Glaucoma Characteristics and Influencing Factors during the COVID-19 Pandemic in the Huizhou Region

Objective. Glaucoma in individuals who tested positive for the coronavirus disease 2019 (COVID-19) during the pandemic outbreak has not been comprehensively studied. Therefore, this study aimed to analyze the characteristics and risk factors of glaucoma during the COVID-19 pandemic in Huizhou. Methods. Retrospective data from outpatients with glaucoma at the Huizhou Hospital Affiliated with Guangzhou Medical University and Longmen County People’s Hospital were collected during two periods: the COVID-19 pandemic period (Phase A: December 1, 2022, to January 19, 2023) and the prevention and control period (Phase B: December 1, 2021, to January 19, 2022). The demographic characteristics of the outpatients during both phases were compared. The characteristics of glaucoma in patients with COVID-19 during Phase A were examined. Multivariate logistic regression analysis was used to identify factors influencing the development of acute angle-closure glaucoma (AACG) in Phase A patients. Results. The proportion of patients with glaucoma was significantly higher during Phase A than during Phase B at both hospitals. No statistically significant differences were observed between patients with glaucoma during Phases A and B for age, sex, and region. A high COVID-19-positive rate was associated with old age, females, AACG, newly diagnosed glaucoma, and binocular involvement during phase A. Females testing positive for COVID-19, glaucoma that started after testing positive for COVID-19, and a history of medication use were associated with a higher proportion of AACG in phase A. Multivariable logistic regression analysis identified testing positive for COVID-19 as an independent potential risk factor for developing AACG. Conclusion. In summary, during the COVID-19 pandemic in Huizhou, patients with COVID-19 were primarily affected by AACG, especially females, older individuals, and those with binocular involvement. Testing positive for COVID-19 increases the risk of developing AACG

Autophagy in retinal ganglion cells in a rhesus monkey chronic hypertensive glaucoma model.

Primary open angle glaucoma (POAG) is a neurodegenerative disease characterized by physiological intraocular hypertension that causes damage to the retinal ganglion cells (RGCs). In the past, RGC damage in POAG was suggested to have been attributed to RGC apoptosis. However, in the present study, we applied a model closer to human POAG through the use of a chronic hypertensive glaucoma model in rhesus monkeys to investigate whether another mode of progressive cell death, autophagy, was activated in the glaucomatous retinas. First, in the glaucomatous retinas, the levels of LC3B-II, LC3B-II/LC3B-I and Beclin 1 increased as demonstrated by Western blot analyses, whereas early or initial autophagic vacuoles (AVi) and late or degraded autophagic vacuoles (AVd) accumulated in the ganglion cell layer (GCL) and in the inner plexiform layer (IPL) as determined by transmission electron microscopy (TEM) analysis. Second, lysosome activity and autophagosome-lysosomal fusion increased in the RGCs of the glaucomatous retinas, as demonstrated by Western blotting against lysosome associated membrane protein-1 (LAMP1) and double labeling against LC3B and LAMP1. Third, apoptosis was activated in the glaucomatous eyes with increased levels of caspase-3 and cleaved caspase-3 and an increased number of TUNEL-positive RGCs. Our results suggested that autophagy was activated in RGCs in the chronic hypertensive glaucoma model of rhesus monkeys and that autophagy may have potential as a new target for intervention in glaucoma treatment

Role of N6-methyladenosine-related lncRnas in pseudoexfoliation glaucoma

ABSTRACTTo 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

Western blot analyses of the expression of Beclin 1, LC3B-II and LC3B-II/LC3B-I in the normal and exp gl retinas.

<p>After normalization to GAPDH, the levels of Beclin 1, LC3B-II and LC3B-II/LC3B-I in the glaucomatous retinas significantly increased compared with the normal retinas (*<i>P</i><0.05).</p

Clinical Outcomes of FP-7/8 Ahmed Glaucoma Valves in the Management of Refractory Glaucoma in the Mainland Chinese Population

<div><p>Background</p><p>To evaluate the efficacy and safety of the Ahmed glaucoma valve (AGV) and the risk factors associated with AGV implantation failure in a population of Chinese patients with refractory glaucoma.</p><p>Method</p><p>In total, 79 eyes with refractory glaucoma from 79 patients treated in our institution from November 2007 to November 2010 were enrolled in this retrospective study. The demographic data, preoperative and postoperative intraocular pressures (IOPs), best corrected visual acuity (BCVA), number of anti-glaucoma medications used, completed and qualified surgery success rates and postoperative complications were recorded to evaluate the outcomes of AGV implantation. Factors that were associated with implant failure were determined using Cox proportional hazard regression model analysis and multiple linear regression analysis.</p><p>Principle Findings</p><p>The average follow-up time was 12.7±5.8 months (mean±SD). We observed a significant reduction in the mean IOP from 39.9±12.6 mm Hg before surgery to 19.3±9.6 mm Hg at the final follow-up. The complete success rate was 59.5%, and the qualified success rate was 83.5%. The number of previous surgeries was negatively correlated with qualified success rate (P<0.05, OR=0.736, 95% CI 0.547-0.99). Patients with previous trabeculectomy were more likely to use multiple anti-glaucoma drugs to control IOP (P<0.01). The primary complication was determined to be a flat anterior chamber (AC).</p><p>Conclusion</p><p>AGV implantation was safe and effective for the management of refractory glaucoma. Patients with a greater number of previous surgeries were more likely to experience surgical failure, and patients with previous trabeculectomy were more likely to use multiple anti-glaucoma drugs to control postoperative IOP.</p></div

Preoperative and postoperative comparisons in FP-7 AGV patients.

<p>IOP = intraocular pressure, AGV = Ahmed glaucoma valve, SD = standard deviation, BCVA = best corrected vision acuity</p><p>Preoperative and postoperative comparisons in FP-7 AGV patients.</p

Above: Western blot analysis of LAMP1.

<p>After normalization to GAPDH, LAMP1 levels in the glaucomatous retinas increased significantly compared with the normal retinas (*<i>P</i> <0.05). Below: The double immunolabeling for LC3B and LAMP1. The nucleus (blue) was immunolabeled with DAPI, and all retinal sections were stained with the same concentration of antibody against LC3B (green) and LAMP1 (red). In A-D, both LC3B and LAMP1-positive RGC with positive granules in the cytoplasm (red arrow) were occasionally observed in the normal retinas. E-H, frequent LC3B-positive RGC with increased LAMP1-positive granules in the cytoplasm (red arrows) were observed in the glaucomatous retinas, indicating that the fusion of autophagosomes with lysosomes increased in the neurons. Furthermore, LAMP1-positive RGC without LC3-positive granules was visible in the cytoplasm of the glaucomatous retinas (white arrows). Scale bar=20 μm.</p

Immunolocalization analysis of LC3B in the normal and exp gl retinas.

<p>The nucleus (blue) was immunolabeled with hematoxylin for immunoperoxidase labeling (A, B, D and E) and with DAPI for immunofluorescent analysis (C and F). LC3B immunoreactivity was observed as clusters of small, intensely stained granules, which were brown in A, B, D and E and green in C and F. A, C, D and F. Strong increases in LC3B expression were observed in the GCL (black arrows) and IPL (red arrows) in the glaucomatous retinas compared with the normal retinas. B, C, E and F. With higher magnification, a markedly increased number of positive granules are visible in the cytosol of the RGC in the GCL (black arrows) and in the dendrites of the RGC in the IPL (red arrows) in the glaucomatous retinas compared with the normal retinas. (A, D scale bar=50 μm; B, C, E and F scale bar=20 μm). .</p

The complete success rate of patients with various glaucoma diagnoses.

<p>ICE = iridocorneal endothelial, OAG = open angle glaucoma, POAG = primary open angle glaucoma, PACG = primary angle closure glaucoma</p><p>The complete success rate of patients with various glaucoma diagnoses.</p

Above: Western blot analyses for caspase-3 and cleaved caspase-3.

<p>After normalization to β-Actin, the levels of caspase-3 and cleaved caspase-3 in the glaucomatous retina increased significantly compared with the normal retinas (*<i>P</i> <0.05). Below: TUNEL staining of the normal and exp gl retinas. Few TUNEL-positive RGCs were observed in the normal retina, whereas a larger number were observed in the glaucomatous retina in the GCL (red arrow). Scale bar=20 μm. </p