, parallel analysis of the clinical presentation of glaucoma accelerates the translational progress towards improved understanding, treatment, and clinical testing of glaucoma. Optic nerve axon injury triggers early alterations of retinal ganglion cell (RGC) synapses with function deficits prior to manifest RGC loss in animal models of glaucoma. For testing the clinical relevance of experimental observations, this study analyzed the functional correlation of localized alterations in the inner plexiform layer (IPL), where RGCs establish synaptic connections with retinal bipolar and amacrine cells. Participants of the study included a retrospective cohort of 36 eyes with glaucoma and a control group of 18 non-glaucomatous subjects followed for two-years. The IPL was analyzed on consecutively collected macular SD-OCT scans, and functional correlations with corresponding 10-2 visual field scores were tested using generalized estimating equations (GEE) models. The GEE-estimated rate of decrease in IPL thickness (R = 0.36, P<0.001) and IPL density (R = 0.36, P<0.001), as opposed to unchanged or increased IPL thickness or density, was significantly associated with visual field worsening at corresponding analysis locations. Based on multivariate logistic regression analysis, this association was independent from the patients' age, the baseline visual field scores, or the baseline thickness or alterations of retinal nerve fiber or RGC layers (P>0.05). These findings support early localized IPL alterations in correlation with progressing visual field defects in glaucomatous eyes. Considering the experimental data, glaucoma-related increase in IPL thickness/density might reflect dendritic remodeling, mitochondrial redistribution, and glial responses for synapse maintenance, but decreased IPL thickness/density might correspond to dendrite atrophy. The bridging of experimental data with clinical findings encourages further research along the translational path.


Assuntos
Glaucoma de Ângulo Aberto/patologia , Macula Lutea/patologia , Campos Visuais/fisiologia , Idoso , Idoso de 80 Anos ou mais , Células Amácrinas/patologia , Cegueira/patologia , Feminino , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Nervo Óptico/patologia , Células Ganglionares da Retina/patologia , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos , Testes de Campo Visual/métodos
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