Iris Of Patients Research Articles

Global and Comparative Proteome Signatures in the Lens Capsule, Trabecular Meshwork, and Iris of Patients With Pseudoexfoliation Glaucoma.

Pseudoexfoliation (PXF) is characterized by the accumulation of the exfoliative material in the eye and high rates of blindness if left untreated. Pseudoexfoliation glaucoma (PXG) is generally diagnosed too late due to its asymptomatic nature, necessitating the development of new effective screening tools for the early diagnosis of the disease. Thus, the increasing prevalence of this disease due to an aging population has demanded the identification of suitable biomarkers for the early detection of the disease or detection of the onset of glaucoma in the eyes with PXF. We applied a proteomics strategy based on a high-throughput screening method for the determination of proteins involving PXF and PXG pathogenesis. The lens capsule (LC), iris, and trabecular meshwork (TM) samples with PXF and PXG were taken by surgical trabeculectomy, and control samples were taken from the donor corneal buttons obtained from the institutional eye bank to characterize the proteome profile. Peptides from the LC were analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS). The protein of interest and cytokine/chemokine profiles were verified using immunohistochemistry and the bio-plex kit assay, respectively. There were a total of 1433 proteins identified in the human LC, of which 27 proteins were overexpressed and eight proteins were underexpressed in PXG compared with PXF. Overexpressed proteins such as fibromodulin, decorin, lysyl oxidase homolog 1, collagen alpha-1(I) chain, collagen alpha-3(VI) chain, and biglycan were the major components of the extracellular matrix (ECM) proteins involved in cell-matrix interactions or ECM proteoglycans and the assembly and cross-linking of collagen fibrils. The ECM composition and homeostasis are altered in glaucoma. Thus, quantitative proteomics is a method to discover molecular markers in the eye. Monitoring these events can help evaluate disease progression in future studies.

Comparison of anterior chamber angle parameters and iris structure of juvenile open-angle glaucoma and pigmentary glaucoma.

Purpose:To compare the quantitative measurements of the anterior chamber angle (ACA) and iris parameters in patients with juvenile open-angle glaucoma (JOAG), pigmentary glaucoma (PG), and healthy controls using anterior segment optical coherence tomography (AS-OCT).Methods:This was a retrospective, cross-sectional study of 25 eyes with JOAG, 25 eyes with PG, and 25 control eyes. Anterior chamber depth, angle-opening distance 500 and 750, trabecular–iris space 500 and 750, scleral spur angle, iris thickness (IT, measured at the thickest part), and iris bowing were obtained using AS-OCT (Visante” OCT 3.0 Model 1000, Carl Zeiss Meditec, Inc).Results:The quantitative ACA parameters were found to be significantly higher in JOAG and PG patients compared to healthy controls (P < 0.001); there was no significant difference between the eyes with JOAG and PG (P > 0.05). In eyes with JOAG and PG, there was significantly backward bowing of the iris in temporal and nasal angles compared to control subjects (P < 0.001). Median iris bowing was not significantly different between the patients with JOAG and PG (P > 0.05). The temporal and nasal angle iris thickness were significantly thinner in eyes with JOAG than the eyes with PG (P < 0.001) and age-matched control subjects (P < 0.001). The median IT did not differ between the patients with PG and control subjects (P > 0.05). In patients with JOAG, the intraocular pressure (IOP) was inversely correlated with IT (r = -0.43, P < 0.05).Conclusion:AS-OCT provided quantitative data on the ACA and iris parameters in JOAG and PG. The evaluation of the ACA and iris structures using AS-OCT revealed higher ACA measurements and posterior bowing of the iris in patients with JOAG and PG. Furthermore, the patients with JOAG were found to have thinner IT than the ones with PG and healthy controls.

Dynamics of Plasmatic Levels of Pro- and Anti-Inflammatory Cytokines in HIV-Infected Individuals with M. tuberculosis Co-Infection.

Tuberculosis (TB) and HIV have profound effects on the immune system, which can lead to the activation of viral replication and negatively regulate the activation of T cells. Dysregulation in the production of cytokines necessary to fight HIV and M. tuberculosis may ultimately affect the results of the treatment and be important in the pathogenesis of HIV infection and TB. This work presents the results of a study of the expression of pro- and anti-inflammatory cytokines (IFN-γ, TNF-α, IL-2, IL-4, IL-6, IL-10, IL-1RA) in drug-naïve patients with dual infection of HIV/TB at the late stages of HIV-infection, with newly diagnosed HIV and TB, and previously untreated HIV in the process of receiving antiretroviral (ART) and TB treatment vs. a cohort of patients with HIV monoinfection and TB monoinfection. The study revealed that during a double HIV/TB infection, both Th1 and Th2 immune responses are suppressed, and a prolonged dysregulation of the immune response and an increased severity of the disease in pulmonary/extrapulmonary tuberculosis is observed in HIV/TB co-infection. Moreover, it was revealed that a double HIV/TB infection is characterized by delayed and incomplete recovery of immune activity. High levels of IL-6 were detected in patients with HIV/TB co-infection before initiation of dual therapy (2.1-fold increase vs. HIV), which persisted even after 6 months of treatment (8.96-fold increase vs. HIV), unlike other cytokines. The persistent enhanced expression of IL-6 in patients with dual HIV/TB co-infection allows the consideration of it as a potential marker of early detection of M. tuberculosis infection in HIV-infected individuals. The results of multivariate regression analysis showed a statistical trend towards an increase in the incidence of IRIS in patients with high IL-1Ra levels (in the range of 1550–2500 pg/mL): OR = 4.3 (95%CI 3.7–14.12, p = 0.53), which also allows IL-1Ra to be considered as a potential predictive biomarker of the development of TB-IRIS and treatment outcomes.

Vascular Endothelial Growth Factor, Basic Fibroblast Growth Factor, and Pigment Epithelium-Derived Factor Expression in the Neovascular Iris in Retinal Diseases.

Objective To determine the expression of cytokines in the iris of patients with neovascular glaucoma (NVG). Methods Patients with NVG associated with proliferative diabetic retinopathy (PDR, group 1) or central retinal vein occlusion (CRVO, group 2) who had undergone surgical treatment were enrolled. Patients with primary open-angle glaucoma requiring surgical treatment were included in the control group (group 3). All iris specimens were obtained during trabeculectomy, 7 days after intravitreal injections of ranibizumab. The messenger RNA (mRNA) and protein levels of three target cytokines—vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and pigment epithelium-derived factor (PEDF)—in the iris were analyzed and compared. Results We included 39 eyes from 39 patients (12, 15, and 12 in groups 1, 2, and 3, resp.). The protein and mRNA levels of PEDF were higher in two NVG groups. The protein levels, but not mRNA level, of bFGF were higher in the two NVG groups. The protein and mRNA levels of VEGF were similar in the three groups. Conclusions The protein level of bFGF increased in the irises of the NVG patients was not expressed by the iris itself, whereas PEDF may be expressed by the iris tissue in these patients.

The color of the iris in patients with neuronal intranuclear hyaline inclusion disease will change?

The color of the iris in patients with neuronal intranuclear hyaline inclusion disease will change?

Iris ultrastructure in patients with synechiae as revealed by in vivo laser scanning confocal microscopy : In vivo iris ultrastructure in patients with Synechiae by Laser Scanning Confocal Microscopy.

BackgroundIris plays important roles in ocular physiology and disease pathogenesis. Currently it is technically challenging to noninvasively examine the human iris ultrastructure in vivo. The purpose of the current study is to reveal human iris ultrastructure in patients with synechiae by using noninvasive in vivo laser scanning confocal microscopy (LSCM).MethodsThe ultrastructure of iris in thirty one patients, each with synechiae but transparent cornea, was examined by in vivo LSCM.ResultsFive characteristic iris ultrastructures was revealed in patients with synechiae by in vivo LSCM, which include: 1. tree trunk-like structure; 2. tree branch/bush-like structure; 3. Fruit-like structure; 4. Epithelioid-like structure; 5. deep structure. Pigment granules can be observed as a loose structure on the top of the arborization structure. In iris-associated diseases with Tyndall’s Phenomenon and keratic precipitates, the pigment particles are more likely to fall off from the arborization structure.ConclusionsThe ultrastructure of iris in patients with synechiae has been visualized using in vivo LSCM. Five iris ultrastructures can be clearly observed, with some of the structures maybe disease-associated. The fall-off of the pigment particles may cause the Tyndall’s Phenomenon positive. In vivo LSCM provides a non-invasive approach to observe the human iris ultrastructure under certain eye disease conditions, which sets up a foundation to visualize certain iris-associated diseases in the future.Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-016-0224-2) contains supplementary material, which is available to authorized users.

Plateau Iris in Primary Angle Closure Glaucoma

To determine prevalence and anterior segment morphology of plateau iris in patients with primary angle closure glaucoma (PACG) after laser peripheral iridotomy using ultrasound biomicroscopy (UBM). In this prospective study, 262 PACG patients and 144 normal controls underwent UBM examination. Plateau iris in a quadrant was defined by the presence of anteriorly directed ciliary process, absent ciliary sulcus, steep iris root from its point of insertion followed by a downward angulation, flat iris plane, and irido-angle contact in the same quadrant. At least 2 quadrants had to fulfill these UBM criteria. UBM analysis showed plateau iris in 83/262 (31.68%, 95% confidence interval: 26.7%-37.9%) PACG eyes, it was common in female individuals (61.44%), and patients were significantly younger than PACG patients (P=0.006). Plateau iris was found in superior quadrant in 19/83 (22.89%) eyes, inferior quadrant in 19/83 (22.89%) eyes, nasal quadrant in 21/83 (25.3%) eyes, and temporal quadrant in 24/83 (28.91%) eyes. In plateau iris patients, the central anterior chamber depth was shallower, the anterior chamber angle, the scleral-iris angle, and the sclera-ciliary process angle were significantly narrower, and the trabecular ciliary process distance and the iris ciliary process distance were significantly shorter in patients than in PACG subjects. Patients with plateau iris had significantly shallow central ACD when compared with those with pupillary block and normal eyes. After laser peripheral iridotomy, about a third of PACG eyes had plateau iris. This is clinically important because these patients can develop synechial angle closure and should be followed up closely.

T-helper1/T-helper2 cytokine imbalance in the iris of patients with glaucoma.

The mechanistic study of glaucoma pathogenesis has shifted to seeking to understand the effects of immune responses on retinal ganglion cell damage and protection. Cytokines mediate the biological effects of the immune system, and our previous study revealed an imbalance of T-helper (Th) 1-derived and Th2-derived cytokines in the serum of patients with glaucoma. In this study, we collected irises from normal individuals and patients with primary open-angle closure (POAG) or chronic angle-closure glaucoma (CACG). We used real-time polymerase chain reaction (PCR) to measure the expression of Th1 (interleukin (IL)-2, interferon-gamma (IFN-γ)), Th2 (IL-4, IL-6, IL-10), and Th3 (transforming growth factor-beta (TGF-β)) cytokines. We then performed immunohistochemical staining to characterize the localization of the upregulated cytokines in iris cryosections. We observed an upward trend in the expression of IL-2 and IFN-γ and a downward trend in IL-6 expression in the iris of POAG and CACG patients. Expression of TGF-β also increased. Immunohistochemistry revealed that IL-2 expression in POAG and CACG patients was localized in the anterior surface of the blood vessel wall in the stroma of the iris, in the cytoplasm of some cells, in the anterior epithelium, and in the posterior pigment epithelium. These findings indicate that immune status differed between the iris tissues of POAG and CACG patients and those of normal individuals. A T-helper cytokine imbalance may modulate the immune microenvironment in glaucomatous eyes and thus influence optic neuropathy.

Expression of cytokines on the iris of patients with neovascular glaucoma.

To determine the expression levels of cytokines, including growth factors, inflammatory cytokines, and cell migration associated factors on the iris from subjects with neovascular glaucoma (NVG). After receiving formal consent from 12 subjects with NVG secondary to proliferative diabetic retinopathy and 12 subjects with primary open angle glaucoma (POAG), trabeculectomy was performed and iris specimens were collected during the surgery. Each subject with NVG received intravitreal injection of bevacizumab 1week prior to the surgery. The mRNA level of vascular endothelial growth factor, basic fibroblastic growth factor, placental-induced growth factor, interleukin-2, interleukin 6, tumour necrosis factor α, intercellular adhesion molecule 1 (ICAM-1) and integrin subunit αV were determined by real-time polymerase chain reaction. The mRNA levels were compared between the two groups. The mRNA levels of all inflammatory cytokines and integrin subunit αV were significantly increased in the NVG group compared with POAG controls. However, the mRNA level of growth factors and ICAM-1 did not show any difference between the two groups. Inflammatory process maybe an important cause of iris neovascularization in subjects with NVG in addition to growth factors alone. Further studies should focus on the effect of growth factors in different phases in the pathogenesis of NVG.

PReS-FINAL-2153: Intestinal gamma/delta- T cells are upregulated in children with active uveitis

Conclusion Our finding suggests, that intestinal immune activation involving the increase of g/δ lymphocytes contributes to the pathogenesis of uveitis in children with JIA. Although both the factors inducing the intestinal mucosal immune activation in JIA and the mechanism linking intestinal activation and uveitis remain speculative, we suspect that pathological entry of the gut originating lymphocytes into the iris is possible because intensive distribution of the adhesion molecules on the endothelium of the vessels in the iris in patients with uveitis. Our finding encourages to study the potential role of gastrointestinal factors in the pathogenesis of uveitis associated with JIA. Our finding together with reports of experimental autoimmune uveitis models support the hypothesis of gut mucosa, gut lymphocyte homing receptors in the uvea, and the role of gut originating lymphocytes in the development of uveitis.

A Novel Cyclosporine A Drug-Delivery System for Prevention of Human Corneal Rejection after High-risk Keratoplasty: A Clinical Study

To evaluate the efficacy of a novel cyclosporine A (CsA) drug-delivery system (DDS) in the anterior chamber for suppressing the occurrence of rejection and improving the survival of corneal allografts after high-risk keratoplasty. Single-center, noncomparative case series. Ninety-two eyes of 92 patients with corneal blindness who required corneal transplantation at Shandong Eye Institute from May 2003 to June 2011. The CsA DDS was implanted into the anterior chamber during high-risk keratoplasty, and subsequent therapeutic effects were evaluated. Occurrence and reversal of graft rejection within 12 months after surgery, long-term survival of corneal grafts (>12 months), biodegradation of the CsA DDS, endothelial cell density by noncontact specular microscopy, and iris status by ultrasound biomicroscopy (UBM). At 6 months, the transplantation was scored as success in 81 eyes (88.0%), partial success in 7 eyes (7.6%), and failure in 4 eyes (4.3%). The mean graft survival time was 36.1 ± 17.7 months (range, 12.3-61.6 months). The carrier of the CsA DDS, polylactide-co-glycolide-co-caprolactone, biodegraded completely at 7.6 ± 4.3 months (range, 5-13 months). The density of endothelial cells was 2154 ± 230 cells/mm(2) (range, 2067-2319 cells/mm(2)) immediately after surgery and 2079 ± 156 cells/mm(2) (range, 1950-2254 cells/mm(2); P > 0.05) at 6 months. No edema of corneal stroma and iris was observed by UBM. The CsA DDS implanted in the anterior chamber seems to be effective for the prophylaxis of immune rejection after high-risk keratoplasty without toxicity to the cornea and the iris of patients. It can decrease the rejection episode and prolong the survival time of allografts. The anterior chamber may be a promising drug-delivery target for treatment or prevention of endothelial graft rejection after corneal transplantation.

Further data on the association between Helicobacter pylori infection and primary open-angle glaucoma

Further data on the association between Helicobacter pylori infection and primary open-angle glaucoma

Prevalence of plateau iris configuration in primary angle closure glaucoma using ultrasound biomicroscopy in the Indian population

Purpose:To report the prevalence of plateau iris in patients with primary angle closure glaucoma (PACG), in North India.Materials and Methods:The patients with PACG, attending the glaucoma services at a tertiary care center in North India were included in the study. All patients had undergone Nd-YAG laser peripheral iridotomy at least four weeks prior to inclusion in the study. Four weeks prior to inclusion in the study, none of the patients had used pilocarpine. Ultrasound Biomicroscopy (UBM) images were qualitatively evaluated and plateau iris configuration was defined in an eye if the following criteria were fulfilled in two or more quadrants: anteriorly directed ciliary process supporting the peripheral iris, steep rise of iris root from its point of insertion followed by a downward angulation from the corneoscleral wall, absent ciliary sulcus, and iridotrabecular contact in the same quadrant.Results:One hundred and one eyes were included in the study. There were 63 (62.4%) females and 38 (37.6%) males. The mean age of the patients was 57.8 ± 9.5 years (range: 42 to 78 years). The mean axial length in the study population was 22.2 ± 1.1 mm. The mean spherical equivalent refraction was 0.06 ± 1.12 D. The mean intraocular pressure was 18.5 ± 4.7 mmHg (range: 12 – 24 mmHg). Twenty-nine (28.7%) subjects were diagnosed with plateau iris on the basis of above-defined criteria. Of the 29 eyes, 18 (62.1%) subjects had plateau iris in two quadrants, nine (31.03%) in three quadrants, and two (6.8%) had this configuration in all the four quadrants.Conclusions:Approximately 30% of the eyes with PACG had plateau iris on UBM. Plateau iris was very often the cause for residual angle closure following laser peripheral iridotomy in Indian eyes with PACG.

Histological Presence of Helicobacter pylori Bacteria in the Trabeculum and Iris of Patients with Primary Open-Angle Glaucoma

Purpose: To investigate the role of Helicobacter pylori in primary open-angle glaucoma (POAG) pathophysiology by detecting its presence in eye biopsies of POAG patients during trabeculectomy. Patients and Methods: Fifty-one consecutive patients who underwent trabeculectomy for POAG not responsive to antiglaucoma therapy, and 35 consecutive anemic controls were examined for H. pylori presence mainly by gastric mucosa histology. In POAG patients, eye biopsies were also obtained and stained for H. pylori presence in situ. Results: Forty-three of 51 (84.3%) POAG patients and 17 of 35 (48.6%) controls were tested H. pylori positive (p = 0.0004). In 5 H. pylori-positive POAG patients, H. pylori bacteria were identified in the trabeculum and iris specimens. Conclusion: For the first time, H. pylori bacteria have been detected histologically in eye biopsies of POAG patients.

Ультраструктурные изменения радужки больных эксфолиативной глаукомой

Ультраструктурные изменения радужки больных эксфолиативной глаукомой

Tamsulosin and floppy iris syndrome in benign prostatic hyperplasia patients

The American Society of Cataract and Refractive Surgery have cautioned ophthalmic surgeons of a new, sporadic problem associated with the pupil during cataract surgery in patients who are taking tamsulosin. The rare syndrome has been christened as intraoperative floppy iris syndrome (IFIS) by ophthalmologists. IFIS is characterised by subnormal preoperative pupil dilation and repeated intraoperative prolapse of a billowing, floppy iris in patients taking tamsulosin hydrochloride. Tamsulosin is the most commonly prescribed α-blocker for the treatment of benign prostatic hyperplasia in the ageing male population. Surprisingly, IFIS is not manifested in patients taking other α-blockers, such as terazosin, doxazosin or prazosin. The aetiology of IFIS with tamsulosin principally involves pharmacological mechanisms. Furthermore, there could be confounding factors (other than potency and selectivity of α-blockers for α1-adrenoceptors) that might be responsible for the association of IFIS with tamsulosin. IFIS will obviously have clinical implications in cataract surgery of benign prostatic hyperplasia patients with a medical history of tamsulosin use.

Latanoprost-induced pigmentation in human iridial melanocytes is fibroblast dependent

The prostaglandin F2α derivative, latanoprost (LT), used in glaucoma treatment, can induce pigmentation in irises of patients with hazel or heterochromatic eye colour. The mechanism by which LT induces pigmentation in the iris is not yet established, although it does not appear to induce proliferation of iridial melanocytes. The purpose of this study was to develop an in vitro model in which to investigate this mechanism. The pigmentary responses to LT and prostaglandin F 2α (PGF 2α) were examined in human iridial melanocytes alone or in co-culture with epithelial cells (non-ocular human epidermal keratinocytes and iris pigment epithelial cells) or mesenchymal cells (non-ocular dermal fibroblasts or iridial fibroblasts). Melanogenesis was assessed after 4 days culture with prostanoids, using dopa oxidase activity. Prostaglandin FP expression on human iridial fibroblasts and melanocytes was investigated using an immunofluorescent technique employing antibody to PGF 2α receptor and RT-PCR. Iridial melanocytes did not show a convincing increase in dopa oxidase when cultured alone but in the presence of fibroblasts (ocular or non-ocular) there was a significant increase (25–30%) in dopa oxidase activity in response to 10 −7–10 −5 m LT and PGF 2α. Co-culture of melanocytes with epithelial cells, while leading to increased dopa oxidase activity, did not lead to any melanogenic response to LT or PGF 2α. FP receptor expression was detected on fibroblasts but not iridial melanocytes by immunocytochemistry and RT-PCR. The melanocyte/fibroblast co-culture model developed in this study also showed that LT and PGF 2α increased dopa oxidase activity in melanocytes from donors with brown but not blue eyes. These results suggest that LT may be inducing pigmentation in the human iris indirectly through the FP receptor on adjacent fibroblasts.

Adhesion molecules in iris biopsy specimens from patients with uveitis

BACKGROUND/AIMSEarlier studies on intraocular tissue have demonstrated that T lymphocytes play a major role in the pathogenesis of uveitis. Adhesion molecules are immunoregulatory molecules for the interaction between T lymphocytes...

Histochemical and polarization optical investigation for glycosaminoglycans in exfoliation syndrome.

The iris of patients with exfoliation syndrome and senile cataracts were studied with a polarization microscope as well as histochemically. Amorphous substance stained by pH 1.0 alcian blue was observed in exfoliation syndrome on the posterior surface of the iris. This layer was thicker in exfoliation syndrome than in senile cataracts. The major component of this layer was verified as chondroitin sulphate and the minor one as hyaluronic acid. Polarization microscopic study demonstrated the presence of more sulphated glycosaminoglycans in exfoliation syndrome than in senile cataracts. Abnormal metabolism of glycosaminoglycans is indicated in the iris of exfoliation syndrome.