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Ophthalmic research [journal]
- Expression of Endoplasmic Reticulum Stress Markers GRP78 and CHOP Induced by Oxidative Stress in Blue Light-Mediated Damage of A2E-Containing Retinal Pigment Epithelium Cells. [JOURNAL ARTICLE]
- Ophthalmic Res 2014 Nov 12; 52(4):224-233.
Aims: Age-related lipofuscin N-retinylidene-N-retinylethanolamine (A2E) accumulated in human retinal pigment epithelium (RPE) cells confers susceptibility to blue light-mediated damage, which represents one pathogenesis of age-related macular degeneration. This study investigated the expression of 2 best-characterized endoplasmic reticulum (ER) stress markers, glucose-related protein 78 (GRP78) and C/EBP homologous protein (CHOP), as well as their regulation by oxidative stress after blue light-mediated damage of A2E-containing RPE cells. Methods: ARPE-19 cells were incubated with A2E (10, 25, 50 μM) for 2 h and exposed to blue light for 20 min. A2E distributions in RPE cells were assessed via laser scanning confocal microscope and liquid chromatography-mass spectrometry. Cell viability was measured by a Cell Titer 96 Aqueous One Solution cell proliferation assay. The quantity of intracellular reactive oxygen species (ROS) was detected by dihydroethidium fluorescence using flow cytometry. Expressions of GRP78 and CHOP were measured at both mRNA and protein levels. To examine the role of oxidative stress in regulating GRP78 and CHOP expression, RPE cells were pretreated with the antioxidant N-acetylcysteine (NAC) for 2 h. RNA interference of GRP78 performed by short hairpin RNA was used to evaluate the effect of GRP78 in blue light-mediated damage of RPE cells. Results: After blue light exposure, A2E-treated RPE cells showed a gradual decrease in cell viability and a particular increase in ROS levels. Meanwhile, the expressions of GRP78 and CHOP in A2E-treated RPE cells were significantly increased at different time points after illumination. Pretreatment with NAC attenuated the expression of 2 ER stress markers, especially CHOP in A2E and blue light-treated RPE cells. Silencing of GRP78 by RNA interference upregulated CHOP and caspase-12 expression as well as aggravated the blue light-mediated damage of A2E-laden RPE cells. Conclusion: RPE cells exhibited ROS accumulation and subsequent elevation of GRP78 and CHOP expression after A2E and blue light-induced damage. The ROS scavenger NAC diminished ER stress protein expression, suggesting a connection between ER and oxidative stress in blue light-mediated damage of A2E-containing RPE cells. Besides, GRP78 may play a protective role in it. © 2014 S. Karger AG, Basel.
- Accuracy of Scheimpflug Holladay Equivalent Keratometry Readings after Corneal Refractive Surgery in the Absence of Clinical History. [JOURNAL ARTICLE]
- Ophthalmic Res 2014 Nov 8; 52(4):217-223.
Background and Objective: To identify the most accurate combination of Pentacam's equivalent keratometry readings (EKR) and intraocular lens power formula when the clinical history is unavailable. Patients and Methods: A total of 18 patients underwent cataract surgery after refractive surgery. The Pentacam 4.5- and 3.0-mm EKR were combined with the SRK II, SRK/T, Hoffer-Q, and Holladay I and II formulas. Results: The smallest deviation from the predicted value was achieved by combining the 4.5 EKR with the Holladay II formula (mean arithmetic deviation, -0.2 ± 0.4 dpt). Conclusion: The 4.5-mm EKR + Holladay II formula can accurately calculate intraocular lens power in patients with previous refractive surgery. © 2014 S. Karger AG, Basel.
- Effectiveness of a Mobile Diabetic Retinopathy Screening Campaign to Encourage Diabetics to Undergo Regular Ophthalmic Follow-Up. [JOURNAL ARTICLE]
- Ophthalmic Res 2014 Nov 7; 52(4):206-211.
Aim: To evaluate the effectiveness of a mobile diabetic retinopathy (DR) screening campaign with a non-mydriatic camera to encourage diabetics to undergo a subsequent ophthalmic follow-up. Methods: Diabetic patients who underwent free DR screening with a non-mydriatic fundus camera were given the recommendation to have an ophthalmic visit, in a time frame suited to the DR stage or in case abnormalities in the macula, the optic nerve or intra-ocular pressure were detected. The photographs were performed by a trained orthoptist. The date of the visit to their ophthalmologist and the report of this consultation were recorded. Results: During 5 annual campaigns, 4,699 diabetics were screened. Of the 1,573 ophthalmic examinations recommended at the screening, 1,241 (79%) were actually conducted. A total of 623 new cases of DR were found in the course of this screening campaign, with a fair concordance between the diagnosis suggested at screening and the examination by the ophthalmologist (κ = 0.48). Conclusion: Information and recommendations given during DR screening helped to reintroduce patients to a regular ophthalmic follow-up, at least in the short term. © 2014 S. Karger AG, Basel.
- Anterior Chamber Paracentesis Might Prevent Sustained Intraocular Pressure Elevation after Intravitreal Injections of Ranibizumab for Age-Related Macular Degeneration. [JOURNAL ARTICLE]
- Ophthalmic Res 2014 Nov 14; 52(4):234-238.
Background/Aims: To evaluate the efficacy of anterior chamber paracentesis for preventing sustained intraocular pressure (IOP) elevation after intravitreal ranibizumab (IVR) injections for age-related macular degeneration (AMD). Methods: The medical records for all cases of exudative AMD treated with IVR injections and followed monthly for 12 months or longer were reviewed retrospectively. Anterior chamber paracentesis was performed just before IVR injections. A sustained IOP elevation was defined as 22 mm Hg or higher during 2 consecutive visits with an increase exceeding 6 mm Hg from baseline. Results: One hundred and eleven eyes met the inclusion criteria, and none of these eyes had a sustained IOP elevation. Conclusions: Anterior chamber paracentesis before IVR injections may prevent sustained IOP elevations. © 2014 S. Karger AG, Basel.
- Visual Impairment and Hip Fractures: A Case-Control Study in Elderly Patients. [JOURNAL ARTICLE]
- Ophthalmic Res 2014 Nov 6; 52(4):212-216.
Aims: To investigate the relationship between visual impairment and fall-related hip fracture and to determine the etiology of visual impairment in a population of elderly patients with hip fracture. Methods: A case-control study compared 96 patients diagnosed with hip fracture to a randomly selected control group of 103 patients without hip fracture. Inclusion criteria for the case group were as follows: patients aged 60 years and over with a hip fracture. Clinical assessment included visual acuity and ophthalmic examination. Results: Forty-three patients with hip fracture had a visual impairment compared to only 12 patients in the control group. Visual impairment was a significant risk factor for hip fracture (OR = 6.15; 95% CI 2.98-12.69). Twenty-seven hip fracture patients had an uncorrected refractive error compared to only 15 controls (OR = 2.78; 95% CI 0.92-8.35). There was no significant difference of dense cataract between both groups (OR = 2.28; 95% CI 0.75-6.93). Fourteen hip fracture patients had a macular degeneration compared to only 8 controls (OR = 5.63; 95% CI 1.57-20.18), and 10 patients had suspicion of glaucoma compared to only 5 controls (OR = 10.65; 95% CI 2.21-51.3). Conclusion: Visual impairment was significantly associated with an increased risk of hip fracture in elderly people. There are many etiologies that may contribute to hip fractures, most notably refractive error, cataract, macular degeneration and glaucoma. © 2014 S. Karger AG, Basel.
- SIRCOVA-OFTARED-RIG Joined Congress Abstracts. Valencia (Spain), November 7-8, 2014: Abstracts. [JOURNAL ARTICLE]
- Ophthalmic Res 2014 Nov 6; 52(4):175-197.
- Role of Lutein Supplementation in the Management of Age-Related Macular Degeneration: Meta-Analysis of Randomized Controlled Trials. [JOURNAL ARTICLE]
- Ophthalmic Res 2014 Oct 25; 52(4):198-205.
Objective: The conduct of this meta-analysis aimed at examining the individual role of lutein as a dietary supplement in improving conditions of age-related macular degeneration (AMD) from the data generated from randomized controlled trials (RCTs). Method: The literature search was made in multiple electronic databases. Eligibility criteria were RCTs that recruited AMD patients or individuals at risk and evaluated lutein supplementation efficacy against placebo. The quality of the trials was assessed by using the Jadad scale. The meta-analysis was conducted under the fixed effect model with RevMan software by calculating the mean differences of the changes from baseline of both lutein and placebo groups. Parameters of interest were macular pigment optical density (MPOD) and visual acuity (VA) in logMAR (minimum angle of resolution). Heterogeneity was determined by χ(2) and I(2) and publication bias was assessed by visual examination of funnel plots. Results: After following predetermined inclusion and exclusion criteria, five RCTs that recruited 445 participants were selected for the meta-analysis. It has been found that lutein treatment was associated with a significant improvement in MPOD, with mean differences between lutein and placebo groups in the changes from baseline of 0.09 (95% CI: 0.06, 0.12; p < 0.00001). VA also improved with a mean difference between lutein and placebo groups in the changes from baseline of -0.04 (95% CI-0.07, 0.00; p = 0.05). Statistical heterogeneity was not apparent. Conclusion: A statistically highly significant effect of lutein supplementation has been observed for improving the MPOD, whereas the improvement in VA was milder. A daily dose of 10 mg was found as effective as higher doses in this meta-analysis. However, the number of input studies is not adequate for conclusive evidence. © 2014 S. Karger AG, Basel.
- Antiangiogenic Effect of Itraconazole on Corneal Neovascularization: A Pilot Experimental Investigation. [JOURNAL ARTICLE]
- Ophthalmic Res 2014 Oct 21; 52(4):170-174.
Purpose: To investigate the antiangiogenic effect of itraconazole for the prevention of experimentally induced corneal neovascularization and whether the efficacy depends on the route of administration. Materials and Methods: Thirty-six rats were randomly divided into 6 groups with 6 rats in each group. Chemical cauterization of the cornea was performed using silver nitrate/potassium nitrate sticks, and the rats were subsequently treated daily with topical (10 mg/ml), subconjunctival (10 mg/ml) or intraperitoneal (19 mg/kg) itraconazole for 7 days. Control rats received topical, subconjunctival or intraperitoneal 0.9% saline. On the 8th day of the experiment, the rat corneas were photographed to determine the percentage area of the cornea covered by neovascularization. The maximum density of corneal neovascularization was determined by microscopy. Results: The median percentage of corneal neovascularization for group 1 was 31.5% (95% confidence interval, 27.5-35.5%); in group 3, it was 32% (23.5-39.8%); in group 5, it was 47% (36.3-60.0%). The percentages of corneal neovascularization in groups 2, 4 and 6 (the control groups) were 70% (95% confidence interval, 60.7-77.3%), 69% (63.0-77.7%) and 68% (56.5-78.5%), respectively. The area of neovascularization was smaller after itraconazole treatment as compared to saline treatment. Further, the area of neovascularization was smaller after topical and subconjunctival administration than after intraperitoneal administration. Histological evaluation of the corneas showed the most extensive corneal neovascularization in the control group. No local or systemic adverse effects were seen from either treatment group. Conclusion: Itraconazole reduces corneal neovascularization shortly after chemical burn. However, a larger experimental study is necessary to confirm the data of this investigation. © 2014 S. Karger AG, Basel.
- Lagophthalmos after Facial Palsy: Current Therapeutic Options. [JOURNAL ARTICLE]
- Ophthalmic Res 2014 Oct 18; 52(4):165-169.
As the facial nerve carries sensory, motor and parasympathetic fibres involved in facial muscle innervation, facial palsy results in functional and cosmetic impairment. It can result from a wide variety of causes like infectious processes, trauma, neoplasms, autoimmune diseases, and most commonly Bell's palsy, but it can also be of iatrogenic origin. The main ophthalmic sequel is lagophthalmos. The increased surface exposure increases the risk of keratitis, corneal ulceration, and potentially loss of vision. Treatment options are wide; some are temporary, some permanent. In addition to gold standard and traditional therapies and procedures, new options are being proposed aiming to improve not only lagophthalmos but also the quality of life of these patients. © 2014 S. Karger AG, Basel.
- Influence of intravitreal triamcinolone acetonide injection in scleral buckling surgery for macula-off retinal detachment. [Journal Article]
- Ophthalmic Res 2014; 52(3):160-4.
To investigate the effect of intravitreal triamcinolone acetonide injection on the resolution of subretinal fluid (SRF), and its correlation with visual outcome after scleral buckle (SB) surgery.A prospective consecutive case series was conducted in patients who underwent SB surgery for macula-off rhegmatogenous retinal detachment (RRD) at Farabi Eye Hospital from February 1, 2012 to August 30, 2013. Exclusion criteria included previous ocular surgery (e.g. primary surgical failure) except cataract surgery, recurrent retinal detachment, macular hole, epiretinal membrane, proliferative vitreoretinopathy grade C, history of trauma, other retinal diseases, and diabetes mellitus. Patients were assigned to two groups. In group 1, patients received 2 mg of intravitreal triamcinolone acetonide injection at the end of surgery while patients in group 2 received intravitreal balanced saline solution for balancing the intraocular pressure (IOP). Patients were followed up at 1 day, 1 week, 1 month, 2 months and 3 months after the surgery by best-corrected visual acuity (BCVA), slitlamp examination, indirect ophthalmoscopy and optical coherence tomography (OCT). OCT (Heidelberg Engineering, Heidelberg, Germany) was used at all visits except day 1 after the surgery. Student's t test and χ(2) tests were used for comparisons; p value ≤0.05 was considered significant.Sixty-two eyes of 62 patients were enrolled in the study. There were 33 male patients (53%) and 29 female patients (47%). The average age was 43.8 years (18-72 years). The mean duration of symptoms was 34.7 ± 46.8 days. There were 29 eyes in group 1 and 33 eyes in group 2. Twelve weeks after the operation, 25 patients (40%) had SRF beneath the macula, but there was no significant difference (p = 0.24, χ(2) test) between the two groups. Improvement in BCVA in both groups was statistically significant (p ≤ 0.001) but did not differ between the two groups (p = 0.09) apart from week 12, in which the improvement in group 1 was significantly higher (p = 0.03). The incidence of cystoid macular edema did not differ in a statistically significant way between the groups (p = 0.19). IOP in 4 (15%) patients in group 1 rose above 21 mm Hg but responded quickly to 2 weeks of topical antiglaucoma medication. There was no cataract progression in either group. There was no correlation between the incidence of persistent SRF and the extent of detachment in both groups (p = 0.83). There was no surgical failure or redetachment in either group during the study period.Single-dose intravitreal triamcinolone may increase the final BCVA in macula-off RRD patients despite persistent SRF, suggesting the anti-inflammatory role of this drug. © 2014 S. Karger AG, Basel.