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1.
Int J Mol Sci ; 22(16)2021 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-34445531

RESUMO

Glaucoma is associated with increased intraocular pressure (IOP), causing the apoptosis of retinal ganglion cells (RGCs) and the loss of their axons leading to blindness. Pituitary adenylate cyclase activating polypeptide (PACAP) is neuroprotective in several neural injuries, including retinopathies. The aim of this study was to investigate the effects of PACAP1-38 eye drops in a model of glaucoma. IOP was elevated bilaterally by injections of microbeads to block the aqueous humor outflow. The control groups received the same volume of saline. Animals were treated with PACAP1-38 (1 µg/drop, 3 × 1 drop/day) or vehicle for 4 weeks starting one day after the injections. Retinal morphology by histology and optical coherence tomography, function by electroretinography, and IOP changes were analyzed. Animals were sacrificed 8 weeks after the injections. Microbeads injections induced a significant increase in the IOP, while PACAP1-38 treatment lowered it to normal levels (~10 mmHg). Significant retinal degeneration and functional impairment were observed in the microbead-injected group without PACAP1-38 treatment. In the microbeads + PACAP1-38 group, the retinal morphology and functionality were close to the normal values. In summary, our results show that PACAP1-38, given in form of eye drops, is neuroprotective in glaucoma, providing the basis for potential future therapeutic administration.


Assuntos
Modelos Animais de Doenças , Glaucoma/tratamento farmacológico , Microesferas , Fármacos Neuroprotetores/farmacologia , Soluções Oftálmicas/farmacologia , Polipeptídeo Hipofisário Ativador de Adenilato Ciclase/farmacologia , Degeneração Retiniana/prevenção & controle , Animais , Glaucoma/etiologia , Glaucoma/patologia , Masculino , Ratos , Ratos Sprague-Dawley , Degeneração Retiniana/etiologia , Degeneração Retiniana/patologia
2.
Int J Mol Sci ; 22(14)2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34299211

RESUMO

Glaucoma is a leading cause of irreversible blindness worldwide, and increased intraocular pressure (IOP) is a major risk factor. We aimed to determine if early functional and molecular differences in the glaucomatous retina manifest before significant retinal ganglion cell (RGC) loss is apparent. Adenoviral vectors expressing a pathogenic form of myocilin (Ad5.MYOC) were used to induce IOP elevation in C57BL/6 mice. IOP and pattern electroretinograms (pERG) were recorded, and retinas were prepared for RNA sequencing, immunohistochemistry, or to determine RGC loss. Ocular injection of Ad5.MYOC leads to reliable IOP elevation, resulting in significant loss of RGC after nine weeks. A significant decrease in the pERG amplitude was evident in eyes three weeks after IOP elevation. Retinal gene expression analysis revealed increased expression for 291 genes related to complement cascade, inflammation, and antigen presentation in hypertensive eyes. Decreased expression was found for 378 genes associated with the γ-aminobutyric acid (GABA)ergic and glutamatergic systems and axon guidance. These data suggest that early functional changes in RGC might be due to reduced GABAA receptor signaling and neuroinflammation that precedes RGC loss in this glaucoma model. These initial changes may offer new targets for early detection of glaucoma and the development of new interventions.


Assuntos
Neurônios GABAérgicos/metabolismo , Glaucoma/patologia , Células Ganglionares da Retina/patologia , Ácido gama-Aminobutírico/metabolismo , Animais , Proteínas do Citoesqueleto/genética , Proteínas do Citoesqueleto/metabolismo , Modelos Animais de Doenças , Proteínas do Olho/genética , Proteínas do Olho/metabolismo , Feminino , Neurônios GABAérgicos/patologia , Regulação da Expressão Gênica , Glaucoma/etiologia , Glaucoma/metabolismo , Glicoproteínas/genética , Glicoproteínas/metabolismo , Inflamação/metabolismo , Inflamação/patologia , Pressão Intraocular , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Células Ganglionares da Retina/metabolismo
3.
Invest Ophthalmol Vis Sci ; 62(9): 9, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34232257

RESUMO

Purpose: Glaucoma is a multifactorial disease, causing retinal ganglion cells (RGCs) and optic nerve degeneration. The role of diabetes as a risk factor for glaucoma has been postulated but still not unequivocally demonstrated. The purpose of this study is to clarify the effect of diabetes in the early progression of glaucomatous RGC dysfunction preceding intraocular pressure (IOP) elevation, using the DBA/2J mouse (D2) model of glaucoma. Methods: D2 mice were injected with streptozotocin (STZ) obtaining a combined model of diabetes and glaucoma (D2 + STZ). D2 and D2 + STZ mice were monitored for weight, glycemia, and IOP from 3.5 to 6 months of age. In addition, the activity of RGC and outer retina were assessed using pattern electroretinogram (PERG) and flash electroretinogram (FERG), respectively. At the end point, RGC density and astrogliosis were evaluated in flat mounted retinas. In addition, Müller cell reactivity was evaluated in retinal cross-sections. Finally, the expression of inflammation and oxidative stress markers were analyzed. Results: IOP was not influenced by time or diabetes. In contrast, RGC activity resulted progressively decreased in the D2 group independently from IOP elevation and outer retinal dysfunction. Diabetes exacerbated RGC dysfunction, which resulted independent from variation in IOP and outer retinal activity. Diabetic retinas displayed decreased RGC density and increased glial reactivity given by an increment in oxidative stress and inflammation. Conclusions: Diabetes can act as an IOP-independent risk factor for the early progression of glaucoma promoting oxidative stress and inflammation-mediated RGC dysfunction, glial reactivity, and cellular death.


Assuntos
Diabetes Mellitus Experimental/complicações , Glaucoma/fisiopatologia , Pressão Intraocular/fisiologia , Retina/fisiopatologia , Células Ganglionares da Retina/patologia , Animais , Axônios/patologia , Diabetes Mellitus Experimental/fisiopatologia , Eletrorretinografia , Glaucoma/diagnóstico , Glaucoma/etiologia , Camundongos , Camundongos Endogâmicos DBA , Retina/diagnóstico por imagem
4.
Orphanet J Rare Dis ; 16(1): 312, 2021 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-34266471

RESUMO

Mucopolysaccharidoses are a group of lysosomal storage disorders that are caused by deficiency of enzymes involved in glycosaminoglycans degradation. Due to low prevalence and high childhood mortality, researches on mucopolysaccharidoses were mainly focused on the fatal manifestations. With the development of treatments, more and more mucopolysaccharidoses patients were treated by approved therapies, thereby getting prolonged life span and improved quality of life. Abnormal accumulation of glycosaminoglycans in the eye may block trabecular meshwork, thicken sclera and change mechanical behavior of lamina cribrosa, which, by increasing intraocular pressure and damaging optic nerve, could cause glaucoma. Glaucoma was the leading cause of irreversible blindness worldwide, but it was rarely reported in mucopolysaccharidoses patients. Although non-fatal, it seriously affected quality of life. Prevalence of glaucoma in mucopolysaccharidoses patients (ranged from 2.1 to 12.5%) indicated that glaucoma in patients with mucopolysaccharidoses was worthy of attention and further study, thereby improving the quality of life for MPSs patients.


Assuntos
Glaucoma , Mucopolissacaridoses , Criança , Glaucoma/etiologia , Humanos , Longevidade , Mucopolissacaridoses/complicações , Prevalência , Qualidade de Vida
5.
Int J Mol Sci ; 22(11)2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34072647

RESUMO

Steroid-induced glaucoma is a severe pathological condition, sustained by a rapidly progressive increase in intraocular pressure (IOP), which is diagnosed in a subset of subjects who adhere to a glucocorticoid (GC)-based therapy. Molecular and clinical studies suggest that either natural or synthetic GCs induce a severe metabolic dysregulation of Trabecular Meshwork Cells (TMCs), an endothelial-derived histotype with phagocytic and secretive functions which lay at the iridocorneal angle in the anterior segment of the eye. Since TMCs physiologically regulate the composition and architecture of trabecular meshwork (TM), which is the main outflow pathway of aqueous humor, a fluid which shapes the eye globe and nourishes the lining cell types, GCs are supposed to trigger a pathological remodeling of the TM, inducing an IOP increase and retina mechanical compression. The metabolic dysregulation of TMCs induced by GCs exposure has never been characterized at the molecular detail. Herein, we report that, upon dexamethasone exposure, a TMCs strain develops a marked inhibition of the autophagosome biogenesis pathway through an enhanced turnover of two members of the Ulk-1 complex, the main platform for autophagy induction, through the Ubiquitin Proteasome System (UPS).


Assuntos
Proteína Homóloga à Proteína-1 Relacionada à Autofagia/metabolismo , Autofagia/efeitos dos fármacos , Dexametasona/farmacologia , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Complexos Multiproteicos/metabolismo , Malha Trabecular/efeitos dos fármacos , Malha Trabecular/metabolismo , Apoptose/efeitos dos fármacos , Autofagia/genética , Proteína Homóloga à Proteína-1 Relacionada à Autofagia/genética , Proliferação de Células/efeitos dos fármacos , Dexametasona/efeitos adversos , Suscetibilidade a Doenças , Glaucoma/etiologia , Glaucoma/metabolismo , Glaucoma/fisiopatologia , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/genética , Complexo de Endopeptidases do Proteassoma/metabolismo
6.
BMC Ophthalmol ; 21(1): 268, 2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34187412

RESUMO

BACKGROUND: With the rapid development of intraocular collamer lens (ICL) operation, it is foreseeable that we will encounter a large number of glaucoma patients with ICL implantation history. However, our current understanding of the treatment of glaucoma patients with ICL is limited. Hence we report a rare case of refractory glaucoma after intraocular collamer lens and intraocular lens implantation in a patient who underwent unsuccessful transscleral cyclophotocoagulation, which led to intraocular collamer lens displacement, angle closure and uncontrolled intraocular pressure. CASE PRESENTATION: A 39-year-old woman presented with intractably elevated intraocular pressure in the right eye. Since her intraocular collamer lens implantation surgery in 2017, her intraocular pressure had remained over 40 mmHg while using 3 types of anti-glaucoma medications. The patient had a history of phacoemulsification and posterior chamber phakic intraocular lens implantation for complicated cataracts secondary to uveitis in 2006. On gonioscope examination, there were signs of pigment dispersion, and the anterior chamber angle was open. Ultrasound biomicroscopy examination showed contact and rubbing between the intraocular collamer lens and posterior surface of the iris. And typical advanced glaucomatous optic neuropathy and visual field defects were observed. Transscleral cyclophotocoagulation was performed to control the intraocular pressure and prevent further visual field loss. However, the intraocular collamer lens was displaced after transscleral cyclophotocoagulation, which resulted in formation of a shallow anterior chamber 1 week later, angle closure and loss of intraocular pressure control 1 month later, even though the maximum dose of anti-glaucoma medication was used. Finally, an Ahmed glaucoma valve was successfully implanted in her anterior chamber, and the glaucoma was controlled, as observed at the 10-month follow-up. CONCLUSIONS: Pigment dispersion is a common phenomenon after intraocular collamer lens implantation and may accelerate the progression of glaucoma. Transscleral cyclophotocoagulation should be carefully considered in glaucoma patients with elevated intraocular pressure after intraocular collamer lens implantation, given that transscleral cyclophotocoagulation may cause intraocular collamer lens displacement.


Assuntos
Glaucoma , Lasers Semicondutores , Adulto , Corpo Ciliar/cirurgia , Feminino , Glaucoma/etiologia , Glaucoma/cirurgia , Humanos , Pressão Intraocular , Fotocoagulação a Laser , Lasers Semicondutores/uso terapêutico
7.
Medicine (Baltimore) ; 100(20): e25828, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011047

RESUMO

OBJECTIVE: The aim of this study was to determine the best thickness of corneal slices acquired from femtosecond laser surgery-small incision lenticule extraction (SMILE surgery) as patch graft in glaucoma drainage implantation surgery. METHODS: This study is a prospective randomized study. Patients who received glaucoma drainage implantation from September 2016 to November 2018 were observed. The patients were randomly divided into 3 groups. Group A included 102 cases (104 eyes), receiving 1 layer (120-150 µm) of allogeneic lamellar corneal tissue as the graft. Group B included 117 cases (120 eyes), receiving 2 layers of lamellar corneal tissue from one donor. Group C included 109 cases (111 eyes), using 3 layers of lamellar corneal tissue from 2 donors. The intraocular pressure, corneal graft, conjunctiva stromalysis, drainage tube exposure, and drainage plate were observed. RESULTS: Patients were followed up for 6 to 33 months. The intraocular pressure was significantly reduced after surgery in all three groups. Conjunctiva stromalysis and drainage tubes were exposed in 3 eyes (3%) in group A and 1 eye (0.8%, a special case which has nystagmus and the plate was placed infratemporally) in group B, whereas no conjunctiva stromalysis or tube exposure was reported in group C. CONCLUSIONS: The corneal graft acquired from SMILE surgery can effectively prevent drainage tube exposure and give patients a better cosmetic appearance. Two layers of lamellar corneal tissue (240-300 µm) may be the best suitable thickness because it can effectively reduce tube exposure and rejection. In some special cases, 3 layers of lamellar corneal tissue are needed.


Assuntos
Transplante de Córnea/métodos , Drenagem/métodos , Implantes para Drenagem de Glaucoma , Glaucoma/cirurgia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Transplante de Córnea/instrumentação , Drenagem/instrumentação , Estudos de Viabilidade , Feminino , Seguimentos , Glaucoma/diagnóstico , Glaucoma/etiologia , Humanos , Lactente , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tonometria Ocular , Resultado do Tratamento , Adulto Jovem
8.
Nepal J Ophthalmol ; 13(25): 98-103, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33981103

RESUMO

BACKGROUND: To determine the clinical profile and causes of various types of secondary glaucoma. MATERIALS AND METHODS: This was a hospital-based cross-sectional study conducted in a tertiary eye hospital of eastern Nepal from 1st June to 30th November, 2017. Patients who met the criteria for secondary glaucoma underwent detailed ophthalmic examination. RESULTS: Out of 7079 patients diagnosed with glaucoma or glaucoma suspects, 528 (7.4%) had secondary glaucoma. The mean age at presentation was 52 ± 17 years with male to female ratio of 1.5:1. The most common cause was lens induced 173 (32.8%) followed by neovascular 107 (20.3%), steroid induced 86 (16.3%), traumatic 76 (14.4%), post-vitrectomy 17 (3.2%), uveitic 11 (2.1%), pseudophakic 10 (1.9%), aphakic 8 (1.5%), post-keratoplasty 5 (0.9%) and miscellaneous included 35 (6.6%). Post-traumatic 31 (29.5%) was more prevalent below 41 years while lens induced glaucoma 86 (49%) above 60 years of age. At presentation, the average IOP was 40 ± 11 mmHg. 36 (6.8%) had no light perception in the presenting eye and a large number of participants 307 (58.1%) presented with visual acuity of <3/60 to perception of light. Glaucomatous optic atrophy was found in 22 (9.0%) cases. CONCLUSION: The causes of secondary glaucoma are diverse, lens induced glaucoma being most common. Most patients present late with poor vision, high IOP and even glaucomatous optic atrophy. So, early identification and treatment of the causes is important so that we can prevent the burden of blindness due to secondary glaucoma.


Assuntos
Glaucoma , Pressão Intraocular , Estudos Transversais , Feminino , Glaucoma/diagnóstico , Glaucoma/epidemiologia , Glaucoma/etiologia , Humanos , Masculino , Nepal/epidemiologia , Centros de Atenção Terciária
9.
BMJ Case Rep ; 14(4)2021 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-33931424

RESUMO

Cytomegalovirus (CMV) can cause recalcitrant recurrent keratouveitis and secondary glaucoma. We report a case of chronic recurrent anterior uveitis with secondary glaucoma presenting with acute visual loss and interface fluid 9 years after laser in situ keratomileusis. Based on clinical presentation, a viral aetiology was suspected. Aqueous tap was positive for CMV-DNA by real-time quantitative PCR of the aqueous humour. The patient was treated with systemic antivirals, topical corticosteroids and antiglaucoma medications. The interface fluid resorbed rapidly. The intraocular pressure (IOP) was controlled by trabeculectomy. There was no further corneal deterioration at 7-month follow-up and the IOP had also stabilised. We believe this is only the third reported case of CMV-related interface fluid syndrome. This case highlights the role of quantitative PCR analysis for establishing viral aetiology in recurrent unilateral hypertensive anterior uveitis and reports the unusual finding of interface fluid which resolved after starting systemic antiviral therapy.


Assuntos
Infecções por Citomegalovirus , Infecções Oculares Virais , Glaucoma , Ceratomileuse Assistida por Excimer Laser In Situ , Uveíte Anterior , Humor Aquoso , Citomegalovirus/genética , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/tratamento farmacológico , DNA Viral , Infecções Oculares Virais/diagnóstico , Infecções Oculares Virais/tratamento farmacológico , Glaucoma/tratamento farmacológico , Glaucoma/etiologia , Humanos , Pressão Intraocular , Ceratomileuse Assistida por Excimer Laser In Situ/efeitos adversos , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico , Uveíte Anterior/etiologia
10.
Int Ophthalmol ; 41(9): 3153-3161, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34056702

RESUMO

PURPOSE: The present research aimed to investigate the effects of Inferior peripheral irido-capsulo-hyaloidotomy for the management of pseudophakic malignant glaucoma. METHOD: Ten pseudophakic eyes with aqueous misdirection were diagnosed between September 2017 and December 2018 (10 eyes of 8 patients), which were included in the prospective consecutive case series study. Seven eyes underwent Inferior laser peripheral irido-capsulo-hyaloidotomy, and three eyes underwent pars plana vitrectomy, zonulo-capsulo-hyaloidectomy, and inferior iridectomy. RESULTS: Eight eyes (80%) had angle-closure glaucoma. The mean duration of the follow-up was 12.25 ± 3.05 months (ranging from 10-18 months). The patients had a mean age of 69.25 ± 6 years. The IOP at the onset of malignant glaucoma was found to be 33.8 ± 5.5 mmHg, which was reduced to 13.9 ± 2.7 mmHg at the final visit (P value = 0.002). The reduction in the number ± SD of anti-glaucoma medications (3.3 ± 0.48 to 1.4 ± 0.51) and improvement in mean ± SD LogMAR visual acuity (1.2 ± 0.06 to 0.61 ± 0.26) between the onset and final visit were significant (p = 0.004 and P = 0.005, respectively). All the patients responded to Inferior peripheral irido-capsulo-hyaloidotomy (with YAG laser or with the surgical procedure), which led to a significant reduction in intraocular pressure (IOP) and deepening of the anterior chamber. CONCLUSION: The success rate of peripheral irido-capsulo-hyaloidotomy with laser or surgical procedure in the inferior quadrant was high regarding pseudophakic malignant glaucoma patients. The establishment of a patent inferior communication between the vitreous cavity and the anterior chamber was the main component in the treatment of pseudophakic malignant glaucoma patients.


Assuntos
Glaucoma de Ângulo Fechado , Glaucoma , Idoso , Glaucoma/etiologia , Glaucoma/cirurgia , Glaucoma de Ângulo Fechado/cirurgia , Humanos , Pressão Intraocular , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Vitrectomia
11.
Exp Eye Res ; 208: 108615, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33971222

RESUMO

Animal models of the Boston keratoprosthesis type 1 (KPro) are needed to study glaucoma damage after KPro implantation to control for confounding comorbidities common in human KPro recipients. The purpose of this study was to determine the feasibility of establishing a reproducible mouse model of glaucoma after KPro surgery, specifically that of a miniaturized mouse model of KPro (mKPro). In the present study, a total of 20 corneas of donor C57BL/6 mice (n = 10) were implanted in one eye of each recipient BALB/C mouse (n = 20), assembled as part of the mKPro, either with or without intraoperative lensectomy. Main feasibility outcomes consisted in incidence rates of loss of tone, capsule nicking, and lens extrusion, as well as acquisition of posterior segment optical coherence tomography (OCT) images. With lensectomy (n = 10), loss of ocular tone and retinal detachment occurred in 100% of mice. Without lensectomy (n = 10), capsule nicking and opening, as well as lens extrusion, occurred in 80% of mice. Causes of these complications included the large proportion of intraocular volume occupied by the lens, the shallow anterior chamber, and thus the lack of available intraocular volume to implant the KPro if the lens remains present. Successful mouse KPro surgery may require a great deal of practice to be useful as a reproducible model. Animal KPro models ought to be pursued further by research teams in future studies.


Assuntos
Córnea/cirurgia , Doenças da Córnea/cirurgia , Glaucoma/etiologia , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Complicações Pós-Operatórias , Próteses e Implantes/efeitos adversos , Tomografia de Coerência Óptica/métodos , Animais , Córnea/patologia , Doenças da Córnea/diagnóstico , Glaucoma/diagnóstico , Glaucoma/fisiopatologia , Pressão Intraocular/fisiologia , Camundongos , Acuidade Visual
12.
Int J Mol Sci ; 22(9)2021 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-33925045

RESUMO

Glaucomatous optic neuropathies have been regarded as diseases caused by high intraocular pressure for a long time, despite the concept of vascular glaucoma dating back to von Graefe in 1854. Since then, a tremendous amount of knowledge about the ocular vasculature has been gained; cohort studies have established new vascular risk factors for glaucoma as well as identifying protective measures acting on blood vessels. The knowledge about the physiology and pathophysiology of the choroidal, retinal, as well as ciliary and episcleral circulation has also advanced. Only recently have novel drugs based on that knowledge been approved for clinical use, with more to follow. This review provides an overview of the current vascular concepts in glaucoma, ranging from novel pathogenesis insights to promising therapeutic approaches, covering the supply of the optic nerve head as well as the aqueous humor production and drainage system.


Assuntos
Glaucoma/etiologia , Animais , Circulação Sanguínea/fisiologia , Pressão Sanguínea/fisiologia , Olho/irrigação sanguínea , Glaucoma/tratamento farmacológico , Glaucoma/fisiopatologia , Hemodinâmica/fisiologia , Humanos , Pressão Intraocular/fisiologia , Fluxo Sanguíneo Regional/fisiologia , Fatores de Risco
13.
BMJ Case Rep ; 14(4)2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33858890

RESUMO

Siderotic glaucoma is a rare and challenging clinical scenario caused by a retained iron intraocular foreign body (IOFB), which results in irreversible vision loss. Presented here is a case of secondary open-angle glaucoma in a 36-year-old man that was refractory to maximal medical therapy. A meticulous history and careful clinical examination revealed that he had a penetrating trauma 15 years ago, a self-sealed corneal entry wound, open angles, a retained encapsulated metallic IOFB and siderosis bulbi. Removal of the foreign body not only controlled intraocular pressure, but also improved vision.


Assuntos
Corpos Estranhos no Olho , Ferimentos Oculares Penetrantes , Glaucoma , Siderose , Adulto , Corpos Estranhos no Olho/complicações , Corpos Estranhos no Olho/diagnóstico por imagem , Corpos Estranhos no Olho/cirurgia , Ferimentos Oculares Penetrantes/complicações , Ferimentos Oculares Penetrantes/diagnóstico por imagem , Glaucoma/etiologia , Humanos , Ferro , Masculino , Siderose/diagnóstico por imagem , Siderose/etiologia
14.
Int J Mol Sci ; 22(7)2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33916246

RESUMO

Glaucoma, the leading cause of irreversible blindness, is a heterogeneous group of diseases characterized by progressive loss of retinal ganglion cells (RGCs) and their axons and leads to visual loss and blindness. Risk factors for the onset and progression of glaucoma include systemic and ocular factors such as older age, lower ocular perfusion pressure, and intraocular pressure (IOP). Early signs of RGC damage comprise impairment of axonal transport, downregulation of specific genes and metabolic changes. The brain is often cited to be the highest energy-demanding tissue of the human body. The retina is estimated to have equally high demands. RGCs are particularly active in metabolism and vulnerable to energy insufficiency. Understanding the energy metabolism of the inner retina, especially of the RGCs, is pivotal for understanding glaucoma's pathophysiology. Here we review the key contributors to the high energy demands in the retina and the distinguishing features of energy metabolism of the inner retina. The major features of glaucoma include progressive cell death of retinal ganglions and optic nerve damage. Therefore, this review focuses on the energetic budget of the retinal ganglion cells, optic nerve and the relevant cells that surround them.


Assuntos
Metabolismo Energético , Glaucoma/metabolismo , Células Ganglionares da Retina/metabolismo , Animais , Glaucoma/etiologia , Humanos
15.
Int J Clin Pract ; 75(7): e14169, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33788372

RESUMO

OBJECTIVES: To provide epidemiologic evidence of whether gout increases the risk of new-onset glaucoma. METHODS: We conducted a 13-year nationwide, population-based, retrospective cohort study to examine the association between the history of gout and risk of glaucoma by using the Longitudinal Health Insurance Database (LHID) of Taiwan. The gout cohort included 52 943 patients with newly diagnosed gout who were recruited between 2000 and 2012. Each patient was propensity score matching with 1:1 person without gout from the LHID. To determine glaucoma occurrence, the study population was followed up until the end of 2013. Cumulative incidence, hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated after adjusting for age, sex, comorbidities, and ever ophthalmic visit. A Cox proportional hazard model was used to analyse the association between gout and incidence of glaucoma amongst patients with different potential risks. RESULTS: The adjusted HR for newly diagnosed glaucoma in the gout cohort was 1.00 (95% CI = 0.93-1.07, P = .931), compared with the non-gout cohort. Stratified subgroup analysis revealed that the HRs of glaucoma were 1.36 (95% CI = 1.09-1.70, P = .007), 0.99 (95% CI = 0.87-1.12, P = .871), and 0.95 (95% CI = 0.87-1.03, P = .235) in patients with gout aged 20-39, 40-54, and ≥55 years, respectively (P for interaction = .011). CONCLUSION: This nationwide population-based cohort study revealed that gout patients in the age group 20-39 years had a higher risk of glaucoma than non-gout controls.


Assuntos
Glaucoma , Gota , Adulto , Estudos de Coortes , Glaucoma/epidemiologia , Glaucoma/etiologia , Gota/complicações , Gota/epidemiologia , Humanos , Incidência , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia , Adulto Jovem
16.
BMJ Case Rep ; 14(3)2021 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-33758043

RESUMO

We report a case of a 7-year-old boy, who presented with plate exposure after Ahmed glaucoma valve (AGV) implantation in the eye with secondary glaucoma following penetrating trauma. He underwent AGV explantation with scleral patch graft and conjunctival limbal autograft and started on topical and oral antiglaucoma medication (AGM) for intraocular pressure (IOP) control. Two months later, he presented to us with high intraocular pressure and uveal tissue prolapse at the site of previous tube entry displacing the scleral and conjunctival grafts posteriorly. The defect was closed with corneal patch graft. Patient underwent limited transscleral cyclophotocoagulation and was maintained on topical AGM for IOP control. Our case highlights that explantation is a definitive management in such cases of plate exposure. Tube entry site is a potential weak area and there is risk of uveal prolapse through this area with high IOP. Corneal patch graft helps in successfully managing such defects involving the sclero-limbal region.


Assuntos
Implantes para Drenagem de Glaucoma , Glaucoma , Criança , Seguimentos , Glaucoma/etiologia , Glaucoma/cirurgia , Implantes para Drenagem de Glaucoma/efeitos adversos , Humanos , Pressão Intraocular , Masculino , Implantação de Prótese , Estudos Retrospectivos , Resultado do Tratamento
17.
J Pharmacol Sci ; 145(3): 262-267, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33602506

RESUMO

Glaucoma, a progressive optic neuropathy and the leading cause of blindness, is characterized by impairment or degeneration of retinal ganglion cells (RGCs), which transmit visual information to the brain. Currently, 70 million people worldwide are affected by glaucoma. Elevated intraocular pressure (IOP), a major risk factor of glaucoma, directly damages RGCs. However, a substantial proportion of glaucoma patients have a normal IOP level. In particular, over 90% of Japanese glaucoma patients are reported to have normal IOP levels. Thus, a new focus for glaucoma pathology has emerged. Glial cells contribute to tissue homeostasis. Under pathological conditions, glial cells become reactive, lose their homeostatic functions, and gain neurotoxic functions, which trigger neurodegeneration in several diseases including glaucoma. Reactive glial cells have been identified in the eyes of glaucoma patients. In a glaucoma animal model, reactive glial cells are observed at early stages of the disease when RGCs are intact, indicating the possible role of glial cells in the pathogenesis of glaucoma. In this review, we introduce potential roles of glial cells in the pathogenesis of glaucoma. We focus on the roles of the ocular macroglial cells such as astrocytes and Müller cells, and discuss their roles in the pathogenesis of glaucoma.


Assuntos
Astrócitos/patologia , Astrócitos/fisiologia , Células Ependimogliais/patologia , Células Ependimogliais/fisiologia , Glaucoma/etiologia , Glaucoma/patologia , Retina/citologia , Retina/patologia , Complemento C3 , Gliose , Ácido Glutâmico/metabolismo , Humanos , Pressão Intraocular , Fatores de Crescimento Neural , Disco Óptico/patologia , Fatores de Risco , Fator de Transcrição STAT3
18.
Graefes Arch Clin Exp Ophthalmol ; 259(6): 1587-1595, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33515315

RESUMO

PURPOSE: To evaluate the effect of tube shunt type [Ahmed (AGV) versus Baerveldt (BGI)] on the frequency of tube-cornea touch and corneal decompensation after tube shunt surgery. METHODS: This retrospective comparative study included 145 eyes of 130 patients with uveitic glaucoma who underwent AGV (75 eyes) or BGI (70 eyes) implantations. Electronic medical records were reviewed to document demographic factors, intraocular pressure (IOP) reduction, frequency of tube-cornea touch, corneal decompensation, and need for subsequent corneal transplantation. RESULTS: The mean follow-up was 27.7±3.3 months for AGV and 32.8±3.8 months for BGI (p=0.30). Tube-cornea touch was observed in 5 eyes after BGI and 1 eye in the AGV group (p=0.08). The BGI group reported a significantly higher rate of corneal decompensation (9 versus 0; p=0.001) and transplantation (6 versus 0; p=0.01) compared to the AGV group. Previous trabeculectomy was a significant risk factor for corneal complications in eyes undergoing BGI implantation (odds ratio [OR]= 8.17, 95% confidence interval [CI]=1.78-37.45, p=0.007). CONCLUSION: Similar rates of tube-cornea touch were observed in both shunt types; BGI shunts were associated with a greater incidence of corneal complications and transplantation as compared to AGV in this retrospective series of uveitic glaucoma cases.


Assuntos
Implantes para Drenagem de Glaucoma , Glaucoma , Córnea , Seguimentos , Glaucoma/etiologia , Glaucoma/cirurgia , Humanos , Pressão Intraocular , Implantação de Prótese , Estudos Retrospectivos , Tato , Resultado do Tratamento
19.
Int Ophthalmol ; 41(4): 1531-1539, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33471248

RESUMO

PURPOSE: To assess the intraocular pressure and visual acuity before and after pediatric congenital cataract surgery performed at a relatively older age. METHODS: A retrospective analysis of all consecutive pediatric patients diagnosed and operated for bilateral congenital cataracts during a seven-year period (2012-2018) in rural southern Ethiopia. Non-ambulatory vision was defined as hand motion or worse. The main outcome measures were intraocular pressure (IOP) and visual acuity. RESULTS: Thirty-two children were included, 17 females (53.1%), with a mean age of 11 years (± 2.83) [range, 7-18]. A total of 59 eyes were operated on. The mean follow-up was 4.8 ± 1.8 years (range, 2-8). VA improved from 20/1400 preoperatively to 20/440 postoperatively OD and 20/540 OS (p < 0.001). More eyes had ambulatory vision after cataract surgery than pre-surgery (56 eyes [95%] vs. 29 eyes [49%], p < 0.001). The IOP decreased from a mean preoperative value of 18.4 ± 7.1 mmHg to 14.5 ± 2.9 postoperatively OD (p < 0.001) and 16.3 ± 5.9 mmHg to 13.9 ± 3.5 OS (p < 0.001). Fifteen eyes (24%) had increased IOP (> 21 mmHg) preoperatively, of which three remained high after surgery. Positive correlations were found between IOP, axial length and cup-to-disc ratio. None of the patients required pressure-lowering procedures. CONCLUSION: Bilateral congenital cataracts may be associated with ocular hypertension, with possible progression to glaucoma if left untreated. Surgery at a relatively older age often was associated with a significant improvement in intraocular pressure and ambulatory vision.


Assuntos
Extração de Catarata , Catarata , Glaucoma , Idoso , Catarata/epidemiologia , Criança , Feminino , Seguimentos , Glaucoma/epidemiologia , Glaucoma/etiologia , Glaucoma/cirurgia , Humanos , Pressão Intraocular , Estudos Retrospectivos , Tonometria Ocular , Resultado do Tratamento
20.
Yakugaku Zasshi ; 141(1): 61-66, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-33390449

RESUMO

Glaucoma, the leading cause of blindness in adults, is a progressive neurodegenerative disease characterized by retinal ganglion cell (RGC) death. Currently, many intraocular pressure (IOP)-lowering drugs known to affect this disease progression have been developed as therapeutic agents. However, there are many cases of disease progression, even with sufficient IOP reduction. Therefore, newer therapeutic approaches other than IOP-lowering drugs are needed. To elucidate the pathogenesis of glaucoma and to develop therapeutic agents, the evaluation of RGCs is imperative, as their degeneration is the main cause of this disease. However, it is difficult to obtain RGCs from healthy individuals, let alone glaucoma patients. Therefore, research on the pathophysiology of glaucoma and drug discovery has not progressed sufficiently. Recent developments have made it possible to generate induced pluripotent stem (iPS) cells from the blood or skin of glaucoma patients and induce them to differentiate into RGCs to study the pathogenesis of glaucoma. In addition, drug repositioning for ophthalmological diseases such as glaucoma is one of the most active fields. Many of these repositioned drugs have found therapeutic applications in ophthalmology. Here, we introduce the current status of the pharmacological treatment of glaucoma and its prospects.


Assuntos
Descoberta de Drogas/tendências , Reposicionamento de Medicamentos/tendências , Glaucoma/terapia , Diferenciação Celular , Progressão da Doença , Glaucoma/etiologia , Glaucoma/patologia , Humanos , Células-Tronco Pluripotentes Induzidas/citologia , Pressão Intraocular , Células Ganglionares da Retina/patologia
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