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Liu C, Lin MTY, Lee IXY, Wong JHF, Lu D, Lam TC, Zhou L, Mehta JS, Ong HS, Ang M, Tong L, Liu YC. Neuropathic Corneal Pain: Tear Proteomic and Neuromediator Profiles, Imaging Features, and Clinical Manifestations. Am J Ophthalmol 2024; 265:6-20. [PMID: 38521157 DOI: 10.1016/j.ajo.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/05/2024] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE To investigate the tear proteomic and neuromediator profiles, in vivo confocal microscopy (IVCM) imaging features, and clinical manifestations in neuropathic corneal pain (NCP) patients. DESIGN Cross-sectional study. METHODS A total of 20 NCP patients and 20 age-matched controls were recruited. All subjects were evaluated by corneal sensitivity, Schirmer test, tear break-up time, and corneal and ocular surface staining, Ocular Surface Disease Index and Ocular Pain Assessment Survey questionnaires were administered, as well as IVCM examinations for corneal nerves, microneruomas, and epithelial and dendritic cells. Tears were collected for neuromediator and proteomic analysis using enzyme-linked immunosorbent assay and data-independent acquisition mass spectrometry. RESULTS Burning and sensitivity to light were the 2 most common symptoms in NCP. A total of 188 significantly dysregulated proteins, such as elevated metallothionein-2, creatine kinases B-type, vesicle-associated membrane protein 2, neurofilament light polypeptide, and myelin basic protein, were identified in the NCP patients. The top 10 dysregulated biological pathways in NCP include neurotoxicity, axonal signaling, wound healing, neutrophil degradation, apoptosis, thrombin signaling mitochondrial dysfunction, and RHOGDI and P70S6K signaling pathways. Compared to controls, the NCP cohort presented with significantly decreased corneal sensitivity (P < .001), decreased corneal nerve fiber length (P = .003), corneal nerve fiber density (P = .006), and nerve fiber fractal dimension (P = .033), as well as increased corneal nerve fiber width (P = .002), increased length, total area and perimeter of microneuromas (P < .001, P < .001, P = .019), smaller corneal epithelial size (P = .017), and higher nerve growth factor level in tears (P = .006). CONCLUSIONS These clinical manifestations, imaging features, and molecular characterizations would contribute to the diagnostics and potential therapeutic targets for NCP.
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Affiliation(s)
- Chang Liu
- From Tissue Engineering and Cell Therapy Group (C.L., M.T.-Y.L., I.X.Y.L., J.S.M., H.S.O., Y.-C.L.), Singapore Eye Research Institute, Singapore; Cornea and Refractive Surgery Group (C.L., J.S.M., H.S.O., Y.-C.L.), Singapore Eye Research Institute, Singapore
| | - Molly Tzu-Yu Lin
- From Tissue Engineering and Cell Therapy Group (C.L., M.T.-Y.L., I.X.Y.L., J.S.M., H.S.O., Y.-C.L.), Singapore Eye Research Institute, Singapore
| | - Isabelle Xin Yu Lee
- From Tissue Engineering and Cell Therapy Group (C.L., M.T.-Y.L., I.X.Y.L., J.S.M., H.S.O., Y.-C.L.), Singapore Eye Research Institute, Singapore
| | - Jipson Hon Fai Wong
- Clinical Research Platform (J.H.F.W.), Singapore Eye Research Institute, Singapore
| | - Daqian Lu
- Centre for Myopia Research (D.L., T.C.L.), School of Optometry, Hong Kong Polytechnic University, Hong Kong
| | - Thomas Chuen Lam
- Centre for Myopia Research (D.L., T.C.L.), School of Optometry, Hong Kong Polytechnic University, Hong Kong; Centre for Eye and Vision Research (CEVR) (T.C.L.), Hong Kong
| | - Lei Zhou
- School of Optometry (L.Z.), Department of Applied Biology and Chemical Technology, Research Centre for SHARP Vision (RCSV); The Hong Kong Polytechnic University, Hong Kong
| | - Jodhbir S Mehta
- From Tissue Engineering and Cell Therapy Group (C.L., M.T.-Y.L., I.X.Y.L., J.S.M., H.S.O., Y.-C.L.), Singapore Eye Research Institute, Singapore; Cornea and Refractive Surgery Group (C.L., J.S.M., H.S.O., Y.-C.L.), Singapore Eye Research Institute, Singapore; Department of Cornea and External Eye Disease (J.S.M., H.S.O., M.A., L.T., Y.-C.L.), Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program (J.S.M., H.S.O., M.A., Y.-C.L.), Duke-NUS Medical School, Singapore
| | - Hon Shing Ong
- From Tissue Engineering and Cell Therapy Group (C.L., M.T.-Y.L., I.X.Y.L., J.S.M., H.S.O., Y.-C.L.), Singapore Eye Research Institute, Singapore; Cornea and Refractive Surgery Group (C.L., J.S.M., H.S.O., Y.-C.L.), Singapore Eye Research Institute, Singapore; Department of Cornea and External Eye Disease (J.S.M., H.S.O., M.A., L.T., Y.-C.L.), Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program (J.S.M., H.S.O., M.A., Y.-C.L.), Duke-NUS Medical School, Singapore
| | - Marcus Ang
- Department of Cornea and External Eye Disease (J.S.M., H.S.O., M.A., L.T., Y.-C.L.), Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program (J.S.M., H.S.O., M.A., Y.-C.L.), Duke-NUS Medical School, Singapore
| | - Louis Tong
- Department of Cornea and External Eye Disease (J.S.M., H.S.O., M.A., L.T., Y.-C.L.), Singapore National Eye Centre, Singapore; Ocular Surface Research Group (L.T.), Singapore Eye Research Institute, Singapore; Eye Academic Clinical Program (L.T.), Duke-NUS Medical School, Singapore; Department of Ophthalmology (L.T.), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Yu-Chi Liu
- From Tissue Engineering and Cell Therapy Group (C.L., M.T.-Y.L., I.X.Y.L., J.S.M., H.S.O., Y.-C.L.), Singapore Eye Research Institute, Singapore; Cornea and Refractive Surgery Group (C.L., J.S.M., H.S.O., Y.-C.L.), Singapore Eye Research Institute, Singapore; Department of Cornea and External Eye Disease (J.S.M., H.S.O., M.A., L.T., Y.-C.L.), Singapore National Eye Centre, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program (J.S.M., H.S.O., M.A., Y.-C.L.), Duke-NUS Medical School, Singapore; Department of Ophthalmology (Y.-C.L.), National Taiwan University, Taiwan.
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Ibrahim OMA, Ayaki M, Yotsukura E, Torii H, Negishi K. A Possible Reciprocal Relationship Between Myopia and Dry Eye Disease in Japanese Teenagers. Clin Ophthalmol 2024; 18:1991-1998. [PMID: 39005585 PMCID: PMC11246637 DOI: 10.2147/opth.s444765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 06/13/2024] [Indexed: 07/16/2024] Open
Abstract
Purpose To investigate the relationship between dry eye disease (DED) and myopia in Japanese teenagers. Methods This clinic-based, retrospective, cross-sectional study assessed DED condition in 10- to 19-year-old teenagers presenting at Japanese eye clinics. They included 106 high myopic patients (HM; mean age, 16.4 ± 2.2 years), 494 mild myopic patients (15.0 ± 2.6 years) and 82 non-myopic teenagers (NM; 13.8 ± 2.6 years). Subjective refraction and anisometropia were measured. Myopia grade was classified as HM (≤ -6.00 D), MM (> -6.00 D, < -0.50 D), or NM (≥ -0.5 D). The presence of DED-related symptoms including dryness, irritation, pain, fatigue, blurring and photophobia were assessed through a questionnaire. Tear film break-up time (BUT) and fluorescein corneal staining were investigated. Comparison among three groups and regression analysis of myopic error and other variables were conducted. Results Anisometropia and astigmatic error were greatest in the HM group compared with the other groups (p < 0.001). The HM group reported less photophobia (p < 0.001) and less pain (p = 0.039) compared with the NM group. Regression analysis revealed that myopic error was correlated with astigmatic error (β = -0.231, p <0.001), anisometropia (β = -0.191, p <0.001), short BUT (β = -0.086, p = 0.028) and the presence of diagnosed DED (β = -0.112, p = 0.003). Dryness (β = -0.127 p = 0.004), photophobia (β = 0.117, p = 0.002) and pain (β = 0.084, p = 0.034) correlated with myopic error. Conclusion This study associated clinical findings of DED in HM teenagers. The present results suggest DED might be associated with myopia, possibly in a reciprocal relationship.
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Affiliation(s)
- Osama M A Ibrahim
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Otake Eye Clinic, Kanagawa, Japan
| | - Erisa Yotsukura
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Matynia A, Recio BS, Myers Z, Parikh S, Goit RK, Brecha NC, Pérez de Sevilla Müller L. Preservation of Intrinsically Photosensitive Retinal Ganglion Cells (ipRGCs) in Late Adult Mice: Implications as a Potential Biomarker for Early Onset Ocular Degenerative Diseases. Invest Ophthalmol Vis Sci 2024; 65:28. [PMID: 38224335 PMCID: PMC10793389 DOI: 10.1167/iovs.65.1.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/27/2023] [Indexed: 01/16/2024] Open
Abstract
Purpose Intrinsically photosensitive retinal ganglion cells (ipRGCs) play a crucial role in non-image-forming visual functions. Given their significant loss observed in various ocular degenerative diseases at early stages, this study aimed to assess changes in both the morphology and associated behavioral functions of ipRGCs in mice between 6 (mature) and 12 (late adult) months old. The findings contribute to understanding the preservation of ipRGCs in late adults and their potential as a biomarker for early ocular degenerative diseases. Methods Female and male C57BL/6J mice were used to assess the behavioral consequences of aging to mature and old adults, including pupillary light reflex, light aversion, visual acuity, and contrast sensitivity. Immunohistochemistry on retinal wholemounts from these mice was then conducted to evaluate ipRGC dendritic morphology in the ganglion cell layer (GCL) and inner nuclear layer (INL). Results Morphological analysis showed that ipRGC dendritic field complexity was remarkably stable through 12 months old of age. Similarly, the pupillary light reflex, visual acuity, and contrast sensitivity were stable in mature and old adults. Although alterations were observed in ipRGC-independent light aversion distinct from the pupillary light reflex, aged wild-type mice continuously showed enhanced light aversion with dilation. No effect of sex was observed in any tests. Conclusions The preservation of both ipRGC morphology and function highlights the potential of ipRGC-mediated function as a valuable biomarker for ocular diseases characterized by early ipRGC loss. The consistent stability of ipRGCs in mature and old adult mice suggests that detected changes in ipRGC-mediated functions could serve as early indicators or diagnostic tools for early-onset conditions such as Alzheimer's disease, Parkinson's disease, and diabetes, where ipRGC loss has been documented.
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Affiliation(s)
- Anna Matynia
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California, United States
| | - Brandy S. Recio
- Department of Neurobiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - Zachary Myers
- Department of Neurobiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - Sachin Parikh
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California, United States
| | - Rajesh Kumar Goit
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California, United States
| | - Nicholas C. Brecha
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
- Brain Research Institute, University of California, Los Angeles, Los Angeles, California, United States
- Department of Neurobiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
| | - Luis Pérez de Sevilla Müller
- Department of Neurobiology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
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Ayaki M, Kuze M, Negishi K. Association of eye strain with dry eye and retinal thickness. PLoS One 2023; 18:e0293320. [PMID: 37862343 PMCID: PMC10588844 DOI: 10.1371/journal.pone.0293320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/09/2023] [Indexed: 10/22/2023] Open
Abstract
PURPOSE The purpose of this cohort study was to investigate the association between the prevalence of abnormal ocular examination results and the common visual symptoms of eye strain, blurred vision and photophobia. METHODS Consecutive first-visit outpatients with best-corrected visual acuity better than 20/30 in both eyes were enrolled and those with a history of intra-ocular lens implantation and glaucoma were excluded. Dry eye-related examinations and retinal thickness measurement were conducted. The odds ratio (OR) was calculated with logistic regression analyses of ocular data in relation to the presence of visual symptoms. RESULTS A total of 6078 patients (3920 women, mean age 49.0 ± 20.4 years) were analyzed. The prevalence of each symptom was 31.8% for eye strain, 22.5% for blurred vision and 16.0% for photophobia. A significant risk factor for eye strain was short tear break-up time (TBUT) (OR 1.88), superficial punctate keratitis (SPK) (OR 1.44), and thickness of ganglion cell complex (GCC) (OR 1.30). Risk factors for blurred vision were short TBUT (OR 1.85), SPK (OR 1.24) and GCC (OR 0.59). Risk factors for photophobia were short TBUT (OR 1.77) and SPK (OR 1.32). Schirmer test value, peripapillary nerve fiber layer thickness and full macular thickness were not associated with the tested symptoms. CONCLUSION The current study successfully identified female gender, short TBUT, and SPK as significant risk factors for eye strain, blurred vision, and photophobia with considerable ORs.
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Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Otake Eye Clinic, Kanagawa, Japan
| | | | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
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Tamayo E, Mouland JW, Lucas RJ, Brown TM. Regulation of mouse exploratory behaviour by irradiance and cone-opponent signals. BMC Biol 2023; 21:178. [PMID: 37605163 PMCID: PMC10441731 DOI: 10.1186/s12915-023-01663-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/14/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Animal survival depends on the ability to adjust behaviour according to environmental conditions. The circadian system plays a key role in this capability, with diel changes in the quantity (irradiance) and spectral content ('colour') of ambient illumination providing signals of time-of-day that regulate the timing of rest and activity. Light also exerts much more immediate effects on behaviour, however, that are equally important in shaping daily activity patterns. Hence, nocturnal mammals will actively avoid light and dramatically reduce their activity when light cannot be avoided. The sensory mechanisms underlying these acute effects of light are incompletely understood, particularly the importance of colour. RESULTS To define sensory mechanisms controlling mouse behaviour, we used photoreceptor-isolating stimuli and mice with altered cone spectral sensitivity (Opn1mwR), lacking melanopsin (Opn1mwR; Opn4-/-) or cone phototransduction (Cnga3-/-) in assays of light-avoidance and activity suppression. In addition to roles for melanopsin-dependent irradiance signals, we find a major influence of spectral content in both cases. Hence, remarkably, selective increases in S-cone irradiance (producing a blue-shift in spectrum replicating twilight) drive light-seeking behaviour and promote activity. These effects are opposed by signals from longer-wavelength sensitive cones, indicating a true spectrally-opponent mechanism. Using c-Fos-mapping and multielectrode electrophysiology, we further show these effects are associated with a selective cone-opponent modulation of neural activity in the key brain site implicated in acute effects of light on behaviour, the subparaventricular zone. CONCLUSIONS Collectively, these data reveal a mechanism whereby blue-shifts in the spectrum of environmental illumination, such as during twilight, promote mouse exploratory behaviour.
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Affiliation(s)
- E Tamayo
- Centre for Biological Timing, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - J W Mouland
- Centre for Biological Timing, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - R J Lucas
- Centre for Biological Timing, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - T M Brown
- Centre for Biological Timing, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
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Liu AL, Liu YF, Wang G, Shao YQ, Yu CX, Yang Z, Zhou ZR, Han X, Gong X, Qian KW, Wang LQ, Ma YY, Zhong YM, Weng SJ, Yang XL. The role of ipRGCs in ocular growth and myopia development. SCIENCE ADVANCES 2022; 8:eabm9027. [PMID: 35675393 PMCID: PMC9176740 DOI: 10.1126/sciadv.abm9027] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
The increasing global prevalence of myopia calls for elaboration of the pathogenesis of this disease. Here, we show that selective ablation and activation of intrinsically photosensitive retinal ganglion cells (ipRGCs) in developing mice induced myopic and hyperopic refractive shifts by modulating the corneal radius of curvature (CRC) and axial length (AL) in an opposite way. Melanopsin- and rod/cone-driven signals of ipRGCs were found to influence refractive development by affecting the AL and CRC, respectively. The role of ipRGCs in myopia progression is evidenced by attenuated form-deprivation myopia magnitudes in ipRGC-ablated and melanopsin-deficient animals and by enhanced melanopsin expression/photoresponses in form-deprived eyes. Cell subtype-specific ablation showed that M1 subtype cells, and probably M2/M3 subtype cells, are involved in ocular development. Thus, ipRGCs contribute substantially to mouse eye growth and myopia development, which may inspire novel strategies for myopia intervention.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Shi-Jun Weng
- Corresponding author. (X.-L.Y.); (S.-J.W.); (Y.-M.Z.)
| | - Xiong-Li Yang
- Corresponding author. (X.-L.Y.); (S.-J.W.); (Y.-M.Z.)
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Honig MG, Del Mar NA, Henderson DL, O'Neal D, Yammanur M, Cox R, Li C, Perry AM, Moore BM, Reiner A. Raloxifene, a cannabinoid type-2 receptor inverse agonist, mitigates visual deficits and pathology and modulates microglia after ocular blast. Exp Eye Res 2022; 218:108966. [PMID: 35143834 DOI: 10.1016/j.exer.2022.108966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/04/2022] [Accepted: 01/24/2022] [Indexed: 11/19/2022]
Abstract
Visual deficits after ocular blast injury (OBI) are common, but pharmacological approaches to improve long-term outcomes have not been identified. Blast forces frequently damage the retina and optic nerves, and work on experimental animals has shown the pro-inflammatory actions of microglia can further exacerbate such injuries. Cannabinoid type-2 receptor (CB2) inverse agonists specifically target activated microglia, biasing them away from the harmful pro-inflammatory M1 state toward the helpful reparative M2 state. We previously found that treating mice with CB2 inverse agonists after traumatic brain injury, produced by either focal cranial air blast or dorsal cranial impact, greatly attenuated the visual deficits and pathology that otherwise resulted. Here we examined the consequences of single and repeat OBI and the benefit provided by raloxifene, an FDA-approved estrogen receptor drug that possesses noteworthy CB2 inverse agonism. After single OBI, although the amplitudes of the A- and B-waves of the electroretinogram and pupil light response appeared to be normal, the mice showed hints of deficits in contrast sensitivity and visual acuity, a trend toward optic nerve axon loss, and significantly increased light aversion, which were reversed by 2 weeks of daily treatment with raloxifene. Mice subjected to repeat OBI (5 blasts spaced 1 min apart), exhibited more severe visual deficits, including decreases in contrast sensitivity, visual acuity, the amplitudes of the A- and B-waves of the electroretinogram, light aversion, and resting pupil diameter (i.e. hyperconstriction), accompanied by the loss of photoreceptor cells and optic nerve axons, nearly all of which were mitigated by raloxifene. Interestingly, optic nerve axon abundance was strongly correlated with contrast sensitivity and visual acuity across all groups of experimental mice in the repeat OBI study, suggesting optic nerve axon loss with rOBI and its attenuation with raloxifene are associated with the extent of these two deficits while photoreceptor abundance was highly correlated with A-wave amplitude and resting pupil size, suggesting a prominent role for photoreceptors in these two deficits. Quantitative PCR (qPCR) showed levels of M1-type microglial markers (e.g. iNOS, IL1β, TNFα, and CD32) in retina, optic nerve, and thalamus were increased 3 days after repeat OBI. With raloxifene treatment, the overall expression of M1 markers was more similar to that in sham mice. Raloxifene treatment was also associated with the elevation of IL10 transcripts in all three tissues compared to repeat OBI alone, but the results for the three other M2 microglial markers we examined were more varied. Taken together, the qPCR results suggest that raloxifene benefit for visual function and pathology was associated with a lessening of the pro-inflammatory actions of microglia. The benefit we find for raloxifene following OBI provides a strong basis for phase-2 efficacy testing in human clinical trials for treating ocular injury.
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Affiliation(s)
- Marcia G Honig
- Department of Anatomy and Neurobiology(,) the University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Nobel A Del Mar
- Department of Anatomy and Neurobiology(,) the University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Desmond L Henderson
- Department of Anatomy and Neurobiology(,) the University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Dylan O'Neal
- Department of Anatomy and Neurobiology(,) the University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Meghna Yammanur
- Department of Anatomy and Neurobiology(,) the University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Rachel Cox
- Department of Anatomy and Neurobiology(,) the University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Chunyan Li
- Department of Anatomy and Neurobiology(,) the University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Aaron M Perry
- Department of Anatomy and Neurobiology(,) the University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Bob M Moore
- Department of Pharmaceutical Sciences, The University of Tennessee Health Science Center, Memphis, TN, 38163, USA
| | - Anton Reiner
- Department of Anatomy and Neurobiology(,) the University of Tennessee Health Science Center, Memphis, TN, 38163, USA; Department of Ophthalmology, The University of Tennessee Health Science Center, Memphis, TN, 38163, USA.
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8
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Honig MG, Del Mar NA, Henderson DL, O'Neal D, Doty JB, Cox R, Li C, Perry AM, Moore BM, Reiner A. Raloxifene Modulates Microglia and Rescues Visual Deficits and Pathology After Impact Traumatic Brain Injury. Front Neurosci 2021; 15:701317. [PMID: 34776838 PMCID: PMC8585747 DOI: 10.3389/fnins.2021.701317] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 09/07/2021] [Indexed: 11/29/2022] Open
Abstract
Mild traumatic brain injury (TBI) involves widespread axonal injury and activation of microglia, which initiates secondary processes that worsen the TBI outcome. The upregulation of cannabinoid type-2 receptors (CB2) when microglia become activated allows CB2-binding drugs to selectively target microglia. CB2 inverse agonists modulate activated microglia by shifting them away from the harmful pro-inflammatory M1 state toward the helpful reparative M2 state and thus can stem secondary injury cascades. We previously found that treatment with the CB2 inverse agonist SMM-189 after mild TBI in mice produced by focal cranial blast rescues visual deficits and the optic nerve axon loss that would otherwise result. We have further shown that raloxifene, which is Food and Drug Administration (FDA)-approved as an estrogen receptor modulator to treat osteoporosis, but also possesses CB2 inverse agonism, yields similar benefit in this TBI model through its modulation of microglia. As many different traumatic events produce TBI in humans, it is widely acknowledged that diverse animal models must be used in evaluating possible therapies. Here we examine the consequences of TBI created by blunt impact to the mouse head for visual function and associated pathologies and assess raloxifene benefit. We found that mice subjected to impact TBI exhibited decreases in contrast sensitivity and the B-wave of the electroretinogram, increases in light aversion and resting pupil diameter, and optic nerve axon loss, which were rescued by daily injection of raloxifene at 5 or 10 mg/ml for 2 weeks. Raloxifene treatment was associated with reduced M1 activation and/or enhanced M2 activation in retina, optic nerve, and optic tract after impact TBI. Our results suggest that the higher raloxifene dose, in particular, may be therapeutic for the optic nerve by enhancing the phagocytosis of axonal debris that would otherwise promote inflammation, thereby salvaging less damaged axons. Our current work, together with our prior studies, shows that microglial activation drives secondary injury processes after both impact and cranial blast TBI and raloxifene mitigates microglial activation and visual system injury in both cases. The results thus provide a strong basis for phase 2 human clinical trials evaluating raloxifene as a TBI therapy.
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Affiliation(s)
- Marcia G Honig
- Department of Anatomy and Neurobiology, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Nobel A Del Mar
- Department of Anatomy and Neurobiology, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Desmond L Henderson
- Department of Anatomy and Neurobiology, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Dylan O'Neal
- Department of Anatomy and Neurobiology, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - John B Doty
- Department of Anatomy and Neurobiology, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Rachel Cox
- Department of Anatomy and Neurobiology, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Chunyan Li
- Department of Anatomy and Neurobiology, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Aaron M Perry
- Department of Anatomy and Neurobiology, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Bob M Moore
- Department of Pharmaceutical Sciences, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Anton Reiner
- Department of Anatomy and Neurobiology, The University of Tennessee Health Science Center, Memphis, TN, United States.,Department of Ophthalmology, The University of Tennessee Health Science Center, Memphis, TN, United States
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Kaiser EA, McAdams H, Igdalova A, Haggerty EB, Cucchiara BL, Brainard DH, Aguirre GK. Reflexive Eye Closure in Response to Cone and Melanopsin Stimulation: A Study of Implicit Measures of Light Sensitivity in Migraine. Neurology 2021; 97:e1672-e1680. [PMID: 34493620 DOI: 10.1212/wnl.0000000000012734] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/16/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To quantify interictal photophobia in migraine with and without aura using reflexive eye closure as an implicit measure of light sensitivity and to assess the contribution of melanopsin and cone signals to these responses. METHODS Participants were screened to meet criteria for 1 of 3 groups: headache-free (HF) controls, migraine without aura (MO), and migraine with visual aura (MA). MO and MA participants were included if they endorsed ictal and interictal photophobia. Exclusion criteria included impaired vision, inability to collect usable pupillometry, and history of either head trauma or seizure. Participants viewed light pulses that selectively targeted melanopsin, the cones, or their combination during recording of orbicularis oculi EMG (OO-EMG) and blinking activity. RESULTS We studied 20 participants in each group. MA and MO groups reported increased visual discomfort to light stimuli (discomfort rating, 400% contrast, MA: 4.84 [95% confidence interval 0.33, 9.35]; MO: 5.23 [0.96, 9.50]) as compared to HF controls (2.71 [0, 6.47]). Time course analysis of OO-EMG and blinking activity demonstrated that reflexive eye closure was tightly coupled to the light pulses. The MA group had greater OO-EMG and blinking activity in response to these stimuli (EMG activity, 400% contrast: 42.9%Δ [28.4, 57.4]; blink activity, 400% contrast: 11.2% [8.8, 13.6]) as compared to the MO (EMG activity, 400% contrast: 9.9%Δ [5.8, 14.0]; blink activity, 400% contrast: 4.7% [3.5, 5.9]) and HF control (EMG activity, 400% contrast: 13.2%Δ [7.1, 19.3]; blink activity, 400% contrast: 4.5% [3.1, 5.9]) groups. DISCUSSION Our findings suggest that the intrinsically photosensitive retinal ganglion cells (ipRGCs), which integrate melanopsin and cone signals, provide the afferent input for light-induced reflexive eye closure in a photophobic state. Moreover, we find a dissociation between implicit and explicit measures of interictal photophobia depending on a history of visual aura in migraine. This implies distinct pathophysiology in forms of migraine, interacting with separate neural pathways by which the amplification of ipRGC signals elicits implicit and explicit signs of visual discomfort.
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Affiliation(s)
- Eric A Kaiser
- From the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia.
| | - Harrison McAdams
- From the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia
| | - Aleksandra Igdalova
- From the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia
| | - Edda B Haggerty
- From the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia
| | - Brett L Cucchiara
- From the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia
| | - David H Brainard
- From the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia
| | - Geoffrey K Aguirre
- From the Departments of Neurology (E.A.K., A.I., E.B.H., B.L.C., G.K.A.) and Neuroscience (H.M.), Perelman School of Medicine, and Department of Psychology (D.H.B.), University of Pennsylvania, Philadelphia
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Wang M, Mason BN, Sowers LP, Kuburas A, Rea BJ, Russo AF. Investigating Migraine-Like Behavior using Light Aversion in Mice. J Vis Exp 2021. [PMID: 34459825 DOI: 10.3791/62839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Migraine is a complex neurological disorder characterized by headache and sensory abnormalities, such as hypersensitivity to light, observed as photophobia. Whilst it is impossible to confirm that a mouse is experiencing migraine, light aversion can be used as a behavioral surrogate for the migraine symptom of photophobia. To test for light aversion, we utilize the light/dark assay to measure the time mice freely choose to spend in either a light or dark environment. The assay has been refined by introducing two critical modifications: pre-exposures to the chamber prior to running the test procedure and adjustable chamber lighting, permitting the use of a range of light intensities from 55 lux to 27,000 lux. Because the choice to spend more time in the dark is also indicative of anxiety, we also utilize a light-independent anxiety test, the open field assay, to distinguish anxiety from light-aversive behavior. Here, we describe a modified test paradigm for the light/dark and open field assays. The application of these assays is described for intraperitoneal injection of calcitonin gene-related peptide (CGRP) in two mouse strains and for optogenetic brain stimulation studies.
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Affiliation(s)
- Mengya Wang
- Department of Neuroscience and Pharmacology, University of Iowa
| | - Bianca N Mason
- School of Behavioral and Brain Sciences, University of Texas at Dallas
| | - Levi P Sowers
- Center for the Prevention and Treatment of Visual Loss, Veterans Administration Health Center, Iowa City, IA; Department of Molecular Physiology and Biophysics, University of Iowa
| | - Adisa Kuburas
- Department of Molecular Physiology and Biophysics, University of Iowa
| | - Brandon J Rea
- Center for the Prevention and Treatment of Visual Loss, Veterans Administration Health Center, Iowa City, IA; Department of Molecular Physiology and Biophysics, University of Iowa
| | - Andrew F Russo
- Center for the Prevention and Treatment of Visual Loss, Veterans Administration Health Center, Iowa City, IA; Department of Molecular Physiology and Biophysics, University of Iowa; Department of Neurology, University of Iowa;
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11
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Diel RJ, Mehra D, Kardon R, Buse DC, Moulton E, Galor A. Photophobia: shared pathophysiology underlying dry eye disease, migraine and traumatic brain injury leading to central neuroplasticity of the trigeminothalamic pathway. Br J Ophthalmol 2021; 105:751-760. [PMID: 32703784 PMCID: PMC8022288 DOI: 10.1136/bjophthalmol-2020-316417] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/26/2020] [Accepted: 06/29/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Photophobia is a potentially debilitating symptom often found in dry eye disease (DE), migraine and traumatic brain injury (TBI). METHODS We conducted a review of the literature via a PubMed search of English language articles with a focus on how photophobia may relate to a shared pathophysiology across DE, migraine and TBI. RESULTS DE, migraine and TBI are common conditions in the general population, are often comorbid, and share photophobia as a symptom. Across the three conditions, neural dysregulation of peripheral and central nervous system components is implicated in photophobia in various animal models and in humans. Enhanced activity of the neuropeptide calcitonin gene-related peptide (CGRP) is closely linked to photophobia. Current therapies for photophobia include glasses which shield the eyes from specific wavelengths, botulinum toxin, and inhibition of CGRP and its receptor. Many individuals have persistent photophobia despite the use of these therapies, and thus, development of new therapies is needed. CONCLUSIONS The presence of photophobia in DE, migraine and TBI suggests shared trigeminothalamic pathophysiologic mechanisms, as explained by central neuroplasticity and hypersensitivity mediated by neuropeptide CGRP. Treatment strategies which target neural pathways (ie, oral neuromodulators, transcutaneous nerve stimulation) should be considered in patients with persistent photophobia, specifically in individuals with DE whose symptoms are not controlled with traditional therapies.
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Affiliation(s)
- Ryan J Diel
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
| | - Divy Mehra
- Ophthalmology, VA Medical Center Miami, Miami, Florida, USA
- Ophthalmology, University of Miami Bascom Palmer Eye Institute, Miami, Florida, USA
| | - Randy Kardon
- Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals & Clinics, Iowa City, Iowa, USA
- Center for the Prevention and Treatment of Visual Loss, Iowa City VA Health Care System, Iowa City, IA, USA
| | - Dawn C Buse
- Albert Einstein College of Medicine Department of Neurology, Bronx, New York, USA
| | - Eric Moulton
- Department of Anesthesiology, Center for Pain and the Brain; Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| | - Anat Galor
- Ophthalmology, VA Medical Center Miami, Miami, Florida, USA
- Ophthalmology, University of Miami Bascom Palmer Eye Institute, Miami, Florida, USA
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Abstract
Photophobia is one of the most common symptoms in migraine, and the underlying mechanism is uncertain. The discovery of the intrinsically-photosensitive retinal ganglion cells which signal the intensity of light on the retina has led to discussion of their role in the pathogenesis of photophobia. In the current review, we discuss the relationship between pain and discomfort leading to light aversion (traditional photophobia) and discomfort from flicker, patterns, and colour that are also common in migraine and cannot be explained solely by the activity of intrinsically-photosensitive retinal ganglion cells. We argue that, at least in migraine, a cortical mechanism provides a parsimonious explanation for discomfort from all forms of visual stimulation, and that the traditional definition of photophobia as pain in response to light may be too restrictive. Future investigation that directly compares the retinal and cortical contributions to photophobia in migraine with that in other conditions may offer better specificity in identifying biomarkers and possible mechanisms to target for treatment.
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Affiliation(s)
| | - Sarah M Haigh
- Department of Psychology and Integrative Neuroscience, University of Nevada, Reno, USA
| | - Omar A Mahroo
- Institute of Ophthalmology, University College London, London, UK and Retinal Service, Moorfields Eye Hospital, London, UK
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13
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McAdams H, Kaiser EA, Igdalova A, Haggerty EB, Cucchiara B, Brainard DH, Aguirre GK. Selective amplification of ipRGC signals accounts for interictal photophobia in migraine. Proc Natl Acad Sci U S A 2020; 117:17320-17329. [PMID: 32632006 PMCID: PMC7382295 DOI: 10.1073/pnas.2007402117] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Second only to headache, photophobia is the most debilitating symptom reported by people with migraine. While the melanopsin-containing intrinsically photosensitive retinal ganglion cells (ipRGCs) are thought to play a role, how cone and melanopsin signals are integrated in this pathway to produce visual discomfort is poorly understood. We studied 60 people: 20 without headache and 20 each with interictal photophobia from migraine with or without visual aura. Participants viewed pulses of spectral change that selectively targeted melanopsin, the cones, or both and rated the degree of visual discomfort produced by these stimuli while we recorded pupil responses. We examined the data within a model that describes how cone and melanopsin signals are weighted and combined at the level of the retina and how this combined signal is transformed into a rating of discomfort or pupil response. Our results indicate that people with migraine do not differ from headache-free controls in the manner in which melanopsin and cone signals are combined. Instead, people with migraine demonstrate an enhanced response to integrated ipRGC signals for discomfort. This effect of migraine is selective for ratings of visual discomfort, in that an enhancement of pupil responses was not seen in the migraine group, nor were group differences found in surveys of other behaviors putatively linked to ipRGC function (chronotype, seasonal sensitivity, presence of a photic sneeze reflex). By revealing a dissociation in the amplification of discomfort vs. pupil response, our findings suggest a postretinal alteration in processing of ipRGC signals for photophobia in migraine.
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Affiliation(s)
- Harrison McAdams
- Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Eric A Kaiser
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Aleksandra Igdalova
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Edda B Haggerty
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - Brett Cucchiara
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104
| | - David H Brainard
- Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104
| | - Geoffrey K Aguirre
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104;
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14
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Optimization of a Rabbit Dry Eye Model Induced by Topical Instillation of Benzalkonium Chloride. J Ophthalmol 2020; 2020:7204951. [PMID: 32566267 PMCID: PMC7277021 DOI: 10.1155/2020/7204951] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/07/2020] [Accepted: 05/18/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose To optimize a rabbit dry eye model induced by topical instillation of benzalkonium chloride (BAC), reduce the days of instillation of the original model by increasing the concentration of BAC from 0.1% to 0.2%. Materials and Methods An experimental, prospective, and randomized study was performed on 10 male New Zealand white rabbits, divided into two groups, considering both eyes: 5 rabbits as control (n = 10) and 5 rabbits with 0.2% BAC treatment (n = 10). Saline solution (control) and 0.2% BAC were instilled for 5 consecutive days, twice daily. Tear secretion with and without anesthesia, tear breakup time, tear osmolarity, corneal staining, conjunctival hyperemia, density of goblet cells, height of mucin cloud, and transcript levels of IL-6 were measured before and after the treatment. Results After the instillation of 0.2% BAC for 5 consecutive days, there was a significant increase in tear secretion without anesthesia (P < 0.001), corneal staining (P < 0.001), conjunctival hyperemia (P < 0.001), and levels of IL-6 mRNA (P=0.005) compared to the control group. Conversely, there was a decrease in tear secretion with anesthesia (P < 0.001), tear breakup time (P=0.007), tear osmolarity (P < 0.001), density of goblet cells (P < 0.001), and height of mucin cloud (P < 0.001). Conclusions The topical instillation of 0.2% BAC for 5 consecutive days, twice daily, was a proper procedure to induce a rabbit dry eye model, reducing the number of days of instillation compared to the original model (14 days).
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15
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Hanyuda A, Negishi K, Tsubota K, Ayaki M. Persistently Worsened Tear Break-up Time and Keratitis in Unilateral Pseudophakic Eyes after a Long Postoperative Period. Biomedicines 2020; 8:biomedicines8040077. [PMID: 32260530 PMCID: PMC7235885 DOI: 10.3390/biomedicines8040077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/16/2020] [Accepted: 04/03/2020] [Indexed: 11/16/2022] Open
Abstract
Dry eye disease may develop and persist after cataract surgery; however, unilateral cases have not been fully documented. This cross-sectional, observational study was conducted in five eye clinics in Japan. A total of 1023 outpatients were initially enrolled, and 89 unilateral pseudophakic subjects with 1+ year of follow-up after uncomplicated cataract surgery were included. The tear break-up times (TBUTs) and keratoconjunctival staining results were compared between phakic and pseudophakic eyes. The mean age of the patients was 69.3 ± 10.4 years (32 men, 36.0%), and the mean postoperative period was 4.6 ± 4.4 (1–20) years. For the ophthalmic parameters, the TBUTs were 4.4 ± 1.9 and 3.8 ± 1.9 s (p < 0.001), the keratoconjunctival staining scores were 0.11 ± 0.38 and 0.22 ± 0.56 (p = 0.02), the spherical equivalents were −1.27 ± 2.51 and −0.99 ± 1.45 D (p = 0.21), the astigmatic errors were 0.79 ± 0.66 and 0.78 ± 0.58 D (p = 0.80), and the intraocular pressures were 13.6 ± 2.9 and 13.5 ± 2.6 mmHg (p = 0.62) for the phakic and pseudophakic eyes, respectively. The corneal status was significantly worse in the pseudophakic eyes than in the contralateral phakic eyes, even after more than one year after implant surgery. The present results suggested that long-term ocular surface problems should be examined further since they may not originate only from surgery or postoperative ocular surface diseases.
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Affiliation(s)
- Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.H.); (K.N.); (K.T.)
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo 104-0045, Japan
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA 02215, USA
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.H.); (K.N.); (K.T.)
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.H.); (K.N.); (K.T.)
| | - Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan; (A.H.); (K.N.); (K.T.)
- Otake Clinic Moon View Eye Center, Kanagawa 242-0001, Japan
- Correspondence:
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16
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Honig MG, Del Mar NA, Henderson DL, Ragsdale TD, Doty JB, Driver JH, Li C, Fortugno AP, Mitchell WM, Perry AM, Moore BM, Reiner A. Amelioration of visual deficits and visual system pathology after mild TBI via the cannabinoid Type-2 receptor inverse agonism of raloxifene. Exp Neurol 2019; 322:113063. [DOI: 10.1016/j.expneurol.2019.113063] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/09/2019] [Accepted: 09/07/2019] [Indexed: 11/29/2022]
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Marek V, Reboussin E, Dégardin-Chicaud J, Charbonnier A, Domínguez-López A, Villette T, Denoyer A, Baudouin C, Réaux-Le Goazigo A, Mélik Parsadaniantz S. Implication of Melanopsin and Trigeminal Neural Pathways in Blue Light Photosensitivity in vivo. Front Neurosci 2019; 13:497. [PMID: 31178682 PMCID: PMC6543920 DOI: 10.3389/fnins.2019.00497] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 04/30/2019] [Indexed: 01/30/2023] Open
Abstract
Photophobia may arise from various causes and frequently accompanies numerous ocular diseases. In modern highly illuminated world, complaints about greater photosensitivity to blue light increasingly appear. However, the pathophysiology of photophobia is still debated. In the present work, we investigated in vivo the role of various neural pathways potentially implicated in blue-light aversion. Moreover, we studied the light-induced neuroinflammatory processes on the ocular surface and in the trigeminal pathways. Adult male C57BL/6J mice were exposed either to blue (400-500 nm) or to yellow (530-710 nm) LED light (3 h, 6 mW/cm2). Photosensitivity was measured as the time spent in dark or illuminated parts of the cage. Pharmacological treatments were applied: topical instillation of atropine, pilocarpine or oxybuprocaine, intravitreal injection of lidocaine, norepinephrine or "blocker" of the visual photoreceptor transmission, and intraperitoneal injection of a melanopsin antagonist. Clinical evaluations (ocular surface state, corneal mechanical sensitivity and tear quantity) were performed directly after exposure to light and after 3 days of recovery in standard light conditions. Trigeminal ganglia (TGs), brainstems and retinas were dissected out and conditioned for analyses. Mice demonstrated strong aversion to blue but not to yellow light. The only drug that significantly decreased the blue-light aversion was the intraperitoneally injected melanopsin antagonist. After blue-light exposure, dry-eye-related inflammatory signs were observed, notably after 3 days of recovery. In the retina, we observed the increased immunoreactivity for GFAP, ATF3, and Iba1; these data were corroborated by RT-qPCR. Moreover, retinal visual and non-visual photopigments distribution was altered. In the trigeminal pathway, we detected the increased mRNA expression of cFOS and ATF3 as well as alterations in cytokines' levels. Thus, the wavelength-dependent light aversion was mainly mediated by melanopsin-containing cells, most likely in the retina. Other potential pathways of light reception were also discussed. The phototoxic message was transmitted to the trigeminal system, inducing both inflammation at the ocular surface and stress in the retina. Further investigations of retina-TG connections are needed.
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Affiliation(s)
- Veronika Marek
- R&D, Essilor International, Paris, France
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | - Elodie Reboussin
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | - Julie Dégardin-Chicaud
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | - Angéline Charbonnier
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | - Alfredo Domínguez-López
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | | | - Alexandre Denoyer
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
- Centre Hospitalier Nationale d’Ophtalmologie des Quinze-Vingts, Paris, France
- CHU Robert Debré, Université Reims Champagne-Ardenne, Reims, France
| | - Christophe Baudouin
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
- Centre Hospitalier Nationale d’Ophtalmologie des Quinze-Vingts, Paris, France
- Versailles Saint-Quentin-en-Yvelines Université, Versailles, France
| | - Annabelle Réaux-Le Goazigo
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | - Stéphane Mélik Parsadaniantz
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
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18
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Diel RJ, Hwang J, Kroeger ZA, Levitt RC, Sarantopoulos CD, Sered H, Felix ER, Martinez-Barrizonte J, Galor A. Photophobia and sensations of dryness in patients with migraine occur independent of baseline tear volume and improve following botulinum toxin A injections. Br J Ophthalmol 2018; 103:1024-1029. [PMID: 30269099 DOI: 10.1136/bjophthalmol-2018-312649] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/22/2018] [Accepted: 09/03/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND To evaluate the efficacy of botulinum toxin A (BoNT-A) in reducing photophobia and dry eye symptoms in individuals with chronic migraine. Additionally, we aimed to evaluate tear film volume as a potential contributor to symptoms in these patients. METHODS Retrospective review of 76 patients who received BoNT-A for chronic migraine between 23 August 2017 and 13 December 2017 at the Miami Veterans Affairs Medical Center Neurotoxin Clinic. Demographic data and all comorbidities were queried via chart review. Standardised validated surveys were administered to assess symptoms prior to and after BoNT-A injection. Preinjection tear volumes were obtained using the phenol red thread (PRT) test. RESULTS Preinjection migraine, photophobia and dry eye symptom scores were all significantly correlated, p<0.05, and none were associated with preinjection PRT results. After BoNT-A, improvements in migraine, photophobia and dry eye symptoms were also significantly correlated, p<0.05 and similarly did not associate with preinjection PRT results. Photophobia scores significantly improved following BoNT-A, while dry eye symptoms significantly improved in those with severe symptoms at baseline (DEQ-5 score ≥12), p=0.027. In logistic regression analysis of all individuals with dry eye symptoms (DEQ-5 ≥6), individuals with more severe dry eye symptoms were more likely improve, OR 1.27, 95% CI 1.06 to 1.51, p<0.01. CONCLUSIONS BoNT-A significantly improved photophobia in patients being treated for migraine and also improved dry eye symptoms in patients with severe symptoms at baseline, independent of baseline tear film volume. These improvements may be due to modulation of shared trigeminal neural pathways.
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Affiliation(s)
- Ryan J Diel
- Miami Veterans Administration Medical Center, Miami, Florida, USA.,Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Jodi Hwang
- Miami Veterans Administration Medical Center, Miami, Florida, USA.,University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Zachary A Kroeger
- Miami Veterans Administration Medical Center, Miami, Florida, USA.,University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Roy C Levitt
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.,Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, Florida, USA.,John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, Florida, USA.,John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Constantine D Sarantopoulos
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.,Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Heather Sered
- Miami Veterans Administration Medical Center, Miami, Florida, USA
| | - Elizabeth R Felix
- Miami Veterans Administration Medical Center, Miami, Florida, USA.,Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Anat Galor
- Miami Veterans Administration Medical Center, Miami, Florida, USA .,Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, Florida, USA.,Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, Florida, USA
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Ayaki M, Hattori A, Maruyama Y, Tsubota K, Negishi K. Large-scale integration in tablet screens for blue-light reduction with optimized color: The effects on sleep, sleepiness, and ocular parameters. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/23312025.2017.1294550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, 1608582 Tokyo, Japan
| | - Atsuhiko Hattori
- Department of Biology, Tokyo Medical and Dental University, 2-8-30 Kokufudai, Ichikawa, Chiba, Japan
| | - Yusuke Maruyama
- Department of Biology, Tokyo Medical and Dental University, 2-8-30 Kokufudai, Ichikawa, Chiba, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, 1608582 Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, 1608582 Tokyo, Japan
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Matynia A, Nguyen E, Sun X, Blixt FW, Parikh S, Kessler J, Pérez de Sevilla Müller L, Habib S, Kim P, Wang ZZ, Rodriguez A, Charles A, Nusinowitz S, Edvinsson L, Barnes S, Brecha NC, Gorin MB. Peripheral Sensory Neurons Expressing Melanopsin Respond to Light. Front Neural Circuits 2016; 10:60. [PMID: 27559310 PMCID: PMC4978714 DOI: 10.3389/fncir.2016.00060] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 07/26/2016] [Indexed: 01/17/2023] Open
Abstract
The ability of light to cause pain is paradoxical. The retina detects light but is devoid of nociceptors while the trigeminal sensory ganglia (TG) contain nociceptors but not photoreceptors. Melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs) are thought to mediate light-induced pain but recent evidence raises the possibility of an alternative light responsive pathway independent of the retina and optic nerve. Here, we show that melanopsin is expressed in both human and mouse TG neurons. In mice, they represent 3% of small TG neurons that are preferentially localized in the ophthalmic branch of the trigeminal nerve and are likely nociceptive C fibers and high-threshold mechanoreceptor Aδ fibers based on a strong size-function association. These isolated neurons respond to blue light stimuli with a delayed onset and sustained firing, similar to the melanopsin-dependent intrinsic photosensitivity observed in ipRGCs. Mice with severe bilateral optic nerve crush exhibit no light-induced responses including behavioral light aversion until treated with nitroglycerin, an inducer of migraine in people and migraine-like symptoms in mice. With nitroglycerin, these same mice with optic nerve crush exhibit significant light aversion. Furthermore, this retained light aversion remains dependent on melanopsin-expressing neurons. Our results demonstrate a novel light-responsive neural function independent of the optic nerve that may originate in the peripheral nervous system to provide the first direct mechanism for an alternative light detection pathway that influences motivated behavior.
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Affiliation(s)
- Anna Matynia
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, UCLALos Angeles, CA, USA; Brain Research Institute, UCLALos Angeles, CA, USA
| | - Eileen Nguyen
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, UCLA Los Angeles, CA, USA
| | - Xiaoping Sun
- Department of Neurobiology and Medicine, David Geffen School of Medicine, UCLA Los Angeles, CA, USA
| | - Frank W Blixt
- Division of Experimental Vascular Research, Department of Clinical Sciences, Lund University Lund, Sweden
| | - Sachin Parikh
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, UCLALos Angeles, CA, USA; Brain Research Institute, UCLALos Angeles, CA, USA
| | - Jason Kessler
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, UCLA Los Angeles, CA, USA
| | | | - Samer Habib
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, UCLA Los Angeles, CA, USA
| | - Paul Kim
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, UCLA Los Angeles, CA, USA
| | - Zhe Z Wang
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, UCLA Los Angeles, CA, USA
| | - Allen Rodriguez
- Department of Neurobiology and Medicine, David Geffen School of Medicine, UCLA Los Angeles, CA, USA
| | - Andrew Charles
- Brain Research Institute, UCLALos Angeles, CA, USA; Department of Neurology, David Geffen School of Medicine, UCLALos Angeles, CA, USA
| | - Steven Nusinowitz
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, UCLA Los Angeles, CA, USA
| | - Lars Edvinsson
- Division of Experimental Vascular Research, Department of Clinical Sciences, Lund University Lund, Sweden
| | - Steven Barnes
- Department of Neurobiology and Medicine, David Geffen School of Medicine, UCLALos Angeles, CA, USA; Departments of Physiology & Biophysics and Ophthalmology and Visual Sciences, Dalhousie UniversityHalifax, NS, Canada
| | - Nicholas C Brecha
- Brain Research Institute, UCLALos Angeles, CA, USA; Department of Neurobiology and Medicine, David Geffen School of Medicine, UCLALos Angeles, CA, USA; Veterans Administration Greater Los Angeles Health SystemLos Angeles, CA, USA
| | - Michael B Gorin
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, UCLALos Angeles, CA, USA; Brain Research Institute, UCLALos Angeles, CA, USA
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