Risk Factors in Normal-Tension Glaucoma and High-Tension Glaucoma in relation to Polymorphisms of Endothelin-1 Gene and Endothelin-1 Receptor Type A Gene

The aim of the research is to analyse the influence of polymorphisms of endothelin-1 gene and endothelin-1 receptor type A gene on the clinical condition of patients with primary open angle glaucoma. Methods. 285 Polish patients took part in the research (160 normal-tension glaucoma and 125 high-tension glaucoma). DNA was isolated by standard methods and genotype distributions of four polymorphisms in genes encoding endothelin-1 (K198N) and endothelin-1 receptor type A polymorphisms (C1222T, C70G, and G231A) were determined. Genotype distributions were compared between NTG and HTG groups. The clinical condition of participants was examined for association with polymorphisms. Results. A similar frequency of occurrence of the polymorphic varieties of the studied genes was observed in patients with NTG and HTG. There is no relation between NTG risk factors and examined polymorphisms. NTG patients with TT genotype of K198N polymorphism presented with the lowest intraocular pressure in comparison to GG + GT genotype (p=0.03). In NTG patients with CC genotype of C1222T polymorphism (p=0.028) and GG of C70G polymorphism (p=0.03) the lowest values of mean blood pressure were observed. Conclusions. The studied polymorphic varieties (K198N, C1222T) do have an influence on intraocular pressure as well as arterial blood pressure in NTG patients

MikroRNA w patogenezie jaskry

MicroRNAs are short ribonucleic acid molecules that regulate gene expression. The involvement of various types of microRNAs in the pathogenesis of glaucoma has been proved. Most of them affect trabecular meshwork in the anterior chamber angle, causing excessive deposition of extracellular matrix and blockage of the aqueous humor outflow. MicroRNAs affect the contractility of the trabecular meshwork cells, decreasing its permeability and increasing intraocular pressure. They participate in the regulation of apoptosis of trabecular meshwork cells and retinal ganglion cells. MicroRNAs may be potential biomarkers for glaucoma and, in the future, a target for gene therapy.MikroRNA to krótkie cząsteczki kwasu rybonukleinowego regulujące ekspresję genów. Wykazano udział różnych rodzajów mikroRNA w patogenezie jaskry. Większość z nich wpływa na beleczkowanie w kącie przesączania, powodując nadmierne odkładanie się macierzy zewnątrzkomórkowej i blokowanie drogi odpływu cieczy wodnistej. Cząsteczki mikroRNA zmieniają kurczliwość komórek beleczkowania, powodują spadek jego przepuszczalności i wzrost ciśnienia wewnątrzgałkowego. Uczestniczą w regulacji apoptozy komórek beleczkowania i komórek zwojowych siatkówki. Cząsteczki mikroRNA mogą być biomarkerami jaskry, a w przyszłości stać się celem terapii genowej

Revisiting the Awareness and Understanding the Associations between Intracranial Tumors and Optic Neuropathy

The aim of this paper is to report clinically various cases of intracranial tumors in patients referred to glaucoma clinic for consultation. The secondary aim was to increase the awareness of intracranial tumors in atypical cases of glaucoma. We present the retrospective analysis of five patients referred to glaucoma clinic for consultation. Due to atypical course of the disease, in addition to standard glaucoma examinations, all patients had a neurologic full visual field, color vision, and MRI done. In all patients, intracranial malignancies were found, some patients underwent surgery of the lesions with consecutive clinical improvements. Interestingly, in some patients, coexisting glaucoma was diagnosed. Patients were selected deliberately to present a wide spectrum of possible clinical scenarios when glaucoma may be complicated by intracranial tumors. Sometimes, the relevance of intracranial tumors with respect to their influence on the clinical picture of the optic nerve cannot be established. To conclude, in the “atypical cases of glaucoma” the assessment of the optic nerve may indicate the necessity of neuroimaging in differential diagnostics

Nailfold Videocapillaroscopy in Patients with Central Serous Chorioretinopathy and Its Relationship to Morphological and Functional Findings

The aim of the study was to evaluate the results of nailfold videocapillaroscopy (NVC) in patients with central serous chorioretinopathy (CSC) and their correlation with different functional, morphological features and general risk factors. Material and methods: The examined group included 59 CSC patients (14 F, 45 M, mean age 47.2 ± 9.4) and 53 healthy controls (13 F, 40 M, mean age 46 ± 11.5). The NVC was qualified as a normal or abnormal pattern. In the CSC group, the ophthalmoscopy, angio-Optical Coherence Tomography (OCT-A), OCT and microperimetry were performed. The medical history regarding CSC, chronic general disorders and known risk factors was recorded. Results: In the CSC group an abnormal NVC pattern was more common (33.88% CSC vs. 7.54%, p < 0.001). Dilated apical part of capillaries, microaneurysmal dilatation, megacapillaries, fresh microhaemorrhages, bizarre and broken capillaries were observed only in CSC patients. Dilation of capillaries (47.56% vs. 13.21%, p = 0.004), ramified capillaries and neoangiogenesis (38.98% vs. 5.66%, p < 0.001), glomerular loops (32.20% vs. 1.88% p < 0.001) were more frequent in the CSC group. Conclusions: The presence of various NVC abnormalities confirms microvascular involvement in CSC pathogenesis. The results correlate with visual acuity, microperimetry, OCT data and stress. The NVC technique may play a useful diagnostic and prognostic role in CSC

Ocular and Systemic Risk Factors of Different Morphologies of Scotoma in Patients with Normal-Tension Glaucoma

The Aim. The aim of this study was to assess general and ocular profiles of patients with single-localisation changes in visual field. Material and Methods. The study group consisted of 215 Caucasian patients with normal-tension glaucoma with scotoma on single localisation or with preperimetric glaucoma. During regular follow-up visits, ophthalmic examination was carried out and medical history was recorded. The results of the visual field were allocated as paracentral scotomas, arcuate scotomas, peripheral defects, or hemispheric defects. Statistical analysis was conducted with Statistica 12, and p<0.05 was considered statistically significant. Results. Risk factors such as notch, disc hemorrhage, general hypertension, migraine, and diabetes were strongly associated with specific visual field defects. Paracentral defect was significantly more frequent for women (p=0.05) and patients with disc hemorrhage (p<0.001). Arcuate scotoma occurred frequently in patients without disc hemorrhage (p=0.046) or migraines (p=0.048) but was observed in coexistence with general hypertension (p<0.001). The hemispheric defect corresponded with notch (p=0.0036) and migraine (p=0.081). Initial IOP was highest in patients with arcuate scotoma and lowest in patients with preperimetric glaucoma (p=0.0120). Conclusions. The specific morphology of scotoma in patients with normal-tension glaucoma is connected with definite general and ocular risk factors

The Efficacy and Safety of the GATT Procedure in Open-Angle Glaucoma&mdash;6-Month Results

AIM. The aim of the study was to retrospectively evaluate the efficacy and safety of GATT during a 6-month observation period. MATERIAL AND METHODS. The studied group consisted of 69 open-angle glaucoma patients treated with GATT as the only procedure or in combination with cataract surgery. Patients were assessed 1 day, 10 days, 1 month, 3 months, and 6 months after the surgery via standard ophthalmic examination including VF, IOP, and BCVA. The number of medications taken daily and possible complications were checked. Two criteria of success were established (S1: IOP decrease by 30% and S2: IOP lower than 18 mm Hg). RESULTS. Before the surgery, the mean IOP was 26.94 mmHg and significantly decreased after GATT to 15.59 mmHg at 6M. BCVA did not significantly differ between the visits. The mean MD did not change significantly within the 6-month observation period (&minus;8.20 dB vs. &minus;8.16 dB, p = 0.9824), similar to the mean VFI (64.31% vs. 63.05%, p = 0.8571). A 30% IOP decrease at 6M visit was obtained in 95.6% of patients, and 37.7% needed medications to stabilize IOP. An IOP lower than 18 mmHg at 6M was obtained in 91.3% of studied patients after the GATT procedure, and in 58.0% without additional medications. The mean number of medications received daily decreased significantly at 6M compared to preoperative results (2.59 at inclusion vs. 0.76 at 6M, p = 0.0004). The most frequent complication after surgery was hyphema, which resolved spontaneously within 10 days. CONCLUSION. The 6-month observation showed that GATT is a minimally invasive glaucoma-surgery technique that enables an effective and safe IOP decrease

Analysis of the impact of different schemes of preparation to trabeculectomy on the healing markers on the Tenon fibroblasts cultures

Abstract The aim of the study was to assess the influence of different regimes of patient’s preparation before trabeculectomy on the markers of healing process in Tenon’s fibroblast cultures.The studied group consisted of 66 patients with open angle glaucoma undergoing primary trabeculectomy. The patients were divided into 5 groups with different regimes of preparation before the surgery based on application or withdrawal of topical antiglaucoma medications and steroids (G1—patients using antiglaucoma drops until the day of the surgery; G2—patients using antiglaucoma drops until the day of the surgery and additionally dexamethasone for 4 weeks before surgery; G3—patients who stopped using antiglaucoma drops 4 weeks before the surgery and introduced dexamethasone for 4 weeks before surgery; G4—patients who stopped using antiglaucoma drops 4 weeks before the surgery; G5—control group, patients with newly diagnosed glaucoma in whom trabeculectomy was the first treatment option without medical treatment). During trabeculectomy the samples of Tenon’s capsule were obtained. Tenon fibroblasts were isolated directly from the explants to test their proliferation ability and the level of released healing markers. Following factors typical of healing process were evaluated using commercially available ELISA kits: IL 1-β, IL-6, IL-8, VEGF-A, TGF-β1 and MMP-9. Concentrations of IL-1β, IL-6 and TGF-β1 were significantly higher in the group obtaining antiglaucoma drops. Additionally, in this group the fibroblasts revealed the highest proliferation potential, indicating the active healing process. The levels of IL-8, VEGF-A and MMP-9 were similar between the groups. Our study shows that for the best conjunctival anti-inflammatory control, the most influential factor is the withdrawal of antiglaucoma medications

Visual Tract Degradation in Bilateral Normal-Tension Glaucoma&mdash;Cortical Thickness Maps and Volumetric Study of Visual Pathway Areas

The aim of the study was to evaluate changes in the central visual pathways during the early and advanced stages of bilateral normal-tension glaucoma (NTG). Methods: The studied groups constituted patients with bilateral normal-tension glaucoma of the same stage (n = 45) and age-matched healthy volunteers (n = 17). All patients underwent ophthalmic examination and examination on a 1.5 Tesla Magnetic Resonance Scanner (Optima 360, GE Healthcare). Volume and cortical thickness analyses were performed using the open-source automated software package FreeSurfer. Results: There was a significant difference in lateral geniculate nuclei volume between the control and advanced glaucoma groups in the right hemisphere (p = 0.03) and in the left hemisphere between the early and advanced glaucoma patients (p = 0.026). The optic chiasm volume differed significantly between the control and advanced NTG groups (p = 0.0003) and between early and advanced glaucoma patients (p = 0.004). Mean cortical thickness analysis revealed a significant increase in values in the advanced glaucoma group in the right Brodmann area 17 (BA17) (p = 0.007) and right BA18 (p = 0.049) as compared to early NTG. In the left BA18 area, the mean thickness of the cortex in the early glaucoma group was significantly lower than in the control group (p = 0.03). Conclusions: The increase in the grey matter thickness in the V1 region with more-advanced glaucoma stages may reflect compensatory hypertrophy. Additionally, the regions of the brain early affected during glaucoma with reduced thickness were the right lateral occipital gyrus and left lingual gyrus. The most prominent change during the course of glaucoma was the increase in grey matter thickness in the right cuneus

Visual Tract Degradation in Bilateral Normal-Tension Glaucoma—Cortical Thickness Maps and Volumetric Study of Visual Pathway Areas

The aim of the study was to evaluate changes in the central visual pathways during the early and advanced stages of bilateral normal-tension glaucoma (NTG). Methods: The studied groups constituted patients with bilateral normal-tension glaucoma of the same stage (n = 45) and age-matched healthy volunteers (n = 17). All patients underwent ophthalmic examination and examination on a 1.5 Tesla Magnetic Resonance Scanner (Optima 360, GE Healthcare). Volume and cortical thickness analyses were performed using the open-source automated software package FreeSurfer. Results: There was a significant difference in lateral geniculate nuclei volume between the control and advanced glaucoma groups in the right hemisphere (p = 0.03) and in the left hemisphere between the early and advanced glaucoma patients (p = 0.026). The optic chiasm volume differed significantly between the control and advanced NTG groups (p = 0.0003) and between early and advanced glaucoma patients (p = 0.004). Mean cortical thickness analysis revealed a significant increase in values in the advanced glaucoma group in the right Brodmann area 17 (BA17) (p = 0.007) and right BA18 (p = 0.049) as compared to early NTG. In the left BA18 area, the mean thickness of the cortex in the early glaucoma group was significantly lower than in the control group (p = 0.03). Conclusions: The increase in the grey matter thickness in the V1 region with more-advanced glaucoma stages may reflect compensatory hypertrophy. Additionally, the regions of the brain early affected during glaucoma with reduced thickness were the right lateral occipital gyrus and left lingual gyrus. The most prominent change during the course of glaucoma was the increase in grey matter thickness in the right cuneus

Small Nucleolar RNAs in Pseudoexfoliation Glaucoma

Small nucleolar RNAs (snoRNAs) are small non-coding regulatory RNAs that have been investigated extensively in recent years. However, the relationship between snoRNA and glaucoma is still unknown. This study aims to analyze the levels of snoRNA expression in the aqueous humor (AH) of patients with pseudoexfoliation glaucoma (PEXG) compared to a control group and identify hypothetical snoRNA-dependent mechanisms contributing to PEXG. The AH was obtained from eighteen Caucasian patients, comprising nine PEXG and nine age-matched control patients. RNA was isolated, and a microarray system was used to determine the snoRNA expression profiles. Functional and enrichment analyses were performed. We identified seven snoRNAs, SNORD73B, SNORD58A, SNORD56, SNORA77, SNORA72, SNORA64, and SNORA32, in the AH of the PEXG and control group patients. Five snoRNAs showed statistically significantly lower expression in the PEXG group, and two snoRNAs had statistically significantly higher expression in the PEXG group compared to the control group. In addition, we identified two factors—CACNB3 for SNORA64 and TMEM63C for SNORA32, similar to PEX-related genes (CACNA1A and TMEM136). The enrichment analysis for four genes targeted by snoRNAs revealed possible mechanisms associated with glaucoma and/or PEX, but the direct role of snoRNAs in these biological processes was not proven