Oxygen and Glucose Deprivation on Human Müller Cells (MIO-M1) and Human Organotypic Retinal Cultures (HORCs) in Relation to Glaucoma

Purpose: The purpose of this research was to investigate the effect of glaucoma-related insults, specifically oxygen and/or glucose deprivation (OGD) on the survival and genes expression of human Müller cells (MIO-M1), and retinal ganglion cells (RGCs) using the human organotypic retinal culture (HORC) model. Methods: MIO-M1 cells and HORCs were exposed to different levels of OGD using a custom-built chamber to control oxygen levels. Cell survival was evaluated using MTS and LDH assays while RGC death in HORCs was investigated using NeuN immunohistochemistry and TUNEL-labelling. Expression of genes of interest was assessed using QRT-PCR. Results: Reduced levels of oxygen and glucose (1.11mMglucose/4%O2) caused proliferation of MIO-M1 cells. Full deprivation of glucose caused cell death, but full hypoxia did not affect survival. In HORCs, glucose deprivation and OGD, but not oxygen deprivation alone, caused loss of RGCs. Different levels of OGD regulated expression of genes associated with angiogenesis, glial activation, excitotoxicity and neuroprotection in MIO-M1 cells and HORCs. VEGF expression significantly increased in MIO-M1 cells and HORCs treated with full OGD, and VEGF protein was secreted under reduced levels (1.11mMglucose/4%O2). Secretion of VEGF in MIO-M1 cells and HORCs was also increased under conditions of raised glucose. The PKCβ inhibitor LY333531 decreased VEGF secretion under conditions of raised glucose and hypoxia. Co-culture of MIO-M1 cells resulted in more damage/apoptosis to HORCs and reduced RGCs survival. Conclusions: Use MIO-M1 cells and the HORC model were effective in studying the effect of OGD in relation to glaucoma. Glucose rather than oxygen was the key survival factor for RGCs and MIO-M1 cells. The secreted factors by Müller cells could have protective and detrimental effects on RGC survival. Investigation of mechanisms using these models may be of benefit in development of potential therapeutic interventions for retinal neurodegenerative diseases including glaucoma

Hydrostatic pressure does not cause detectable changes to survival of human retinal ganglion

Purpose: Elevated intraocular pressure (IOP) is a major risk factor for glaucoma. One consequence of raised IOP is that ocular tissues are subjected to increased hydrostatic pressure (HP). The effect of raised HP on stress pathway signaling and retinal ganglion cell (RGC) survival in the human retina was investigated. Methods: A chamber was designed to expose cells to increased HP (constant and fluctuating). Accurate pressure control (10-100mmHg) was achieved using mass flow controllers. Human organotypic retinal cultures (HORCs) from donor eyes (<24h post mortem) were cultured in serum-free DMEM/HamF12. Increased HP was compared to simulated ischemia (oxygen glucose deprivation, OGD). Cell death and apoptosis were measured by LDH and TUNEL assays, RGC marker expression by qRT-PCR (THY-1) and RGC number by immunohistochemistry (NeuN). Activated p38 and JNK were detected by Western blot. Results: Exposure of HORCs to constant (60mmHg) or fluctuating (10-100mmHg; 1 cycle/min) pressure for 24 or 48h caused no loss of structural integrity, LDH release, decrease in RGC marker expression (THY-1) or loss of RGCs compared with controls. In addition, there was no increase in TUNEL-positive NeuN-labelled cells at either time-point indicating no increase in apoptosis of RGCs. OGD increased apoptosis, reduced RGC marker expression and RGC number and caused elevated LDH release at 24h. p38 and JNK phosphorylation remained unchanged in HORCs exposed to fluctuating pressure (10-100mmHg; 1 cycle/min) for 15, 30, 60 and 90min durations, whereas OGD (3h) increased activation of p38 and JNK, remaining elevated for 90min post-OGD. Conclusions: Directly applied HP had no detectable impact on RGC survival and stress-signalling in HORCs. Simulated ischemia, however, activated stress pathways and caused RGC death. These results show that direct HP does not cause degeneration of RGCs in the ex vivo human retina

Visual resolution under photopic and mesopic conditions in patients with Sjögren's syndrome

AIM: To focus on different visual resolution tasks under photopic and mesopic conditions in Sjögren's syndrome patients compared to age-matched healthy controls. METHODS: The visual resolution measurements included high and low visual acuities and contrast sensitivity functions. These tests were conducted under photopic and then mesopic conditions. Twenty-one Sjögren's syndrome patients and 21 aged-matched healthy volunteers completed all the measurements in this study. RESULTS: Sjögren's syndrome patients have greater impairment in contrast sensitivity than standardized visual acuity. This reduction was significant under the mesopic condition. Also, Sjögren's syndrome patients treated with pilocarpine suffer more than patients without pilocarpine treatment under low light conditions. CONCLUSION: Sjögren's syndrome patients shows greater impairment in different visual resolution tasks due to dry eye symptoms

Journey of Hope for Patients with Fibromyalgia: From Diagnosis to Self-Management&mdash;A Qualitative Study

Background/Objectives: Fibromyalgia syndrome (FMS) is a chronic, debilitating condition characterized by widespread pain, fatigue, and psychological distress. There is a lack of qualitative studies on the unique experiences of patients with FMS in Arab countries, particularly through social media. Despite the availability of diagnostic criteria, diagnosing and managing patients remains challenging. This study aimed to describe the experiences of patients with FMS in Arab countries, their understanding of the illness, and perceptions of treatment. Methods: A qualitative study was conducted using a content analysis of patients&rsquo; narratives published in a supportive group, describing their experiences with fibromyalgia. The dataset included 2305 quotes from 192 main posts and 2113 comments collected between 2019 and 2024. Results: The analysis of the posts and associated comments revealed six main themes: patients&rsquo; experiences with the syndrome, symptoms, searching for a doctor, pharmacological management, self-management, and the impact of fibromyalgia and peer support. Most posts and comments focused on patients&rsquo; experiences with self-management approaches and coping strategies, highlighting significant noncompliance with therapeutic modalities. Factors influencing patients&rsquo; experiences and decisions included their relationship with physicians, medication side effects, personal fears, and physical and mental health. Conclusions: Patients with FMS in Arab countries face similar challenges to those in other regions, including physical, psychological, social, and economic impacts. Many patients reject conventional therapeutic management strategies and adopt coping mechanisms to mitigate adverse effects and healthcare costs. The findings suggest that the physician&ndash;patient relationship, as well as the physician&rsquo;s knowledge and attitude toward fibromyalgia syndrome, are the cornerstones of gaining patients&rsquo; trust

Correlation between dry eye and refractive error in Saudi young adults using noninvasive Keratograph 4

Purpose: The purpose is to study the correlation between dry eye and refractive errors in young adults using noninvasive Keratograph. Methods: In this cross sectional study, a total of 126 participants in the age range of 19–25 years and who were free of ocular surface disease, were recruited from King Saud University Campus. Refraction was defined by the spherical equivalent (SE) as the following: 49 emmetropic eyes (±0.50 SE), 48 myopic eyes (≤−0.75 SE and above), and 31 hyperopic eyes (>+0.75 SE). All participants underwent full ophthalmic examinations assessing their refractive status and dryness level including noninvasive breakup time (NIBUT) and tear meniscus height using Keratograph 4. Results: The prevalence of dry eye was 24.6%, 36.5%, and 17.4% in emmetropes, myopes, and hypermetropes, respectively. NIBUT has a negative correlation with hyperopia and a positive correlation with myopia with a significant reduction in the average NIBUT in myopes and hypermetropes in comparison to emmetropes. Conclusion: The current results succeeded to demonstrate a correlation between refractive errors and dryness level

Knowledge of Saudi Patients with Autoimmune Diseases about Hydroxychloroquine Toxicity: The Role of Physician&ndash;Patient Communication

This cross-sectional internet-based questionnaire aimed to assess the knowledge and experience of autoimmune disease patients in Saudi Arabia of the ocular effects of hydroxychloroquine (HCQ). Among the 245 respondents, discontinuation of the drug was linked to its ocular toxicity in approximately 7.3%. Most patients had taken HCQ for a period longer than five years, exceeding a dose of 5 mg/Kg. A lack of education and physician communication about medication toxicity was reported by approximately 40.8% of the participants. Despite the knowledge about HCQ retinopathy, the drug is prescribed to autoimmune disease patients at an inappropriate dosage. Knowledge obtained from physicians&rsquo; communication may improve the health outcomes of chronically ill patients. Rheumatologists and ophthalmologists should work together to recognize patients at risk of hydroxychloroquine toxicity and ensure they receive proper education and adhere to periodic follow-up

Self-Efficacy of Saudi Patients with Autoimmune Diseases in Managing Hydroxychloroquine-Induced Ocular Complications: A Cross-Sectional Survey

Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are common autoimmune diseases (AD) that affect joints and have multi-organ involvement that results in disability, morbidity, and increased mortality. Both conditions are known to cause a wide range of ocular manifestations. Antimalarial drugs, mainly hydroxychloroquine (HCQ), are among the treatment options for AD that is uniquely characterized by retinopathy as a main side effect. This study examines self-efficacy levels in autoimmune disease patients who were or are currently treated with HCQ and related factors such as patient education, communication with the physician, self-education, and ability to cope with the disease

Self-Efficacy of Saudi Patients with Autoimmune Diseases in Managing Hydroxychloroquine-Induced Ocular Complications: A Cross-Sectional Survey

Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are common autoimmune diseases (AD) that affect joints and have multi-organ involvement that results in disability, morbidity, and increased mortality. Both conditions are known to cause a wide range of ocular manifestations. Antimalarial drugs, mainly hydroxychloroquine (HCQ), are among the treatment options for AD that is uniquely characterized by retinopathy as a main side effect. This study examines self-efficacy levels in autoimmune disease patients who were or are currently treated with HCQ and related factors such as patient education, communication with the physician, self-education, and ability to cope with the disease.</jats:p

Grapefruit Extract-Mediated Fabrication of Photosensitive Aluminum Oxide Nanoparticle and Their Antioxidant and Anti-Inflammatory Potential

Aluminum oxide nanoparticles (Al2O3 NPs) were synthesized using a simple, eco-friendly green synthesis approach in an alkaline medium from the extract of grapefruit peel waste. The pre-synthesized, nano-crystalline Al2O3 NPs were characterized by using spectroscopic (UV&ndash;vis, FTIR, XRD, and EDX) and microscopic (SEM and TEM) techniques. The formed Al2O3 NPs exhibited a pronounced absorption peak at 278 nm in the UV&ndash;vis spectrum. The average particle size of the as-prepared Al2O3 NPs was evaluated to be 57.34 nm, and the atomic percentages of O and Al were found to be 54.58 and 45.54, respectively. The fabricated Al2O3 NPs were evaluated for antioxidant, anti-inflammatory, and immunomodulatory properties. The Al2O3 NPs showed strong antioxidant potential towards all the four tested assays. The anti-inflammatory and immunomodulatory potential of Al2O3 NPs was investigated by measuring the production of nitric oxide and superoxide anion (O2&bull;&minus;), as well as proinflammatory cytokines tumour necrosis factor (TNF-&alpha;, IL-6) and inhibition of nuclear factor kappa B (NF- &kappa;B). The results revealed that Al2O3 NPs inhibited the production of O2&bull;&minus; (99.4%) at 100 &mu;g mL&minus;1 concentrations and intracellular NO&bull;&minus; (55%), proinflammatory cytokines IL-6 (83.3%), and TNF-&alpha; (87.9%) at 50 &mu;g mL&minus;1 concentrations, respectively. Additionally, the Al2O3 NPs inhibited 41.8% of nuclear factor kappa B at 20 &mu;g mL&minus;1 concentrations. Overall, the outcomes of current research studies indicated that Al2O3 NPs possess anti-inflammatory and immunomodulatory properties and could be used to treat chronic and acute anti-inflammatory conditions