Open-angle Pseudoexfoliation Glaucoma Research Articles

The Effect of Latanoprostene Bunod 0.024% on Optical Coherence Tomography Angiography in Newly Diagnosed Open Angle Glaucoma.

The aim of this study was to investigate the effect of topical latanoprostene bunod 0.024% applied once daily on intraocular pressure and macular vessel density in newly diagnosed primary and pseudoexfoliative open angle glaucoma patients. A total of 66 patients with newly diagnosed open angle glaucoma were included in this study (group 1). Thirty-four patients had primary (POAG, group 1A) and 32 patients had secondary (pseudoexfoliative glaucoma, PXG, group 1B) open angle glaucoma. Thirty-two healthy participants (group 2) were included in this single-center, prospective study. In group 1, the mean IOP decrease in first month of treatment with LBN was 7.7mm Hg and IOP change was -30.8%. In the superficial slab, the vessel density (VD) in the superior and nasal quadrants was lower in group 1B compared to group 1A in the first month of treatment (P=0.038, P=0.019, respectively). In the choriocapillaris slab, the VD in the superior quadrant at baseline (before treatment) was statistically lower in both groups compared to the VD in the superior quadrant in the first month of treatment (P<0.001, for both). In conclusion, treatment with LBN ophthalmic solution 0.024% reduced IOP by an average of 29.9% and 31.8% in patients with POAG and PXG, respectively, and improved VD in different quadrants in all slabs. Therefore, the importance of LBN in the treatment of glaucoma is likely to be that it increases macular microcirculation, possibly via NO, independent of its IOP-reducing effect.

Role of N6-methyladenosine-related lncRnas in pseudoexfoliation glaucoma

ABSTRACT To explore the role of lncRNA m6A methylation modification in aqueous humour (AH) of patients with pseudoexfoliation glaucoma (PXG). Patients with open-angle PXG under surgery from June 2021 to December 2021 were selected. Age- and gender-matched patients with age-related cataract (ARC) were chosen as control. Patients underwent detailed ophthalmic examinations. 0.05–0.1 ml AH were extracted during surgery for MeRIP-Seq and RNA-Seq. Joint analysis was used to screen lncRNAs with differential m6A methylation modification and expression. Online software tools were used to draw lncRNA-miRNA-mRNA network (ceRNA). Expression of lncRNAs and mRNAs was confirmed using quantitative real-time PCR. A total of 4151 lncRNAs and 4386 associated m6A methylation modified peaks were identified in the PXG group. Similarly, 2490 lncRNAs and 2595 associated m6A methylation modified peaks were detected in the control. Compared to the ARC group, the PXG group had 234 hypermethylated and 402 hypomethylated m6A peaks, with statistically significant differences (| Fold Change (FC) |≥2, p < 0.05). Bioinformatic analysis revealed that these differentially methylated lncRNA enriched in extracellular matrix formation, tight adhesion, TGF- β signalling pathway, AMPK signalling pathway, and MAPK signalling pathway. Joint analysis identified 10 lncRNAs with differential m6A methylation and expression simultaneously. Among them, the expression of ENST000000485383 and ROCK1 were confirmed downregulated in the PXG group by RT-qPCR. m6A methylation modification may affect the expression of lncRNA and participate in the pathogenesis of PXG through the ceRNA network. ENST000000485383-hsa miR592-ROCK1 May be a potential target pathway for further investigation in PXG m6A methylation.

Case Report: Temporary management of delayed postoperative hypotony with Baerveldt tube: Ab Interno stenting using 3-0 nylon suture

Background To describe the management of delayed postoperative hypotony and choroidal detachment in a 79-year-old female patient with advanced pseudoexfoliative open-angle glaucoma. Case The patient, refractory to maximal medical therapy, underwent Baerveldt tube implantation with a ripcord using a 4-0 nylon suture. Ripcord removal and the reintroduction of antiglaucoma medication were initiated in response to a hypertensive phase. Delayed postoperative hypotony and choroidal effusions were managed through ab interno stenting of the tube, employing a 3-0 nylon suture. Ab interno stenting of the tube, employing a short segment of 3-0 nylon suture, initially addressed delayed postoperative hypotony and choroidal effusions. However, recurrence of hypotony and choroidal detachment occurred as the short stent descended into the anterior chamber. To manage the recurrent hypotony, Baerveldt tube truncation was performed, along with re-stenting of the tube using a longer 3-0 Nylon ripcord. Conclusions While ab interno occlusion with a short segment of 3-0 nylon suture may offer temporary hypotony control, the risk of segment descent warranted the use of a longer ripcord to enhance efficacy and stability.

Increased concentration of tumour necrosis factor alpha in the plasma of glaucoma patients

Background/Aim. Changes in the concentration of various mediators of inflammation in blood, aqueous humor, or eye tissues support the role of inflammation in the pathogenesis of open-angle glaucoma (OAG). Inflammatory biomarkers have a great potential for application in clinical practice. The aim of the study was to determine concentrations of tumor necrosis factor (TNF)-? in the plasma of patients with OAG and subjects without glaucoma and examine the correlation between the TNF-? concentration in plasma in glaucoma patients and specific clinical parameters. Methods. The study included 87 participants (87 eyes) divided into three groups: 35 subjects (35 eyes) with primary OAG (POAG) with elevated intraocular pressure (IOP) ? hypertension glaucoma (HTG) (POAG-HTG), 23 subjects (23 eyes) with pseudoexfoliative OAG (XFG), and 29 subjects in the control group (healthy subjects) matched with the patient groups in terms of age and gender. We performed a complete clinical examination, including standard automated perimetry and determination of changes in the participant?s repeated visual field, optical coherence tomography and determination of peripapillary retinal nerve fiber layer (RNFL) thickness. The concentration of TNF-? in participants? plasma was measured using commercial enzyme-linked immunosorbent assay ? ELISA. Results. The concentrations of TNF-? in the plasma of glaucoma patients (POAG-HTG 2.04 ? 1.98 pg/mL and XFG OAG 2.05 ? 1.48 pg/mL) were significantly higher than in healthy subjects (1.43 ? 2.00 pg/mL, p &lt; 0.05). In none of the groups of subjects suffering from glaucoma was there a statistically significant correlation of TNF-? concentration in the plasma with any of the clinical parameters, including IOP, cup/disk ratio, mean deviation, average RNFL, and RNFL in the superior and inferior quadrant. Conclusion. The concentration of the pro-inflammatory cytokine TNF-? in the plasma is significantly higher in glaucoma patients compared to non-glaucomatous subjects, and it confirms the role of inflammation in the pathogenesis of glaucoma as one of the non-inflammatory ocular diseases. The concentrations of TNF-? in the plasma of glaucoma patients did not correlate with any of the examined clinical parameters; hence, it cannot be considered a measure of progression and damage in glaucoma.

Структурно-функциональные и гемодинамические особенности у пациентов с простой первичной и псевдоэксфолиативной открытоугольной глаукомой и офтальмогипертензией

Структурно-функциональные и гемодинамические особенности у пациентов с простой первичной и псевдоэксфолиативной открытоугольной глаукомой и офтальмогипертензией

Структурно-функциональные и гемодинамические характеристики при простой первичной и псевдоэксфолиативной открытоугольной глаукоме и офтальмогипертензии

Структурно-функциональные и гемодинамические характеристики при простой первичной и псевдоэксфолиативной открытоугольной глаукоме и офтальмогипертензии

Clinical characteristics of newly diagnosed primary, pigmentary and pseudoexfoliative open-angle glaucoma in the Collaborative Initial Glaucoma Treatment Study

Background/aimsThree types of open-angle glaucoma (OAG)—primary, pigmentary and pseudoexfoliative—are frequently encountered. The aim of this study was to compare demographic, ocular and systemic medical information collected on people with these...

CO2 Laser-assisted Sclerectomy Surgery for Open-angle Glaucoma

Purpose:To evaluate the safety and performance of CO2 laser-assisted sclerectomy surgery (CLASS).Materials and Methods:CLASS using the IOPtiMate™ system was performed in experimental models and in patients with primary and pseudoexfoliative open-angle glaucoma. CO2 laser was used to achieve deep scleral ablation. Percolation and perforation rates were recorded. Histopathological analysis was performed on laboratory models, complications were recorded and postoperative intraocular pressure (IOP) was measured.Results:Deep scleral ablation and aqueous percolation were repeatedly achieved. Histology disclosed deep scleral craters with a thin intact sclero-corneal tissue at the ablation area with mild, transient and limited thermal damage. Thirty of 37 patients with glaucoma completed 12 months of follow-up. The baseline IOP of 26.3 ± 7.8 mmHg (mean ± SD) dropped to 14.4 ± 3.4 mmHg and 14.3 ± 3.1 mmHg at six and 12 months, respectively (p&lt;0.001). Complications were mild and transitory with no sequelae.Conclusions:CLASS using the IOPtiMate system is a safe and efficacious procedure for achieving effective fluid percolation.

C677T variant in the methylentetrahydrofolate reductase gene is a genetic risk factor for primary open-angle glaucoma

To estimate the prevalence of C677T single nucleotide polymorphism in the 5,10-methylentetrahydrofolate reductase (MTHFR) gene in primary open-angle glaucoma (POAG) and pseudoexfoliation open-angle glaucoma (PEXG). Case-control study MTHFR was assessed in 147 patients (76 POAG, 71 PEXG) and 71 control subjects with cataract. Associations of genotypes were assessed by Armitage's trend test and the corresponding odds ratio (OR) for allele positivity with 95% confidence interval (CI). We observed significant evidence of a higher prevalence of C677T in POAG (9% homozygote, 49% heterozygote, 42% wildtype, P = .01, OR = 2.38, 95% CI 1.23-4.62), but not in PEXG (9% homozygote, 41% heterozygote, 50% wildtype, P = .09, OR = 1.78, 95% CI 0.91-3.50) compared with the controls (3% homozygote, 34% heterozygote, 63% wildtype). The MTHFR C677T variant leading to moderate hyperhomocysteinemia may play a role in the pathogenesis of POAG acting as a genetic risk factor.

Elevated homocysteine levels in aqueous humor of patients with pseudoexfoliation glaucoma

Purpose To determine total homocysteine levels in aqueous humor of pseudoexfoliation open-angle glaucoma patients. Design Case-control study. Methods Total homocysteine levels were measured by enzyme-linked immunosorbent assay in aqueous humor and plasma of 29 patients with pseudoexfoliation glaucoma and 31 control patients with cataract. Patients with factors affecting homocysteine levels were excluded. Results We observed significantly elevated (twofold) homocysteine levels in the aqueous humor of the glaucoma patients ( Z = −5.11, P < .0001). Additionally, the calculated ratio (plasma:aqueous humor) was significantly lower in these patients ( Z = −3.57, P < .001), and aqueous homocysteine was significantly correlated with their respective elevated plasma levels ( r = .42, P = .02). Conclusions Because homocysteine induces vascular injury and alterations of extracellular matrix, high aqueous homocysteine may trigger the abnormal matrix accumulation characteristic. It may reflect the proposed impairment of the blood-aqueous barrier of pseudoexfoliation open-angle glaucoma and be involved in its pathogenesis.