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BMC Ophthalmology May 2024To present six cases exhibiting transient anterior subcapsular vacuolar lens opacities following early postoperative Tanito microhook trabeculotomy (TMH) performed by...
OBJECTIVE
To present six cases exhibiting transient anterior subcapsular vacuolar lens opacities following early postoperative Tanito microhook trabeculotomy (TMH) performed by the same surgeon.
METHODS
Six patients who underwent lens-sparing TMH at Meizankai Shimizu Eye Clinic from November 2021 to May 2023, and developed anterior subcapsular vacuolar lens opacities postoperatively were reviewed. Detailed records of surgeries, follow-up findings were collected and reported.
RESULTS
In all six cases, anterior vacuolar subcapsular lens opacities were observed on the day after surgery, gradually decreasing without affecting visual acuity or contrast sensitivity. In all cases, without any specific interventions, the opacities disappeared by 21 months postoperatively.
CONCLUSION
Anterior subcapsular cataracts, characterized by a vacuolar appearance and transient existence, should be recognized as an early complication of ab interno glaucoma surgery, possibly linked to use of distributed ophthalmic viscosurgical devices and excessive anterior chamber irrigation leading to traumatic cataracts on the lens surface.
Topics: Humans; Trabeculectomy; Female; Male; Cataract; Middle Aged; Aged; Visual Acuity; Postoperative Complications; Lens Capsule, Crystalline; Vacuoles; Retrospective Studies; Intraocular Pressure; Glaucoma; Adult
PubMed: 38811878
DOI: 10.1186/s12886-024-03498-3 -
Journal of Biomedical Research Apr 2024Pericytes are located in the stromal membrane of the capillary outer wall and contain endothelial cells (ECs). They are pivotal in regulating blood flow, enhancing...
Pericytes are located in the stromal membrane of the capillary outer wall and contain endothelial cells (ECs). They are pivotal in regulating blood flow, enhancing vascular stability, and maintaining the integrity of the blood-retina barrier (BRB)/blood-brain barrier (BBB). The pluripotency of pericytes allows them to differentiate into various cell types, highlighting their significance in vascular disease pathogenesis, as demonstrated by previous studies. This potential enables pericytes to be a potential biomarker for the diagnosis and a target for treatment of vascular disorders. The retina, an essential part of the eyeball, is an extension of cerebral tissue with a transparent refractive medium. It offers a unique window for assessing systemic microvascular lesions. Routine fundus examination is necessary for patients with diabetes and hypertension. Manifestations, such as retinal artery tortuosity, dilation, stenosis, and abnormal arteriovenous anastomosis, serve as typical hallmarks of retinal vasculopathy. Therefore, studies of ocular vascular diseases significantly facilitate the exploration of systemic vascular diseases.
PubMed: 38808554
DOI: 10.7555/JBR.37.20230314 -
Indian Journal of Ophthalmology Jun 2024Glaucoma, the silent thief of sight, is one of the most common vision-threatening conditions. Even though POAG (primary open angle glaucoma) is more common, PACG... (Review)
Review
BACKGROUND
Glaucoma, the silent thief of sight, is one of the most common vision-threatening conditions. Even though POAG (primary open angle glaucoma) is more common, PACG (primary angle closure glaucoma) is the dreaded variant. ISGEO (International Society for Geographical and Epidemiological Ophthalmology) has classified primary angle closure as PACS (primary angle closure suspect), PAC (primary angle closure), and PACG (primary angle closure glaucoma. The inconspicuous nature of PACS makes its diagnosis and treatment very tricky.
PURPOSE
To determine which cases are best suited for laser peripheral iridotomy.
SYNOPSIS
Laser peripheral iridotomy is the gold standard for acute primary angle closure glaucoma treatment. But there is a lot of confusion regarding its use in PACS as a prophylactic measure. We have tried to throw light on laser peripheral iridotomy, a much debatable topic. The video focuses on various trials regarding laser peripheral iridotomy, the indications, side effects, and contraindications. We have also discussed its use as a therapeutic and prophylactic procedure.
HIGHLIGHTS
The video highlights that the approach of laser peripheral iridotomy should be on a case-by-case basis.
VIDEO LINK
https://youtu.be/kiEYI9ct2Oo.
Topics: Humans; Glaucoma, Angle-Closure; Iridectomy; Intraocular Pressure; Laser Therapy; Iris; Gonioscopy
PubMed: 38804805
DOI: 10.4103/IJO.IJO_1362_23 -
BioRxiv : the Preprint Server For... May 2024Trabecular meshwork (TM) cell therapy has been proposed as a next-generation treatment for elevated intraocular pressure (IOP) in glaucoma, the most common cause of...
UNLABELLED
Trabecular meshwork (TM) cell therapy has been proposed as a next-generation treatment for elevated intraocular pressure (IOP) in glaucoma, the most common cause of irreversible blindness. Using a magnetic cell steering technique with excellent efficiency and tissue-specific targeting, we delivered two types of cells into a mouse model of glaucoma: either human adipose-derived mesenchymal stem cells (hAMSCs) or induced pluripotent cell derivatives (iPSC-TM cells). We observed a 4.5 [3.1, 6.0] mmHg or 27% reduction in intraocular pressure (IOP) for nine months after a single dose of only 1500 magnetically-steered hAMSCs, associated with restoration of function to the conventional outflow pathway, as judged by increased outflow facility and TM cellularity. iPSC-TM cells were also effective, but less so, showing only a 1.9 [0.4, 3.3] mmHg or 13% IOP reduction and increased risk of tumorigenicity. In both cases, injected cells remained detectable in the iridocorneal angle three weeks post-transplantation. Based on the locations of the delivered cells, the mechanism of IOP lowering is most likely paracrine signaling. We conclude that magnetically-steered hAMSC cell therapy has potential for long-term treatment of ocular hypertension in glaucoma.
ONE SENTENCE SUMMARY
A novel magnetic cell therapy provided effective intraocular pressure control in a mouse model of glaucoma, motivating future translational studies.
PubMed: 38798683
DOI: 10.1101/2024.05.13.593917 -
Pharmaceuticals (Basel, Switzerland) Apr 2024Bimatoprost has emerged as a significant medication in the field of medicine over the past several decades, with diverse applications in ophthalmology, dermatology, and... (Review)
Review
BACKGROUND
Bimatoprost has emerged as a significant medication in the field of medicine over the past several decades, with diverse applications in ophthalmology, dermatology, and beyond. Originally developed as an ocular hypotensive agent, it has proven highly effective in treating glaucoma and ocular hypertension. Its ability to reduce intraocular pressure has established it as a first-line treatment option, improving management and preventing vision loss. In dermatology, bimatoprost has shown promising results in the promotion of hair growth, particularly in the treatment of alopecia and hypotrichosis. Its mechanism of action, stimulating the hair cycle and prolonging the growth phase, has led to the development of bimatoprost-containing solutions for enhancing eyelash growth.
AIM
The aim of our review is to provide a brief description, overview, and studies in the current literature regarding the versatile clinical use of bimatoprost in recent years. This can help clinicians determine the most suitable individualized therapy to meet the needs of each patient.
METHODS
Our methods involve a comprehensive review of the latest advancements reported in the literature in bimatoprost formulations, which range from traditional eye drops to sustained-release implants. These innovations offer extended drug delivery, enhance patient compliance, and minimize side effects.
RESULTS
The vast literature published on PubMed has confirmed the clinical usefulness of bimatoprost in lowering intraocular pressure and in managing patients with glaucoma. Numerous studies have shown promising results in dermatology and esthetics in promoting hair growth, particularly in treating alopecia and hypotrichosis. Its mechanism of action involves stimulating the hair cycle and prolonging the growth phase, leading to the development of solutions that enhance eyelash growth. The global use of bimatoprost has expanded significantly, with applications growing beyond its initial indications. Ongoing research is exploring its potential in glaucoma surgery, neuroprotection, and cosmetic procedures.
CONCLUSIONS
Bimatoprost has shown immense potential for addressing a wide range of therapeutic needs through various formulations and advancements. Promising future perspectives include the exploration of novel delivery systems such as contact lenses and microneedles to further enhance drug efficacy and patient comfort. Ongoing research and future perspectives continue to shape its role in medicine, promising further advancements and improved patient outcomes.
PubMed: 38794131
DOI: 10.3390/ph17050561 -
Ethiopian Journal of Health Sciences Jul 2023Glaucoma is a serious eye disease that impairs eyesight and negatively impacts quality of life. If left untreated, glaucoma can lead to blindness. This study aims at...
BACKGROUND
Glaucoma is a serious eye disease that impairs eyesight and negatively impacts quality of life. If left untreated, glaucoma can lead to blindness. This study aims at assessing the quality of life among glaucoma patients in the West Bank (WB) of Palestine and main influencing the factors.
METHODS
This is a cross-sectional study and included two questionnaires; the Short-Form 36 Health Survey (SF-36) and Glaucoma Quality of Life-15 (GQL-15). Data were collected from a systematically randomized 100 glaucoma patients in the WB. ANOVA test was used to compare means of continuous variables at a statistically significant P value ≤ to 0.05.
RESULTS
The overall quality of life among glaucoma patients was relatively suboptimal. The analysis revealed that the glaucoma quality of life is worse among older patients (mean=3.55±0.64), patients who are less educated (mean=3.91±0.77), among patients who were unemployed (mean=3.44±0.86), and patients who were treated in private clinics (3.57±0.8). Patients with good health (mean=2.48±0.94), type of glaucoma (close glaucoma; mean=3.22±0.9), less than 5 years duration of glaucoma (mean=2.88±1.13), and less than 5 years duration of cryonic diseases (mean=2.48±0.73 have a better glaucoma quality of life.
CONCLUSIONS
This study revealed numerous factors that can impact the quality of life of glaucoma patients in WB. Health professionals, specialists, ophthalmologists, and health educators should be aware of how various socioeconomic and general health factors impact the quality of life of glaucoma patients in order to better diagnose, manage, guide, and educate patients for better health outcomes.
Topics: Humans; Quality of Life; Cross-Sectional Studies; Female; Male; Glaucoma; Middle Aged; Aged; Adult; Surveys and Questionnaires; Middle East; Arabs
PubMed: 38784204
DOI: 10.4314/ejhs.v33i4.4 -
Scientific Reports May 2024Glaucoma is a progressive neurodegenerative disease characterized by the gradual degeneration of retinal ganglion cells, leading to irreversible blindness worldwide....
Glaucoma is a progressive neurodegenerative disease characterized by the gradual degeneration of retinal ganglion cells, leading to irreversible blindness worldwide. Therefore, timely and accurate diagnosis of glaucoma is crucial, enabling early intervention and facilitating effective disease management to mitigate further vision deterioration. The advent of optical coherence tomography (OCT) has marked a transformative era in ophthalmology, offering detailed visualization of the macula and optic nerve head (ONH) regions. In recent years, both 2D and 3D convolutional neural network (CNN) algorithms have been applied to OCT image analysis. While 2D CNNs rely on post-prediction aggregation of all B-scans within OCT volumes, 3D CNNs allow for direct glaucoma prediction from the OCT data. However, in the absence of extensively pre-trained 3D models, the comparative efficacy of 2D and 3D-CNN algorithms in detecting glaucoma from volumetric OCT images remains unclear. Therefore, this study explores the efficacy of glaucoma detection through volumetric OCT images using select state-of-the-art (SOTA) 2D-CNN models, 3D adaptations of these 2D-CNN models with specific weight transfer techniques, and a custom 5-layer 3D-CNN-Encoder algorithm. The performance across two distinct datasets is evaluated, each focusing on the macula and the ONH, to provide a comprehensive understanding of the models' capabilities in identifying glaucoma. Our findings demonstrate that the 2D-CNN algorithm consistently provided robust results compared to their 3D counterparts tested in this study for glaucoma detection, achieving AUC values of 0.960 and 0.943 for the macular and ONH OCT test images, respectively. Given the scarcity of pre-trained 3D models trained on extensive datasets, this comparative analysis underscores the overall utility of 2D and 3D-CNN algorithms in advancing glaucoma diagnostic systems in ophthalmology and highlights the potential of 2D algorithms for volumetric OCT image-based glaucoma detection.
Topics: Tomography, Optical Coherence; Humans; Glaucoma; Algorithms; Neural Networks, Computer; Imaging, Three-Dimensional; Optic Disk; Retinal Ganglion Cells
PubMed: 38783015
DOI: 10.1038/s41598-024-62411-6 -
Scientific Reports May 2024To explore altered patterns of static and dynamic functional brain network connectivity (sFNC and dFNC) in Primary angle-closure glaucoma (PACG) patients. Clinically...
To explore altered patterns of static and dynamic functional brain network connectivity (sFNC and dFNC) in Primary angle-closure glaucoma (PACG) patients. Clinically confirmed 34 PACG patients and 33 age- and gender-matched healthy controls (HCs) underwent evaluation using T1 anatomical and functional MRI on a 3 T scanner. Independent component analysis, sliding window, and the K-means clustering method were employed to investigate the functional network connectivity (FNC) and temporal metrics based on eight resting-state networks. Differences in FNC and temporal metrics were identified and subsequently correlated with clinical variables. For sFNC, compared with HCs, PACG patients showed three decreased interactions, including SMN-AN, SMN-VN and VN-AN pairs. For dFNC, we derived four highly structured states of FC that occurred repeatedly between individual scans and subjects, and the results are highly congruent with sFNC. In addition, PACG patients had a decreased fraction of time in state 3 and negatively correlated with IOP (p < 0.05). PACG patients exhibit abnormalities in both sFNC and dFNC. The high degree of overlap between static and dynamic results suggests the stability of functional connectivity networks in PACG patients, which provide a new perspective to understand the neuropathological mechanisms of optic nerve damage in PACG patients.
Topics: Humans; Glaucoma, Angle-Closure; Female; Male; Middle Aged; Magnetic Resonance Imaging; Aged; Nerve Net; Case-Control Studies; Brain
PubMed: 38778225
DOI: 10.1038/s41598-024-62635-6 -
Investigative Ophthalmology & Visual... May 2024A thin cornea is a potent risk factor for glaucoma. The underlying mechanisms remain unexplained. It has been postulated that central corneal thickness (CCT) may be a...
PURPOSE
A thin cornea is a potent risk factor for glaucoma. The underlying mechanisms remain unexplained. It has been postulated that central corneal thickness (CCT) may be a surrogate for biomechanical parameters of the posterior eye. In this study, we aimed to explore correlations of biomechanical responses between the cornea and the optic nerve head (ONH) and the peripapillary sclera (PPS) to elevated intraocular pressure (IOP), the primary risk factor of glaucoma.
METHODS
Inflation tests were performed in nine pairs of human donor globes. One eye of each pair was randomly assigned for cornea or posterior eye inflation. IOP was raised from 5 to 30 millimeters of mercury (mmHg) at 0.5 mmHg steps in the whole globe and the cornea or the ONH/PPS was imaged using a 50 MHz ultrasound probe. Correlation-based ultrasound speckle tracking was used to calculate tissue displacements and strains. Associations of radial, tangential, and shear strains at 30 mmHg between the cornea and the ONH or PPS were evaluated.
RESULTS
Corneal shear strain was significantly correlated with ONH shear strain (R = 0.857, P = 0.003) and PPS shear strain (R = 0.724, P = 0.028). CCT was not correlated with any strains in the cornea, ONH, or PPS.
CONCLUSIONS
Our results suggested that an eye that experiences a larger shear strain in the cornea would likely experience a larger shear strain in its ONH and PPS at IOP elevations. The strong correlation between the cornea's and the ONH's shear response to IOP provides new insights and suggests a plausible explanation of the cornea's connection to glaucoma risk.
Topics: Humans; Optic Disk; Cornea; Intraocular Pressure; Biomechanical Phenomena; Aged; Middle Aged; Sclera; Male; Female; Glaucoma; Aged, 80 and over; Tissue Donors; Adult
PubMed: 38776117
DOI: 10.1167/iovs.65.5.34 -
BMJ Open May 2024To assess whether patients from minority ethnic groups have different perceptions about the quality-of-life outcomes that matter most to them. (Observational Study)
Observational Study
OBJECTIVES
To assess whether patients from minority ethnic groups have different perceptions about the quality-of-life outcomes that matter most to them.
DESIGN
Cross-sectional observational study.
SETTING
High volume eye centres serving the most ethnically diverse region in the UK, recruiting from July 2021 to February 2022.
PARTICIPANTS
511 patients with primary open-angle glaucoma and the predisease state of ocular hypertension.
MAIN OUTCOME MEASURES
The main outcome was participants' self-reported priorities for health outcomes.
RESULTS
Participants fell into one of four clusters with differing priorities for health outcomes, namely: (1) vision, (2) drop freedom, (3) intraocular pressure and (4) one-time treatment. Ethnicity was the strongest determinant of cluster membership after adjusting for potential confounders. Compared with white patients prioritising vision alone, the OR for black/black British patients was 7.31 (95% CI 3.43 to 15.57, p<0.001) for prioritising drop freedom; 5.95 (2.91 to 12.16, p<0.001) for intraocular pressure; and 2.99 (1.44 to 6.18, p=0.003) for one-time treatment. For Asian/Asian British patients, the OR was 3.17 (1.12 to 8.96, p=0.030) for prioritising intraocular pressure as highly as vision. Other ethnic minority groups also had higher ORs for prioritising health outcomes other than vision alone: 4.50 (1.03 to 19.63, p=0.045) for drop freedom and 5.37 (1.47 to 19.60, p=0.011) for intraocular pressure.
CONCLUSIONS
Ethnicity is strongly associated with differing perceptions about the health outcomes that matter. An individualised and ethnically inclusive approach is needed when selecting and evaluating treatments in clinical and research settings.
Topics: Humans; Male; Female; United Kingdom; Cross-Sectional Studies; Aged; Quality of Life; Glaucoma, Open-Angle; Middle Aged; Intraocular Pressure; Ethnicity; Ocular Hypertension; Health Priorities
PubMed: 38772893
DOI: 10.1136/bmjopen-2023-081998