RESUMEN
Background: Ocular comorbidities of hidradenitis suppurativa (HS) has been widely evaluated; however real-world evidence was scarce. Moreover, risk of glaucoma in HS patients remained unclear. This study aimed to evaluate the 5-year glaucoma risk in HS patients. Methods: This retrospective cohort study used the TriNetX database covering 2005-2017. In total, 53,281 HS patients were propensity score matched 1:1 to controls based on demographics, including comorbidities, medications, healthcare utilization, etc. Patients were followed for 5 years post-index date. Glaucoma risks were calculated based on hazard ratios and 95% confidence intervals (95% CI). Stratified analyses by sex and age were performed. Results: After matching, baseline characteristics were similar between groups. HS was associated with a 1.25 times higher 5-year glaucoma risk (95% CI, 1.10-1.42). The risk was significant within 1 year (HR=1.37; 95% CI, 1.03-1.82), 3 years (HR=1.31; 95% CI, 1.12-1.54), and 5 years post-index. In subgroup analysis, women had a 1.28 times higher risk (95% CI, 1.10-1.49). Patients aged 18-64 years (HR=1.33; 95% CI, 1.14-1.55) and ≥65 years (HR=1.33; 95% CI, 1.05-1.67) also presented elevated glaucoma risks. Conclusion: This real-world data analysis demonstrated a significantly increased 5-year glaucoma risk in HS patients versus matched controls. Ocular complications should be concerned while managing HS patients.
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Glaucoma , Hidradenitis Supurativa , Puntaje de Propensión , Humanos , Femenino , Masculino , Hidradenitis Supurativa/epidemiología , Hidradenitis Supurativa/complicaciones , Adulto , Estudios Retrospectivos , Persona de Mediana Edad , Glaucoma/epidemiología , Glaucoma/etiología , Factores de Riesgo , Adulto Joven , Anciano , Comorbilidad , Medición de Riesgo/estadística & datos numéricos , Bases de Datos Factuales/estadística & datos numéricosRESUMEN
INTRODUCTION: Delayed cataract surgery has long been known to cause lens-induced glaucoma (LIG). This study examined the demographic and clinical profile, ocular characteristics and outcomes of LIG in a tertiary referral centre in Malaysia. MATERIALS AND METHODS: Data from the National Eye Database (Malaysia) for cataract surgery performed at Hospital Taiping, Perak, between January 2019 and December 2020 were reviewed. The medical records of patients with LIG were retrieved to obtain demographic data, clinical profiles and visual outcomes. RESULTS: Of 3233 patients who underwent cataract surgery at Hospital Taiping, Perak, between 2019 and 2020, 25 underwent emergency surgery for LIG. However, only 24 patients fulfilling the diagnostic criteria for LIG were included in the study: 14 (58.33%) patients with phacomorphic and 10 (41.6%) patients with phacolytic glaucoma. The mean age of the patients was 66±12 years. Women and men were equally affected. Most patients were Malay (75%), followed by Chinese (16.67%) and Indian (8.33%). The anterior chamber depth (ACD) was significantly shallow with a mean value of 2.72 mm. Nineteen (79.1%) patients presented with visual acuity of worse than counting fingers. The mean intraocular pressure (IOP) at presentation was 47.5±13.66mmHg, which improved to 15.08±8.09mmHg postoperatively. A best-corrected visual acuity of 6/15 and better was achieved in 20 patients (83.33%) despite glaucomatous optic neuropathy being present in 41.67% of the cases. The majority (58.3%) of surgeries were performed via extracapsular cataract extraction, while six (25%) of our patients underwent successful phacoemulsification. Seven (29.17%) patients had intraocular complications: five with zonular dialysis and two with posterior capsule rupture. Of these seven cases, four ended up with intracapsular cataract extraction, leaving two of them aphakic. CONCLUSION: Prompt cataract surgery is paramount in all LIG cases to reduce IOP and achieve better visual outcomes. Despite the promising prognosis associated with early surgical intervention, patients should be counselled about the potential for a guarded visual prognosis from complicated surgery and its long-term complications.
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Extracción de Catarata , Glaucoma , Humanos , Malasia/epidemiología , Masculino , Femenino , Estudios Retrospectivos , Anciano , Persona de Mediana Edad , Extracción de Catarata/efectos adversos , Extracción de Catarata/estadística & datos numéricos , Glaucoma/etiología , Glaucoma/epidemiología , Glaucoma/cirugía , Agudeza Visual , Anciano de 80 o más Años , Presión Intraocular/fisiologíaRESUMEN
The current primary approach to the therapeutic and surgical management of glaucoma is limited to lowering intraocular pressure (IOP). While normalization of IOP stabilizes some functional parameters, there is still potential for further restoration of lost visual function in the post-operative period while maintaining the "therapeutic window". Neuroprotection refers to the modification of retinal ganglion cells and the neuronal microenvironment to promote their survival and function. Numerous studies have identified effective neuroprotective methods for glaucoma; however, their implementation into clinical practice remains a significant challenge. This review presents the most clinically significant treatment strategies, as well as the latest therapeutic advances in physiotherapy.
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Glaucoma , Enfermedades del Nervio Óptico , Modalidades de Fisioterapia , Humanos , Glaucoma/cirugía , Glaucoma/fisiopatología , Glaucoma/etiología , Enfermedades del Nervio Óptico/etiología , Enfermedades del Nervio Óptico/diagnóstico , Enfermedades del Nervio Óptico/terapia , Presión Intraocular/fisiología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/prevención & control , Complicaciones Posoperatorias/terapia , Células Ganglionares de la Retina/patologíaRESUMEN
The rare neurocutaneous condition known as Sturge-Weber syndrome (SWS) is characterized by leptomeninges, or angiomas affecting the face, eyes, and brain. We report a newly diagnosed case that came to our institute complaining of a diminution of vision BE that had been going on for the past 1 year. Upon examination, the patient exhibited bluish discoloration of the sclera, an increase in the size of the cornea, and the characteristic port wine stain (PWS) on the face. Intraocular pressure BE was 30 mmHg with an applanation tonometer. The cup disc ratio on fundoscopy was 0.9 RE and 0.8 LE with characteristic glaucomatous disc changes BE. The child was treated with antiglaucoma medications. Abbreviations: SWS = Sturge-Weber syndrome, PWS = Port wine stain, CNS = Central nervous system, CT = Computed Tomography, IOP = Intraocular pressure, OCT = Optical coherence tomography, RE = Right eye, LE = Left eye, BE = Both eyes, ASOCT = Anterior segment optical coherence tomography.
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Presión Intraocular , Síndrome de Sturge-Weber , Humanos , Síndrome de Sturge-Weber/diagnóstico , Síndrome de Sturge-Weber/complicaciones , Presión Intraocular/fisiología , Tomografía de Coherencia Óptica/métodos , Masculino , Mancha Vino de Oporto/diagnóstico , Mancha Vino de Oporto/etiología , Glaucoma/diagnóstico , Glaucoma/etiología , Glaucoma/fisiopatología , Niño , FemeninoAsunto(s)
Trasplante de Córnea , Implantes de Drenaje de Glaucoma , Glaucoma , Humanos , Implantes de Drenaje de Glaucoma/efectos adversos , Trasplante de Córnea/métodos , Glaucoma/cirugía , Glaucoma/etiología , Córnea/cirugía , Córnea/patología , Masculino , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/diagnóstico , Prótesis e Implantes/efectos adversos , Enfermedades de la Córnea/cirugía , Enfermedades de la Córnea/etiología , Enfermedades de la Córnea/diagnóstico , Órganos Artificiales , Femenino , Falla de PrótesisRESUMEN
A Japanese woman in her 70s was referred to our hospital for the evaluation and treatment of high intraocular pressure (IOP) in her right eye. She had undergone bilateral cataract surgeries and the insertion of hydrophilic acrylic intraocular lenses (IOLs). We performed trabeculotomy and trabeculectomy to lower her right IOP; thereafter, a circular opacity was observed on the right eye's IOL surface. We removed the right IOL because that eye's vision had decreased due to IOL opacification. The analysis of the removed IOL revealed that the main opacity component was calcium phosphate. This is the first post-glaucoma-surgery IOL calcification case report.
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Calcinosis , Glaucoma , Lentes Intraoculares , Humanos , Femenino , Lentes Intraoculares/efectos adversos , Calcinosis/etiología , Anciano , Glaucoma/cirugía , Glaucoma/etiología , Implantación de Lentes Intraoculares/efectos adversos , Complicaciones Posoperatorias/etiologíaRESUMEN
PURPOSE: This review aims to elucidate the role of T cell-induced autoimmune responses in the pathogenesis of glaucoma, focusing on the immunological changes contributing to retinal ganglion cell (RGC) damage. METHODS: A comprehensive review of recent studies examining immunological mechanisms in glaucoma was conducted. This included analyses of T cell interactions, heat shock proteins (HSPs), and resultant autoimmune responses. Key findings from experimental models and clinical observations were synthesized to present a coherent understanding of immune dynamics in glaucoma. RESULTS: Glaucoma is a neurodegenerative disease marked by optic nerve atrophy and irreversible vision loss due to RGC damage. The disease is etiologically heterogeneous, with multiple risk factors and pathogenic mechanisms. Recent research highlights the dual immunomodulatory role of T cells in immune protection and injury. T cells, pre-sensitized by bacterial HSPs, can cross-react with endogenous HSPs in RGCs under stress, leading to autoimmune damage. Elevated levels of HSP autoantibodies and abnormal T cell activity have been observed in glaucoma patients, indicating a significant autoimmune component in disease progression. CONCLUSIONS: T cell-induced autoimmune responses are crucial in the pathogenesis of glaucoma, contributing to RGC degeneration beyond the effects of elevated intraocular pressure. Understanding these immunological mechanisms is vital for developing targeted neuroprotective therapies for glaucoma.
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Autoinmunidad , Glaucoma , Células Ganglionares de la Retina , Linfocitos T , Humanos , Glaucoma/inmunología , Glaucoma/etiología , Glaucoma/fisiopatología , Linfocitos T/inmunología , Células Ganglionares de la Retina/patología , Células Ganglionares de la Retina/inmunología , Autoinmunidad/inmunología , Presión Intraocular/fisiología , Animales , Proteínas de Choque Térmico/inmunologíaRESUMEN
Epithelial inclusion cysts (EIC) are a rare ocular disease and its physiopathology is not well-known. They consist on growths of ocular surface epithelial cells inside the anterior segment of the eye in the form of a cyst. To date several cases have been published in the literature, none of them related to glaucoma surgery. We describe two cases of EIC after glaucoma devices implantation. An 86 year-old male patient with primary open angle glaucoma develop an EIC in right eye three years after removal of PRESERFLO™ MicroShunt (Santen, Osaka, Japan) and a 9 year-old female patient with glaucoma secondary to uveitis for juvenile idiopathic arthritis develops an EIC under the tube of an Ahmed valve implant during postoperative period. EIC develop after ocular penetrating wounds and an inflammatory stimulus. They are benign proliferations, follow-up is necessary to detect space complications early, so less mutilating surgery is needed for removal.
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Implantes de Drenaje de Glaucoma , Complicaciones Posoperatorias , Humanos , Masculino , Femenino , Anciano de 80 o más Años , Complicaciones Posoperatorias/etiología , Implantes de Drenaje de Glaucoma/efectos adversos , Niño , Quistes/etiología , Quistes/cirugía , Glaucoma de Ángulo Abierto/cirugía , Glaucoma de Ángulo Abierto/etiología , Artritis Juvenil/complicaciones , Glaucoma/etiología , Glaucoma/cirugía , Uveítis/etiologíaRESUMEN
This study aims to assess the association between nicotine replacement therapy (NRT), varenicline, and untreated smoking with the risk of developing eye disorders. We employed a new-user design to investigate the association between NRT use and the incidence of eye disorders by the Taiwan National Health Insurance program. This study included 8416 smokers who received NRT and 8416 smokers who did not receive NRT (control group) matched using propensity scores between 2007 and 2018. After adjustment for relevant factors, a multivariable Cox regression analysis revealed that compared with untreated smokers, NRT use was associated with a significantly reduced risk of macular degeneration (hazard ratio [HR]: 0.34; 95% confidence interval [CI]: 0.13-0.87, P = 0.024). When stratified by dose, short-term NRT use (8-28 defined daily doses) was associated with significantly lower risk of glaucoma (HR: 0.35; 95% CI: 0.16-0.80, P = 0.012) and a trend toward reduced risk of cataract (HR: 0.60; 95% CI: 0.36-1.01, P = 0.053) compared to no treatment. However, these associations were not observed with long-term NRT use. The results of this real-world observational study indicate that NRT use, particularly short-term use, was associated with a lower risk of certain eye disorders compared to no treatment for smoking cessation. Long-term NRT use did not demonstrate the same benefits. Thus, short-term NRT may be a beneficial treatment strategy for reducing the risk of eye disorders in smokers attempting to quit. However, further evidence is required to verify these findings and determine the optimal duration of NRT use.
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Catarata , Glaucoma , Degeneración Macular , Cese del Hábito de Fumar , Humanos , Masculino , Femenino , Glaucoma/epidemiología , Glaucoma/etiología , Persona de Mediana Edad , Degeneración Macular/epidemiología , Degeneración Macular/etiología , Estudios Retrospectivos , Catarata/epidemiología , Taiwán/epidemiología , Anciano , Adulto , Fumar/efectos adversos , Fumar/epidemiología , Dispositivos para Dejar de Fumar Tabaco , Incidencia , Vareniclina/uso terapéuticoRESUMEN
OBJECTIVES: The long-term risk of developing glaucoma after vitrectomy remains uncertain. This retrospective population-based cohort study aimed to explore this risk following vitrectomy for macular pucker or hole. METHODS: Utilizing Taiwan's National Health Insurance Research Database (NHIRD), we included patients who were older than 18 years and had undergone vitrectomy surgery between 2011 and 2019. Exclusions were made for patients with prior diagnoses of glaucoma, congenital or secondary glaucoma, as well as those who had received previous vitreoretinal treatments or had undergone multiple vitrectomies. RESULTS: After an average follow-up period of 51 and 53 months respectively for the vitrectomized and non-vitrectomized group, our results showed a relative risk of 1.71 for glaucoma development in the vitrectomized group. Higher adjusted hazard ratios were also observed for open-angle glaucoma and normal tension glaucoma. Increased risks were associated with male sex, obstructive sleep apnoea, and migraine. In the subgroup analysis, phakic eyes at baseline and those who had undergone cataract surgery post-vitrectomy were associated with a lower risk of glaucoma development during follow-up. Among all glaucoma events, pseudophakic status at baseline had the shortest interval to glaucoma development following vitrectomy. CONCLUSIONS: These findings underscore the potential relationship between vitrectomy and glaucoma onset, emphasizing the need for vigilant monitoring and early detection of glaucoma in post-vitrectomy patients.
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Perforaciones de la Retina , Vitrectomía , Humanos , Vitrectomía/efectos adversos , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Anciano , Factores de Riesgo , Taiwán/epidemiología , Perforaciones de la Retina/cirugía , Perforaciones de la Retina/etiología , Glaucoma/etiología , Estudios de Seguimiento , Presión Intraocular/fisiología , Incidencia , Complicaciones Posoperatorias/epidemiología , Adulto , Glaucoma de Ángulo Abierto/cirugía , Agudeza Visual/fisiologíaRESUMEN
Objective: To investigate the clinical characteristics and treatment outcomes of glaucoma secondary to congenital ectropion uveae (CEU) using penetrating Schlemm's canaloplasty. Methods: This was a retrospective case series study. Medical records of patients diagnosed with glaucoma secondary to CEU and undergoing penetrating Schlemm's canaloplasty at the Eye Hospital of Wenzhou Medical University between August 2020 and December 2021 were collected. Clinical characteristics including the extent and location of iris ectropion, type of glaucoma, were analyzed. Follow-up visits were conducted at 1, 3, 6 months, and 1 year postoperatively. Visual acuity, intraocular pressure (IOP), anterior segment and fundus condition, filtering bleb morphology, use of IOP-lowering medications, ultrasound biomicroscopy results, and other indicators were analyzed to summarize surgical outcomes. Results: Six cases (6 eyes) of glaucoma secondary to CEU were included, all unilateral, with 3 left eyes and 3 right eyes; median age was 10.0 (5.3, 28.8) years; including 3 males and 3 females. Preoperative IOP was (31.7±10.0) mmHg (1 mmHg=0.133 kPa), and the preoperative number of IOP-lowering medications used was 2.0 (2.0, 3.2). The extent of iris ectropion in the 6 cases ranged from 270 ° to 360 °, with peripheral anterior synechiae corresponding to the location of iris ectropion, and angle closure with the degree of synechiae extending beyond Schwalbe's line. No surgical complications occurred in any of the 6 cases postoperatively. At 1 month postoperatively, the IOP was (16.4±3.2) mmHg, with a median of 0.0 (0.0, 1.5) medications used. At 3 months postoperatively, the IOP was (14.8±6.0) mmHg, with a median of 0.0 (0.0, 2.2) medications used. At 6 months postoperatively, the IOP was (18.1±6.1) mmHg, with a median of 0.0 (0.0, 0.5) medications used. Among them, 5 patients had a follow-up period of 1 year postoperatively, all achieving controlled IOP without the use of IOP-lowering medications, with an average IOP of (15.5±3.1) mmHg. No obvious filtering bleb formation was observed at the surgical site in all patients. Conclusions: Glaucoma secondary to CEU manifests primarily as closed-angle glaucoma, with a correspondence between the closure range of anterior iris adhesions in the angle and the extent of iris ectropion. Penetrating Schlemm's canaloplasty demonstrates favorable and stable efficacy for its treatment.
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Ectropión , Glaucoma , Presión Intraocular , Humanos , Estudios Retrospectivos , Masculino , Femenino , Glaucoma/cirugía , Glaucoma/etiología , Ectropión/etiología , Ectropión/cirugía , Niño , Preescolar , Adulto , Úvea/cirugía , Cirugía Filtrante/métodos , Resultado del Tratamiento , Agudeza Visual , Iris/cirugía , Adulto Joven , AdolescenteRESUMEN
A 15-month-old, grey, Thoroughbred filly presented for investigation of a 6-week history of corneal oedema and blepharospasm on the right eye (OD). The filly was otherwise healthy. Following ophthalmic examination, glaucoma on the OD was diagnosed. A space occupying mass within the anterior chamber was documented on transpalpebral ultrasonographic examination. This mass obliterated most of the anterior intraocular structures on the peripheral nasal side (corneal endothelium and drainage angle), leading to secondary glaucoma. After systemic and topical treatment addressing secondary glaucoma, the corneal oedema reduced. The mass was visualised as an irregularly rounded brown structure associated with the iris on the peripheral nasal side of the anterior chamber. Given the filly's signalment, location and appearance of the mass, a tentative diagnosis of intraocular melanoma was made and enucleation was performed. Histopathological evaluation of the globe revealed solid sheets of heavily pigmented melanocytic cells, disrupting the normal ciliary body architecture and extending into the iris and subretinal. The cells were pleomorphic, polyhedral to round with occasional spindle-shaped cells, and contained moderate to large amounts of granular black-brown pigment (melanin). The iridal component expanded into the anterior chamber, with cells directly opposed to Descemet's membrane, with loss of the endothelium and expanding and occluding the filtration angle in this area. The lesion infiltrated locally into the edge of the sclera, but did not extend through the sclera, though occasional perivascular clusters of melanophages were observed within the scleral stroma adjacent to the optic nerve. Diagnosis of a uveal melanocytic neoplasm was confirmed, with characteristics similar to only one reported case . This is a unique case of a rapidly growing, invasive, uveal melanoma in a young horse. Intraocular melanoma should be considered as a differential diagnoses for glaucoma in grey horses, regardless of the age and absence of melanocytic skin lesions.
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Glaucoma , Enfermedades de los Caballos , Melanoma , Animales , Caballos , Enfermedades de los Caballos/patología , Enfermedades de los Caballos/cirugía , Glaucoma/veterinaria , Glaucoma/etiología , Melanoma/veterinaria , Melanoma/cirugía , Femenino , Neoplasias del Ojo/veterinaria , Neoplasias del Ojo/cirugíaRESUMEN
This study assessed the prevalence of myopia, cataracts, glaucoma, and macular degeneration among Koreans over 40, utilizing data from the 7th Korea National Health and Nutrition Examination Survey (KNHANES VII, 2018). We analyzed 204,973 adults (44% men, 56% women; mean age 58.70 ± 10.75 years), exploring the association between myopia and these eye diseases through multivariate logistic regression, adjusting for confounders and calculating adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Results showed a myopia prevalence of 44.6%, cataracts at 19.4%, macular degeneration at 16.2%, and glaucoma at 2.3%, with significant differences across ages and genders. A potential link was found between myopia and an increased risk of cataracts and macular degeneration, but not with glaucoma. Additionally, a higher dietary intake of carbohydrates, polyunsaturated and n-6 fatty acids, vitamins, and minerals correlated with lower risks of these diseases, underscoring the importance of the diet in managing and preventing age-related eye conditions. These findings highlight the need for dietary considerations in public health strategies and confirm myopia as a significant risk factor for specific eye diseases in the aging Korean population.
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Catarata , Dieta , Degeneración Macular , Miopía , Encuestas Nutricionales , Humanos , Masculino , Femenino , República de Corea/epidemiología , Persona de Mediana Edad , Estudios Transversales , Miopía/epidemiología , Miopía/etiología , Anciano , Prevalencia , Degeneración Macular/epidemiología , Degeneración Macular/etiología , Adulto , Factores de Riesgo , Catarata/epidemiología , Catarata/etiología , Dieta/estadística & datos numéricos , Dieta/efectos adversos , Oftalmopatías/epidemiología , Oftalmopatías/etiología , Glaucoma/epidemiología , Glaucoma/etiología , Oportunidad Relativa , NutrientesRESUMEN
Acute glaucoma following carotid artery recanalization is a rare but severe complication of underlying ocular ischemic syndrome. We present a case of a 71-year-old woman with ocular ischemic syndrome and severe stenosis of the right internal and external carotid artery undergoing carotid artery stenting. Immediate postprocedural angiography showed pronounced reperfusion of the ophthalmic artery. Subsequently, the patient developed vision-threatening acute glaucoma despite treatment with acetazolamide. Monitoring of intraocular pressure is important in patients who are at risk of developing ocular ischemic syndrome because of internal carotid artery stenosis. Interventionalists should also assess the degree of vascular collateralization from the external carotid artery.
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Arteria Carótida Interna , Estenosis Carotídea , Glaucoma , Stents , Humanos , Femenino , Anciano , Estenosis Carotídea/cirugía , Stents/efectos adversos , Glaucoma/etiología , Glaucoma/cirugía , Arteria Carótida Interna/diagnóstico por imagen , Isquemia/etiologíaRESUMEN
Glaucoma is characterized by the progressive degeneration of retinal ganglion cells (RGCs) and their axons, and its risk increases with aging. Yet comprehensive insights into the complex mechanisms are largely unknown. Here, we found that anti-aging molecule Sirt6 was highly expressed in RGCs. Deleting Sirt6 globally or specifically in RGCs led to progressive RGC loss and optic nerve degeneration during aging, despite normal intraocular pressure (IOP), resembling a phenotype of normal-tension glaucoma. These detrimental effects were potentially mediated by accelerated RGC senescence through Caveolin-1 upregulation and by the induction of mitochondrial dysfunction. In mouse models of high-tension glaucoma, Sirt6 level was decreased after IOP elevation. Genetic overexpression of Sirt6 globally or specifically in RGCs significantly attenuated high tension-induced degeneration of RGCs and their axons, whereas partial or RGC-specific Sirt6 deletion accelerated RGC loss. Importantly, therapeutically targeting Sirt6 with pharmacological activator or AAV2-mediated gene delivery ameliorated high IOP-induced RGC degeneration. Together, our studies reveal a critical role of Sirt6 in preventing RGC and optic nerve degeneration during aging and glaucoma, setting the stage for further exploration of Sirt6 activation as a potential therapy for glaucoma.
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Envejecimiento , Modelos Animales de Enfermedad , Glaucoma , Nervio Óptico , Células Ganglionares de la Retina , Sirtuinas , Animales , Células Ganglionares de la Retina/metabolismo , Células Ganglionares de la Retina/patología , Ratones , Sirtuinas/metabolismo , Sirtuinas/genética , Glaucoma/metabolismo , Glaucoma/genética , Glaucoma/patología , Glaucoma/etiología , Nervio Óptico/metabolismo , Nervio Óptico/patología , Envejecimiento/metabolismo , Envejecimiento/genética , Presión Intraocular , Humanos , Axones/metabolismo , Axones/patología , Ratones Noqueados , Degeneración Nerviosa/metabolismoRESUMEN
OBJECTIVE: The aim of this study was to examine the relationship of ultra-processed food (UPF) intake with the incidence of glaucoma in a large sample of Spanish university graduates followed prospectively. METHODS: Prospective cohort study using data from the SUN Project. A final sample of 19,225 participants (60.1% women) was included in this study, with a mean age of 38.2 years (standard deviation (SD) = 12.4). Participants were followed-up for a mean time of 12.9 years (SD = 5.4). Dietary intake was measured using a 136-item semiquantitative food-frequency questionnaire. UPFs were defined based on the NOVA classification system. Glaucoma diagnosis was determined by asking the participants if they had ever been diagnosed with glaucoma by an ophthalmologist. This self-reported diagnosis of glaucoma has been previously validated. RESULTS: After adjusting for several covariates, participants with the highest UPF consumption were at higher risk of glaucoma (hazard ratio (HR) = 1.83; 95% confidence interval (CI) 1.06 to 3.17) when compared to participants in the lowest category of UPF consumption. Regarding subgroup analyses, a significant multiplicative interaction was found for age (p = 0.004) and omega 3:6 ratio (p = 0.040). However, an association between UPF consumption and glaucoma was only found in older participants (aged ≥ 55 years), in men, in the most physically active group, in the group of non- or former smokers, in those with a lower omega 3:6 ratio, and in those with a lower energy intake. Regarding the contribution of each type of UPF group, UPF coming from sweets showed a significant risky effect (HR = 1.51; CI 95% 1.07 to 2.12). CONCLUSIONS: This prospective cohort study shows that participants with a greater UPF consumption have a higher risk of developing glaucoma when compared to participants with a lower consumption. Our findings emphasize the relevance of monitoring and limiting the consumption of UPFs as a means of preventing glaucoma incidence.
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Ácidos Grasos Omega-3 , Glaucoma , Masculino , Humanos , Femenino , Anciano , Adulto , Alimentos Procesados , Estudios Prospectivos , Dulces , Ingestión de Energía , Glaucoma/epidemiología , Glaucoma/etiologíaRESUMEN
BACKGROUND: Psoriasis is a chronic systemic disorder with ocular involvement. OBJECTIVES: To evaluate the risk of glaucoma among patients with psoriasis. METHODS: Participants in this cohort study were selected based on Chang Gung Research Database from 1 January 2003 to 31 December 2012. Follow-up ended on 31 December 2017. The participants in the control group were matched with the psoriasis group by sex, age and index date with a 4 : 1 ratio. The hazard ratios of glaucoma were estimated using Cox regression analysis. We also evaluated the relationship between the risk of glaucoma and systemic therapies as well as phototherapy and topical corticosteroid in patients with psoriasis. RESULTS: In total, 6682 patients with psoriasis and 26 728 matched controls were enrolled. The study population was composed mainly of males accounting for 64.2% (21 445/33 410) of the study population. The psoriasis group had higher incidence rates than the control group for glaucoma (adjusted hazard ratio 1.405, 95% confidence interval, 1.051-1.879). Patients with psoriasis receiving psoralen-ultraviolet A (PUVA) therapy for > 200 sessions had an increased risk of glaucoma. CONCLUSIONS: Patients with psoriasis had an increased risk of glaucoma. Long-term PUVA therapy raised the risk of glaucoma in people with psoriasis.
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Glaucoma , Psoriasis , Humanos , Psoriasis/complicaciones , Psoriasis/epidemiología , Psoriasis/tratamiento farmacológico , Masculino , Femenino , Glaucoma/epidemiología , Glaucoma/etiología , Persona de Mediana Edad , Adulto , Factores de Riesgo , Incidencia , Anciano , Terapia PUVA/efectos adversos , Modelos de Riesgos Proporcionales , Estudios de Cohortes , Estudios de Casos y Controles , Taiwán/epidemiología , Adulto JovenRESUMEN
Glaucoma is a neurodegenerative disease that causes blindness. In this study, we aimed to evaluate the protective role of cilastatin (CIL), generally used in the treatment of nephropathologies associated with inflammation, in an experimental mouse model based on unilateral (left) laser-induced ocular hypertension (OHT). Male Swiss mice were administered CIL daily (300 mg/kg, i.p.) two days before OHT surgery until sacrifice 3 or 7 days later. Intraocular Pressure (IOP), as well as retinal ganglion cell (RGC) survival, was registered, and the inflammatory responses of macroglial and microglial cells were studied via immunohistochemical techniques. Results from OHT eyes were compared to normotensive contralateral (CONTRA) and naïve control eyes considering nine retinal areas and all retinal layers. OHT successfully increased IOP values in OHT eyes but not in CONTRA eyes; CIL did not affect IOP values. Surgery induced a higher loss of RGCs in OHT eyes than in CONTRA eyes, while CIL attenuated this loss. Similarly, surgery increased macroglial and microglial activation in OHT eyes and to a lesser extent in CONTRA eyes; CIL prevented both macroglial and microglial activation in OHT and CONTRA eyes. Therefore, CIL arises as a potential effective strategy to reduce OHT-associated damage in the retina of experimental mice.
Asunto(s)
Glaucoma , Enfermedades Neurodegenerativas , Hipertensión Ocular , Masculino , Ratones , Animales , Enfermedades Neurodegenerativas/complicaciones , Glaucoma/etiología , Hipertensión Ocular/tratamiento farmacológico , Hipertensión Ocular/patología , Presión Intraocular , Antiinflamatorios/farmacología , Antiinflamatorios/uso terapéutico , Cilastatina/uso terapéutico , Modelos Animales de EnfermedadRESUMEN
PRCIS: Long-term intraocular pressure control can be difficult to achieve in eyes with Sturge-Weber syndrome glaucoma. The most commonly performed primary surgery was trabeculotomyin early onset disease and tube shunt implantation in late onset disease. PURPOSE: To compare long-term surgical outcomes of glaucoma associated with Sturge-Weber syndrome (SWS) in eyes with early and late-onset disease. METHODS: Medical records of children with glaucoma associated with SWS who underwent surgical treatment between January 1990 and December 2018 were reviewed. Those diagnosed ≤2 years of age were categorized as early onset while those who were diagnosed >2 years of age were late onset. Failure was defined as intraocular pressure (IOP) >21 mm Hg or reduced <20% below baseline on 2 consecutive follow-up visits after 3 months, IOP ≤5 mm Hg on 2 consecutive follow-up visits, reoperation for glaucoma or a complication, or loss of light perception. RESULTS: Forty-three eyes of 36 children were studied, including 26 eyes in the early-onset group and 17 eyes in the late-onset group. The early-onset group more frequently presented with buphthalmos, corneal edema, and Haab striae, while late-onset group had higher baseline IOP, larger cup-to-disc ratio, and longer axial length. The most commonly performed primary surgery was trabeculotomy (50%) in early-onset group and tube shunt implantation (71%) in late-onset group. The cumulative probability of failure after 5 years follow-up was 50.6% in early-onset group and 50.9% in the late-onset group ( P =0.56). Postoperative complications occurred in 3 eyes (12%) in early-onset group and 11 eyes (65%) in late-onset group ( P <0.001). CONCLUSIONS: Early and late-onset SWS glaucoma may represent 2 entities with different pathogenetic mechanisms, clinical presentations, primary surgical choices, and outcomes, though this needs corroboration in future studies.