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1.
Acta Neuropathol Commun ; 12(1): 89, 2024 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-38845058

RESUMO

The microtubule-associated protein Tau is a key player in various neurodegenerative conditions, including Alzheimer's disease (AD) and Tauopathies, where its hyperphosphorylation disrupts neuronal microtubular lattice stability. Glaucoma, a neurodegenerative disorder affecting the retina, leads to irreversible vision loss by damaging retinal ganglion cells and the optic nerve, often associated with increased intraocular pressure. Prior studies have indicated Tau expression and phosphorylation alterations in the retina in both AD and glaucoma, yet the causative or downstream nature of Tau protein changes in these pathologies remains unclear. This study investigates the impact of Tau protein modulation on retinal neurons under normal and experimental glaucoma conditions. Employing AAV9-mediated gene therapy for Tau overexpression and knockdown, both manipulations were found to adversely affect retinal structural and functional measures as well as neuroprotective Akt/Erk survival signalling in healthy conditions. In the experimental glaucoma model, Tau overexpression intensified inner retinal degeneration, while Tau silencing provided significant protection against these degenerative changes. These findings underscore the critical role of endogenous Tau protein levels in preserving retinal integrity and emphasize the therapeutic potential of targeting Tau in glaucoma pathology.


Assuntos
Terapia Genética , Glaucoma , Proteínas tau , Proteínas tau/metabolismo , Animais , Glaucoma/metabolismo , Glaucoma/patologia , Glaucoma/genética , Terapia Genética/métodos , Proteínas Proto-Oncogênicas c-akt/metabolismo , Dependovirus/genética , Modelos Animais de Doenças , Degeneração Retiniana/metabolismo , Degeneração Retiniana/patologia , Degeneração Retiniana/genética , Retina/metabolismo , Retina/patologia , Sistema de Sinalização das MAP Quinases/fisiologia , Transdução de Sinais/fisiologia , Camundongos , Camundongos Endogâmicos C57BL , Células Ganglionares da Retina/metabolismo , Células Ganglionares da Retina/patologia , Fenótipo
2.
Sci Rep ; 14(1): 12850, 2024 06 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834618

RESUMO

This study aimed to compare the IOP-lowering effectiveness and safety of standalone Preserflo MicroShunt and iStent 1st generation implantation combined with phacoemulsification in Caucasian patients with a 12-month follow-up period. This retrospective study analyzed the medical histories of patients undergoing antiglaucoma surgery at the Department of Ophthalmology, Medical University of Bialystok, between January 2019 and January 2022. The main outcome measures were success rates (complete: proportion of eyes with IOP < 18 mmHg (criterion A) and < 15 mmHg (criterion B) or 20% reduction in IOP without any glaucoma medication; qualified: proportion of eyes achieving IOPs < 18 mmHg and < 15 mmHg or 20% reduction in IOP from baseline with or without medications), mean reduction (%) in IOP, medication burden, number of complications and additional interventions. In both groups, a significant decrease in IOP and medication burden were observed at 6 and 12 months when compared with baseline. At 12 months, qualified surgical success in criterion A was recorded in 67.4% and 85.7% of patients in the Preserfo and iStent groups, respectively (p = 0.045). Complete surgical success in criterion B at 12 months accounted to 61.4% of patients from Prserflo group and 32.7% patients in iStent group (p = 0.04). Surgical failure at 12 months was documented in 30.2% and 6.3% of patients, respectively (p = 0.003). There was a significant difference between groups in %IOP reduction after 12 months. Greater reduction was observed in Preserflo group, MD = - 8.41 CI95 [- 15.88; - 0.95], p = 0.028, (- 33.49% ± 21.59 vs - 25.07% ± 14.15 in iStent group). Both procedures effectively reduced IOP and postoperative use of antiglaucoma medications in glaucoma patients.


Assuntos
Glaucoma , Pressão Intraocular , Procedimentos Cirúrgicos Minimamente Invasivos , Humanos , Masculino , Feminino , Estudos Retrospectivos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Idoso , Glaucoma/cirurgia , Pessoa de Meia-Idade , Resultado do Tratamento , Facoemulsificação/métodos , Facoemulsificação/efeitos adversos , Implantes para Drenagem de Glaucoma , Idoso de 80 Anos ou mais
3.
Transl Vis Sci Technol ; 13(6): 1, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38829624

RESUMO

Purpose: Deep learning architectures can automatically learn complex features and patterns associated with glaucomatous optic neuropathy (GON). However, developing robust algorithms requires a large number of data sets. We sought to train an adversarial model for generating high-quality optic disc images from a large, diverse data set and then assessed the performance of models on generated synthetic images for detecting GON. Methods: A total of 17,060 (6874 glaucomatous and 10,186 healthy) fundus images were used to train deep convolutional generative adversarial networks (DCGANs) for synthesizing disc images for both classes. We then trained two models to detect GON, one solely on these synthetic images and another on a mixed data set (synthetic and real clinical images). Both the models were externally validated on a data set not used for training. The multiple classification metrics were evaluated with 95% confidence intervals. Models' decision-making processes were assessed using gradient-weighted class activation mapping (Grad-CAM) techniques. Results: Following receiver operating characteristic curve analysis, an optimal cup-to-disc ratio threshold for detecting GON from the training data was found to be 0.619. DCGANs generated high-quality synthetic disc images for healthy and glaucomatous eyes. When trained on a mixed data set, the model's area under the receiver operating characteristic curve attained 99.85% on internal validation and 86.45% on external validation. Grad-CAM saliency maps were primarily centered on the optic nerve head, indicating a more precise and clinically relevant attention area of the fundus image. Conclusions: Although our model performed well on synthetic data, training on a mixed data set demonstrated better performance and generalization. Integrating synthetic and real clinical images can optimize the performance of a deep learning model in glaucoma detection. Translational Relevance: Optimizing deep learning models for glaucoma detection through integrating DCGAN-generated synthetic and real-world clinical data can be improved and generalized in clinical practice.


Assuntos
Aprendizado Profundo , Glaucoma , Disco Óptico , Doenças do Nervo Óptico , Curva ROC , Humanos , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Doenças do Nervo Óptico/diagnóstico por imagem , Doenças do Nervo Óptico/diagnóstico , Glaucoma/diagnóstico por imagem , Glaucoma/diagnóstico , Feminino , Masculino , Pessoa de Meia-Idade , Algoritmos
4.
BMJ Open Ophthalmol ; 9(1)2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38830728

RESUMO

BACKGROUND: Unpreserved single-dose unit (SDU) eye drops are commonly used to avoid benzalkonium chloride-related toxicity. Although intended for single use, many patients report off-label repeated use of SDUs over a prolonged period. We investigated whether repeated use of dexamethasone 0.1% SDUs in the same patient increases the bacterial contamination rate. METHODS: We prospectively enrolled patients scheduled for inpatient corneal and glaucoma surgery receiving dexamethasone 0.1% SDU four times per day from the same vial. To assess contamination rates, one drop from the vial was cultured immediately after opening the SDU (t0), 10 hours later after four drop applications (t10) and 24 hours after opening without further drop applications (t24). Conjunctival swabs were taken before and after drop application. Contamination rate was assessed with a standard clinical culturing protocol without introducing a positive control. RESULTS: 110 eyes of 109 patients were evaluated. Drops collected immediately after opening the SDU (t0) were contaminated in 9/110 cultures (8.1%). At t10, 13/110 cultures were contaminated (11.8%; p=0.267) and 11/110 at t24 (10.0%; t24 vs t0; p=1.00). In 5 of 21 cases of contaminated drops at t10 and/or t24, the same isolates were cultured from the initial conjunctival swab and the SDU. In three cases, the same bacterial species was found in consecutive samples. CONCLUSION: The contamination rate of the SDU did not increase after multiple use within 24 hours. Contamination from fingertip flora was more likely than from ocular surface flora. Reuse of dexamethasone 0.1% SDU in the same patient within 24 hours appears to be safe.


Assuntos
Dexametasona , Glucocorticoides , Soluções Oftálmicas , Conservantes Farmacêuticos , Humanos , Dexametasona/administração & dosagem , Dexametasona/efeitos adversos , Soluções Oftálmicas/efeitos adversos , Masculino , Feminino , Estudos Prospectivos , Conservantes Farmacêuticos/efeitos adversos , Conservantes Farmacêuticos/administração & dosagem , Idoso , Pessoa de Meia-Idade , Glucocorticoides/administração & dosagem , Glucocorticoides/efeitos adversos , Idoso de 80 Anos ou mais , Adulto , Contaminação de Medicamentos , Glaucoma/tratamento farmacológico , Túnica Conjuntiva/microbiologia , Túnica Conjuntiva/efeitos dos fármacos , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Doenças da Córnea/induzido quimicamente
5.
Int Ophthalmol ; 44(1): 231, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38822988

RESUMO

PURPOSE: To analyze the intraoperative challenges of cataract surgery in children, following glaucoma filtering surgery. METHODS: This was a retrospective study to analyze intra-op challenges and outcomes of pediatric cataract surgery in post-glaucoma filtration surgery eyes, between January 2007 and December 2019. RESULTS: We included 20 eyes of 16 children. The most common glaucoma surgery performed was trabeculectomy and trabeculotomy (14 eyes). The median age at the time of cataract surgery was 74.5 months. The most common cataract surgery performed was lens aspiration with posterior chamber intraocular lens implantation (LA + PCIOL) (9/20). The most common intraoperative challenge faced was difficulty in capsulorrhexis (ten eyes), followed by extension of primary posterior capsulotomy (six eyes). At the final follow up eight eyes had improvement in visual acuity, five eyes had stable visual acuity and five eyes had a drop in visual acuity. In 12/20 eyes IOL was implanted, nine eyes in-the-bag and three eyes had in ciliary sulcus. None of the IOLs in the bag had decentration of IOL. The median postoperative IOP (p = 0.12) and median number of postoperative AGM (p = 0.13) at 2 years remained stable compared to the preoperative values. The IOP remained well controlled in 4 eyes without anti-glaucoma medications and in 14 eyes with anti-glaucoma medications and none needed additional surgery for IOP control. Two eyes developed retinal detachment postoperatively. CONCLUSION: Cataract surgery in pediatric eyes with prior glaucoma surgeries, have challenges with capsulorrhexis and IOL stability. The visual outcomes were reasonably good so was the IOP control.


Assuntos
Extração de Catarata , Catarata , Glaucoma , Pressão Intraocular , Acuidade Visual , Humanos , Estudos Retrospectivos , Masculino , Feminino , Extração de Catarata/métodos , Extração de Catarata/efeitos adversos , Criança , Pré-Escolar , Pressão Intraocular/fisiologia , Glaucoma/cirurgia , Glaucoma/fisiopatologia , Catarata/complicações , Cirurgia Filtrante/métodos , Seguimentos , Resultado do Tratamento , Adolescente , Complicações Intraoperatórias , Lactente , Trabeculectomia/métodos , Implante de Lente Intraocular/métodos
6.
BMC Ophthalmol ; 24(1): 233, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38831268

RESUMO

BACKGROUND: The long-term safety and efficacy of repeated applications of subliminal transscleral cyclophotocoagulation (SL-TSCPC) with a focus on cumulative energy was evaluated in glaucoma patients. METHODS: In this retrospective, multicentric study the data of a total of 82 eyes with various causes of glaucoma that were treated with a single or multiple applications of SL-TSCPC were collected. Treatments were performed under general or local anesthesia with an 810 nm diode laser. Power was 2000 mW; duty cycle, 31.3%; total treatment duration, 80-320 s; equaling a total energy of 50-200 J per treatment session. Fifty-five eyes (55 patients) presented for all follow-ups, and these eyes were selected for further statistical analysis. The mean age was 60.0 ± 17.1 years, and 22 (40%) of the patients were female. Intraocular pressure (IOP) and dependence on further glaucoma medication were evaluated at 12 months following the initial treatment. RESULTS: Eyes underwent 1 or 2 consecutive SL-TSCPC treatments. Median (min-max) baseline IOP of 34 (13-69) decreased to 21.5 (7-61), 22 (8-68), 20 (9-68), and 19.5 (3-60) mmHg at the 1, 3, 6, and 12-month postoperative timepoints respectively. The mean (± SD) IOP decrease at 12 months was 26 ± 27%, 39 ± 32%, and 49 ± 33% in the low (below 120 J, n = 18), medium (120-200 J, n = 24), and high (above 200 J, n = 13) cumulative energy groups respectively. At the 12-month timepoint, oral carbonic anhydrase use was discontinued in ¾ of the cases. CONCLUSIONS: It was found that the repeated application of SL-TSCPC safely and efficiently decreases IOP in a Caucasian population with heterogenous causes of glaucoma, eyes with silicone oil responded to a greater extent. Inclusion of cumulative energy scales may contribute to better addressing repeated procedures in a standardized fashion.


Assuntos
Corpo Ciliar , Glaucoma , Pressão Intraocular , Fotocoagulação a Laser , Lasers Semicondutores , Esclera , Humanos , Estudos Retrospectivos , Feminino , Masculino , Pessoa de Meia-Idade , Pressão Intraocular/fisiologia , Fotocoagulação a Laser/métodos , Corpo Ciliar/cirurgia , Idoso , Esclera/cirurgia , Glaucoma/cirurgia , Glaucoma/fisiopatologia , Adulto , Lasers Semicondutores/uso terapêutico , Acuidade Visual/fisiologia , Idoso de 80 Anos ou mais , Seguimentos , Resultado do Tratamento
7.
J Neuroinflammation ; 21(1): 145, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38824526

RESUMO

BACKGROUND: Recent experimental studies of neuroinflammation in glaucoma pointed to cFLIP as a molecular switch for cell fate decisions, mainly regulating cell type-specific caspase-8 functions in cell death and inflammation. This study aimed to determine the importance of cFLIP for regulating astroglia-driven neuroinflammation in experimental glaucoma by analyzing the outcomes of astroglia-targeted transgenic deletion of cFLIP or cFLIPL. METHODS: Glaucoma was modeled by anterior chamber microbead injections to induce ocular hypertension in mouse lines with or without conditional deletion of cFLIP or cFLIPL in astroglia. Morphological analysis of astroglia responses assessed quantitative parameters in retinal whole mounts immunolabeled for GFAP and inflammatory molecules or assayed for TUNEL. The molecular analysis included 36-plexed immunoassays of the retina and optic nerve cytokines and chemokines, NanoString-based profiling of inflammation-related gene expression, and Western blot analysis of selected proteins in freshly isolated samples of astroglia. RESULTS: Immunoassays and immunolabeling of retina and optic nerve tissues presented reduced production of various proinflammatory cytokines, including TNFα, in GFAP/cFLIP and GFAP/cFLIPL relative to controls at 12 weeks of ocular hypertension with no detectable alteration in TUNEL. Besides presenting a similar trend of the proinflammatory versus anti-inflammatory molecules displayed by immunoassays, NanoString-based molecular profiling detected downregulated NF-κB/RelA and upregulated RelB expression of astroglia in ocular hypertensive samples of GFAP/cFLIP compared to ocular hypertensive controls. Analysis of protein expression also revealed decreased phospho-RelA and increased phospho-RelB in parallel with an increase in caspase-8 cleavage products. CONCLUSIONS: A prominent response limiting neuroinflammation in ocular hypertensive eyes with cFLIP-deletion in astroglia values the role of cFLIP in the molecular regulation of glia-driven neuroinflammation during glaucomatous neurodegeneration. The molecular responses accompanying the lessening of neurodegenerative inflammation also seem to maintain astroglia survival despite increased caspase-8 cleavage with cFLIP deletion. A transcriptional autoregulatory response, dampening RelA but boosting RelB for selective expression of NF-κB target genes, might reinforce cell survival in cFLIP-deleted astroglia.


Assuntos
Astrócitos , Proteína Reguladora de Apoptosis Semelhante a CASP8 e FADD , Glaucoma , Doenças Neuroinflamatórias , Animais , Proteína Reguladora de Apoptosis Semelhante a CASP8 e FADD/metabolismo , Proteína Reguladora de Apoptosis Semelhante a CASP8 e FADD/genética , Camundongos , Astrócitos/metabolismo , Astrócitos/patologia , Glaucoma/metabolismo , Glaucoma/patologia , Glaucoma/genética , Doenças Neuroinflamatórias/metabolismo , Doenças Neuroinflamatórias/patologia , Camundongos Transgênicos , Modelos Animais de Doenças , Citocinas/metabolismo , Retina/metabolismo , Retina/patologia , Camundongos Endogâmicos C57BL , Nervo Óptico/patologia , Nervo Óptico/metabolismo , Proteína Glial Fibrilar Ácida/metabolismo
8.
Math Biosci Eng ; 21(4): 5092-5117, 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38872528

RESUMO

Glaucoma is a chronic neurodegenerative disease that can result in irreversible vision loss if not treated in its early stages. The cup-to-disc ratio is a key criterion for glaucoma screening and diagnosis, and it is determined by dividing the area of the optic cup (OC) by that of the optic disc (OD) in fundus images. Consequently, the automatic and accurate segmentation of the OC and OD is a pivotal step in glaucoma detection. In recent years, numerous methods have resulted in great success on this task. However, most existing methods either have unsatisfactory segmentation accuracy or high time costs. In this paper, we propose a lightweight deep-learning architecture for the simultaneous segmentation of the OC and OD, where we have adopted fuzzy learning and a multi-layer perceptron to simplify the learning complexity and improve segmentation accuracy. Experimental results demonstrate the superiority of our proposed method as compared to most state-of-the-art approaches in terms of both training time and segmentation accuracy.


Assuntos
Algoritmos , Aprendizado Profundo , Lógica Fuzzy , Glaucoma , Disco Óptico , Humanos , Disco Óptico/diagnóstico por imagem , Glaucoma/diagnóstico por imagem , Redes Neurais de Computação , Processamento de Imagem Assistida por Computador/métodos , Reprodutibilidade dos Testes , Interpretação de Imagem Assistida por Computador/métodos , Fundo de Olho
9.
Actas Esp Psiquiatr ; 52(3): 325-333, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38863056

RESUMO

OBJECTIVE: Glaucoma is a chronic disease with an insidious onset that often brings severe psychological burden to patients. Therefore, based on a systematic review and meta-analysis, we explore the prevalence and severity of depression and anxiety in glaucoma patients, and provide clinically valuable information for medical staff. METHODS: Computer searches were conducted for relevant studies in PubMed, Embase, ProQuest PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, The Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure, Wanfang Database, and China VIP Database. The search date range was from the establishment of the database to December 2023. Literature was screened and data were extracted. The Cochrane risk of bias assessment tool was used to evaluate the quality of the literature, and RevMan5.4 was used for meta-analysis. RESULTS: The total sample size of the 15 included studies was 24,334 cases. All included studies were of high quality. The results of the meta-analysis revealed that, compared with control patients without glaucoma, patients with glaucoma were more likely to experience depression and to have more severe depressive symptoms [RR (Relative Risk) = 5.92, 95% CI (Confidence Interva) (3.29, 10.66), p < 0.01]; they were also more likely to experience anxiety and to have more severe anxiety symptoms [RR = 2.99, 95% CI (1.93, 4.64), p < 0.01]. The results of the sensitivity analysis showed that the two studies by Cumurcu E. 2005 and Yochim 2012 were the sources of heterogeneity in the meta-analysis of depression; and the three studies by Mabuchi 2012, Otori 2017, and Yochim 2012 were the sources of heterogeneity in the meta-analysis of anxiety disorders. CONCLUSION: People with glaucoma are more likely to experience depression and anxiety than people without glaucoma. Medical staff should pay greater attention to patients' emotional problems and help patients improve their quality of life.


Assuntos
Transtornos de Ansiedade , Glaucoma , Humanos , Glaucoma/epidemiologia , Glaucoma/psicologia , Prevalência , Estudos Transversais , Transtornos de Ansiedade/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo/epidemiologia
10.
BMC Ophthalmol ; 24(1): 248, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862946

RESUMO

BACKGROUND: Ahmed valve implantation demonstrated an increasing proportion in glaucoma surgery, but predicting the successful maintenance of target intraocular pressure remains a challenging task. This study aimed to evaluate the performance of machine learning (ML) in predicting surgical outcomes after Ahmed valve implantation and to assess potential risk factors associated with surgical failure to contribute to improving the success rate. METHODS: This study used preoperative data of patients who underwent Ahmed valve implantation from 2017 to 2021 at Ajou University Hospital. These datasets included demographic and ophthalmic parameters (dataset A), systemic medical records excluding psychiatric records (dataset B), and psychiatric medications (dataset C). Logistic regression, extreme gradient boosting (XGBoost), and support vector machines were first evaluated using only dataset A. The algorithm with the best performance was selected based on the area under the receiver operating characteristics curve (AUROC). Finally, three additional prediction models were developed using the best performance algorithm, incorporating combinations of multiple datasets to predict surgical outcomes at 1 year. RESULTS: Among 153 eyes of 133 patients, 131 (85.6%) and 22 (14.4%) eyes were categorized as the success and failure groups, respectively. The XGBoost was shown as the best-performance model with an AUROC value of 0.684, using only dataset A. The final three further prediction models were developed based on the combination of multiple datasets using the XGBoost model. All datasets combinations demonstrated the best performances in terms of AUROC (dataset A + B: 0.782; A + C: 0.773; A + B + C: 0.801). Furthermore, advancing age was a risk factor associated with a higher surgical failure incidence. CONCLUSIONS: ML provides some predictive value in predicting the outcomes of Ahmed valve implantation at 1 year. ML evaluation revealed advancing age as a common risk factor for surgical failure.


Assuntos
Implantes para Drenagem de Glaucoma , Glaucoma , Pressão Intraocular , Aprendizado de Máquina , Humanos , Feminino , Masculino , Glaucoma/cirurgia , Glaucoma/fisiopatologia , Pressão Intraocular/fisiologia , Pessoa de Meia-Idade , Idoso , Estudos Retrospectivos , Curva ROC , Adulto , Implantação de Prótese/métodos , Fatores de Risco , Acuidade Visual/fisiologia , Resultado do Tratamento , Idoso de 80 Anos ou mais
12.
Invest Ophthalmol Vis Sci ; 65(6): 10, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38842831

RESUMO

Purpose: To investigate whether fractal dimension (FD)-based oculomics could be used for individual risk prediction by evaluating repeatability and robustness. Methods: We used two datasets: "Caledonia," healthy adults imaged multiple times in quick succession for research (26 subjects, 39 eyes, 377 color fundus images), and GRAPE, glaucoma patients with baseline and follow-up visits (106 subjects, 196 eyes, 392 images). Mean follow-up time was 18.3 months in GRAPE; thus it provides a pessimistic lower bound because vasculature could change. FD was computed with DART and AutoMorph. Image quality was assessed with QuickQual, but no images were initially excluded. Pearson, Spearman, and intraclass correlation (ICC) were used for population-level repeatability. For individual-level repeatability, we introduce measurement noise parameter λ, which is within-eye standard deviation (SD) of FD measurements in units of between-eyes SD. Results: In Caledonia, ICC was 0.8153 for DART and 0.5779 for AutoMorph, Pearson/Spearman correlation (first and last image) 0.7857/0.7824 for DART, and 0.3933/0.6253 for AutoMorph. In GRAPE, Pearson/Spearman correlation (first and next visit) was 0.7479/0.7474 for DART, and 0.7109/0.7208 for AutoMorph (all P < 0.0001). Median λ in Caledonia without exclusions was 3.55% for DART and 12.65% for AutoMorph and improved to up to 1.67% and 6.64% with quality-based exclusions, respectively. Quality exclusions primarily mitigated large outliers. Worst quality in an eye correlated strongly with λ (Pearson 0.5350-0.7550, depending on dataset and method, all P < 0.0001). Conclusions: Repeatability was sufficient for individual-level predictions in heterogeneous populations. DART performed better on all metrics and might be able to detect small, longitudinal changes, highlighting the potential of robust methods.


Assuntos
Fractais , Humanos , Feminino , Reprodutibilidade dos Testes , Masculino , Pessoa de Meia-Idade , Adulto , Medição de Risco/métodos , Idoso , Glaucoma/diagnóstico , Glaucoma/fisiopatologia , Seguimentos , Retina/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem
13.
BMC Ophthalmol ; 24(1): 243, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38858622

RESUMO

BACKGROUND: Due to the asymptomatic nature of the disease and lack of awareness, most glaucoma patients present for eye examination late, after significant damage of optic nerve occur. Being aware of glaucoma is important for timely diagnosis of the disease and preventing blindness from it. OBJECTIVE: The aim of this study was to assess glaucoma awareness and associated factors among adult patients aged 35 and over attending the eye outpatient department. METHODS: Hospital based cross-sectional study was conducted on 284 adult patients aged 35 and over attending ophthalmic outpatient department from July to August 2022 using systematic random sampling. An interviewer-administered questionnaire was used to collect data. The data were checked for completeness, and then entered to SPSS version 22 software. Descriptive and binary logistic regression analyses were performed. Independent variables with p-value ≤ 0.05 in multivariate logistic regression were considered as statistically significant. RESULTS: About 284 study participants, of whom 57.75% were male, participated in this study with a response rate of 94.1%. The mean age of the study participants was 53.58 years. Only 39.09%(95% CI: 36.53-41.65) were aware of glaucoma. Age groups 46-50 [AOR; 1.83: 1.18, 2.56] and 51-64 [AOR; 3.21: 2.03, 4.39], having college education or above [AOR; 3.1: 2.20, 6.64], family member with glaucoma [AOR; 5.86:3.25, 8.0], income 6500 ETB [AOR; 2.9: 1.97, 5.00] and previous eye examination [AOR; 2.15: 1.46, 4.05] were factors significantly associated with awareness of glaucoma. The main sources of information were news media, family members with glaucoma and health workers. CONCLUSION: More than half (60.91%) of adult ophthalmic patients attending HUCSH were unaware of glaucoma and need eye health education concerning glaucoma.


Assuntos
Glaucoma , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Etiópia/epidemiologia , Estudos Transversais , Glaucoma/epidemiologia , Adulto , Idoso , Inquéritos e Questionários , Hospitais Especializados/estatística & dados numéricos , Oftalmologia , Hospitais Universitários
14.
Eur J Med Res ; 29(1): 332, 2024 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-38880889

RESUMO

Glaucoma is the most common cause of irreversible blindness in the world. It is associated with elevated intraocular pressure (IOP). Fluctuations in tonometer readings have implications for glaucoma research, where accurate IOP measurements are vital for evaluating disease progression and treatment efficacy. Researchers should carefully select the appropriate tonometer and consider biases associated with different tonometers. Validation against standard measurements can improve IOP measurement accuracy in rat models. In conclusion, this systematic review will emphasize on the importance of selecting the appropriate tonometer for IOP measurement in rat models, considering potential biases and their implications for glaucoma research. Accurate and consistent IOP measurement in rat models is crucial for understanding glaucoma pathophysiology and developing effective treatments. This systematic review aims to assess agreement among tonometers used for measuring IOP in Wistar rat models primarily focusing on TonoLab, TonoVet, and Tono-pen. The review was conducted using PRISMA guidelines. Two articles were included for qualitative synthesis. The studies compared manometric IOP with TonoLab, rebound tonometer, and Tono-pen XL readings. It was observed that TonoLab consistently underestimated IOP, while Tono-pen XL tended to overestimate IOP compared to manometric measurements. The study's findings will help researchers in making decisions about tonometer selection, leading to more reliable outcomes in glaucoma research using rat models. Further research, specifically RCT's (randomized controlled trial) is needed to confirm the results and enhance IOP measurement precision in rat models.


Assuntos
Glaucoma , Pressão Intraocular , Ratos Wistar , Tonometria Ocular , Animais , Pressão Intraocular/fisiologia , Tonometria Ocular/métodos , Tonometria Ocular/instrumentação , Ratos , Glaucoma/fisiopatologia , Glaucoma/diagnóstico , Modelos Animais de Doenças
15.
Medicine (Baltimore) ; 103(24): e38455, 2024 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-38875430

RESUMO

To determine whether there is a causal relationship between Corona Virus Disease 2019 (COVID-19) and glaucoma, a 2-sample Mendelian Randomization (MR) design was applied with the main analysis method of inverse-variance-weighted. The reliability of the results was checked using the heterogeneity test, pleiotropy test, and leave-one-out method. Four sets of instrumental variables (IVs) were used to investigate the causality between COVID-19 and glaucoma risk according to data from the IEU Genome Wide Association Study (GWAS). The results showed that 2 sets of COVID-19(RELEASE) were significantly associated with the risk of glaucoma [ID: ebi-a-GCST011071, OR (95% CI) = 1.227 (1.076-1.400), P = .002259; ID: ebi-a-GCST011073: OR (95% CI) = 1.164 (1.022-1.327), P = .022450; 2 sets of COVID-19 hospitalizations were significantly associated with the risk of glaucoma (ID: ebi-a-GCST011081, OR (95% CI) = 1.156 (1.033-1.292), P = .011342; ID: ebi-a-GCST011082: OR (95% CI) = 1.097 (1.007-1.196), P = .034908)]. The sensitivity of the results was acceptable (P > .05) for the 3 test methods. In conclusion, this MR analysis provides preliminary evidence of a potential causal relationship between COVID-19 and glaucoma.


Assuntos
COVID-19 , Estudo de Associação Genômica Ampla , Glaucoma , Análise da Randomização Mendeliana , SARS-CoV-2 , Humanos , Análise da Randomização Mendeliana/métodos , COVID-19/epidemiologia , Glaucoma/genética , Glaucoma/epidemiologia , SARS-CoV-2/genética , Causalidade , Polimorfismo de Nucleotídeo Único , Reprodutibilidade dos Testes
16.
Transl Vis Sci Technol ; 13(6): 10, 2024 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-38884547

RESUMO

Purpose: To explore the structural-functional loss relationship from optic-nerve-head- and macula-centred spectral-domain (SD) Optical Coherence Tomography (OCT) images in the full spectrum of glaucoma patients using deep-learning methods. Methods: A cohort comprising 5238 unique eyes classified as suspects or diagnosed with glaucoma was considered. All patients underwent ophthalmologic examination consisting of standard automated perimetry (SAP), macular OCT, and peri-papillary OCT on the same day. Deep learning models were trained to estimate G-pattern visual field (VF) mean deviation (MD) and cluster MD using retinal thickness maps from seven layers: retinal nerve fiber layer (RNFL), ganglion cell layer and inner plexiform layer (GCL + IPL), inner nuclear layer and outer plexiform layer (INL + OPL), outer nuclear layer (ONL), photoreceptors and retinal pigmented epithelium (PR + RPE), choriocapillaris and choroidal stroma (CC + CS), total retinal thickness (RT). Results: The best performance on MD prediction is achieved by RNFL, GCL + IPL and RT layers, with R2 scores of 0.37, 0.33, and 0.31, respectively. Combining macular and peri-papillary scans outperforms single modality prediction, achieving an R2 value of 0.48. Cluster MD predictions show promising results, notably in central clusters, reaching an R2 of 0.56. Conclusions: The combination of multiple modalities, such as optic-nerve-head circular B-scans and retinal thickness maps from macular SD-OCT images, improves the performance of MD and cluster MD prediction. Our proposed model demonstrates the highest level of accuracy in predicting MD in the early-to-mid stages of glaucoma. Translational Relevance: Objective measures recorded with SD-OCT can optimize the number of visual field tests and improve individualized glaucoma care by adjusting VF testing frequency based on deep-learning estimates of functional damage.


Assuntos
Aprendizado Profundo , Macula Lutea , Tomografia de Coerência Óptica , Campos Visuais , Tomografia de Coerência Óptica/métodos , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Campos Visuais/fisiologia , Macula Lutea/diagnóstico por imagem , Macula Lutea/patologia , Prognóstico , Idoso , Células Ganglionares da Retina/patologia , Glaucoma/diagnóstico por imagem , Glaucoma/patologia , Fibras Nervosas/patologia , Testes de Campo Visual/métodos , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia
17.
J. optom. (Internet) ; 17(2): [100488], Abr-Jun, 2024. tab, graf
Artigo em Inglês | IBECS | ID: ibc-231623

RESUMO

Purpose: As ocular dryness and glaucoma are more prevalent with increasing age, understanding how the tear film affects tonometry is important. The present study aims to understand the impact that changes in the tear film have on intraocular pressure (IOP), corneal hysteresis, and corneal resistance factor measurements. Methods: Cross-sectional research was conducted and 37 patients were assessed. The tear film lipid layer and the non-invasive break-up time (NIBUT) were evaluated using the Tearscope Plus (Keeler, Windsor, UK). Dry eye symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. IOP was measured using rebound tonometry and the Ocular Response Analyzer (ORA, Reichert). Corneal biomechanical properties were measured using ORA. Results: It was found that an increase in the IOP measured with the iCare was directly correlated with the subclass that evaluated symptomatology associated with environmental factors (r = 0.414, p<0.05, Spearman). Goldmann-correlated IOP (IOPg) and Corneal-compensated IOP (IOPcc) values were statistically significantly different between the various interferometric patterns (p<0.05). It was also found that an increase in the corneal biomechanical properties measured with ORA was directly correlated with the overall scores obtained when using the OSDI and some of its subclasses. Conclusions: Tear film interferometric patterns were shown to have some impact on the IOP measured using ORA. The IOP measured with iCare seems to be related to the symptomatology obtained from OSDI. Corneal biomechanical properties were related to the OSDI total score and some of its subclasses. An increase in symptomatology was associated with an increase in the measured biomechanical properties of the cornea.(AU)


Assuntos
Humanos , Masculino , Feminino , Optometria , Aparelho Lacrimal , Visão Ocular , Síndromes do Olho Seco , Glaucoma , Pressão Intraocular
18.
J Glaucoma ; 33(6): 381-386, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38722193

RESUMO

PRCIS: A review of the literature found that certain types of exercise and physical activity result in transient reductions in intraocular pressure and may have a beneficial effect on glaucoma severity and progression. INTRODUCTION: Glaucoma is the most common cause of irreversible vision loss worldwide. Raised intraocular pressure (IOP) is the most important risk factor for the disease. Exercise is known to result in changes in IOP. The purpose of this review was to investigate the effect of exercise on IOP and glaucoma. METHODS: A comprehensive search of multiple literature databases was performed. Medline, EMBASE, and Cochrane libraries were used to search for the relevant terms. 16 original studies were selected for the review. RESULTS: Exercise of varying intensity and type has differing effects on IOP. Moderate-intensity aerobic exercise results in transient reductions in IOP, while high-intensity resistance exercise and weight-lifting lead to transient elevations in IOP. There is evidence to suggest that exercise and higher levels of fitness may be protective against the development of glaucoma. In addition, increased daily physical activity may be associated with less visual field progression in patients with glaucoma. While secondary causes of glaucoma are included in some of the studies discussed in this review, the findings are largely applicable to primary open angle glaucoma. CONCLUSION: Exercise may be a beneficial lifestyle modification in the management of glaucoma; however, further longitudinal studies are required to validate this.


Assuntos
Exercício Físico , Glaucoma , Pressão Intraocular , Humanos , Pressão Intraocular/fisiologia , Exercício Físico/fisiologia , Glaucoma/fisiopatologia , Campos Visuais/fisiologia , Glaucoma de Ângulo Aberto/fisiopatologia , Tonometria Ocular
19.
Asia Pac J Ophthalmol (Phila) ; 13(3): 100074, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38795865

RESUMO

PURPOSE: To evaluate the long-term efficacy of endoscopic cyclophotocoagulation (ECP) via a pars plana approach in a large cohort of refractory glaucoma patients DESIGN: Single-center, retrospective, longitudinal, cohort study. METHODS: This study recruited patients who underwent ECP and consecutively visited and were followed up for at least 5 years at Beijing Tongren Eye Center, China from January 2013 to December 2017. All patients underwent a complete ophthalmic examination. Treatment success was defined as 6 mmHg ≤ IOP ≤ 21 mmHg with or without anti-glaucoma medications. RESULTS: A total of 121 eyes of 105 patients including 51 children and 54 adults were enrolled. The mean follow-up was 7.2 ± 1.3 years. The most common glaucoma diagnoses were secondary glaucoma (74 eyes, 61.1 %) and primary congenital glaucoma (19 eyes 15.7 %). The mean extent of the first ECP was 259 degrees. There was an overall decrease in IOP of 38.3 % from 33.3 ± 9.0 mmHg preoperatively to 20.5 ± 7.5 mmHg after surgery, which was statistically significant (P < 0.001). The success rate after 1 or more ECP surgery was 65.3 %. After adjusting for sex, number of prior TCP surgeries and the extent of ECP degree, the failure of ECP was associated with being children (as compared with adults; P = 0.028; OR = 2.549) and higher preoperative IOP (P = 0.001; OR = 1.084). CONCLUSION: ECP is an effective procedure for lowing IOP in refractory glaucoma, particularly in patients who are also candidates for vitreoretinal interventions. Hence, a collaborative approach between glaucoma and retinal specialists is of utmost importance in devising an optimal management strategy for glaucoma treatment.


Assuntos
Corpo Ciliar , Endoscopia , Glaucoma , Pressão Intraocular , Fotocoagulação a Laser , Acuidade Visual , Humanos , Feminino , Masculino , Glaucoma/cirurgia , Estudos Retrospectivos , Seguimentos , Pressão Intraocular/fisiologia , Fotocoagulação a Laser/métodos , Criança , Pessoa de Meia-Idade , Adulto , Corpo Ciliar/cirurgia , Adolescente , Endoscopia/métodos , Pré-Escolar , Resultado do Tratamento , Idoso , Adulto Jovem , Centros de Atenção Terciária , Lactente , Fatores de Tempo
20.
Invest Ophthalmol Vis Sci ; 65(5): 15, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38717426

RESUMO

Purpose: Mutations in the genes encoding type IV collagen alpha 1 (COL4A1) and alpha 2 (COL4A2) cause a multisystem disorder that includes ocular anterior segment dysgenesis (ASD) and glaucoma. We previously showed that transforming growth factor beta (TGFß) signaling was elevated in developing anterior segments from Col4a1 mutant mice and that reducing TGFß signaling ameliorated ASD, supporting a role for the TGFß pathway in disease pathogenesis. Here, we tested whether altered TGFß signaling also contributes to glaucoma-related phenotypes in Col4a1 mutant mice. Methods: To test the role of TGFß signaling in glaucoma-relevant phenotypes, we genetically reduced TGFß signaling using mice with mutated Tgfbr2, which encodes the common receptor for all TGFß ligands in Col4a1+/G1344D mice. We performed slit-lamp biomicroscopy and optical coherence tomography for qualitative and quantitative analyses of anterior and posterior ocular segments, histological analyses of ocular tissues and optic nerves, and intraocular pressure assessments using rebound tonometry. Results: Col4a1+/G1344D mice showed defects of the ocular drainage structures, including iridocorneal adhesions, and phenotypes consistent with glaucomatous neurodegeneration, including thinning of the nerve fiber layer, retinal ganglion cell loss, optic nerve head excavation, and optic nerve degeneration. We found that reducing TGFß receptor 2 (TGFBR2) was protective for ASD, ameliorated ocular drainage structure defects, and protected against glaucomatous neurodegeneration in Col4a1+/G1344D mice. Conclusions: Our results suggest that elevated TGFß signaling contributes to glaucomatous neurodegeneration in Col4a1 mutant mice.


Assuntos
Colágeno Tipo IV , Glaucoma , Receptor do Fator de Crescimento Transformador beta Tipo II , Transdução de Sinais , Fator de Crescimento Transformador beta , Animais , Camundongos , Segmento Anterior do Olho/metabolismo , Segmento Anterior do Olho/patologia , Colágeno Tipo IV/metabolismo , Colágeno Tipo IV/genética , Modelos Animais de Doenças , Glaucoma/metabolismo , Glaucoma/genética , Glaucoma/patologia , Pressão Intraocular/fisiologia , Camundongos Endogâmicos C57BL , Mutação , Nervo Óptico/patologia , Nervo Óptico/metabolismo , Doenças do Nervo Óptico/metabolismo , Doenças do Nervo Óptico/genética , Fenótipo , Receptor do Fator de Crescimento Transformador beta Tipo II/genética , Receptor do Fator de Crescimento Transformador beta Tipo II/metabolismo , Células Ganglionares da Retina/patologia , Células Ganglionares da Retina/metabolismo , Transdução de Sinais/fisiologia , Microscopia com Lâmpada de Fenda , Tomografia de Coerência Óptica , Tonometria Ocular , Fator de Crescimento Transformador beta/metabolismo
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