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Schilcher AV, Roth M, Steindor FA, Helweh R, Geerling G. "Dirty Dry Eye"- A waste volume analysis from topical therapy in keratoconjunctivitis sicca. Graefes Arch Clin Exp Ophthalmol 2024; 262:2917-2924. [PMID: 38520515 PMCID: PMC11377519 DOI: 10.1007/s00417-024-06431-y] [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: 11/15/2023] [Revised: 02/20/2024] [Accepted: 02/27/2024] [Indexed: 03/25/2024] Open
Abstract
PURPOSE The healthcare system is responsible for around 5% of CO2 emissions globally and in Germany. So far, there are no data on the amount of waste from dry eye disease (DED) therapy in ophthalmology. The aim of this project was to evaluate the amount and type of waste from single- and multi-dose units (SDU/MDU) generated by eyedrops used to treat DED in Germany. METHODS The net waste weight (outer/inner packaging, instruction leaflet, empty container) from factory-sealed products was determined using a precision scale. Based on prescription data from PharMaAnalyst, a database of medical prescriptions from over 70 million patients in Germany, the total annual waste volume for 2016-2021 and the net weight of a 30-day treatment were calculated. RESULTS The total annual waste volume increased significantly (p < 0.0001) from 7.13 tons in 2016 to 20.64 tons in 2021. A 30-day treatment with MDUs (without/with filter) results in a significantly lower mean waste volume (paper: SDU 24.3 ± 18.7 g; MDU 4.8 ± 1.7 g/8.8 g ± 1.7 g; SDU/MDU p = 0.0003, with filter p = 0.0034; plastic: SDU 35.0 ± 4.0, MDU 6.6 ± 0.7 g/ 15.1 g ± 5.8 g, SDU/MDU p < 0.0001, with filter p < 0.0001). CONCLUSION Prescription-based treatment of DED in Germany causes an increasing and substantial waste volume. The use of SDUs is considerably more resource-intensive than MDUs. Due to the large and rising number of patients suffering from DED improvements in packaging could considerably reduce the CO2 footprint of DED treatment.
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Affiliation(s)
| | - Mathias Roth
- Department of Ophthalmology, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Friedrich A Steindor
- Department of Ophthalmology, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Ranya Helweh
- Department of Ophthalmology, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Gerd Geerling
- Department of Ophthalmology, University Hospital Duesseldorf, Duesseldorf, Germany
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Wiebe-Ben Zakour KE, Kaya S, Grumm L, Matros J, Hacker MC, Geerling G, Witt J. Modulation of Decellularized Lacrimal Gland Hydrogel Biodegradation by Genipin Crosslinking. Invest Ophthalmol Vis Sci 2024; 65:24. [PMID: 38748430 PMCID: PMC11098053 DOI: 10.1167/iovs.65.5.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/23/2024] [Indexed: 05/18/2024] Open
Abstract
Purpose Hydrogels derived from decellularized tissues are promising biomaterials in tissue engineering, but their rapid biodegradation can hinder in vitro cultivation. This study aimed to retard biodegradation of a hydrogel derived from porcine decellularized lacrimal glands (dLG-HG) by crosslinking with genipin to increase the mechanical stability without affecting the function and viability of lacrimal gland (LG)-associated cells. Methods The effect of different genipin concentrations on dLG-HG stiffness was measured rheologically. Cell-dependent biodegradation was quantified over 10 days, and the impact on matrix metalloproteinase (MMP) activity was quantified by gelatin and collagen zymography. The viability of LG epithelial cells (EpCs), mesenchymal stem cells (MSCs), and endothelial cells (ECs) cultured on genipin-crosslinked dLG-HG was assessed after 10 days, and EpC secretory activity was analyzed by β-hexosaminidase assay. Results The 0.5-mM genipin increased the stiffness of dLG-HG by about 46%, and concentrations > 0.25 mM caused delayed cell-dependent biodegradation and reduced MMP activity. The viability of EpCs, MSCs, and ECs was not affected by genipin concentrations of up to 0.5 mM after 10 days. Moreover, up to 0.5-mM genipin did not negatively affect EpC secretory activity compared to control groups. Conclusions A concentration of 0.5-mM genipin increased dLG-HG stiffness, and 0.25-mM genipin was sufficient to prevent MMP-dependent degradation. Importantly, concentrations of up to 0.5-mM genipin did not compromise the viability of LG-associated cells or the secretory activity of EpCs. Thus, crosslinking with genipin improves the properties of dLG-HG for use as a substrate in LG tissue engineering.
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Affiliation(s)
| | - Sema Kaya
- Department of Ophthalmology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Luis Grumm
- Department of Ophthalmology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Julia Matros
- Faculty of Mathematics and Natural Sciences, Institute of Pharmaceutics and Biopharmaceutics, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Michael C. Hacker
- Faculty of Mathematics and Natural Sciences, Institute of Pharmaceutics and Biopharmaceutics, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Gerd Geerling
- Department of Ophthalmology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Joana Witt
- Department of Ophthalmology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Khan J, Shaw S. Risk of cataract and glaucoma among older persons with diabetes in India: a cross-sectional study based on LASI, Wave-1. Sci Rep 2023; 13:11973. [PMID: 37488196 PMCID: PMC10366202 DOI: 10.1038/s41598-023-38229-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 07/05/2023] [Indexed: 07/26/2023] Open
Abstract
According to the International Diabetes Federation-2019 estimates, India is home to 77 million diabetic individuals which is projected to grow up to 147.2 million by 2045. Diabetes being a progressive health disorder leads to multiple morbidities and complications including eye diseases and visual impairments. As the burden of diabetes mellitus is increasing, eye problems like cataracts and glaucoma are commonly cited problems among the older adults. In this context, this study aims to provide the public health evidences on diabetes associated burden and risk of developing cataracts and glaucoma among older adults aged 60 and above in India. The analytical sample of this cross-sectional study comprised of 31,464 individuals aged 60 and above. Bivariate cross-tabulation and chi-square test were performed to understand the differential in the prevalence of cataracts and glaucoma by diabetes mellitus including the socio-economic and demographic characteristics of the individuals. Binary logistic regression estimation was executed to estimate the adjusted odds ratio for each of the outcome variables within a multivariate framework. The cataract problem affects more than one-fifth of the older people, while glaucoma affects 2% of them. The prevalence of cataract and glaucoma is 29% among diabetic older adults compared to 22% among non-diabetic persons. In terms of gender, the cataract prevalence is comparatively higher among females (25%) than males (21%). It is important to note that while adjusting for socio-economic and demographic characteristics, the likelihood of cataract (AOR 1.495; p-value < 0.01) and glaucoma (AOR 1.554; p-value < 0.01) is significantly higher among older adults with diabetes than among their counterparts. Medical practitioners should conduct prognosis for diabetic eye problems among patients and raise awareness about the potential risks of developing vision loss, such as cataracts and glaucoma, which are more prevalent among individuals with diabetes.
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Affiliation(s)
- Junaid Khan
- Department of Population and Development, International Institute for Population Sciences, Mumbai, India
| | - Subhojit Shaw
- Department of Population and Development, International Institute for Population Sciences, Mumbai, India.
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Effect of Cataract Surgery on Frequency of Falls among Older Persons: A Systematic Review and Meta-Analysis. J Ophthalmol 2021; 2021:2169571. [PMID: 33815834 PMCID: PMC7987466 DOI: 10.1155/2021/2169571] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 03/04/2021] [Accepted: 03/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background Falls are a significant public health problem among older people worldwide. The aim was to perform a new systematic review and meta-analysis to assess whether cataract surgery is effective in reducing the rate of falls in older persons. Methods The systematic review was performed following the recommendations by the Cochrane Collaboration. Original papers were included with RCT or quasi-experimental design, which described the effect on uni- or bilateral cataract surgery on the rate of falls among people aged 60 or older. Titles and abstracts were reviewed, full-text versions were retrieved, and two independent examiners reviewed them to assess inclusion criteria. All relevant variables were synthesised in an evidence table. Random-effects meta-analyses were performed pooling the trials, and results were expressed as relative risk (RR) and 95% confidence intervals. Results The initial search reported 99 potential abstracts, and 41 full-text versions were examined. In the end, eight studies were included. Five included patients 65 years of age and older, two patients 55 years and older, and one included patients 50 years or older. Phacoemulsification and intraocular lens implant were performed in all studies. Two were RCT, and six were quasi-experimental. Falls was the main outcome. The six quasi-experimental studies reported that a reduction in the frequency of falls was observed (RR 0.68, 95% CI 0.48-0.96), although heterogeneity was significant (I 2 = 74%). Only one RCT reported risk reduction of 34% (RR 0.66, 95% CI 0.45-0.96). Conclusions This meta-analysis provides evidence that the first cataract surgery reduces the frequency of falls in older people with bilateral cataracts, but a second surgery does not have significant impact.
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Xu Z, Zhang M, Zhang Q, Xu T, Tao L. Thyroid disease is associated with higher age-related macular degeneration risk: results from a meta-analysis of epidemiologic studies. Ophthalmic Res 2021; 64:696-703. [PMID: 33596562 DOI: 10.1159/000515273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/30/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although epidemiologic studies have suggested that thyroid disease may be a risk factor for age-related macular degeneration (AMD), this finding is still controversial. OBJECTIVES The aim of this meta-analysis was to investigate whether an association exists between thyroid disease and medication and AMD in epidemiologic studies. METHODS We searched PubMed, EMBASE, and Google Scholar from their inception to March 2020 for cross-sectional, case-control and cohort studies that assessed thyroid function and AMD risk. Data from selected studies were extracted, and a meta-analysis was performed using fixed-effect or random-effect models. The statistical heterogeneity (I2) among studies and the possibility of publication bias were evaluated. If I2 > 50%, a significant heterogeneity existed among studies and a random effects model was used to calculate the pooled RR. Otherwise, a fixed-effects model was performed. RESULTS A total of 13 epidemiologic studies that consisted of 7 thyroid disease and 7 thyroid medication studies were included. Statistically significant heterogeneity was observed in the study results (I2 thyroid disease = 80.1%, I2 thyroid medication = 69.0%). A significant positive association was found between thyroid disease and AMD, with an overall relative risk (RR) of 1.25 (95% CI: 1.02, 1.54). However, there was no statistical association between thyroid medication and AMD risk (pooled RR 1.26 [95% CI 0.92-1.72]). Egger's test indicated that there was no significant publication bias for thyroid disease (P=0.889) or thyroid medication (P = 0.226). CONCLUSIONS Our findings indicate that thyroid disease is associated with higher AMD risk. Thyroid disease prevention strategies may have a significant effect on the prevention of AMD and warrant further evaluation.
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Affiliation(s)
- Ziming Xu
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Mei Zhang
- School of Life Science, University of Science and Technology of China, Hefei, China
| | - Qing Zhang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Tingjuan Xu
- Gerontology Institute, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- Anhui Provincial Key Laboratory of Tumor Immunotherapy and Nutrition Therapy, Hefei, China
| | - Liming Tao
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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Park B, Jo K, Lee TG, Lee IS, Kim JS, Kim CS. Polygonum cuspidatum stem extract (PSE) ameliorates dry eye disease by inhibiting inflammation and apoptosis. J Exerc Nutrition Biochem 2019; 23:14-22. [PMID: 32018341 PMCID: PMC7004570 DOI: 10.20463/jenb.2019.0026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 12/12/2019] [Indexed: 01/05/2023] Open
Abstract
[Purpose] Here, we aimed to determine the effect of Polygonum cuspidatum stem extract (PSE) on exorbital lacrimal gland-excised rat models and hyperosmotic stress-stimulated human conjunctival cells (HCCs). [Methods] Seven week old male Wistar rats were divided into six groups. Only the rats in the control group (NOR, n=5) did not undergo surgery. Three days after the surgery, the exorbital lacrimal gland-excised rats were randomly allocated to five groups: (1) vehicle-treated dry-eyed rats (DED, n=5); (2) PSE (10 mg/kg) treated DED rats (PSE-10, n=5); (3) PSE (100 mg/kg) treated DED rats (PSE-100, n=5); and (4) PSE (250 mg/kg) treated DED rats (PSE-250, n=5). In addition, the HCC line was co-treated with hyperosmolar media (528 mOsm) and PSE (1-100 μg/ml). [Results] PSE treatment restored the tear volume and goblet cell density by inhibiting severe corneal irregularities and damage. The treatment with PSE significantly attenuated the hyperosmolar stress-induced inflammation and cell death through the suppression of mRNA expression levels of Tumor necrosis factor-α (TNF-α), Interleukin-6 (IL-6), Interleukin-1β (IL-1β), and Interferon-γ (IFN-γ), and the expression of Bcl-2-associated X protein (Bax) as well as the activation of caspase-3 in vitro. [Conclusion] The inhibitory effects of PSE treatment on dry eye disease indicate the potential of nutritional intervention by PES against inflammatory diseases without adverse effects.
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Miniaturization in Glaucoma Monitoring and Treatment: A Review of New Technologies That Require a Minimal Surgical Approach. Ophthalmol Ther 2019; 8:19-30. [PMID: 30725339 PMCID: PMC6393261 DOI: 10.1007/s40123-019-0161-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Indexed: 11/26/2022] Open
Abstract
In the management of glaucoma, recent and upcoming innovations have the potential to contribute to both the efficacy of intraocular pressure (IOP) monitoring and the number of available treatment options. These new devices and procedures have two things in common: they are part of the trend in medicine towards miniaturization, and they require a limited surgical procedure to become effective. This review focuses on the Eyemate (Argos) intraocular sensor, which offers a new way to reliably measure 24 h IOP, and on intraocular sustained release systems for pharmacological glaucoma therapy. It also briefly reflects on the miniature implants currently used in minimally invasive glaucoma surgery (MIGS).
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Lim CW, Cheng J, Tay ELT, Teo HY, Wong EPY, Yong VKY, Lim BA, Hee OK, Wong HT, Yip LWL. Optical coherence tomography angiography of the macula and optic nerve head: microvascular density and test-retest repeatability in normal subjects. BMC Ophthalmol 2018; 18:315. [PMID: 30526537 PMCID: PMC6288920 DOI: 10.1186/s12886-018-0976-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 11/16/2018] [Indexed: 01/01/2023] Open
Abstract
Background Despite the potential usefulness of optical coherence tomography angiography in retinal and optic disc conditions, the reliability of the imaging modality remains unclear. This study set out to measure the microvascular density of macula and optic disc by mean of optical coherence tomography angiography and report the repeatability of the vessel density measurements. Methods Cross sectional observational cohort study. Subjects with normal eyes were recruited. Two sets of optical coherence tomography angiography images of macula and optic nerve head were acquired during one visit. Novel in-house developed software was used to count the pixels in each images and to compute the microvessel density of the macula and optic disc. Data were analysed to determine the measurement repeatability. Results A total of 176 eyes from 88 consecutive normal subjects were recruited. For macular images, the mean vessel density at superficial retina, deep retina, outer retina and choriocapillaries segment was OD 0.113 and OS 0.111, OD 0.239 and OS 0.230, OD 0.179 and OS 0.164, OD 0.237 and OS 0.215 respectively. For optic disc images, mean vessel density at vitreoretinal interface, radial peripapillary capillary, superficial nerve head and disc segment at the level of choroid were OD 0.084 and OS 0.085, OD 0.140 and OS 0.138, OD 0.216 and OS 0.209, OD 0.227 and OS 0.236 respectively. The measurement repeatability tests showed that the coefficient of variation of macular scans, for right and left eyes, ranged from 6.4 to 31.1% and 5.3 to 59.4%. Likewise, the coefficient of variation of optic disc scans, for right and left eyes, ranged from 14.3 to 77.4% and 13.5 to 75.3%. Conclusions Optical coherence tomography angiography is a useful modality to visualise the microvasculature plexus of macula and optic nerve head. The vessel density measurement of macular scan by mean of optical coherence tomography angiography demonstrated good repeatability. The optic disc scan, on the other hand, showed a higher coefficient of variation indicating a lower measurement repeatability than macular scan. Interpretation of optical coherence tomography angiography should take into account test-retest repeatability of the imaging system. Trial registration National Healthcare Group Domain Specific Review Board (NHG DSRB) Singapore. DSRB Reference: 2015/00301. Electronic supplementary material The online version of this article (10.1186/s12886-018-0976-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ching Wei Lim
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.,Department of Ophthalmology, Sarawak General Hospital, Jalan Hospital, 93586, Kuching, Sarawak, Malaysia
| | - Jun Cheng
- Ocular Imaging Department, Institute for Infocomm Research, Agency for Science, Technology and Research, Singapore, Singapore
| | - Elton Lik Tong Tay
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Hwei Yee Teo
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Elizabeth Poh Ying Wong
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Vernon Khet Yau Yong
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Boon Ang Lim
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Owen Kim Hee
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Hon Tym Wong
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore
| | - Leonard Wei Leon Yip
- Department of Ophthalmology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
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Mateo Orobia AJ, Saa J, Ollero Lorenzo A, Herreras JM. Combination of hyaluronic acid, carmellose, and osmoprotectants for the treatment of dry eye disease. Clin Ophthalmol 2018; 12:453-461. [PMID: 29563769 PMCID: PMC5846763 DOI: 10.2147/opth.s157853] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Dry Eye Disease (DED) is a multifactorial disease, with a high prevalence, that can have a great impact on the quality of life of patients. The first step of treatment includes the use of lacrimal substitutes composed of polymers, possible to associate osmoprotectant agents to the lacrimal substitutes. The aim of this article is to analyze the properties of the combination of hyaluronic acid (HA), carmellose, and osmoprotectors (Optava Fusion®; Allergan, Inc., Irvine, CA, USA) on DED. General considerations on the use of artificial tears are also proposed. Methods A group of ophthalmologists, experts in the management of the ocular surface, analyzed different aspects related to DED; among them, the use of artificial tears in general and the properties of the combination of HA, carmellose, and osmoprotectors, in particular, were discussed. A review of the literature was carried out, which included different articles published in Spanish, English, and French until April 2017. Conclusions DED is a common chronic pathology that usually requires sustained treatment. In addition, the combination of HA, carmellose, and osmoprotectors has proven to be effective in the treatment of symptoms and signs of dry eye by the synergistic action of all its components. This review provides key elements to help ophthalmologists who begin in the management of DED.
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Affiliation(s)
- Antonio José Mateo Orobia
- Cornea and Ocular Surface Unit, Aragón Healthcare Research Institute (Instituto de Investigación Sanitaria de Aragón), Miguel Servet University Hospital, Zaragoza, Spain
| | - Jorge Saa
- Ophthalmology Department and Research Unit of Jove Hospital Foundation, Gijón, Spain
| | - Alberto Ollero Lorenzo
- Cornea and Ocular Surface Unit, Meixoeiro Hospital, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain
| | - José María Herreras
- Valladolid University Clinical Hospital, Valladolid, Spain.,University Institute of Applied Ophthalmobiology (IOBA [Instituto Universitario de Oftalmobiología Aplicada]). Miguel Delibes Campus, Paseo de Belén, Valladolid, Spain
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Banevicius M, Vilkeviciute A, Kriauciuniene L, Liutkeviciene R, Deltuva VP. The Association Between Variants of Receptor for Advanced Glycation End Products (RAGE) Gene Polymorphisms and Age-Related Macular Degeneration. Med Sci Monit 2018; 24:190-199. [PMID: 29317590 PMCID: PMC5771184 DOI: 10.12659/msm.905311] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background Age-related macular degeneration (AMD) is the leading cause of blindness in people aged 65 years and older in developed countries. The pathogenesis of AMD has been linked to mechanisms involving inflammation, oxidative stress, and basal laminar deposit formation between retinal pigment epithelium (RPE) cells and the basal membrane, caused by advanced glycation end products (AGEs). AGEs are implicated in the pathogenesis of AMD through the AGE-and receptor for AGE (RAGE) interaction, which can be altered by polymorphisms of the RAGE gene. We examined RAGE rs1800624 and rs1800625 gene polymorphisms contributing to AMD development. Material/Methods The study enrolled 300 patients with early AMD, 300 patients with exudative AMD, and 800 healthy controls. The genotyping was carried out using the RT-PCR method. Results The analysis of two single nucleotide polymorphisms (SNPs) in the RAGE gene showed that rs1800624 was associated with a 1.6-fold decreased risk for exudative AMD under the dominant model after adjustment for age (OR=0.616; 95% CI: 0.394–0.963; p=0.034) and each copy of allele T at rs1800624 was associated with a 1.4-fold decreased risk for exudative AMD development under the additive model after adjustment for age (OR=0.701; 95% CI: 0.510–0.962; p=0.028). Analysis revealed that the rs1800625 allele G at rs1800625 was associated with a 1.5-fold increased risk for exudative AMD after adjustment for age (OR=1.545; 95% CI: 1.003–2.379; p=0.048). These results suggested that the allele G at rs1800625 was a risk-allele for exudative AMD development. In haplotype analysis, A-G haplotype was significantly more frequently observed in exudative AMD patients compared to healthy controls (3.3% versus 1.4%, p=0.035). Conclusions We revealed a significant association between RAGE gene rs1800624 and rs1800625 polymorphisms and AMD risk. We considered T allele at rs1800624 to be protective against AMD development, while allele G at rs1800625 was considered to be a marker of poor prognosis in AMD development.
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Affiliation(s)
- Mantas Banevicius
- Department of Ophthalmology, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Alvita Vilkeviciute
- Neuroscience Institute, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Loresa Kriauciuniene
- Department of Ophthalmology, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania.,Neuroscience Institute, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Rasa Liutkeviciene
- Department of Ophthalmology, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania.,Neuroscience Institute, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
| | - Vytenis Pranas Deltuva
- Neuroscience Institute, Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania
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Zhao YX, Chen XW. Diabetes and risk of glaucoma: systematic review and a Meta-analysis of prospective cohort studies. Int J Ophthalmol 2017; 10:1430-1435. [PMID: 28944204 DOI: 10.18240/ijo.2017.09.16] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 06/26/2017] [Indexed: 12/27/2022] Open
Abstract
AIM To quantify the association between diabetes and glaucoma using Meta-analysis. METHODS PubMed and Embase were searched using medical subject headings and key words related to diabetes and glaucoma. The inclusion criteria were: 1) the study design was a prospective cohort study; 2) the exposure of interest was diabetes; 3) the outcome of interest was primary open angle glaucoma (POAG); 4) risk ratios (RR) and the corresponding 95% confidence interval (CI). Data were pooled using fixed effects models to take into account heterogeneity between studies. Seven prospective studies were selected. Diabetes increased the incidence of glaucoma by 36% (OR=1.36, 95% CI=1.25-1.50). There was no evidence of statistical heterogeneity (I2=0, P=0.53) or publication bias (the funnel plot did not identify obvious asymmetry). RESULTS Seven prospective cohort studies were incorporated in this Meta-analysis. The pooled RR of the association between POAG and diabetes based on the risk estimates of the seven cohort studies was 1.36 (95%CI=1.24-1.50), with no significant heterogeneity across studies (I2=0; P=0.526). The sensitivity analysis yielded a range of RRs from 1.34 (95%CI=1.22-1.48) to1.40 (95%CI=1.18-1.67). CONCLUSION Diabetes is associated with a significantly increased risk of glaucoma.
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Affiliation(s)
- Ying-Xi Zhao
- Department of Outpatient Service, the Eye Hospital of Wenzhou Medical University, Wenzhou 310020, Zhejiang Province, China
| | - Xiang-Wu Chen
- Department of Outpatient Service, the Eye Hospital of Wenzhou Medical University, Wenzhou 310020, Zhejiang Province, China
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