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Loukovaara S, Auvinen A, Haukka J. Associations between systemic medications and development of wet age-related macular degeneration. Acta Ophthalmol 2021; 100:572-582. [PMID: 34779110 DOI: 10.1111/aos.15056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/04/2021] [Accepted: 10/25/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE To examine whether systemic medications are associated with the subsequent development of wet age-related macular degeneration (AMD). METHODS A retrospective study of 259 562 individuals based on registry data, from January 1, 2001, to December 31, 2017. End-point event was the International Classification of Diseases (ICD)-10 diagnosis for wet AMD. Association between use of systemic medication covering 85 generic drugs categorized according to Anatomical Therapeutic Chemical (ATC) codes and the incidence of wet AMD was evaluated using multivariate Poisson regression model (adjusted for age, sex, diabetes, cancer and socioeconomic group) and nested case-control design. RESULTS The mean length of follow-up was 9.84 years. The number of cases with wet AMD was 2947 and incidence rate was 1.15 per 1000 person-years. After adjustment, we observed an increased risk for the development of wet AMD for patients exposed to amlodipine (IRR 1.33, 95% CI 1.16-1.53), or felodipine (1.24, 95% CI 1.02-1.50). Similarly, an increased risk of wet AMD was associated with the use of bicalutamide (2.14, 95% CI 1.14-4.02), estradiol (1.20, 95% CI 1.03-1.40) and atorvastatin (1.22, 95% CI 1.05-1.43). Of note, digoxin (0.72, 95% CI 0.57-0.91), and ramipril (0.80, 95% CI 0.65-0.99) users had a lower incidence of wet AMD. CONCLUSIONS Our findings suggest that the use of second-generation calcium channel blockers could be associated with an increased risk for wet AMD development. Of note, the incidence of wet AMD seemed to be lower in patients using ramipril and digoxin. More studies are needed to elucidate the associations further.
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Affiliation(s)
- Sirpa Loukovaara
- Unit of Vitreoretinal Surgery Department of Ophthalmology Helsinki University Hospital, and Individualized Drug Therapy Research Program University of Helsinki Helsinki Finland
| | - Anssi Auvinen
- Faculty of Social Sciences Health Sciences Tampere University Tampere Finland
| | - Jari Haukka
- Department of Public Health University of Helsinki Helsinki Finland
- Faculty of Medicine and Health Technology Tampere University Tampere Finland
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Bao X, Zhang Z, Guo Y, Buser C, Kochounian H, Wu N, Li X, He S, Sun B, Ross-Cisneros FN, Sadun AA, Huang L, Zhao M, Fong HKW. Human RGR Gene and Associated Features of Age-Related Macular Degeneration in Models of Retina-Choriocapillaris Atrophy. THE AMERICAN JOURNAL OF PATHOLOGY 2021; 191:1454-1473. [PMID: 34022179 DOI: 10.1016/j.ajpath.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 04/16/2021] [Accepted: 05/05/2021] [Indexed: 01/28/2023]
Abstract
Age-related macular degeneration (AMD) is a progressive eye disease and the most common cause of blindness among the elderly. AMD is characterized by early atrophy of the choriocapillaris and retinal pigment epithelium (RPE). Although AMD is a multifactorial disease with many environmental and genetic risk factors, a hallmark of the disease is the origination of extracellular deposits, or drusen, between the RPE and Bruch membrane. Human retinal G-protein-coupled receptor (RGR) gene generates an exon-skipping splice variant of RGR-opsin (RGR-d; NP_001012740) that is a persistent component of small and large drusen. Herein, the findings show that abnormal RGR proteins, including RGR-d, are pathogenic in an animal retina with degeneration of the choriocapillaris, RPE, and photoreceptors. A frameshift truncating mutation resulted in severe retinal degeneration with a continuous band of basal deposits along the Bruch membrane. RGR-d produced less severe disease with choriocapillaris and RPE atrophy, including focal accumulation of abnormal RGR-d protein at the basal boundary of the RPE. Degeneration of the choriocapillaris was marked by a decrease in endothelial CD31 protein and choriocapillaris breakdown at the ultrastructural level. Fundus lesions with patchy depigmentation were characteristic of old RGR-d mice. RGR-d was mislocalized in cultured cells and caused a strong cell growth defect. These results uphold the notion of a potential hidden link between AMD and a high-frequency RGR allele.
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Affiliation(s)
- Xuan Bao
- Department of Ophthalmology, Beijing Key Laboratory for the Diagnosis and Treatment of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China; Department of Ophthalmology, Keck School of Medicine of USC, Los Angeles, California
| | - Zhaoxia Zhang
- Department of Ophthalmology, Keck School of Medicine of USC, Los Angeles, California; Shanxi Eye Hospital, Taiyuan, China
| | - Yanjiang Guo
- Department of Ophthalmology, Beijing Key Laboratory for the Diagnosis and Treatment of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China
| | | | | | - Nancy Wu
- Norris Cancer Center, Keck School of Medicine of University of Southern California, Los Angeles, California
| | - Xiaohua Li
- Henan Eye Institute, Henan Provincial People's Hospital, Henan, China
| | - Shikun He
- Department of Pathology, Keck School of Medicine of USC, Los Angeles, California
| | - Bin Sun
- Shanxi Eye Hospital, Taiyuan, China
| | | | - Alfredo A Sadun
- Doheny Eye Institute, Los Angeles, California; Department of Ophthalmology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - Lvzhen Huang
- Department of Ophthalmology, Beijing Key Laboratory for the Diagnosis and Treatment of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China
| | - Mingwei Zhao
- Department of Ophthalmology, Beijing Key Laboratory for the Diagnosis and Treatment of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing, China.
| | - Henry K W Fong
- Department of Ophthalmology, Keck School of Medicine of USC, Los Angeles, California; University of Southern California Roski Eye Institute, Los Angeles, California; Department of Molecular Microbiology and Immunology, University of Southern California, Los Angeles, California.
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Giannaccare G, Pellegrini M, Senni C, Bernabei F, Scorcia V, Cicero AFG. Clinical Applications of Astaxanthin in the Treatment of Ocular Diseases: Emerging Insights. Mar Drugs 2020; 18:md18050239. [PMID: 32370045 PMCID: PMC7281326 DOI: 10.3390/md18050239] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 12/12/2022] Open
Abstract
Astaxanthin is a naturally occurring red carotenoid pigment belonging to the family of xanthophylls, and is typically found in marine environments, especially in microalgae and seafood such as salmonids, shrimps and lobsters. Due to its unique molecular structure, astaxanthin features some important biologic properties, mostly represented by strong antioxidant, anti-inflammatory and antiapoptotic activities. A growing body of evidence suggests that astaxanthin is efficacious in the prevention and treatment of several ocular diseases, ranging from the anterior to the posterior pole of the eye. Therefore, the present review aimed at providing a comprehensive evaluation of current clinical applications of astaxanthin in the management of ocular diseases. The efficacy of this carotenoid in the setting of retinal diseases, ocular surface disorders, uveitis, cataract and asthenopia is reported in numerous animal and human studies, which highlight its ability of modulating several metabolic pathways, subsequently restoring the cellular homeostatic balance. To maximize its multitarget therapeutic effects, further long-term clinical trials are warranted in order to define appropriate dosage, route of administration and exact composition of the final product.
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Affiliation(s)
- Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (G.G.); (V.S.)
| | - Marco Pellegrini
- Ophthalmology Unit, S.Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy; (M.P.); (C.S.); (F.B.)
| | - Carlotta Senni
- Ophthalmology Unit, S.Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy; (M.P.); (C.S.); (F.B.)
| | - Federico Bernabei
- Ophthalmology Unit, S.Orsola-Malpighi Hospital, University of Bologna, 40138 Bologna, Italy; (M.P.); (C.S.); (F.B.)
| | - Vincenzo Scorcia
- Department of Ophthalmology, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (G.G.); (V.S.)
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Roizenblatt M, Naranjit N, Maia M, Gehlbach PL. The Question of a Role for Statins in Age-Related Macular Degeneration. Int J Mol Sci 2018; 19:ijms19113688. [PMID: 30469381 PMCID: PMC6274767 DOI: 10.3390/ijms19113688] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 01/22/2023] Open
Abstract
Age-related macular degeneration (AMD) is the leading cause of irreversible central vision loss in patients over the age of 65 years in industrialized countries. Epidemiologic studies suggest that high dietary fat intake is a risk factor for the development and progression of both vascular and retinal disease. These, and other associations, suggest a hypothesis linking elevated cholesterol and AMD progression. It follows, therefore, that cholesterol-lowering medications, such as statins, may influence the onset and progression of AMD. However, the findings have been inconclusive as to whether statins play a role in AMD. Due to the significant public health implications of a potential inhibitory effect of statins on the onset and progression of AMD, it is important to continually evaluate emerging findings germane to this question.
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Affiliation(s)
- Marina Roizenblatt
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
- Department of Ophthalmology, Federal University of São Paulo, São Paulo 04023-062, Brazil.
- Vision Institute, IPEPO, Department of Ophthalmology, Paulista Medical School, Federal University of São Paulo, São Paulo 04038-032, Brazil.
| | - Nara Naranjit
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
| | - Mauricio Maia
- Department of Ophthalmology, Federal University of São Paulo, São Paulo 04023-062, Brazil.
- Vision Institute, IPEPO, Department of Ophthalmology, Paulista Medical School, Federal University of São Paulo, São Paulo 04038-032, Brazil.
| | - Peter L Gehlbach
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
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Curcio CA. A New Online Portal Will Match Eye Banks With Researchers Seeking Human Ocular Tissues. Invest Ophthalmol Vis Sci 2018; 59:4796-4797. [PMID: 30304461 PMCID: PMC6166890 DOI: 10.1167/iovs.18-25632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Christine A. Curcio
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
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Selective permeability of mouse blood-aqueous barrier as determined by 15N-heavy isotope tracing and mass spectrometry. Proc Natl Acad Sci U S A 2018; 115:9032-9037. [PMID: 30127000 DOI: 10.1073/pnas.1807982115] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The blood-aqueous barrier plays a key role in regulating aqueous humor homeostasis by selectively restricting passage of proteins into the eye. The kinetics of aqueous flow are traditionally measured using artificial markers; however, these marker molecules do not address the barrier's selective permeability to plasma proteins. Here we applied stable isotope labeling of all serum proteins with nitrogen-15 (15N) atoms. Following systemic injection of this "heavy" serum in mice, the 15N-to-endogenous nitrogen-14 (14N) ratio of each protein in aqueous was measured by mass spectrometry. By monitoring the kinetic changes in these ratios, we determined the permeability profiles of hundreds of serum proteins. Meanwhile, we subjected one of the eyes to neoangiogenic wound healing by inflicting injury to the corneal limbus and compared the 15N proteomes between the normal eyes and the recovering eyes at 2 weeks after injury. In the injured eye, we detected markedly enhanced permeability to inhibitory complement regulator proteins, such as Cfh, Cfhr, Cfb, Cfi, Cfd, and Vtn. Many of the proteins in this group are implicated in age-related macular degeneration associated with leakage of the blood-retinal barrier due to inflammation. To rule out the possibility that the observed leakage was due simply to physical damage of the blood vessels, we separately created a neovascularization model using an alkali burn of the avascular cornea. In this latter model, elevated levels of Cfh and Cfb were evident. These findings suggest that ocular neovascularization is associated with enhanced permeability to serum complement regulators.
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Biarnés M, Vassilev V, Nogoceke E, Emri E, Rodríguez-Bocanegra E, Ferraro L, Garcia M, Fauser S, Monés J, Lengyel I, Peto T. Precision medicine for age-related macular degeneration: current developments and prospects. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2018. [DOI: 10.1080/23808993.2018.1502037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
| | - Vassil Vassilev
- School of Medicine, Dentistry and Biomedical Science, Queen’s University Belfast, Belfast, UK
| | - Everson Nogoceke
- Roche Innovation Centre Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Eszter Emri
- School of Medicine, Dentistry and Biomedical Science, Queen’s University Belfast, Belfast, UK
| | | | | | | | - Sascha Fauser
- Roche Innovation Centre Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Jordi Monés
- Barcelona Macula Foundation, Barcelona, Spain
| | - Imre Lengyel
- School of Medicine, Dentistry and Biomedical Science, Queen’s University Belfast, Belfast, UK
| | - Tunde Peto
- School of Medicine, Dentistry and Biomedical Science, Queen’s University Belfast, Belfast, UK
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Choriocapillaris Loss in Advanced Age-Related Macular Degeneration. J Ophthalmol 2018; 2018:8125267. [PMID: 29651346 PMCID: PMC5831971 DOI: 10.1155/2018/8125267] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 11/29/2017] [Accepted: 12/11/2017] [Indexed: 12/15/2022] Open
Abstract
The purpose of this review is to summarize the current knowledge on choriocapillaris loss in advanced age macular degeneration (AMD). Several histopathological studies in animal models and human eyes had showed that the choriocapillaris density decreases with age. However, the role of choriocapillaris loss is still unclear in AMD and its advanced forms, either choroidal neovascularization (CNV) or geographic atrophy (GA). Some authors have hypothesized that choriocapillaris loss might precede overt retinal pigment epithelium atrophy. Others have hypothesized that deposition of complement complexes on and around the choriocapillaris could be related to the tissue loss observed in early AMD. The development of imaging modalities, such as optical coherence tomography angiography (OCTA), have led to a better understanding of underlying physiopathological mechanisms in AMD. OCTA showed atrophy of choriocapillaris underneath and beyond the region of photoreceptors and RPE loss, in agreement with previous histopathologic studies. The evolution of OCTA technology suggests that CNV seems to originate from regions of severe choriocapillaris alteration. Significant progress has been made in the understanding of development and progression of GA and CNV. In vivo investigation of the choriocapillaris using OCTA may lead to new insights related to underlying disease mechanisms in AMD.
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