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1.
Nihon Yakurigaku Zasshi ; 155(2): 81-86, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32115483

RESUMO

Because visual information accounts for 80-90% of sensory information that we get from our circumstance, loss of vision seriously diminishes our quality of life. According to a recent epidemiological study, glaucoma is the first, and retinitis pigmentosa (RP) is the second leading causes of acquired blindness in Japan. Degeneration of the retinal ganglion cells (RGC) and photoreceptor cells causes glaucoma and RP, respectively. Intraocular pressure-lowering therapy is an only effective treatment for glaucoma, and the agents that protect RGC directly against glaucomatous injury have not been available yet. In addition, there is no effective treatment for RP at present. microRNAs are a class of small, endogenous, non-coding RNAs comprised of approximately 20 nucleotides. It has been clarified that microRNAs reduces the stability of the target mRNAs and/or repress the translation of the target genes. A single microRNA can affect the transcription of multiple mRNAs, and almost 30% of human genes are thought to be regulated by microRNAs. Therefore, it has been considered that the expression changes of microRNAs are possible to cause various diseases, such as cancer and neurodegenerative diseases. Recently, the expression changes in microRNAs have been reported in the retina of experimental model animals for glaucoma and RP. The expressional changes of microRNAs are suggested to be related with development and progression of glaucoma and RP. Here, we will discuss about the relationship between the expressional changes of microRNAs and neuronal cell death in glaucoma and RP.


Assuntos
MicroRNAs/genética , Retina/patologia , Degeneração Retiniana/genética , Animais , Modelos Animais de Doenças , Glaucoma/genética , Glaucoma/patologia , Humanos , Degeneração Retiniana/patologia , Retinite Pigmentosa/genética , Retinite Pigmentosa/patologia
2.
Nihon Yakurigaku Zasshi ; 155(2): 87-92, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32115484

RESUMO

Glaucoma, progressive optic neuropathy, is the first cause of blindness in Japan. Blindness in this disease is induced by damages or degeneration of retinal ganglion cells (RGCs), retinal neurons transmit visual information to brain. An elevated intraocular pressure (IOP) is widely recognized as one of the most important risk factors and that IOP directly damages RGCs by mechanical stress, however, accumulating evidences have shown that a majority of Japanese patients for primary open angle glaucoma shows normal level of IOP. Thus, new target for glaucoma pathology is emerged. In this issue, we introduce potential roles of glial cells for pathogenesis of glaucoma. In the CNS, reactive gliosis has been recognized in a variety of neurodegenerative diseases. Such glial activation is also found in retinae of human glaucoma patients and animal models. Importantly, glial activation precedes RGS degeneration, indicating the possibility that reactive glial cells actively contribute to pathogenesis of glaucoma. In this issue, we will focus on macroglial cells such as Muller cells and astrocytes, and discuss their roles in glaucoma.


Assuntos
Glaucoma/patologia , Neuroglia/patologia , Retina/patologia , Células Ganglionares da Retina/patologia , Animais , Astrócitos/patologia , Modelos Animais de Doenças , Células Ependimogliais/patologia , Humanos , Pressão Intraocular , Retina/citologia
3.
J Med Syst ; 44(5): 96, 2020 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-32193703

RESUMO

Optic disc (OD) and optic cup (OC) segmentation are important steps for automatic screening and diagnosing of optic nerve head abnormalities such as glaucoma. Many recent works formulated the OD and OC segmentation as a pixel classification task. However, it is hard for these methods to explicitly model the spatial relations between the labels in the output mask. Furthermore, the proportion of the background, OD and OC are unbalanced which also may result in a biased model as well as introduce more noise. To address these problems, we developed an approach that follows a coarse-to-fine segmentation process. We start with a U-Net to obtain a rough segmenting boundary and then crop the area around the boundary to form a boundary contour centered image. Second, inspired by sequence labeling tasks in natural language processing, we regard the OD and OC segmentation as a sequence labeling task and propose a novel fully convolutional network called SU-Net and combine it with the Viterbi algorithm to jointly decode the segmentation boundary. We also introduced a geometric parameter-based data augmentation method to generate more training samples in order to minimize the differences between training and test sets and reduce overfitting. Experimental results show that our method achieved state-of-the-art results on 2 datasets for both OD and OC segmentation and our method outperforms most of the ophthalmologists in terms of achieving agreement out of 6 ophthalmologists on the MESSIDOR dataset for both OD and OC segmentation. In terms of glaucoma screening, we achieved the best cup-to-disc ratio (CDR) error and area under the ROC curve (AUC) for glaucoma classification on the Drishti-GS dataset.


Assuntos
Glaucoma , Processamento de Imagem Assistida por Computador , Disco Óptico/diagnóstico por imagem , Fundo de Olho , Glaucoma/diagnóstico , Humanos , Processamento de Imagem Assistida por Computador/métodos , Processamento de Linguagem Natural
4.
Orv Hetil ; 161(10): 363-373, 2020 Mar.
Artigo em Húngaro | MEDLINE | ID: mdl-32115992

RESUMO

Retrometabolic drug design combines the structure-activity and structure-metabolism relationships, allowing the effective separation of drug action and side effects. This combination results in significant improvement of the therapeutic index. The main aim is not only to study the metabolism but to build into the drug molecule the desired metabolic route, in addition to the therapeutic activity. There are two basically different approaches to achieve this aim. Both use designed-in metabolism. The 1. chemical drug-targeting systems (CDS) and 2. soft drug, both control the drug targeting and action by strategically designed metabolism. In the case of the soft drugs, we want to rely on hydrolytic enzymes, avoiding the oxidative processes. In the present work, we focus on the clinical successes of the soft drugs designed in our laboratories. In order to show the difference, we briefly present a brain-targeted delivery system, where the originally inactive molecular construct undergoes sequential metabolism to allow specific concentration of the active drug in the brain. Among the soft drugs first we present the highly successful soft corticosteroids. Loteprednol etabonate has been used worldwide for over twenty years, and its use is constantly growing. In addition to the dramatically improved therapeutic index, the specific, serious ophthalmic side effects (elevation of intraocular pressure; glaucoma and cataract formation) were completely eliminated. Similarly designed second generation of soft corticosteroids are also presented, where the soft pharmacophore is structurally unexpected. The most recent soft drug design involves anticholinergics. Sofpironium bromide, a highly effective molecule but without the typical anticholinergic side effects, was first developed to treat hyperhidrosis, an unmet need. Phase III clinical studies were successfully completed and its marketing approval is pending. Since the soft drug design principles, methods and rules are general and specific in nature, a computerized expert system was also developed. Orv Hetil. 2020; 161(10): 363-373.


Assuntos
Sistemas de Liberação de Medicamentos , Desenho de Drogas , Soluções Oftálmicas/farmacologia , Preparações Farmacêuticas/classificação , Corticosteroides , Olho , Glaucoma , Humanos , Soluções Oftálmicas/química
5.
Artigo em Russo | MEDLINE | ID: mdl-32119205

RESUMO

The purpose of the study is to assess medical efficiency of family doctors involved in early detection of glaucoma. MATERIALS AND METHODS: The prospective observation was carried on in polyclinic No.3 (the basis institution of the University Department of family medicine) to provide experimental evidence of role of family physician in medical care of ophthalmic patients. The sampling included 1000 patients visited polyclinic for the first time. In total the cohort was formed from 250 patients of therapist (family physician), 250 patients of neurologist, 250 patients of dentist and 250 patients of other physicians. All patients initially passed Maklakov's eye tonometry prior to visiting medical specialists. After tonometry, all patients have been observed by ophthalmologist and in the process of treatment also by therapist, neurologist, dentist and other medical specialists. THE RESULTS: The percentage of patients with intraocular pressure <12, 12-16, 17-21, 22-26, 27-31, l32 mm/Hg in the right and the left eye correspondingly made up to 41.6±1.6 and 42.1±1.6%; 30.0±1.5 and 31.4±1.5; 18.4±1.2 and 16.2±1.2%; 5.6±0.7 and 5.2±0.7%; 2.4±0.5 and 2.9±0.5%; 2.4±0.5 and 2.2±0.5%. It is clear that, at of Among patients, visited polyclinics for the first time, in 10,5±0,97% an increase in intraocular pressure of more than 21 mm / Hg in the right and 10.3 ± 0.96% in the left eye was established. The percentage of patients with visual acuity l6/18; 6/18-6/60; 6/60-3/6 and & <3/60 in the right and left eye made up to 72.3±1.4 and 76.7±1.3%; 22.4±1.3 and 18.4±1.2%; 4.4±0.7 and 3.8±0.6% 0.9±0.3 and 1.1±0.3%. The third category of visual impairment (visual acuity <3/60) was established шт small group of patients. The second category of visual impairment (visual acuity 3/60-6/60) was established in relatively larger group of patients. Out of 100 observed patients, visited polyclinic for the first time in 2016, number of undiagnosed diseases and firstly diagnosed due to active participation of family physician included 4.6±0.7 cases of myopia, 3.8±0.6 cases of hyperopia, 2.2±0.5 astigmatism cases, 1.4±0.4 cataract cases, 2.3±0.5 cases of glaucoma, 0.1±0.1 cases of diabetic retinopathy, 4.4±0.7 cases of other eye diseases. CONCLUSIONS: The family physician using professional knowledge and skills, can implement diagnostic and therapeutic measures during observation of patients with opthalmologic pathology. The family physician, while observing patients aged 40 years and older, can for the first time diagnose 18.8±1.2 % of eye diseases, including 4.6±0.7 cases of myopia, 3.8±0.6 cases of hyperopia, 2.2±0.5 astigmatism cases, 1.4±0.4 cataract cases, 2.3±0.5 cases of glaucoma, 0.1±0.1 cases of diabetic retinopathy, 4.4±0.7 cases of other eye diseases.


Assuntos
Catarata , Glaucoma , Médicos de Família , Adulto , Catarata/diagnóstico , Glaucoma/diagnóstico , Humanos , Pressão Intraocular , Pessoa de Meia-Idade , Papel do Médico , Estudos Prospectivos
6.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 37(3): 329-333, 2020 Mar 10.
Artigo em Chinês | MEDLINE | ID: mdl-32128753

RESUMO

Glaucoma is a group of progressive optic neuropathies featuring retinal ganglion cell and axonal degeneration, which typically manifest as sunken atrophy of optic papilla and characteristic visual field defect. Genetic factors play an important role in the pathogenesis of glaucoma. This guideline mainly focuses on single gene mutation-related glaucoma by summarizing the pathogenic genes, disease diagnosis and clinical consultation of primary congenital glaucoma (PCG) and primary open-angle glaucoma (POAG), with an aim to regulate their molecular diagnosis, genetic counseling and treatment.


Assuntos
Glaucoma/diagnóstico , Glaucoma/genética , Glaucoma/terapia , Guias de Prática Clínica como Assunto , Atrofia , Glaucoma de Ângulo Aberto , Humanos , Mutação , Disco Óptico , Doenças do Nervo Óptico
8.
Klin Monbl Augenheilkd ; 237(2): 158-162, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-32040977

RESUMO

Glaucoma therapy usually includes lowering IOP, but a healthy lifestyle may also be recommended. We discuss how this can be defined and the underlying secondary neuroprotective mechanisms. One neuroprotective measure is to avoid common neurotoxic pollution like cigarette smoking, ethanol, methanol or lead. Nutrition should be rich in variety and prevent vitamin B12 and folate deficiency. Supernutrition may lead to the metabolic syndrome and increase IOP, arterial hypertension and serum steroid levels. The metabolic syndrome can also lead to decreased renal function, which can cause accumulation of neurotoxic substances in the blood. Enhanced physical activities is useful, as this burns calories and reduces caloric intake. In contrast to supernutrition, during starvation ketone bodies like acetone, acetoacetate and ß-hydroxybutyrate are synthesised. These are thought to have neuroprotective effects, due to the additional power supply to the mitochondria. Ketosis can also occur after increased intake of fatty acids - which is generally not recommended, due to the cardiovascular risks involved. In addition to burning calories, endurance sports can reduce fear and depression, and neurotrophins with neuroprotective effects are released. Genetically determined or acquired mitochondrial dysfunction can both play a role in glaucomatous optic nerve impairment. Therefore, knowledge of secondary neuroprotective mechanisms can help in giving patient professional advice to minimise risks and to restore homeostasis in optic nerve metabolism.


Assuntos
Glaucoma , Estilo de Vida , Neuroproteção , Fármacos Neuroprotetores , Exposição Ambiental/prevenção & controle , Glaucoma/prevenção & controle , Humanos , Nervo Óptico
9.
Medicine (Baltimore) ; 99(6): e18836, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028394

RESUMO

RATIONALE: Malignant glaucoma is a refractory glaucoma which often relentlessly worsened despite conventional therapy. Ultrasonographic biomicroscopy always cannot show the ciliary-block of malignant glaucoma. We report a case of capsular tension ring induced ciliary-block and successfully treated by low dose laser cyclophotocoagulation, with 1-year follow-up. PATIENT CONCERNS: A 75-year-old woman was referred for glaucoma with a history of cataract and lens zonular laxity, and surgery with combined phacoemulsification and capsular tension ring implantation. She subsequently underwent trabeculectomy for uncontrolled intraocular pressure on maximal medical therapy. One day later, the patient presented as shallow anterior chamber of Shaffer grade 1 and an elevated intraocular pressure of 51.0 mmHg in the right eye. DIAGNOSIS: Ciliary block caused by capsular tension ring and malignant glaucoma was observed. INTERVENTIONS: Low dose laser cyclophotocoagulation was performed under retrobulbar anesthesia. OUTCOMES: One day later, the patient's intraocular pressure decreased to 14.3 mmHg on topical atropine 1% and 2 classes of intraocular pressure lowering medications. The patient discontinued topical atropine and intraocular pressure lowering medications 4 months postoperatively and her condition had remained stable for 1 year without any medications. The patient had a satisfactory recovery benefited from the low dose laser cyclophotocoagulation. LESSONS: Low dose laser cyclophotocoagulation in this challenging case of capsular tension ring-induced malignant glaucoma provided an effective and fast recovery of anterior chamber depth over a 1-year period.


Assuntos
Corpo Ciliar/cirurgia , Glaucoma/diagnóstico , Idoso , Diagnóstico Diferencial , Feminino , Glaucoma/cirurgia , Humanos , Pressão Intraocular , Fotocoagulação a Laser , Procedimentos Cirúrgicos Oftalmológicos
10.
Adv Exp Med Biol ; 1213: 121-132, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32030667

RESUMO

Early detection of glaucoma is important to slow down progression of the disease and to prevent total vision loss. Retinal fundus photography is frequently obtained for various eye disease diagnosis and record and is a suitable screening exam for its simplicity and low cost. However, the number of ophthalmologists who are specialized in glaucoma diagnosis is limited. We have been studying automated schemes for detection of nerve fiber layer defects and analysis of optic disc deformation, two major signs of glaucoma, in assisting ophthalmologists' accurate and efficient diagnosis. In this chapter, our recent progress in computerized methods is discussed.


Assuntos
Aprendizado Profundo , Fundo de Olho , Glaucoma/diagnóstico por imagem , Glaucoma/patologia , Humanos , Fibras Nervosas/patologia , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia
11.
Medicine (Baltimore) ; 99(7): e18637, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049779

RESUMO

RATIONALE: To report a case of diode laser transscleral cyclophotocoagulation (DLTSC) for uveitis-glaucoma-hyphema syndrome (UGH). PATIENT CONCERNS: The patient developed UGH on the right eye (OD) after vitrectomy and intraocular lens (IOL) implantation. DIAGNOSES: Best corrected visual acuity (BCVA) was HM/50 cm, intraocular pressure (IOP) was 51.3 mm Hg on the OD. He was found to have 3+ anterior chamber cells. A B-scan ultrasound showed vitreous opacity. Ultrasound biomicroscopy (UBM) showed the chafing between the IOL and the posterior surface of the iris. Thus, he was diagnosed as UGH on the OD. INTERVENTIONS: The patient was worried about the complications for removal of the IOL, a DLTSC approach was performed. OUTCOMES: BCVA was 20/40 on the OD, IOP was 12 mm Hg on the OD. There were no anterior chamber inflammation and no vitreous opacity. UBM showed there was no contact between IOL and the posterior surface of the iris, the fundus of the eye was clearly visible. LESSONS: UGH syndrome is a severe complication of cataract extraction. IOL extraction has been the traditional approach to treatment. DLTSC can be an option when the IOL is slightly tilted.


Assuntos
Glaucoma/cirurgia , Hifema/cirurgia , Fotocoagulação a Laser/métodos , Uveíte/cirurgia , Extração de Catarata/efeitos adversos , Glaucoma/etiologia , Humanos , Hifema/etiologia , Lasers Semicondutores , Implante de Lente Intraocular/efeitos adversos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Uveíte/etiologia , Vitrectomia/efeitos adversos
12.
Medicine (Baltimore) ; 99(7): e19149, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049840

RESUMO

This study aimed to compare various visual function parameters for evaluating the quality of life (QOL) of patients with advanced glaucoma with low vision.In total, 44 eyes of advanced glaucoma patients with low vision were included in this cross-sectional study. A moving pattern edge band program was used to assess edge detection ability and the low vision quality-of-life (LVQOL) questionnaire was used for evaluating QOL scores of subjects. Correlation analyses between QOL scores and visual functional parameters including pattern edge band unit, visual acuity (VA), and Mean deviation (MD) of perimetry were performed. The areas under receiver operating characteristic curves (AUROCs) of diverse visual functional parameters were calculated.VA and pattern edge band unit were related to LVQOL score in all subjects. For patients with a decimal VA lower than 0.1, only the pattern edge band showed a significant correlation with the QOL associated with distant activities (P = .031). However, the MD of perimetry was not related to the QOL score. After sorting subjects into 2 groups according to the LVQOL score, VA and pattern edge band unit were significantly different (P < .01 and P = .029, respectively). The AUROC for edge detection ability using pattern edge band was higher than MD of perimetry.Assessment of edge detection ability using pattern edge band was meaningful for predicting QOL associated with visual performance in patients with far-advanced glaucoma. For these patients, edge detection could be used as an additional parameter for visual function with traditional VA and perimetry.


Assuntos
Glaucoma/complicações , Qualidade de Vida , Testes Visuais , Baixa Visão/psicologia , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Baixa Visão/etiologia
13.
Klin Monbl Augenheilkd ; 237(2): 128-132, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-32040975

RESUMO

The development of neuroprotective and regenerative therapies in the central nervous system (CNS) poses a major challenge in clinical and basic research. In contrast to the peripheral nervous system, which has a comparatively high intrinsic regenerative capacity, this characteristic is poorly developed in the adult CNS. In this review, some basic growth mechanisms of CNS neurons will be highlighted, as well as factors that prevent successful regeneration after injury. Primarily in the context of glaucoma, preclinical and clinical studies are presented which can improve the understanding of neurodegenerative processes in the optical system and thus provide the basis for current and future therapeutic strategies.


Assuntos
Sistema Nervoso Central , Neuroproteção , Glaucoma , Humanos , Regeneração Nervosa , Neurônios
14.
Klin Monbl Augenheilkd ; 237(2): 133-139, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-32040976

RESUMO

Glaucoma is a neurodegenerative disease that leads to irreversible blindness over time. Its defining feature is the loss of retinal ganglion cells (RGCs) in the eye and their axons in the optic nerve. Increased intraocular pressure (IOP) is a major risk factor for the development of glaucoma, but is neither necessary nor sufficient for the disease and its progression; this motivates research and development of new strategies for the detection and treatment of glaucoma that focus on neuroprotection - protection of RGCs from dying. In addition, for diagnosis and treatment by reducing IOP, new approaches have been developed in recent years. This article reviews current theories of pathophysiological mechanisms underlying glaucoma and recent research - with a focus on neuroprotection and current preclinical and clinical studies to improve the diagnosis and treatment of glaucoma.


Assuntos
Glaucoma , Doenças Neurodegenerativas , Humanos , Pressão Intraocular , Neuroproteção , Nervo Óptico , Células Ganglionares da Retina
15.
Klin Monbl Augenheilkd ; 237(2): 163-174, 2020 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-32040978

RESUMO

Primary open angle glaucoma (POAG) is currently considered a neurodegenerative systemic disease. The individualised reduction in intraocular pressure alone does not do justice to the complex events in the chronic course of the disease, so that accompanying drug therapy concepts are useful. Based on four therapeutic strategies, such as the improvement of the mitochondrial respiratory chain with coenzyme Q10, the stabilisation of the mitochondrial and cellular plasma membranes with citicoline, the reduction in oxidative stress in the eye and in the body with curcumin and the improvement of fat metabolism, especially LDL cholesterol, with the application of statins, an insight into possible additive therapeutic approaches will be provided. Since neuroprotective therapies as monotherapies are unlikely to be very promising, they are more likely to consist of a combination of different therapeutic approaches.


Assuntos
Glaucoma , Neuroproteção , Glaucoma/tratamento farmacológico , Humanos , Pressão Intraocular , Mitocôndrias
16.
Ophthalmologe ; 117(3): 190-198, 2020 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-32076840

RESUMO

A congenital cataract is a rare disorder, which is associated with a high risk of amblyopia. Ophthalmologists are faced with many diagnostic and surgical challenges in the management of this disease. Older children can undergo primary treatment with an intraocular lens, whereas children younger than 12 months of age usually initially remain aphakic. The most frequent long-term complication of aphakic eyes following congenital cataract surgery in connection with posterior capsulorrhexis and anterior vitrectomy is aphakic glaucoma, which in individual cases can lead to substantial impairment of vision. Many factors have been reported to increase the risk of postoperative glaucoma, including microphthalmos, fetal nuclear cataract, conspicuous family history and associated ocular malformations, such as persistent fetal vasculature (PFV). Cataract surgery during early infancy is well-established to be the most important factor for the formation of postoperative aphakic glaucoma. In individual treatment planning it has to be considered that although younger age at the time of cataract removal can provide better prerequisites for prophylaxis of amblyopia, it also confers a higher risk of development of aphakic glaucoma. Children undergoing congenital cataract surgery have to be regularly monitored given the lifelong risk for postoperative complications, such as aphakic glaucoma.


Assuntos
Ambliopia , Extração de Catarata , Catarata , Glaucoma , Vítreo Primário Hiperplásico Persistente , Ambliopia/cirurgia , Criança , Seguimentos , Glaucoma/cirurgia , Humanos , Lactente , Complicações Pós-Operatórias , Estudos Retrospectivos
17.
Life Sci ; 243: 117303, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31953158

RESUMO

Glaucoma, a neurodegenerative disorder is characterized by damage of ganglion cells of retina and also its axons. The manner of progression of disease and retinal ganglion cells death in glaucoma still remains unknown and hence many mechanisms are put forward to understand the disease. Clinical developments have suggested that in every single patient decreasing intraocular pressure (IOP) is not the solution to prevent glaucoma which suggests on the fact that there are other risk factors affecting the disease. The demand for substitute unconventional treatments gives rise to the need to understand the biologically based tactics (bio-tactics) for stopping the progression of disease. Pragmatic findings of past years have supported novelty of inventive molecules with hallmark of neuroprotection in gene therapy. On the other hand, transformation of the latest drugs to clinic has not been of much fruitful substantially for the reason that it lacked dependability while measuring in vivo retinal injury. This as a consequence thwarted the high quality healing possibility of neuroprotectants whether administered single-handedly or given complimentary with other IOP reducing agents. Advancement in research is crucial to grasp the underlying mechanisms concerned with glaucoma and apply it in clinical field to develop neuroprotective agents. In this context, the present review is to bring forth an update on up to date progress in the domain of neuroprotection of retinal ganglion cells for treating glaucoma.


Assuntos
Glaucoma/terapia , Neuroproteção , Células Ganglionares da Retina/citologia , Animais , Terapia Genética , Glaucoma/fisiopatologia , Ácido Glutâmico/fisiologia , Humanos , Pressão Intraocular , Fármacos Neuroprotetores/uso terapêutico
18.
AAPS PharmSciTech ; 21(2): 63, 2020 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-31933030

RESUMO

Bimatoprost is widely used for the management of glaucoma. Currently, it is delivered via eye drop solution, which is highly inefficient due to low bioavailability. To control the release of ocular drugs, contact lenses are used by scientists. However, the conventional soaking method showed high burst release due to absence of any efficient controlling membrane. The objective of the paper was to apply molecular imprinting technology to improve the loading of bimatoprost from the soaking solution and to sustain the release of drug from the contact lens. The bimatoprost was loaded by conventional soaking method (BT-SM) and compared with the molecular imprinted contact lenses (BT-MP). The loading of bimatoprost by molecular imprinting technology affect the swelling of the contact lens; however, the batch BT-MP-10 did not showed significant alterations. The uptake study showed improvement in the bimatoprost loading by molecular imprinting technology in comparison to the conventional soaking technology. The in vitro bimatoprost release data showed improvement in the bimatoprost release rate profiles with BT-MP contact lenses (up to 36-60 h) lenses in comparison to BT-SM contact lenses (up to 24-36 h). The in vivo rabbit tear fluid data with BT-MP batch showed improvement in the bimatoprost retention time in comparison to BT-SM contact lens and eye drop solution. The rabbit model failed to respond bimatoprost; thus, the efficacy studies need to be conducted on canines or human primates. The paper revealed the potential of using molecular imprinting technology to improve the uptake of bimatoprost and to achieve sustain release kinetics without altering the swelling, transmittance and folding endurance properties of the contact lens.


Assuntos
Bimatoprost/administração & dosagem , Lentes de Contato , Glaucoma/tratamento farmacológico , Impressão Molecular/métodos , Animais , Bimatoprost/química , Liberação Controlada de Fármacos , Feminino , Masculino , Coelhos , Silicones
19.
Medicine (Baltimore) ; 99(2): e18652, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914050

RESUMO

RATIONALE: Choroidal detachment is a major postoperative complication of trabeculectomy. Postoperative choroidal detachment occurs with low intraocular pressure (IOP), and is naturally resolved by elevation of IOP. We report a case of chronic chorioretinal detachment (CRD) in the eye with uveitic glaucoma after trabeculectomy which persisted with normal IOP resistant for medication and required surgery. PATIENT CONCERNS: A 63-year-old man was referred to our department with uncontrolled uveitic glaucoma in his right eye. At first presentation, IOP was 62 mm Hg in the right eye with opened angle, and active ocular inflammation was presented by moderate cell infiltration to the anterior chamber. DIAGNOSIS: Uveitic glaucoma. INTERVENTIONS: Trabeculectomy with mitomycin-C combined with phacoemulsification were performed without any surgical trouble. Postoperative inflammation in the anterior segment was mild, and IOP decreased to the middle-teen. OUTCOMES: At 19 days after surgery, the depth of the anterior chamber changed to shallow and CRD occurred in the inferior quadrant area. This complication could not be resolved by additional systemic corticosteroid medication and scleral fenestration. Although IOP was maintained in middle-teen range, suture fixation of the sclera flap and additional scleral fenestration were necessary to resolve CRD at 191 days after primary surgery. LESSONS: In uveitic eye with uncontrolled ocular hypertension, severe CRD after trabeculectomy is able to occur even with normal IOP, which requires surgical procedure in addition to the medical treatment.


Assuntos
/etiologia , Glaucoma/cirurgia , Trabeculectomia/efeitos adversos , Antibióticos Antineoplásicos/uso terapêutico , Doença Crônica , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Mitomicina/uso terapêutico , Hipotensão Ocular/etiologia , Facoemulsificação/métodos , Trabeculectomia/métodos
20.
Zhonghua Yan Ke Za Zhi ; 56(1): 3-8, 2020 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-31937056

RESUMO

Glaucoma is a major irreversible blindness-causing disease. Traditional Chinese Medicine literature have mentioned glaucoma since Qin and Han Dynasties. Progress has been made since 1949, especially in these 50 years. Since 1990, rapid progress has been achieved in the field of glaucoma, including the research of pathogenesis, education, training and establishment of diagnosis and treatment standard for glaucoma. Nowadays, Chinese glaucoma specialists are giving out more and more voice in the international platform. Though the outcome is delightful, we realize that we are still lack of original innovations. After all, the road is still long and rugged, more efforts should be put into the fight against glaucoma.(Chin J Ophthalmol, 2020, 56: 3-8).


Assuntos
Pesquisa Biomédica/tendências , Cegueira/etiologia , Glaucoma , Oftalmologia/tendências , Grupo com Ancestrais do Continente Asiático , China , Humanos
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