1
|
Wang S, Tong S, Jin X, Li N, Dang P, Sui Y, Liu Y, Wang D. Single-cell RNA sequencing analysis of the retina under acute high intraocular pressure. Neural Regen Res 2024; 19:2522-2531. [PMID: 38526288 PMCID: PMC11090430 DOI: 10.4103/1673-5374.389363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/27/2023] [Accepted: 09/13/2023] [Indexed: 03/26/2024] Open
Abstract
JOURNAL/nrgr/04.03/01300535-202419110-00032/figure1/v/2024-03-08T184507Z/r/image-tiff High intraocular pressure causes retinal ganglion cell injury in primary and secondary glaucoma diseases, yet the molecular landscape characteristics of retinal cells under high intraocular pressure remain unknown. Rat models of acute hypertension ocular pressure were established by injection of cross-linked hyaluronic acid hydrogel (Healaflow®). Single-cell RNA sequencing was then used to describe the cellular composition and molecular profile of the retina following high intraocular pressure. Our results identified a total of 12 cell types, namely retinal pigment epithelial cells, rod-photoreceptor cells, bipolar cells, Müller cells, microglia, cone-photoreceptor cells, retinal ganglion cells, endothelial cells, retinal progenitor cells, oligodendrocytes, pericytes, and fibroblasts. The single-cell RNA sequencing analysis of the retina under acute high intraocular pressure revealed obvious changes in the proportions of various retinal cells, with ganglion cells decreased by 23%. Hematoxylin and eosin staining and TUNEL staining confirmed the damage to retinal ganglion cells under high intraocular pressure. We extracted data from retinal ganglion cells and analyzed the retinal ganglion cell cluster with the most distinct expression. We found upregulation of the B3gat2 gene, which is associated with neuronal migration and adhesion, and downregulation of the Tsc22d gene, which participates in inhibition of inflammation. This study is the first to reveal molecular changes and intercellular interactions in the retina under high intraocular pressure. These data contribute to understanding of the molecular mechanism of retinal injury induced by high intraocular pressure and will benefit the development of novel therapies.
Collapse
Affiliation(s)
- Shaojun Wang
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Siti Tong
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Xin Jin
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Na Li
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Pingxiu Dang
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Yang Sui
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| | - Ying Liu
- Department of Ophthalmology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China
| | - Dajiang Wang
- Division of Ophthalmology, The Third Medical Center of PLA General Hospital, Beijing, China
| |
Collapse
|
2
|
Liu J, Xu S, He P, Wu S, Luo X, Deng Y, Huang H. VSG-GAN: A high-fidelity image synthesis method with semantic manipulation in retinal fundus image. Biophys J 2024:S0006-3495(24)00139-5. [PMID: 38414236 DOI: 10.1016/j.bpj.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/29/2024] [Accepted: 02/22/2024] [Indexed: 02/29/2024] Open
Abstract
In recent years, advancements in retinal image analysis, driven by machine learning and deep learning techniques, have enhanced disease detection and diagnosis through automated feature extraction. However, challenges persist, including limited data set diversity due to privacy concerns and imbalanced sample pairs, hindering effective model training. To address these issues, we introduce the vessel and style guided generative adversarial network (VSG-GAN), an innovative algorithm building upon the foundational concept of GAN. In VSG-GAN, a generator and discriminator engage in an adversarial process to produce realistic retinal images. Our approach decouples retinal image generation into distinct modules: the vascular skeleton and background style. Leveraging style transformation and GAN inversion, our proposed hierarchical variational autoencoder module generates retinal images with diverse morphological traits. In addition, the spatially adaptive denormalization module ensures consistency between input and generated images. We evaluate our model on MESSIDOR and RITE data sets using various metrics, including structural similarity index measure, inception score, Fréchet inception distance, and kernel inception distance. Our results demonstrate the superiority of VSG-GAN, outperforming existing methods across all evaluation assessments. This underscores its effectiveness in addressing data set limitations and imbalances. Our algorithm provides a novel solution to challenges in retinal image analysis by offering diverse and realistic retinal image generation. Implementing the VSG-GAN augmentation approach on downstream diabetic retinopathy classification tasks has shown enhanced disease diagnosis accuracy, further advancing the utility of machine learning in this domain.
Collapse
Affiliation(s)
- Junjie Liu
- Guangdong Provincial Key Laboratory of Interdisciplinary Research and Application for Data Science, Zhuhai, China; BNU-HKBU United International College, Zhuhai, China; Faculty of Science, Hong Kong Baptist University, Hong Kong SAR, China; Trinity College Dublin, Dublin 2, Ireland
| | - Shixin Xu
- Data Science Research Center, Duke Kunshan University, Kunshan, Jiangsu, China
| | - Ping He
- Guangdong Provincial Key Laboratory of Interdisciplinary Research and Application for Data Science, Zhuhai, China; BNU-HKBU United International College, Zhuhai, China
| | - Sirong Wu
- Guangdong Provincial Key Laboratory of Interdisciplinary Research and Application for Data Science, Zhuhai, China; BNU-HKBU United International College, Zhuhai, China; Faculty of Science, Hong Kong Baptist University, Hong Kong SAR, China
| | - Xi Luo
- Guangdong Provincial Key Laboratory of Interdisciplinary Research and Application for Data Science, Zhuhai, China; BNU-HKBU United International College, Zhuhai, China; Faculty of Science, Hong Kong Baptist University, Hong Kong SAR, China
| | - Yuhui Deng
- Guangdong Provincial Key Laboratory of Interdisciplinary Research and Application for Data Science, Zhuhai, China; BNU-HKBU United International College, Zhuhai, China.
| | - Huaxiong Huang
- Research Center for Mathematics, Beijing Normal University, Zhuhai, China; Guangdong Provincial Key Laboratory of Interdisciplinary Research and Application for Data Science, Zhuhai, China; Department of Mathematics and Statistics, York University, Toronto, ON, Canada.
| |
Collapse
|
3
|
Szewczuk A, Wawrzyniak ZM, Szaflik JP, Zaleska-Żmijewska A. Is Primary Open-Angle Glaucoma a Vascular Disease? Assessment of the Relationship between Retinal Arteriolar Morphology and Glaucoma Severity Using Adaptive Optics. J Clin Med 2024; 13:478. [PMID: 38256612 PMCID: PMC10817033 DOI: 10.3390/jcm13020478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/02/2024] [Accepted: 01/13/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Retinal vascular abnormalities may be associated with glaucomatous damage. Adaptive optics (AO) is a new technology that enables the analysis of retinal vasculature at the cellular level in vivo. The purpose of this study was to evaluate retinal arteriolar parameters using the rtx1 adaptive optics fundus camera (AO-FC) in patients with primary open-angle glaucoma (POAG) at different stages and to investigate the relationship between these parameters and changes in spectral-domain optical coherence tomography (SD-OCT) and perimetry. METHODS Parameters of the retinal supratemporal and infratemporal arterioles (wall thickness (WT), lumen diameter (LD), total diameter (TD), wall-to-lumen ratio (WLR), and cross-sectional area of the vascular wall (WCSA)) were analysed with the rtx1 in 111 POAG eyes, which were divided into three groups according to the severity of the disease, and 70 healthy eyes. The associations between RTX1 values and the cup-to-disk ratio, SD-OCT parameters, and visual field parameters were assessed. RESULTS Compared with the control group, the POAG groups showed significantly smaller TD and LD values (p < 0.05) and significantly higher WLR and WT values (p < 0.05) for the supratemporal and infratemporal arterioles. TD was significantly positively correlated with the retinal nerve fibre layer (RNFL) and ganglion cell complex (GCC) (p < 0.05). LD was significantly positively correlated with the RNFL, GCC, and rim area (p < 0.05). The WLR was significantly negatively correlated with the RNFL, GCC, rim area, and MD (p < 0.05), while it was significantly positively correlated with the cup-to-disc ratio and PSD (p < 0.05). CONCLUSIONS The results suggest that vascular dysfunction is present in POAG, even at a very early stage of glaucoma, and increases with the severity of the disease.
Collapse
Affiliation(s)
- Alina Szewczuk
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), 00-576 Warsaw, Poland
| | - Zbigniew M. Wawrzyniak
- Faculty of Electronics and Information Technology, Warsaw University of Technology, 00-665 Warsaw, Poland;
| | - Jacek P. Szaflik
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, 02-091 Warsaw, Poland; (J.P.S.); (A.Z.-Ż.)
| | - Anna Zaleska-Żmijewska
- Department of Ophthalmology, Public Ophthalmic Clinical Hospital (SPKSO), Medical University of Warsaw, 02-091 Warsaw, Poland; (J.P.S.); (A.Z.-Ż.)
| |
Collapse
|
4
|
Nordahl KML, Fedulov V, Holm A, Haanes KA. Intraocular Adeno-Associated Virus-Mediated Transgene Endothelin-1 Delivery to the Rat Eye Induces Functional Changes Indicative of Retinal Ischemia-A Potential Chronic Glaucoma Model. Cells 2023; 12:1987. [PMID: 37566067 PMCID: PMC10417058 DOI: 10.3390/cells12151987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/12/2023] Open
Abstract
Endothelin-1 (ET-1) overactivity has been implicated as a factor contributing to glaucomatous neuropathy, and it has been utilized in animal models of retinal ischemia. The functional effects of long-term ET-1 exposure and possible compensatory mechanisms have, however, not been investigated. This was therefore the purpose of our study. ET-1 was delivered into rat eyes via a single intravitreal injection of 500 µM or via transgene delivery using an adeno-associated viral (AAV) vector. Retinal function was assessed using electroretinography (ERG) and the retinal expression of potentially compensatory genes was evaluated by means of qRT-PCR. Acute ET-1 delivery led to vasoconstriction and a significant reduction in the ERG response. AAV-ET-1 resulted in substantial transgene expression and ERG results similar to the acute ET-1 injections and comparable to other models of retinal ischemia. Compensatory changes were observed, including an increase in calcitonin gene-related peptide (CGRP) gene expression, which may both counterbalance the vasoconstrictive effects of ET-1 and provide neuroprotection. This chronic ET-1 ischemia model might be especially relevant to glaucoma research, mimicking the mild and repeated ischemic events in patients with long-term vascular dysfunction. The compensatory mechanisms, and particularly the role of vasodilatory CGRP in mitigating the retinal damage, warrant further investigation with the aim of evaluating new therapeutic strategies.
Collapse
Affiliation(s)
- Karin M. L. Nordahl
- Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet, 2600 Glostrup, Denmark; (A.H.); (K.A.H.)
| | - Vadim Fedulov
- Clinical and Medical Affairs, Radiometer, 2700 Brønshøj, Denmark;
| | - Anja Holm
- Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet, 2600 Glostrup, Denmark; (A.H.); (K.A.H.)
- Center for RNA Medicine, Department of Clinical Medicine, Aalborg University, 2450 Copenhagen, Denmark
| | - Kristian A. Haanes
- Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet, 2600 Glostrup, Denmark; (A.H.); (K.A.H.)
| |
Collapse
|
5
|
Duan CY, Fan WL, Chen F. Roles of Optineurin and Extracellular Vesicles in Glaucomatous Retinal Cell Loss. Curr Med Sci 2023; 43:367-375. [PMID: 37059934 DOI: 10.1007/s11596-023-2730-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/08/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVE To explore the role of extracellular vesicles (EVs) in the pathogenesis of glaucoma caused by E50K mutation. METHODS A photoreceptor cell line, RGC-5, was transfected with empty plasmids and plasmids expressing wild-type (WT) optineurin (OPTN) or E50K OPTN to investigate the effects of OPTN glaucoma as well as to identify the role of EVs in glaucoma pathology. The RGC-5 cells were also stimulated with glutamate, and their viability was evaluated using flow cytometry or CCK-8 assay. EVs were extracted, labeled with PKH-26, and added into the medium for normal RGC-5 culture, and the status of the cells was observed thereafter. RESULTS WT OPTN overexpression, E50K OPTN, and glutamate stimulation induced apoptosis of RGC-5 cells. However, when glutamate stimulation was used as an add-on treatment, the degree of apoptosis in WT OPTN-overexpressing RGC-5 cells was significantly lower than that in E50K OPTN-expressing and normal RGC-5 cells. The viability of normal RGC-5 cells was reduced when co-cultured with WT OPTN-overexpressing RGC-5 or E50K OPTN-overexpressing RGC-5. EVs released by the latter two transfected lines similarly reduced normal RGC-5 survival. CONCLUSION Our results indicate that WT OPTN overexpression may lead to photoreceptor apoptosis. However, overexpression also confers a degree of protection against high concentrations of extracellular glutamate. Additionally, EVs released by transfected RGC-5 cells may regulate the cell state. These findings may improve our understanding of the mechanisms of cell-cell interactions in pathological conditions, providing a basis for the use of EVs as novel targets for early diagnosis and treatment of glaucoma.
Collapse
Affiliation(s)
- Chao-Ye Duan
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Wan-Lin Fan
- Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, 50937, Germany
| | - Fei Chen
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| |
Collapse
|
6
|
Morgan JIW, Chui TYP, Grieve K. Twenty-five years of clinical applications using adaptive optics ophthalmoscopy [Invited]. Biomed Opt Express 2023; 14:387-428. [PMID: 36698659 PMCID: PMC9841996 DOI: 10.1364/boe.472274] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/22/2022] [Accepted: 11/27/2022] [Indexed: 05/02/2023]
Abstract
Twenty-five years ago, adaptive optics (AO) was combined with fundus photography, thereby initiating a new era in the field of ophthalmic imaging. Since that time, clinical applications of AO ophthalmoscopy to investigate visual system structure and function in both health and disease abound. To date, AO ophthalmoscopy has enabled visualization of most cell types in the retina, offered insight into retinal and systemic disease pathogenesis, and been integrated into clinical trials. This article reviews clinical applications of AO ophthalmoscopy and addresses remaining challenges for AO ophthalmoscopy to become fully integrated into standard ophthalmic care.
Collapse
Affiliation(s)
- Jessica I. W. Morgan
- Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center for Advanced Retinal and Ocular Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Contributed equally
| | - Toco Y. P. Chui
- Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA
- Contributed equally
| | - Kate Grieve
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
- Contributed equally
| |
Collapse
|
7
|
Tong J, Phu J, Alonso‐Caneiro D, Khuu SK, Kalloniatis M. High sampling resolution optical coherence tomography reveals potential concurrent reductions in ganglion cell-inner plexiform and inner nuclear layer thickness but not in outer retinal thickness in glaucoma. Ophthalmic Physiol Opt 2023; 43:46-63. [PMID: 36416369 PMCID: PMC10947055 DOI: 10.1111/opo.13065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/28/2022] [Accepted: 10/30/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To analyse optical coherence tomography (OCT)-derived inner nuclear layer (INL) and outer retinal complex (ORC) measurements relative to ganglion cell-inner plexiform layer (GCIPL) measurements in glaucoma. METHODS Glaucoma participants (n = 271) were categorised by 10-2 visual field defect type. Differences in GCIPL, INL and ORC thickness were calculated between glaucoma and matched healthy eyes (n = 548). Hierarchical cluster algorithms were applied to generate topographic patterns of retinal thickness change, with agreement between layers assessed using Cohen's kappa (κ). Differences in GCIPL, INL and ORC thickness within and outside GCIPL regions showing the greatest reductions and Spearman's correlations between layer pairs were compared with 10-2 mean deviation (MD) and pattern standard deviation (PSD) to determine trends with glaucoma severity. RESULTS Glaucoma participants with inferior and superior defects presented with concordant GCIPL and INL defects demonstrating mostly fair-to-moderate agreement (κ = 0.145-0.540), which was not observed in eyes with no or ring defects (κ = -0.067-0.230). Correlations (r) with MD and PSD were moderate and weak in GCIPL and INL thickness differences, respectively (GCIPL vs. MD r = 0.479, GCIPL vs. PSD r = -0.583, INL vs. MD r = 0.259, INL vs. PSD r = -0.187, p = <0.0001-0.002), and weak in GCIPL-INL correlations (MD r = 0.175, p = 0.004 and PSD r = 0.154, p = 0.01). No consistent patterns in ORC thickness or correlations were observed. CONCLUSIONS In glaucoma, concordant reductions in macular INL and GCIPL thickness can be observed, but reductions in ORC thickness appear unlikely. These findings suggest that trans-synaptic retrograde degeneration may occur in glaucoma and could indicate the usefulness of INL thickness in evaluating glaucomatous damage.
Collapse
Affiliation(s)
- Janelle Tong
- Centre for Eye HealthUniversity of New South WalesNew South WalesSydneyAustralia
- School of Optometry and Vision ScienceUniversity of New South WalesNew South WalesSydneyAustralia
| | - Jack Phu
- Centre for Eye HealthUniversity of New South WalesNew South WalesSydneyAustralia
- School of Optometry and Vision ScienceUniversity of New South WalesNew South WalesSydneyAustralia
- Faculty of MedicineUniversity of SydneySydneyNew South WalesAustralia
| | - David Alonso‐Caneiro
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision ScienceQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Sieu K. Khuu
- School of Optometry and Vision ScienceUniversity of New South WalesNew South WalesSydneyAustralia
| | - Michael Kalloniatis
- School of Optometry and Vision ScienceUniversity of New South WalesNew South WalesSydneyAustralia
- School of Medicine (Optometry)Deakin UniversityWaurn PondsVictoriaAustralia
| |
Collapse
|
8
|
Yoshikawa Y, Shoji T, Kanno J, Ishii H, Chino M, Igawa Y, Shinoda K, Miyake Y. Relationship Between Deep Retinal Macular Vessel Density and Bipolar Cell Function in Glaucomatous Eyes. Transl Vis Sci Technol 2022; 11:4. [PMID: 36180028 PMCID: PMC9547355 DOI: 10.1167/tvst.11.10.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the correlation between macular retinal function and the changes in the macular retinal vascular structure in glaucomatous eyes. Methods The study included patients with glaucoma who visited Saitama Medical University and underwent optical coherence tomography angiography, and multifocal electroretinographic examinations at the same time between February 2020 and April 2021. Correlations among the ocular parameters, macular vessel density, and multifocal electroretinographic parameters were evaluated using a mixed model. Results Forty-one eyes (mean deviation, −12.4 ± 7.8 dB) of 24 subjects (mean age, 75.2 ± 8.3 years) were included in the analysis. There were no significant correlations for macular vessel density in the superficial retinal layer. However, macular vessel density in the deep retinal layer showed a significant positive correlation with P1–N1 amplitude (coefficient = 0.724; P = 0.001). There were no significant correlations between the optical coherence tomography parameters and any of the multifocal electroretinographic parameters. Conclusions A decrease in N1–P1 amplitude was observed in glaucomatous eyes in relation to a reduction in macular vessel density in the deep retinal layer, which suggests that ischemia-induced bipolar cell dysfunction may be involved in the intermediate retinal dysfunction associated with glaucoma. Translational Relevance Intermediate retinal dysfunction in glaucoma is related to the changes in deep retinal microvasculature.
Collapse
Affiliation(s)
- Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Junji Kanno
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Hirokazu Ishii
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Minami Chino
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Yuro Igawa
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | | |
Collapse
|
9
|
Meah A, Boodram V, Bucinca-Cupallari F, Lim H. Axonal architecture of the mouse inner retina revealed by second harmonic generation. PNAS Nexus 2022; 1:pgac160. [PMID: 36106183 PMCID: PMC9463061 DOI: 10.1093/pnasnexus/pgac160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/11/2022] [Indexed: 01/29/2023]
Abstract
We describe a novel method for visualizing the network of axons in the unlabeled fresh wholemount retina. The intrinsic radiation of second harmonic generation (SHG) was utilized to visualize single axons of all major retinal neurons, i.e., photoreceptors, horizontal cells, bipolar cells, amacrine cells, and the retinal ganglion cells. The cell types of SHG+ axons were determined using transgenic GFP/YFP mice. New findings were obtained with retinal SHG imaging: Müller cells do not maintain uniformly polarized microtubules in the processes; SHG+ axons of bipolar cells terminate in the inner plexiform layer (IPL) in a subtype-specific manner; a subset of amacrine cells, presumably the axon-bearing types, emits SHG; and the axon-like neurites of amacrine cells provide a cytoskeletal scaffolding for the IPL stratification. To demonstrate the utility, retinal SHG imaging was applied to testing whether the inner retina is preserved in glaucoma, using DBA/2 mice as a model of glaucoma and DBA/2-Gpnmb+ as the nonglaucomatous control. It was found that the morphology of the inner retina was largely intact in glaucoma and the presynaptic compartments to the retinal ganglion cells were uncompromised. It proves retinal SHG imaging as a promising technology for studying the physiological and diseased retinas in 3D.
Collapse
Affiliation(s)
- Arafat Meah
- Department of Physics and Astronomy, Hunter College, New York, NY 10065, USA
| | - Vinessia Boodram
- Department of Physics and Astronomy, Hunter College, New York, NY 10065, USA
| | - Festa Bucinca-Cupallari
- Department of Physics and Astronomy, Hunter College, New York, NY 10065, USA,The Graduate Centre of the City University of New York, New York, NY 10065, USA
| | | |
Collapse
|
10
|
Vahedian Z, Fakhraie G, Ghasemi M, Azimi A, Tabatabaei SM. The thickness of the outer retina in the macula and circumpapillary area in patients with unilateral advanced glaucoma. Graefes Arch Clin Exp Ophthalmol 2022; 260:3935-3944. [PMID: 35838807 DOI: 10.1007/s00417-022-05756-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 05/27/2022] [Accepted: 06/30/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To compare outer macular and retinal thickness in the circumpapillary area in unilateral advanced glaucomatous eyes to the normal or mild glaucomatous fellow eyes. METHODS Seventy-eight eyes of 39 patients with unilateral advanced glaucoma (mean deviation (MD) worse than -12.00 dB based on visual field 24-2) were included in this cross-sectional study as the cases. The healthy or mild glaucomatous fellow eyes were enrolled as the control group. All eyes underwent optical coherence tomography of the macula and circumpapillary retina by Topcon DRI Triton (Topcon, Tokyo, Japan). Ganglion cell layer 2+ was considered as the inner retina. Total retinal thickness minus the thickness of the inner retina was considered as the outer retina. Comparison between groups was done by paired-sample sign test. The correlation between structural and functional parameters was evaluated by a partial correlation coefficient. RESULTS Seventeen (43.6%), 15 (38.5%), and 7 (17.9%) patients had pseudoexfoliation, primary angle-closure, and primary open-angle glaucoma, respectively. The mean age was 62.69 ± 12.00 years. Thirty-three (84.6%) patients were male. The outer retinal thickness in the circumpapillary area was higher in temporal, superior, and inferior quadrants (p < 0.05). The outer macula in different parafoveal and perifoveal quadrants was also thicker (p < 0.05). Average outer parafoveal thickness in the case group had a significant negative correlation with MD (r = -0.339; p = 0.035). CONCLUSION Advanced glaucomatous eyes had a thicker outer retina in the macula and circumpapillary area. There was a significant negative correlation between outer perifoveal thickness and MD.
Collapse
Affiliation(s)
- Zakieh Vahedian
- Glaucoma Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, Iran
| | - Ghasem Fakhraie
- Glaucoma Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, Iran
| | - Mehrnoosh Ghasemi
- Glaucoma Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, Iran
| | - Ali Azimi
- Glaucoma Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, Iran.,Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mehdi Tabatabaei
- Glaucoma Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, Iran.
| |
Collapse
|
11
|
Alexopoulos P, Madu C, Wollstein G, Schuman JS. The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques. Front Med (Lausanne) 2022; 9:891369. [PMID: 35847772 PMCID: PMC9279625 DOI: 10.3389/fmed.2022.891369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
The field of ophthalmic imaging has grown substantially over the last years. Massive improvements in image processing and computer hardware have allowed the emergence of multiple imaging techniques of the eye that can transform patient care. The purpose of this review is to describe the most recent advances in eye imaging and explain how new technologies and imaging methods can be utilized in a clinical setting. The introduction of optical coherence tomography (OCT) was a revolution in eye imaging and has since become the standard of care for a plethora of conditions. Its most recent iterations, OCT angiography, and visible light OCT, as well as imaging modalities, such as fluorescent lifetime imaging ophthalmoscopy, would allow a more thorough evaluation of patients and provide additional information on disease processes. Toward that goal, the application of adaptive optics (AO) and full-field scanning to a variety of eye imaging techniques has further allowed the histologic study of single cells in the retina and anterior segment. Toward the goal of remote eye care and more accessible eye imaging, methods such as handheld OCT devices and imaging through smartphones, have emerged. Finally, incorporating artificial intelligence (AI) in eye images has the potential to become a new milestone for eye imaging while also contributing in social aspects of eye care.
Collapse
Affiliation(s)
- Palaiologos Alexopoulos
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Chisom Madu
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
- Center for Neural Science, College of Arts & Science, New York University, New York, NY, United States
| | - Joel S. Schuman
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
- Center for Neural Science, College of Arts & Science, New York University, New York, NY, United States
- Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
| |
Collapse
|
12
|
Noailles A, Kutsyr O, Mayordomo-Febrer A, Lax P, López-Murcia M, Sanz-González SM, Pinazo-Durán MD, Cuenca N. Sodium Hyaluronate-Induced Ocular Hypertension in Rats Damages the Direction-Selective Circuit and Inner/Outer Retinal Plexiform Layers. Invest Ophthalmol Vis Sci 2022; 63:2. [PMID: 35503230 PMCID: PMC9078050 DOI: 10.1167/iovs.63.5.2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose To assess the changes in retinal morphology in a rat model of chronic glaucoma induced by ocular hypertension. Methods Intraocular pressure (IOP) was surgically increased through weekly injections of sodium hyaluronate (HYA) in the anterior eye chamber of the left eye of male Wistar rats, whereas the right eyes were sham operated (salt solution). During the 10-week experimental period, IOP was measured weekly with a rebound tonometer. Retinal cryosections were prepared for histological/immunohistochemical analysis and morphometry. Results IOP was higher in HYA-treated eyes than in sham-operated eyes along the 10-week period, which was significant from the fourth to the nineth week. Ocular hypertension in HYA-treated eyes was associated with morphologic and morphometric changes in bipolar cells, ON-OFF direction-selective ganglion cells, ON/OFF starburst amacrine cells, and inner plexiform layer sublamina. Conclusions Serial HYA treatment in the rat anterior eye chamber results in mild-to-moderate elevated and sustained IOP and ganglion cell death, which mimics most human open-angle glaucoma hallmarks. The reduced number of direction-selective ganglion cells and starburst amacrine cells accompanied by a deteriorated ON/OFF plexus in this glaucoma model could lend insight to the abnormalities in motion perception observed in patients with glaucoma.
Collapse
Affiliation(s)
- Agustina Noailles
- Physiology, Genetics and Microbiology, University of Alicante, Spain.,OFTARED. Spanish Net of Ophthalmic Research. Institute of health Carlos III, Madrid, Spain
| | - Oksana Kutsyr
- Physiology, Genetics and Microbiology, University of Alicante, Spain.,OFTARED. Spanish Net of Ophthalmic Research. Institute of health Carlos III, Madrid, Spain
| | - Aloma Mayordomo-Febrer
- Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universidad CEU Cardenal Herrera, Valencia, Spain.,OFTARED. Spanish Net of Ophthalmic Research. Institute of health Carlos III, Madrid, Spain.,Mixed Research Unit for Visual Health and Veterinary Ophthalmology CEU/FISABIO, Valencia, Spain
| | - Pedro Lax
- Physiology, Genetics and Microbiology, University of Alicante, Spain.,OFTARED. Spanish Net of Ophthalmic Research. Institute of health Carlos III, Madrid, Spain
| | - María López-Murcia
- Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universidad CEU Cardenal Herrera, Valencia, Spain.,Mixed Research Unit for Visual Health and Veterinary Ophthalmology CEU/FISABIO, Valencia, Spain
| | - Silvia M Sanz-González
- OFTARED. Spanish Net of Ophthalmic Research. Institute of health Carlos III, Madrid, Spain.,Cellular and Molecular Ophthalmo-biology Research Group, Department of Surgery, University of Valencia, Valencia, Spain.,Ophthalmic Research Unit "Santiago Grisolía"/FISABIO, Valencia, Spain
| | - María Dolores Pinazo-Durán
- OFTARED. Spanish Net of Ophthalmic Research. Institute of health Carlos III, Madrid, Spain.,Cellular and Molecular Ophthalmo-biology Research Group, Department of Surgery, University of Valencia, Valencia, Spain.,Ophthalmic Research Unit "Santiago Grisolía"/FISABIO, Valencia, Spain
| | - Nicolás Cuenca
- Physiology, Genetics and Microbiology, University of Alicante, Spain.,OFTARED. Spanish Net of Ophthalmic Research. Institute of health Carlos III, Madrid, Spain
| |
Collapse
|
13
|
Kumar S, Benavente-Perez A, Ablordeppey R, Lin C, Viswanathan S, Akopian A, Bloomfield SA. A Robust Microbead Occlusion Model of Glaucoma for the Common Marmoset. Transl Vis Sci Technol 2022; 11:14. [PMID: 35019964 PMCID: PMC8762714 DOI: 10.1167/tvst.11.1.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To establish a robust experimental model of glaucoma in the common marmoset (Callithrix jacchus), a New World primate, using an intracameral microbead injection technique. Methods Elevated intraocular pressure (IOP) was induced by an injection of polystyrene microbeads. Morphologic changes in the retina and optic nerve of glaucomatous eyes were assessed and electroretinogram (ERG) recordings were performed to evaluate functional changes. Results Microbead injections induced a sustained IOP elevation for at least 10 weeks in a reproducible manner. At the end of the 10-week experimental period, there was significant loss of retinal ganglion cells (RGCs) in all quadrants and eccentricities, although it was more prominent in the mid-peripheral and peripheral regions. This was consistent with a thinning of the Retinal nerve fiber layer (RNFL) seen in spectral domain optical coherence tomography scans. Surviving RGCs showed marked changes in morphology, including somatic shrinkage and dendritic atrophy. Retinas also showed significant gliosis. The amplitude of the ERG photopic negative response, with subsequent a- and b-wave changes, was reduced in glaucomatous eyes. The optic nerve of glaucomatous eyes showed expanded cupping, disorganization of the astrocytic matrix, axonal loss, and gliosis. Conclusions We developed a robust and reproducible model of glaucoma in the marmoset. The model exhibits both structural and functional alterations of retina and optic nerve characteristic of glaucoma in humans and animal models. Translational Relevance The glaucoma model in the marmoset described here forms a robust method to study the disease etiology, progression, and potential therapies in a nonhuman primate, allowing for more effective translation of animal data to humans.
Collapse
Affiliation(s)
- Sandeep Kumar
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, NY, USA
| | - Alexandra Benavente-Perez
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, NY, USA
| | - Reynolds Ablordeppey
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, NY, USA
| | - Carol Lin
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, NY, USA
| | - Suresh Viswanathan
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, NY, USA
| | - Abram Akopian
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, NY, USA
| | - Stewart A Bloomfield
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, NY, USA
| |
Collapse
|
14
|
Mehta P, Petersen CA, Wen JC, Banitt MR, Chen PP, Bojikian KD, Egan C, Lee SI, Balazinska M, Lee AY, Rokem A. Automated Detection of Glaucoma With Interpretable Machine Learning Using Clinical Data and Multimodal Retinal Images. Am J Ophthalmol 2021; 231:154-169. [PMID: 33945818 DOI: 10.1016/j.ajo.2021.04.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 01/17/2023]
Abstract
PURPOSE To develop a multimodal model to automate glaucoma detection DESIGN: Development of a machine-learning glaucoma detection model METHODS: We selected a study cohort from the UK Biobank data set with 1193 eyes of 863 healthy subjects and 1283 eyes of 771 subjects with glaucoma. We trained a multimodal model that combines multiple deep neural nets, trained on macular optical coherence tomography volumes and color fundus photographs, with demographic and clinical data. We performed an interpretability analysis to identify features the model relied on to detect glaucoma. We determined the importance of different features in detecting glaucoma using interpretable machine learning methods. We also evaluated the model on subjects who did not have a diagnosis of glaucoma on the day of imaging but were later diagnosed (progress-to-glaucoma [PTG]). RESULTS Results show that a multimodal model that combines imaging with demographic and clinical features is highly accurate (area under the curve 0.97). Interpretation of this model highlights biological features known to be related to the disease, such as age, intraocular pressure, and optic disc morphology. Our model also points to previously unknown or disputed features, such as pulmonary function and retinal outer layers. Accurate prediction in PTG highlights variables that change with progression to glaucoma-age and pulmonary function. CONCLUSIONS The accuracy of our model suggests distinct sources of information in each imaging modality and in the different clinical and demographic variables. Interpretable machine learning methods elucidate subject-level prediction and help uncover the factors that lead to accurate predictions, pointing to potential disease mechanisms or variables related to the disease.
Collapse
Affiliation(s)
- Parmita Mehta
- From the Paul G. Allen School of Computer Science and Engineering, Seattle, Washington, USA (PM, S-IL, MB)
| | - Christine A Petersen
- Department of Ophthalmology, Seattle, Washington, USA (CAP, JCW, MRB, PPC, KDB, AYL)
| | - Joanne C Wen
- Department of Ophthalmology, Seattle, Washington, USA (CAP, JCW, MRB, PPC, KDB, AYL)
| | - Michael R Banitt
- Department of Ophthalmology, Seattle, Washington, USA (CAP, JCW, MRB, PPC, KDB, AYL)
| | - Philip P Chen
- Department of Ophthalmology, Seattle, Washington, USA (CAP, JCW, MRB, PPC, KDB, AYL)
| | - Karine D Bojikian
- Department of Ophthalmology, Seattle, Washington, USA (CAP, JCW, MRB, PPC, KDB, AYL)
| | | | - Su-In Lee
- From the Paul G. Allen School of Computer Science and Engineering, Seattle, Washington, USA (PM, S-IL, MB)
| | - Magdalena Balazinska
- From the Paul G. Allen School of Computer Science and Engineering, Seattle, Washington, USA (PM, S-IL, MB); eScience Institute, Seattle, Washington, USA (MB, AR)
| | - Aaron Y Lee
- Department of Ophthalmology, Seattle, Washington, USA (CAP, JCW, MRB, PPC, KDB, AYL)
| | - Ariel Rokem
- eScience Institute, Seattle, Washington, USA (MB, AR); Department of Psychology, Seattle, Washington, USA (AR).
| |
Collapse
|
15
|
Yang X, Yu X, Zhao Z, He Y, Zhang J, Su X, Sun N, Fan Z. Endoplasmic reticulum stress is involved in retinal injury induced by repeated transient spikes of intraocular pressure. J Zhejiang Univ Sci B 2021; 22:746-756. [PMID: 34514754 DOI: 10.1631/jzus.b2100053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Clinically, a large proportion of glaucoma patients undergo repeated intraocular pressure (IOP) spike (Spike IOP) attacks during their sleep, which may facilitate retinopathy. In this study, we established a mouse model of repeated transient Spike IOP to investigate the direct damage to the retina following Spike IOP attacks, and elucidated the underlying molecular mechanism. We analyzed the changes in the number of retinal ganglion cells (RGCs) via immunofluorescence. Thereafter, we detected retinal cell apoptosis via terminal deoxynucleotidyl transferase deoxyuridine triphosphate (dUTP) nick-end labeling (TUNEL) staining, and performed RNA sequencing (RNA-seq) to reveal the underlying molecular mechanism. Finally, we validated the expression of key molecules in the endoplasmic reticulum (ER) stress pathway using quantitative real-time polymerase chain reaction (qRT-PCR) and western blot analysis. Results revealed a time-dependent RGC loss in Spike IOP, evidenced by a reduction in the number of Brn3a-positive RGCs in experimental eyes following a 7-d continuous treatment with Spike IOP. In addition, TUNEL staining indicated that apoptosis of retinal cells started in the outer nuclear layer (ONL), and then spread to the ganglion cell layer (GCL) with time. RNA-seq analysis revealed that ER stress might be involved in Spike IOP-induced retinal injury. This result was corroborated by western blot, which revealed upregulation of ER stress-related proteins including binding immunoglobulin protein/glucose-regulated protein 78 (BiP/GRP78), phosphorylated inositol-requiring enzyme 1 (p-IRE1), unspliced X-box-binding protein 1 (XBP1-u), spliced X-box-binding protein 1 (XBP1-s), phosphorylated c-Jun N-terminal kinase (p-JNK), C/EBP-homologous protein (CHOP), and B-cell lymphoma 2 (Bcl-2)-associated X protein (Bax). These findings indicate that repeated IOP transients are detrimental to the retina, while ER stress plays an important role in retinal cell apoptosis in this situation. Notably, repeated Spike IOP among glaucoma patients is a crucial factor for progressive retinopathy.
Collapse
Affiliation(s)
- Xue Yang
- State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Xiaowei Yu
- State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Zhenni Zhao
- State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Yuqing He
- State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Jiamin Zhang
- State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Xiaoqian Su
- State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
| | - Nannan Sun
- State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
| | - Zhigang Fan
- State Key Laboratory of Ophthalmology, Department of Glaucoma, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China. .,Tongren Eye Center, Beijing Tongren Hospital, Capital Medical School, Beijing 100730, China.
| |
Collapse
|
16
|
Abstract
Early detection and monitoring are critical to the diagnosis and management of glaucoma, a progressive optic neuropathy that causes irreversible blindness. Optical coherence tomography (OCT) has become a commonly utilized imaging modality that aids in the detection and monitoring of structural glaucomatous damage. Since its inception in 1991, OCT has progressed through multiple iterations, from time-domain OCT, to spectral-domain OCT, to swept-source OCT, all of which have progressively improved the resolution and speed of scans. Even newer technological advancements and OCT applications, such as adaptive optics, visible-light OCT, and OCT-angiography, have enriched the use of OCT in the evaluation of glaucoma. This article reviews current commercial and state-of-the-art OCT technologies and analytic techniques in the context of their utility for glaucoma diagnosis and management, as well as promising future directions. Expected final online publication date for the Annual Review of Vision Science, Volume 7 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
Collapse
Affiliation(s)
- Alexi Geevarghese
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA;
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA; .,Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York 11201, USA.,Center for Neural Science, NYU College of Arts and Sciences, New York, NY 10003, USA
| | - Hiroshi Ishikawa
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA; .,Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York 11201, USA
| | - Joel S Schuman
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA; .,Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, New York 11201, USA.,Center for Neural Science, NYU College of Arts and Sciences, New York, NY 10003, USA.,Department of Physiology and Neuroscience, NYU Langone Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| |
Collapse
|
17
|
Kumar S, Ramakrishnan H, Viswanathan S, Akopian A, Bloomfield SA. Neuroprotection of the Inner Retina Also Prevents Secondary Outer Retinal Pathology in a Mouse Model of Glaucoma. Invest Ophthalmol Vis Sci 2021; 62:35. [PMID: 34297802 PMCID: PMC8300060 DOI: 10.1167/iovs.62.9.35] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 06/24/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose We examined structural and functional changes in the outer retina of a mouse model of glaucoma. We examined whether these changes are a secondary consequence of damage in the inner retina and whether neuroprotection of the inner retina also prevents outer retinal changes. Methods We used an established microbead occlusion model of glaucoma whereby intraocular pressure (IOP) was elevated. Specific antibodies were used to label rod and cone bipolar cells (BCs), horizontal cells (HCs), and retinal ganglion cells (RGCs), as well as synaptic components in control and glaucomatous eyes, to assess structural damage and cell loss. ERG recordings were made to assess outer retina function. Results We found structural and functional damage of BCs, including significant cell loss and dendritic/axonal remodeling of HCs, following IOP elevation. The first significant loss of both BCs occurred at 4 to 5 weeks after microbead injection. However, early changes in the dendritic structure of RGCs were observed at 3 weeks, but significant changes in the rod BC axon terminal structure were not seen until 4 weeks. We found that protection of inner retinal neurons in glaucomatous eyes by pharmacological blockade of gap junctions or genetic ablation of connexin 36 largely prevented outer retinal damage. Conclusions Together, our results indicate that outer retinal impairments in glaucoma are a secondary sequalae of primary damage in the inner retina. The finding that neuroprotection of the inner retina can also prevent outer retinal damage has important implications with regard to the targets for effective neuroprotective therapy.
Collapse
Affiliation(s)
- Sandeep Kumar
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, New York, United States
| | - Hariharasubramanian Ramakrishnan
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, New York, United States
| | - Suresh Viswanathan
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, New York, United States
| | - Abram Akopian
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, New York, United States
| | - Stewart A. Bloomfield
- Department of Biological and Vision Sciences, State University of New York College of Optometry, New York, New York, United States
| |
Collapse
|
18
|
Cordeiro MF, Hill D, Patel R, Corazza P, Maddison J, Younis S. Detecting retinal cell stress and apoptosis with DARC: Progression from lab to clinic. Prog Retin Eye Res 2021;:100976. [PMID: 34102318 DOI: 10.1016/j.preteyeres.2021.100976] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 12/15/2022]
Abstract
DARC (Detection of Apoptosing Retinal Cells) is a retinal imaging technology that has been developed within the last 2 decades from basic laboratory science to Phase 2 clinical trials. It uses ANX776 (fluorescently labelled Annexin A5) to identify stressed and apoptotic cells in the living eye. During its development, DARC has undergone biochemistry optimisation, scale-up and GMP manufacture and extensive preclinical evaluation. Initially tested in preclinical glaucoma and optic neuropathy models, it has also been investigated in Alzheimer, Parkinson's and Diabetic models, and used to assess efficacy of therapies. Progression to clinical trials has not been speedy. Intravenous ANX776 has to date been found to be safe and well-tolerated in 129 patients, including 16 from Phase 1 and 113 from Phase 2. Results on glaucoma and AMD patients have been recently published, and suggest DARC with an AI-aided algorithm can be used to predict disease activity. New analyses of DARC in GA prediction are reported here. Although further studies are needed to validate these findings, it appears there is potential of the technology to be used as a biomarker. Much larger clinical studies will be needed before it can be considered as a diagnostic, although the relatively non-invasive nature of the nasal as opposed to intravenous administration would widen its acceptability in the future as a screening tool. This review describes DARC development and its progression into Phase 2 clinical trials from lab-based research. It discusses hypotheses, potential challenges, and regulatory hurdles in translating technology.
Collapse
|
19
|
Abstract
Multimodality ophthalmic imaging systems aim to enhance the contrast, resolution, and functionality of existing technologies to improve disease diagnostics and therapeutic guidance. These systems include advanced acquisition and post-processing methods using optical coherence tomography (OCT), combined scanning laser ophthalmoscopy and OCT systems, adaptive optics, surgical guidance, and photoacoustic technologies. Here, we provide an overview of these ophthalmic imaging systems and their clinical and basic science applications.
Collapse
Affiliation(s)
- Morgan J. Ringel
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Eric M. Tang
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Yuankai K. Tao
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37235, USA
| |
Collapse
|
20
|
Liu Z, Saeedi O, Zhang F, Villanueva R, Asanad S, Agrawal A, Hammer DX. Quantification of Retinal Ganglion Cell Morphology in Human Glaucomatous Eyes. Invest Ophthalmol Vis Sci 2021; 62:34. [PMID: 33760041 PMCID: PMC7995922 DOI: 10.1167/iovs.62.3.34] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose To characterize retinal ganglion cell morphological changes in patients with primary open-angle glaucoma associated with hemifield defect (HD) using adaptive optics–optical coherence tomography (AO-OCT). Methods Six patients with early to moderate primary open-angle glaucoma with an average age of 58 years associated with HD and six age-matched healthy controls with an average age of 61 years were included. All participants underwent in vivo retinal ganglion cell (RGC) imaging at six primary locations across the macula with AO-OCT. Ganglion cell layer (GCL) somas were manually counted, and morphological parameters of GCL soma density, size, and symmetry were calculated. RGC cellular characteristics were correlated with functional visual field measurements. Results GCL soma density was 12,799 ± 7747 cells/mm2, 9370 ± 5572 cells/mm2, and 2134 ± 1494 cells/mm2 at 3°, 6°, and 12°, respectively, in glaucoma patients compared with 25,058 ± 4649 cells/mm2, 15,551 ± 2301 cells/mm2, and 3891 ± 1105 cells/mm2 (P < 0.05 for all locations) at the corresponding retinal locations in healthy participants. Mean soma diameter was significantly larger in glaucoma patients (14.20 ± 2.30 µm) compared with the health controls (12.32 ± 1.94 µm, P < 0.05 for all locations); symmetry was 0.36 ± 0.32 and 0.86 ± 0.13 in glaucoma and control cohorts, respectively. Conclusions Glaucoma patients had lower GCL soma density and symmetry, greater soma size, and increased variation of GCL soma reflectance compared with age-matched control subjects. The morphological changes corresponded with HD, and the cellular level structural loss correlated with visual function loss in glaucoma. AO-based morphological parameters could be potential sensitive biomarkers for glaucoma.
Collapse
Affiliation(s)
- Zhuolin Liu
- Center for Devices and Radiological Health (CDRH), U.S. Food and Drug Administration, Silver Spring, Maryland, United States
| | - Osamah Saeedi
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore Maryland, United States
| | - Furu Zhang
- Center for Devices and Radiological Health (CDRH), U.S. Food and Drug Administration, Silver Spring, Maryland, United States
| | - Ricardo Villanueva
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore Maryland, United States
| | - Samuel Asanad
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore Maryland, United States
| | - Anant Agrawal
- Center for Devices and Radiological Health (CDRH), U.S. Food and Drug Administration, Silver Spring, Maryland, United States
| | - Daniel X Hammer
- Center for Devices and Radiological Health (CDRH), U.S. Food and Drug Administration, Silver Spring, Maryland, United States
| |
Collapse
|
21
|
Medchalmi S, Tare P, Sayyad Z, Swarup G. A glaucoma- and ALS-associated mutant of OPTN induces neuronal cell death dependent on Tbk1 activity, autophagy and ER stress. FEBS J 2021; 288:4576-4595. [PMID: 33548116 DOI: 10.1111/febs.15752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 01/04/2021] [Accepted: 02/04/2021] [Indexed: 02/06/2023]
Abstract
Mutations in OPTN are associated with glaucoma, an eye disease, and also with amyotrophic lateral sclerosis (ALS), a motor neuron disease. A 2-bp insertion in OPTN (691_692insAG or 2bpIns-OPTN) is associated with both glaucoma and ALS. This mutation results in frame shift after 127 amino acids, giving rise to a protein with C-terminal aberrant sequence. We have explored the mechanism of induction of cell death by this mutant in a motor neuron cell line, NSC-34, and also in a retinal cell line, 661W. Compared to wild-type OPTN, this mutant induced more cell death in NSC-34 and 661W cells. This mutant localizes predominantly in the nucleus whereas normal OPTN localizes in the cytoplasm. Deletion analysis of 2bpIns-OPTN showed that the aberrant sequence was not essential for cell death induction. This mutant interacts with TANK-binding kinase 1 (Tbk1) but not with OPTN and activates Tbk1. This mutant induced ER stress in NSC-34 cells as seen by induction of C/EBP homologous protein (CHOP) and some other genes. Induction of CHOP, autophagosomal protein LC3-II and cell death by this mutant were abrogated by Tbk1 knockdown and also by 4-phenylbutyric acid, that inhibits ER stress. Induction of CHOP and cell death by 2bpIns-OPTN was autophagy dependent as shown by the effect of Atg5 knockdown. This mutant caused increased formation of LC3-positive aggregates. Treatment of cells with autophagy inducer rapamycin reduced LC3-positive aggregates, CHOP and cell death induced by 2bpIns-OPTN. These results suggest that constitutive activation of Tbk1 by 2bpIns-OPTN leads to impaired autophagy that results in ER stress and cell death.
Collapse
Affiliation(s)
- Swetha Medchalmi
- CSIR-Centre for Cellular and Molecular Biology, Hyderabad, India
| | - Priyanka Tare
- CSIR-Centre for Cellular and Molecular Biology, Hyderabad, India
| | | | - Ghanshyam Swarup
- CSIR-Centre for Cellular and Molecular Biology, Hyderabad, India
| |
Collapse
|
22
|
Abstract
High-resolution retinal imaging is revolutionizing how scientists and clinicians study the retina on the cellular scale. Its exquisite sensitivity enables time-lapse optical biopsies that capture minute changes in the structure and physiological processes of cells in the living eye. This information is increasingly used to detect disease onset and monitor disease progression during early stages, raising the possibility of personalized eye care. Powerful high-resolution imaging tools have been in development for more than two decades; one that has garnered considerable interest in recent years is optical coherence tomography enhanced with adaptive optics. State-of-the-art adaptive optics optical coherence tomography (AO-OCT) makes it possible to visualize even highly transparent cells and measure some of their internal processes at all depths within the retina, permitting reconstruction of a 3D view of the living microscopic retina. In this review, we report current AO-OCT performance and its success in visualizing and quantifying these once-invisible cells in human eyes.
Collapse
Affiliation(s)
- Donald T Miller
- School of Optometry, Indiana University, Bloomington, Indiana 47405, USA; ,
| | - Kazuhiro Kurokawa
- School of Optometry, Indiana University, Bloomington, Indiana 47405, USA; ,
| |
Collapse
|
23
|
Lakshmanan Y, Wong FSY, Zuo B, Bui BV, Chan HHL. Longitudinal outcomes of circumlimbal suture model-induced chronic ocular hypertension in Sprague-Dawley albino rats. Graefes Arch Clin Exp Ophthalmol 2020; 258:2715-2728. [PMID: 32623578 DOI: 10.1007/s00417-020-04820-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/03/2020] [Accepted: 06/26/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To characterise longitudinal structural and functional changes in albino Sprague-Dawley rats following circumlimbal suture ocular hypertension (OHT) induction. METHODS Ten-week-old rats (n = 24) underwent suture implantation around the limbal region in both eyes. On the next day, the suture was removed from one eye (control eyes) and left intact in the other eye (OHT eyes) of each animal. Intraocular pressure (IOP) was monitored weekly twice for the next 15 weeks. Optical coherence tomography (OCT) and electroretinogram (ERG) were measured at baseline and weeks 4, 8, 12, and 15, and eyes were then collected for histological assessment. RESULTS Sutured eyes (n = 12) developed IOP elevation of ~ 50% in the first 2 weeks that was sustained at ~ 25% above the control eye up to week 15 (p = 0.001). Animals with insufficient IOP elevation (n = 6), corneal changes (n = 3), and attrition (n = 3) were excluded from the analysis. OHT eyes developed significant retinal nerve fibre layer (RNFL) thinning (week 4: - 19 ± 14%, p = 0.10; week 8: - 17 ± 12%, p = 0.04; week 12: - 16 ± 10%, p = 0.04, relative to baseline) and reduction in retinal ganglion cell (RGC) density (- 32 ± 26%, p = 0.02). At week 15, both inner (9 ± 7%, p = 0.01) and outer retinal layer thicknesses (6.0 ± 5%, p = 0.001) showed a mild increase in thicknesses. The positive scotopic threshold response (- 28 ± 25%, p = 0.04) and a-wave were significantly reduced at week 12 (- 35 ± 21%; p = 0.04), whereas b-wave was not significantly affected (week 12: - 18 ± 27%, p = 0.24). CONCLUSION The circumlimbal suture model produced a chronic, moderate IOP elevation in an albino strain that led to RNFL thinning and reduced RGC density along with the reductions in ganglion and photoreceptoral cell functions. There was a small thickening in both outer and inner retinal layers.
Collapse
Affiliation(s)
- Yamunadevi Lakshmanan
- Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Francisca Siu Yin Wong
- Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Bing Zuo
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Bang Viet Bui
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Australia
| | - Henry Ho-Lung Chan
- Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China. .,Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| |
Collapse
|
24
|
Fujihara FMF, de Arruda Mello PA, Lindenmeyer RL, Pakter HM, Lavinsky J, Benfica CZ, Castoldi N, Picetti E, Lavinsky D, Finkelsztejn A, Lavinsky F. Individual Macular Layer Evaluation with Spectral Domain Optical Coherence Tomography in Normal and Glaucomatous Eyes. Clin Ophthalmol 2020; 14:1591-1599. [PMID: 32606574 PMCID: PMC7304678 DOI: 10.2147/opth.s256755] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/20/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate differences in the thickness of the individual macular layers between early, moderate, and severe glaucomatous eyes and compare them with healthy controls. PATIENTS AND METHODS Subjects with glaucoma presenting typical optic nerve head findings, high intraocular pressure with or without visual field (VF) damage and normal controls were included. All participants underwent 24-2 perimetry and spectral-domain OCT. Patients were divided into three groups (early, moderate, and severe) based on the mean deviation of the VF and a healthy control group. The device segmented the layers automatically, and their measurements were plotted using the means of the sectors of the inner (3mm) and outer (6mm) circles of the ETDRS grid. RESULTS A total of 109 eyes qualified for the study: 14 in the control group and 52, 18 and 25 in the early, moderate and severe groups, respectively. Mean age was 66.13 (SD=12.38). The mean thickness of the circumpapillary retinal nerve fiber layer (RNFL), total macular thickness (TMT), macular RNFL, ganglion cell layer (GCL) and inner plexiform layer (IPL) were significantly different between the 4 groups, with progressive decrease in thickness. Significant overall difference was found for the inner nuclear layer (INL), and the severe glaucoma group presented thicker measurements than controls and early glaucoma. Outer nuclear layer (ONL) was thinner in severe glaucoma group compared with early glaucoma group. CONCLUSION Individual macular layer measurement using the inner and outer circles of the ETDRS grid is useful to evaluate different stages of glaucoma. The INL thickening and ONL thinning in advanced glaucoma should be explored in the future studies.
Collapse
Affiliation(s)
- Fernanda Mari Fagundes Fujihara
- Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Hospital Banco de Olhos de Porto Alegre, Porto Alegre, RS, Brazil
| | - Paulo Augusto de Arruda Mello
- Department of Ophthalmology, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Rodrigo Leivas Lindenmeyer
- Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Helena Messinger Pakter
- Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Department of Ophthalmology, Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brazil
| | - Jaco Lavinsky
- Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Camila Zanella Benfica
- Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Nedio Castoldi
- Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Egidio Picetti
- Department of Ophthalmology, Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brazil
| | - Daniel Lavinsky
- Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Alessandro Finkelsztejn
- Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Department of Ophthalmology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fabio Lavinsky
- Department of Ophthalmology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
- Department of Ophthalmology, Paulista School of Medicine, São Paulo Hospital, Federal University of São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
25
|
Lakshmanan Y, Wong FSY, Zuo B, So KF, Bui BV, Chan HHL. Posttreatment Intervention With Lycium Barbarum Polysaccharides is Neuroprotective in a Rat Model of Chronic Ocular Hypertension. Invest Ophthalmol Vis Sci 2020; 60:4606-4618. [PMID: 31756254 DOI: 10.1167/iovs.19-27886] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the neuroprotective effects of Lycium barbarum polysaccharides (LBP) against chronic ocular hypertension (OHT) in rats and to consider if effects differed when treatment was applied before (pretreatment) or during (posttreatment) chronic IOP elevation. Methods Sprague-Dawley rats (10-weeks old) underwent suture implantation around the limbus for 15 weeks (OHT) or 1 day (sham). Four experimental groups were studied, three OHT groups (n = 8 each) treated either with vehicle (PBS), LBP pretreatment or posttreatment, and a sham control (n = 5) received no treatment. LBP (1 mg/kg) pre- and posttreatment were commenced at 1 week before and 4 weeks after OHT induction, respectively. Treatments continued up through week 15. IOP was monitored twice weekly for 15 weeks. Optical coherence tomography and ERG were measured at baseline, week 4, 8, 12, and 15. Eyes were collected for ganglion cell layer (GCL) histologic analysis at week 15. Results Suture implantation successfully induced approximately 50% IOP elevation and the cumulative IOP was similar between the three OHT groups. When compared with vehicle control (week 4: -23 ± 5%, P = 0.03), LBP pretreatment delayed the onset of retinal nerve fiber layer (RNFL) thinning (week 4, 8: -2 ± 7%, -11 ± 3%, P > 0.05) and arrested further reduction up through week 15 (-10 ± 4%, P > 0.05). LBP posttreatment intervention showed no significant change in rate of loss (week 4, 15: -25 ± 4.1%, -28 ± 3%). However, both LBP treatments preserved the retinal ganglion cells (RGC) and retinal functions up to week 15, which were significantly reduced in vehicle control. Conclusions LBP posttreatment arrested the subsequent neuronal degeneration after treatment commencement and preserved RGC density and retinal functions in a chronic OHT model, which was comparable with pretreatment outcomes.
Collapse
Affiliation(s)
- Yamunadevi Lakshmanan
- Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Francisca Siu Yin Wong
- Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Bing Zuo
- Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Kwok-Fai So
- Department of Ophthalmology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Guangdong-Hongkong-Macau (GHM) Institute of CNS Regeneration, Jinan University, Guangzhou, China
| | - Bang Viet Bui
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Australia
| | - Henry Ho-Lung Chan
- Laboratory of Experimental Optometry (Neuroscience), School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China.,Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
| |
Collapse
|
26
|
Ouchi J, Kunikata H, Omodaka K, Sato H, Sato H, Ito A, Aizawa N, Tanaka Y, Ichikawa K, Nakazawa T. Color visual acuity in preperimetric glaucoma and open-angle glaucoma. PLoS One 2019; 14:e0215290. [PMID: 30995280 PMCID: PMC6469804 DOI: 10.1371/journal.pone.0215290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 03/31/2019] [Indexed: 12/26/2022] Open
Abstract
Purpose To investigate the clinical significance of color visual acuity (CVA) in preperimetric glaucoma (PPG) and open-angle glaucoma (OAG). Methods A total of 123 eyes of 73 subjects (22 normal eyes, 14 PPG eyes, and 87 OAG eyes; mean age: 44.9 ± 10.1 years, age range: 21–64 years) were enrolled. CVA was tested for red, green-yellow, blue-green and blue-purple with a newly developed test. Results There was no statistical difference in clinical background factors, including age, sex, intraocular pressure, or spherical equivalent between the three groups. Red VA and blue-green VA were significantly worse in the OAG eyes than in the normal eyes (P = 0.008 and P = 0.015, respectively), although green-yellow VA and blue-purple VA were not significantly worse. Furthermore, red VA and blue-green VA were significantly correlated with MD in a group of eyes with either PPG or OAG (r = -0.23, P = 0.023; r = -0.25, P = 0.012, respectively), but green-yellow VA and blue-purple VA were not. Conclusion Red VA and blue-green VA were detectably worse in eyes with OAG, in close association with the degree of functional loss. This suggests that measuring CVA with the new color test described here may be a promising supplement to existing methods of detecting glaucoma and evaluating its severity.
Collapse
Affiliation(s)
- Junko Ouchi
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroshi Kunikata
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuko Omodaka
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Haruka Sato
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroyuki Sato
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Azusa Ito
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Naoko Aizawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
- * E-mail:
| |
Collapse
|
27
|
Zhou L, Chen W, Lin D, Hu W, Tang Z. Neuronal apoptosis, axon damage and synapse loss occur synchronously in acute ocular hypertension. Exp Eye Res 2019; 180:77-85. [DOI: 10.1016/j.exer.2018.12.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/01/2018] [Accepted: 12/14/2018] [Indexed: 10/27/2022]
|
28
|
Burns SA, Elsner AE, Sapoznik KA, Warner RL, Gast TJ. Adaptive optics imaging of the human retina. Prog Retin Eye Res 2019; 68:1-30. [PMID: 30165239 PMCID: PMC6347528 DOI: 10.1016/j.preteyeres.2018.08.002] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 08/22/2018] [Accepted: 08/24/2018] [Indexed: 12/18/2022]
Abstract
Adaptive Optics (AO) retinal imaging has provided revolutionary tools to scientists and clinicians for studying retinal structure and function in the living eye. From animal models to clinical patients, AO imaging is changing the way scientists are approaching the study of the retina. By providing cellular and subcellular details without the need for histology, it is now possible to perform large scale studies as well as to understand how an individual retina changes over time. Because AO retinal imaging is non-invasive and when performed with near-IR wavelengths both safe and easily tolerated by patients, it holds promise for being incorporated into clinical trials providing cell specific approaches to monitoring diseases and therapeutic interventions. AO is being used to enhance the ability of OCT, fluorescence imaging, and reflectance imaging. By incorporating imaging that is sensitive to differences in the scattering properties of retinal tissue, it is especially sensitive to disease, which can drastically impact retinal tissue properties. This review examines human AO retinal imaging with a concentration on the use of the Adaptive Optics Scanning Laser Ophthalmoscope (AOSLO). It first covers the background and the overall approaches to human AO retinal imaging, and the technology involved, and then concentrates on using AO retinal imaging to study the structure and function of the retina.
Collapse
Affiliation(s)
- Stephen A Burns
- 800E. Atwater S, School of Optometry, Indiana University, Bloomington, IN, United States.
| | - Ann E Elsner
- 800E. Atwater S, School of Optometry, Indiana University, Bloomington, IN, United States
| | - Kaitlyn A Sapoznik
- 800E. Atwater S, School of Optometry, Indiana University, Bloomington, IN, United States
| | - Raymond L Warner
- 800E. Atwater S, School of Optometry, Indiana University, Bloomington, IN, United States
| | - Thomas J Gast
- 800E. Atwater S, School of Optometry, Indiana University, Bloomington, IN, United States
| |
Collapse
|
29
|
Unterlauft JD, Rehak M, Böhm MRR, Rauscher FG. Analyzing the impact of glaucoma on the macular architecture using spectral-domain optical coherence tomography. PLoS One 2018; 13:e0209610. [PMID: 30596720 PMCID: PMC6312265 DOI: 10.1371/journal.pone.0209610] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 12/07/2018] [Indexed: 12/02/2022] Open
Abstract
Purpose Using spectral domain optical coherence tomography (SD-OCT) the retina can be segmented automatically to visualize all retinal layers. In glaucoma chronically elevated intraocular pressure leads to a decline of retinal ganglion cells (RGC) which changes retinal architecture. The goal of these analyses was to gain insight into the changes induced by glaucoma within all macular layers using SD-OCT within a closely circumscribed glaucoma cohort. Materials and methods SD-OCT measurements with automated retinal layer segmentation were performed in both eyes of primary open-angle glaucoma patients with a defined monocular absolute visual field scotoma in the central 10° of the visual field and in an age-matched healthy control group. Thickness of single retinal layers and entire retina were compared with special attention to the localization of the visual field scotoma in the glaucomatous eyes. Results 30 eyes of 15 glaucoma patients and 15 eyes of 15 healthy controls were included in this study. Statistical significant thickness differences were detected in the control group between superior and inferior retina for the retinal nerve fiber layer (RNFL), the outer plexiform layer (OPL) and the outer nuclear layer (ONL). In the glaucoma group thickness differences between worse and less affected eyes in the RNFL, the ganglion cell layer (GCL) and the inner plexiform layers (INL) were found. Comparison between healthy and diseased eyes revealed significant thickness differences in the RNFL, GCL, IPL and total retinal thickness but not the outer retinal layers. Conclusion Comparison between SD-OCT measurements of the macula between healthy and glaucomatous eyes in a closely circumscribed disease stage showed a pronounced disease impact on the inner but not the outer retina. These results provide evidence that GCL and IPL thickness seem to be good measures to discriminate between affected and unaffected eyes in testing for glaucoma.
Collapse
Affiliation(s)
- Jan D. Unterlauft
- Department of Ophthalmology, Leipzig University Hospital, Leipzig, Germany
| | - Matus Rehak
- Department of Ophthalmology, Leipzig University Hospital, Leipzig, Germany
| | - Michael R. R. Böhm
- Department of Ophthalmology, University Hospital Essen, University of Duisburg/Essen, Essen, Germany
| | - Franziska G. Rauscher
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
- * E-mail:
| |
Collapse
|
30
|
Hui F, Tang J, Hadoux X, Coote M, Crowston JG. Optimizing a Portable ERG Device for Glaucoma Clinic: The Effect of Interstimulus Frequency on the Photopic Negative Response. Transl Vis Sci Technol 2018; 7:26. [PMID: 30619646 PMCID: PMC6314062 DOI: 10.1167/tvst.7.6.26] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 10/12/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to investigate the effect of interstimulus frequency on the photopic negative response (PhNR) in the clinical electroretinogram (ERG) in glaucoma and healthy eyes. Methods Participants with open angle glaucoma (n = 15) and age-matched controls (n = 20) were recruited. Photopic ERGs were recorded in one eye using five frequencies (1-5 Hz) delivered in random order. ERGs were analyzed for changes to amplitude and timing between groups and interstimulus frequency. Coefficient of variation (CoV) was used to examine variability within recordings for each frequency. Results While the a-wave and b-wave showed minimal alteration, the PhNR was highly sensitive to changes in interstimulus frequency. The PhNR signal was largest at 1 Hz and steadily diminished with higher frequencies in both control and glaucoma groups. Significant differences in PhNR amplitude were found between controls and glaucoma groups at 2 and 3 Hz. While 1 Hz delivered the largest PhNR, it also showed a significantly greater CoV compared to other frequencies. Conclusions An interstimulus frequency of 2 Hz was optimal for recording the PhNR, creating a good balance between testing time and signal quality. A higher frequency could be used to further shorten clinical testing times; however, this may compromise its clinical utility by dampening the PhNR. Translational Relevance Here we show the importance of considering flash interstimulus frequency when designing ERG protocols for recording the PhNR as while higher frequencies can shorten test times, they also have considerable effects on the PhNR.
Collapse
Affiliation(s)
- Flora Hui
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Jessica Tang
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Xavier Hadoux
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia
| | - Michael Coote
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Jonathan G Crowston
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
31
|
Vianna JR, Butty Z, Torres LA, Sharpe GP, Hutchison DM, Shuba LM, Nicolela MT, Chauhan BC. Outer retinal layer thickness in patients with glaucoma with horizontal hemifield visual field defects. Br J Ophthalmol 2018; 103:1217-1222. [PMID: 30385436 DOI: 10.1136/bjophthalmol-2018-312753] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/11/2018] [Accepted: 10/22/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To determine the effect of glaucoma on outer retinal layer thickness in eyes with horizontal hemifield visual field (VF) defects. METHODS We conducted a cross-sectional study in glaucomatous eyes with repeatable (in three or examinations) horizontal hemifield VF (programme 24-2) defect defined as: all five nasal VF locations immediately either above or below the horizontal midline abnormal in the pattern deviation plot with p<0.5%; no mirror-image adjacent 5 VF locations abnormal in the pattern deviation plot and no non-edge VF locations in the non-affected hemifield abnormal in the pattern deviation plot with p<1%. We used optical coherence tomography to measure thickness of each retinal layer in the temporal macula (12° horizontally and 24° vertically) and computed the absolute (µm) and relative (%) intraindividual asymmetry between the perimetrically normal and abnormal hemimacula. RESULTS We included 10 eyes of 8 patients with median age of 67 years and median VF mean deviation of -8.85 dB. The nerve fibre, ganglion cell and inner plexiform layers were significantly thinner in the perimetrically abnormal hemimacula (median asymmetry of -6.4, -11.5 and -3.8 µm, (corresponding to -27.7, -40.5 and -15.7 %), respectively, all p≤0.01). The inner nuclear layer was slightly thicker in the perimetrically abnormal hemimacula (median asymmetry of 1.3 µm (5.0 %), p=0.01). The outer plexiform, outer nuclear and photoreceptor layers asymmetry values were negligible. CONCLUSION Our study showed no evidence that glaucoma has an effect on the outer retinal layer thickness. In contrast, a large impact was observed in inner layer thickness.
Collapse
Affiliation(s)
- Jayme R Vianna
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ziad Butty
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Lucas A Torres
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Glen P Sharpe
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Donna M Hutchison
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lesya M Shuba
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marcelo T Nicolela
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Balwantray C Chauhan
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| |
Collapse
|
32
|
Najjar RP, Sharma S, Atalay E, Rukmini AV, Sun C, Lock JZ, Baskaran M, Perera SA, Husain R, Lamoureux E, Gooley JJ, Aung T, Milea D. Pupillary Responses to Full-Field Chromatic Stimuli Are Reduced in Patients with Early-Stage Primary Open-Angle Glaucoma. Ophthalmology 2018; 125:1362-1371. [DOI: 10.1016/j.ophtha.2018.02.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/09/2018] [Accepted: 02/15/2018] [Indexed: 10/17/2022] Open
|
33
|
Shim MS, Kim KY, Noh M, Ko JY, Ahn S, An MA, Iwata T, Perkins GA, Weinreb RN, Ju WK. Optineurin E50K triggers BDNF deficiency-mediated mitochondrial dysfunction in retinal photoreceptor cell line. Biochem Biophys Res Commun 2018; 503:2690-2697. [PMID: 30100066 DOI: 10.1016/j.bbrc.2018.08.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022]
Abstract
Optineurin (OPTN) mutations are linked to glaucoma pathology and E50K mutation shows massive cell death in photoreceptor cells and retinal ganglion cells. However, little is known about E50K-mediated mitochondrial dysfunction in photoreceptor cell degeneration. We here show that overexpression of E50K expression triggered BDNF deficiency, leading to Bax activation in RGC-5 cells. BDNF deficiency induced mitochondrial dysfunction by decreasing mitochondrial maximal respiration and reducing intracellular ATP level in RGC-5 cells. However, BDNF deficiency did not alter mitochondrial dynamics. Also, BDNF deficiency resulted in LC3-mediated mitophagosome formation in RGC-5 cells. These results strongly suggest that E50K-mediated BDNF deficiency plays a critical role in compromised mitochondrial function in glaucomatous photoreceptor cell degeneration.
Collapse
Affiliation(s)
- Myoung Sup Shim
- Hamilton Glaucoma Center, Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, CA, 92039, USA
| | - Keun-Young Kim
- National Center for Microscopy and Imaging Research and Department of Neuroscience, University of California San Diego, La Jolla, CA, 92093, USA
| | - Mark Noh
- Hamilton Glaucoma Center, Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, CA, 92039, USA
| | - Ji Yoon Ko
- Hamilton Glaucoma Center, Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, CA, 92039, USA
| | - Sangphil Ahn
- Hamilton Glaucoma Center, Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, CA, 92039, USA
| | - Michelle A An
- Hamilton Glaucoma Center, Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, CA, 92039, USA
| | - Takeshi Iwata
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Guy A Perkins
- National Center for Microscopy and Imaging Research and Department of Neuroscience, University of California San Diego, La Jolla, CA, 92093, USA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, CA, 92039, USA
| | - Won-Kyu Ju
- Hamilton Glaucoma Center, Shiley Eye Institute and Department of Ophthalmology, University of California San Diego, La Jolla, CA, 92039, USA.
| |
Collapse
|
34
|
Ha A, Kim YK, Jeoung JW, Park KH. Ellipsoid Zone Change According to Glaucoma Stage Advancement. Am J Ophthalmol 2018; 192:1-9. [PMID: 29750944 DOI: 10.1016/j.ajo.2018.04.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/24/2018] [Accepted: 04/28/2018] [Indexed: 01/01/2023]
Abstract
PURPOSE To compare retinal photoreceptor ellipsoid zone (EZ) intensity between normal eyes and those with different stages of glaucoma. DESIGN Retrospective cross-sectional study. METHODS The study included 37 normal, 38 preperimetric glaucoma, 39 mild-to-moderate glaucoma (visual field [VF] mean deviation [MD]: -7.7 ± 2.0 dB), and 36 severe glaucoma eyes (VF MD: -17.8 ± 3.2 dB). The subjects underwent high-resolution horizontal and vertical line scans through the fovea by spectral-domain optical coherence tomography (SD-OCT). Image processing software was employed to quantify the intensity of the first and second hyperreflective bands corresponding with the external limiting membrane (ELM) and EZ. In order to account for the brightness variation among scans, the relative EZ intensity as the ratio of the second to first reflective band (EZ/ELM) was determined. RESULTS The relative EZ intensity in severe glaucoma eyes was significantly lower than in mild-to-moderate glaucoma eyes (2.46 ± 0.38 vs 3.15 ± 0.43, P < .001); also, it was lower in mild-to-moderate than in preperimetric glaucoma eyes (3.15 ± 0.43 vs 3.86 ± 0.44, P < .001). However, the comparison between preperimetric glaucoma and normal eyes showed no significant difference (3.86 ± 0.44 vs 4.06 ± 0.40, P = .751). In 75 glaucomatous eyes with VF defect, there was a significant correlation between relative EZ intensity and VF MD (r = 0.83 and P < .001). CONCLUSIONS According to SD-OCT, relative EZ intensity reduction occurs in the mild-to-moderate and severe glaucoma stages. These findings suggest, at least provisionally, that in the course of glaucoma progression, mitochondrial changes in the inner segments of photoreceptors occur. Further investigation is warranted to evaluate the potential clinical significance of EZ intensity reduction in glaucoma.
Collapse
Affiliation(s)
- Ahnul Ha
- Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea; and Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea
| | - Young Kook Kim
- Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea; and Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea
| | - Jin Wook Jeoung
- Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea; and Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea
| | - Ki Ho Park
- Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea; and Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea.
| |
Collapse
|
35
|
Duque-chica GL, Gracitelli CP, Moura AL, Nagy BV, Vidal KS, Paranhos A, Ventura DF. Inner and Outer Retinal Contributions to Pupillary Light Response: Correlation to Functional and Morphologic Parameters in Glaucoma. J Glaucoma 2018; 27:723-32. [DOI: 10.1097/ijg.0000000000001003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
36
|
Tumahai P, Moureaux C, Meillat M, Debellemanière G, Flores M, Delbosc B, Saleh M. High-resolution imaging of photoreceptors in healthy human eyes using an adaptive optics retinal camera. Eye (Lond) 2018; 32:1723-1730. [PMID: 29993035 DOI: 10.1038/s41433-018-0140-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 01/21/2018] [Accepted: 02/19/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To determine the effects of age on perifoveal cone density in healthy subjects using adaptive optics. METHODS Healthy subjects of various ages were imaged using an adaptive optics retinal camera (RTX-1® Imagine Eyes, Orsay, France). All patients underwent a comprehensive ophthalmologic examination and retinal imaging using spectral-domain optical coherence tomography (Spectralis®, Heidelberg Engineering, Heidelberg, Germany). Cone density together with cone spacing and cone mosaic packing were measured in the nasal and temporal area 450 µm from the fovea. A multivariate analysis was performed to determine which of the following parameters were related to a decrease in cone density: age, axial length, central macular thickness, and retrofoveal choroidal thickness. RESULTS One hundred and sixty-seven eyes of 101 subjects aged 6-78 years were studied. Perifoveal cone density significantly decreased with age (R2 = 0.17, p<0.01). Inversely, cone spacing increased with age (R2=0.18, p<0.01). There was no change in the cone packing mosaic (p>0.05). The mean coefficient of variation between fellow eyes was 3.9%. Age and axial length were related to a cone density decrease, while choroidal and retinal thicknesses did not affect cone metrics in healthy subjects. CONCLUSIONS A moderate perifoveal cone loss occurs with age. The precise consequences of these findings on visual function should be investigated. In addition to a better understanding of normal retinal anatomy, these results could act as a comparative database for further studies on normal and diseased retinas.
Collapse
Affiliation(s)
- P Tumahai
- Ophthalmology Department, University Hospital of Besançon, Besançon, Franche-Comté, France.
| | - C Moureaux
- Ophthalmology Department, University Hospital of Besançon, Besançon, Franche-Comté, France
| | - M Meillat
- Ophthalmology Department, University Hospital of Besançon, Besançon, Franche-Comté, France
| | - G Debellemanière
- Ophthalmology Department, University Hospital of Besançon, Besançon, Franche-Comté, France
| | - M Flores
- Ophthalmology Department, University Hospital of Besançon, Besançon, Franche-Comté, France
| | - B Delbosc
- Ophthalmology Department, University Hospital of Besançon, Besançon, Franche-Comté, France
| | - M Saleh
- Ophthalmology Department, University Hospital of Besançon, Besançon, Franche-Comté, France
| |
Collapse
|
37
|
Matsuura M, Fujino Y, Kanamoto T, Murata H, Yanagisawa M, Hirasawa K, Inoue T, Shoji N, Inoue K, Yamagami J, Asaoka R. Improving the structure-function relationship in glaucomatous and normative eyes by incorporating photoreceptor layer thickness. Sci Rep 2018; 8:10450. [PMID: 29993027 DOI: 10.1038/s41598-018-28821-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 06/25/2018] [Indexed: 12/31/2022] Open
Abstract
The purpose of the study was to investigate whether the structure-function relationship in glaucomatous and normative eyes is improved by considering photoreceptor layer thickness. Humphrey 10-2 visual fields (VF) and optical coherence tomography were carried out in 615 eyes of 391 subjects, including 100 eyes of 53 healthy controls and 515 eyes of 338 glaucoma patients. The relationship between mean VF sensitivity and the thickness of the retinal nerve fiber layer (RNFL) and ganglion cell layer and inner plexiform layer (GCL + IPL) was analyzed using linear mixed models, by glaucoma status and degree of myopia. The structure-function relationship was also analyzed by supplementing the RNFL and GCL + IPL thickness with the thicknesses of: (i) the inner nuclear layer and outer plexiform layer (INL + OPL); (ii) the outer nuclear layer and inner segment of photoreceptor layer (ONL + ISL); (iii) the outer segment layer of photoreceptor and retinal pigment epithelium (OSL + RPE). The model included total thickness of RNFL, GCL + IPL and OSL + RPE was highly more optimal than the model that only included the total thickness of RNFL and GCL + IPL, in all subsets of eyes by glaucoma status and degree of myopia.
Collapse
|
38
|
Cifuentes-Canorea P, Ruiz-Medrano J, Gutierrez-Bonet R, Peña-Garcia P, Saenz-Frances F, Garcia-Feijoo J, Martinez-de-la-Casa JM. Analysis of inner and outer retinal layers using spectral domain optical coherence tomography automated segmentation software in ocular hypertensive and glaucoma patients. PLoS One 2018; 13:e0196112. [PMID: 29672563 PMCID: PMC5908140 DOI: 10.1371/journal.pone.0196112] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 04/08/2018] [Indexed: 12/04/2022] Open
Abstract
Objective To analyse the morphological features and diagnostic ability of eight macular retinal layers using a new segmentation software Heidelberg's Spectralis Optical Coherence Tomography (SD-OCT) in healthy, ocular hypertensive and primary open angle glaucoma patients. Methods Single-center, cross-sectional, non-interventional study. 193 eyes from 193 consecutive patients (56 controls, 63 ocular hypertensives, 32 early primary open glaucoma patients and 42 moderate-advanced primary open glaucoma patients). Those patients presenting any retinal disease were excluded. Macular segmentation of the retinal layers was automatically performed using the new segmentation Heidelberg's Spectralis OCT software providing measurements for eight retinal layers. The software provides thickness maps divided into nine subfields. Results Statistically significant differences in inner layers’ thickness was found between all 4 four groups. Superior and inferior sectors of macular retinal nerve fiber layer; nasal, temporal, superior and inferior sectors of ganglion cell layer and inner plexiform layer were significantly different when comparing ocular hypertensive patients and early glaucoma patients. Areas under the ROC curves for early glaucoma diagnosis were 0.781±0.052 for macular retinal nerve fiber layer outer inferior sector, 0.760±0.050 for ganglion cell layer outer temporal sector, 0.767±0.049 for the inner plexiform layer outer temporal sector and 0.807±0.048 for the combination of all three. No differences were found between groups when considering outer retinal layers. Conclusions The automated segmentation software from Heidelberg's Spectralis OCT provides a new diagnostic tool for the diagnosis of ocular hypertensive and glaucoma patients.
Collapse
Affiliation(s)
- Pilar Cifuentes-Canorea
- Servicio de Oftalmología, Hospital Clínico San Carlos, Departamento de Oftalmología, Facultad de Medicina, Universidad Complutense de Madrid and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
- * E-mail:
| | - Jorge Ruiz-Medrano
- Servicio de Oftalmología, Hospital Clínico San Carlos, Departamento de Oftalmología, Facultad de Medicina, Universidad Complutense de Madrid and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | | | - Pablo Peña-Garcia
- Division of Ophtalmology, Miguel Hernandez University, Alicante, Spain
| | - Federico Saenz-Frances
- Servicio de Oftalmología, Hospital Clínico San Carlos, Departamento de Oftalmología, Facultad de Medicina, Universidad Complutense de Madrid and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Julian Garcia-Feijoo
- Servicio de Oftalmología, Hospital Clínico San Carlos, Departamento de Oftalmología, Facultad de Medicina, Universidad Complutense de Madrid and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Jose Maria Martinez-de-la-Casa
- Servicio de Oftalmología, Hospital Clínico San Carlos, Departamento de Oftalmología, Facultad de Medicina, Universidad Complutense de Madrid and Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| |
Collapse
|
39
|
Abstract
AIM to assess macular blood flow in primary open-angle glaucoma (POAG) patients using optical coherence tomography angiography (OCT-A). MATERIAL AND METHODS The study included 65 POAG patients and 22 age-matched healthy volunteers. Using OCT-A, blood flow parameters (Flow Area, Flow Index, and Vessel Density) were assessed in the para- and perifovea (0.6-2.5 mm and 2.5-5.5 mm, respectively) at the level of both superficial and deep vascular pexuses. Statistical analysis was performed with SPSS version 21 and MASS library of the R language. RESULTS All the studied parameters were decreased in glaucoma patients as compared to healthy participants: Index superficial parafovea was 0.03±0.01 and 0.04±0.01 (p<0.001), respectively; Index superficial perifovea - 0.02±0.01 and 0.04±0.01 (p<0.001), respectively; Flow superficial parafovea area - 1.57±0.85 mm2 and 2.53±0.53 mm2 (p<0.001), respectively; Index deep parafovea - 0.02±0.02 and 0.03±0.01 (p<0.001), respectively; Index deep perifovea - 0.01 ±0.01 and 0,03±0.01 (p<0.001), respectively; and Flow deep parafovea area 1.02±0.9 mm2 and 1.97±0.82 mm2 (p<0.001), respectively. The differences were statistically significant between glaucoma patients and the controls, but not between glaucoma patients at different disease stages. CONCLUSION Decreased OCT-A parameters in non-advanced glaucoma indicate an early reduction of blood supply to the macula and explain the involvement of the latter in the pathological process in POAG.
Collapse
Affiliation(s)
- N I Kurysheva
- Consultative and Diagnostic Department of the Ophthalmology Center of the Federal Medical and Biological Agency of Russia, A.I. Burnazyan Federal Medical Biophysical Center of FMBA, Institute of Improvement of Professional Skill of the FMBA of Russia, 15 Gamalei St., Moscow, Russian Federation, 123098
| | - E V Maslova
- Consultative and Diagnostic Department of the Ophthalmology Center of the Federal Medical and Biological Agency of Russia, A.I. Burnazyan Federal Medical Biophysical Center of FMBA, Institute of Improvement of Professional Skill of the FMBA of Russia, 15 Gamalei St., Moscow, Russian Federation, 123098
| | - A V Trubilina
- Consultative and Diagnostic Department of the Ophthalmology Center of the Federal Medical and Biological Agency of Russia, A.I. Burnazyan Federal Medical Biophysical Center of FMBA, Institute of Improvement of Professional Skill of the FMBA of Russia, 15 Gamalei St., Moscow, Russian Federation, 123098
| | - T D Ardzhevnishvili
- Consultative and Diagnostic Department of the Ophthalmology Center of the Federal Medical and Biological Agency of Russia, A.I. Burnazyan Federal Medical Biophysical Center of FMBA, Institute of Improvement of Professional Skill of the FMBA of Russia, 15 Gamalei St., Moscow, Russian Federation, 123098
| | - A V Fomin
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021
| |
Collapse
|
40
|
de Araújo RB, Oyamada MK, Zacharias LC, Cunha LP, Preti RC, Monteiro MLR. Morphological and Functional Inner and Outer Retinal Layer Abnormalities in Eyes with Permanent Temporal Hemianopia from Chiasmal Compression. Front Neurol 2017; 8:619. [PMID: 29255441 PMCID: PMC5723053 DOI: 10.3389/fneur.2017.00619] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 11/06/2017] [Indexed: 12/24/2022] Open
Abstract
Purpose The aims of this study are to compare optical coherence tomography (OCT)-measured macular retinal layers in eyes with permanent temporal hemianopia from chiasmal compression and control eyes; to compare regular and slow-flash multifocal electroretinography (mfERG) in patients and controls; and to assess the correlation between OCT, mfERG, and central visual field (SAP) data. Methods Forty-three eyes of 30 patients with permanent temporal hemianopia due to pituitary tumors who were previously submitted to chiasm decompression and 37 healthy eyes of 19 controls were submitted to macular spectral domain OCT, mfERG, and 10-2 SAP testing. After segmentation, the thickness of the macular retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer, and photoreceptor layer (PRL) was measured. Amplitudes and oscillatory potentials (OPs) were measured on regular and slow-flash mfERG, respectively, and expressed as the mean values per quadrant and hemifield. Results RNFL, GCL, and IPL thickness measurements were significantly reduced in all quadrants, whereas INL, OPL, and PRL thicknesses were significantly increased in the nasal quadrants in patients compared to those in controls. Significant correlations between OCT and 10-2 SAP measurements were positive for the RNFL, GCL, and IPL and negative for the INL, OPL, and PRL. OPs and mfERG N1 amplitudes were significantly reduced in the nasal hemiretina of patients. Significant correlations were found between OP and mfERG amplitudes for inner and outer nasal hemiretina OCT measurements, respectively. Conclusion Patients with permanent temporal hemianopia from previously treated chiasmal compression demonstrated significant thinning of the RNFL, GCL, IPL, and thickening of the INL, OPL, and PRL associated with reduced OP and mfERG N1 amplitudes, suggesting that axonal injury to the inner retina leads to secondary damage to the outer retina in this condition.
Collapse
Affiliation(s)
- Rafael B de Araújo
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Maria K Oyamada
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Leandro C Zacharias
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Leonardo P Cunha
- Department of Ophtalmology, School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Rony C Preti
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| | - Mário L R Monteiro
- Laboratory of Investigation in Ophthalmology (LIM 33), Division of Ophthalmology, University of São Paulo Medical School, São Paulo, Brazil
| |
Collapse
|
41
|
Sayyad Z, Sirohi K, Radha V, Swarup G. 661W is a retinal ganglion precursor-like cell line in which glaucoma-associated optineurin mutants induce cell death selectively. Sci Rep 2017; 7:16855. [PMID: 29203899 PMCID: PMC5715133 DOI: 10.1038/s41598-017-17241-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/22/2017] [Indexed: 01/12/2023] Open
Abstract
A photoreceptor cell line, 661W, derived from a mouse retinal tumor that expresses several markers of cone photoreceptor cells has been described earlier. However, these cells can be differentiated into neuronal cells. Here, we report that this cell line expressed certain markers specific to retinal ganglion cells such as Rbpms, Brn3b (Pou4f2), Brn3c (Pou4f3), Thy1 and γ-synuclein (Sncg), and some other markers of neuronal cells (beta-III tubulin, NeuN and MAP2). These cells also expressed Opn1mw, a cone-specific marker and nestin, a marker for neural precursor cells. Two glaucoma-associated mutants of OPTN, E50K and M98K, but not an amyotrophic lateral sclerosis-associated mutant, E478G, induced cell death selectively in 661W cells. However, in a motor neuron cell line, NSC34, E478G mutant of OPTN but not E50K and M98K induced cell death. We conclude that 661W is a retinal ganglion precursor-like cell line, which shows properties of both retinal ganglion and photoreceptor cells. We suggest that these cells could be utilized for exploring the mechanisms of cell death induction and cytoprotection relevant for glaucoma pathogenesis. RGC-5 cell line which probably arose from 661W cells showed expression of essentially the same markers of retinal ganglion cells and neuronal cells as seen in 661W cells.
Collapse
Affiliation(s)
- Zuberwasim Sayyad
- CSIR-Centre for Cellular and Molecular Biology, Hyderabad, 500007, India
| | - Kapil Sirohi
- CSIR-Centre for Cellular and Molecular Biology, Hyderabad, 500007, India.,Department of medicine, National Jewish Health, Denver, 80206, Colorado, USA
| | - Vegesna Radha
- CSIR-Centre for Cellular and Molecular Biology, Hyderabad, 500007, India.
| | - Ghanshyam Swarup
- CSIR-Centre for Cellular and Molecular Biology, Hyderabad, 500007, India.
| |
Collapse
|
42
|
Lavinsky F, Wollstein G, Tauber J, Schuman JS. The Future of Imaging in Detecting Glaucoma Progression. Ophthalmology 2017; 124:S76-S82. [PMID: 29157365 DOI: 10.1016/j.ophtha.2017.10.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Revised: 09/11/2017] [Accepted: 10/05/2017] [Indexed: 12/12/2022] Open
Abstract
Ocular imaging has been heavily incorporated into glaucoma management and provides important information that aids in the detection of disease progression. Longitudinal studies have shown that the circumpapillary retinal nerve fiber layer is an important parameter for glaucoma progression detection, whereas other studies have demonstrated that macular parameters, such as the ganglion cell inner plexiform layer and optic nerve head parameters, also are useful for progression detection. The introduction of novel technologies with faster scan speeds, wider scanning fields, higher resolution, and improved tissue penetration has enabled the precise quantification of additional key ocular structures, such as the individual retinal layers, optic nerve head, choroid, and lamina cribrosa. Furthermore, extracting functional information from scans such as blood flow rate and oxygen consumption provides new perspectives on the disease and its progression. These novel methods promise improved detection of glaucoma progression and better insight into the mechanisms of progression that will lead to better targeted treatment options to prevent visual damage and blindness.
Collapse
Affiliation(s)
- Fabio Lavinsky
- NYU Langone Eye Center, New York University School of Medicine, New York, New York
| | - Gadi Wollstein
- NYU Langone Eye Center, New York University School of Medicine, New York, New York
| | - Jenna Tauber
- NYU Langone Eye Center, New York University School of Medicine, New York, New York
| | - Joel S Schuman
- NYU Langone Eye Center, New York University School of Medicine, New York, New York.
| |
Collapse
|
43
|
Liu KG, Peng XY, Zhang Z, Sun H, Yang DY, Wang NL. Reduction on OFF-responses of Electroretinogram in Monkeys with Long-term High Intraocular Pressure. Chin Med J (Engl) 2017; 130:2713-2719. [PMID: 29133761 PMCID: PMC5695058 DOI: 10.4103/0366-6999.218021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: There are ON- and OFF-pathways in the normal vertebrate retina. Short- and long-flash electroretinogram (ERG) are suitable methods to observe the function of ON- and OFF-pathways in vivo, respectively. It is clear that high intraocular pressure (IOP) might cause dysfunction of cone-dominated photopic negative response (PhNR) in monkeys with high IOP in ON-pathway. However, whether cone-dominated OFF-responses are also affected is less known. The aim of this study was to observe photopic OFF-responses of ERG in monkeys with high IOP. Methods: Nine monkeys were involved in the experiment from January 2006 to December 2016. High IOP was induced in the right eye by laser coagulation of the mid-trabecular meshwork in five monkeys. Six years after the laser coagulation, both short- and long-flash of the photopic ERG were recorded. Stimulus light was red flashes superimposed on a blue background. Four normal monkeys were examined under the same ERG protocols as controls. Paired t-test was used to compare the difference of each ERG parameter between the lasered eye and the fellow eye. Analysis of variance (ANOVA) with Tukey adjustment was adopted to calculate the differences among the lasered eye, the fellow eye, and the eyes of normal monkeys. Results: The mean amplitude of a-wave (11.73 ± 2.05) and PhNR (8.67 ± 2.44) in lasered eyes was significantly lower than that of a-wave (21.47 ± 3.15) and PhNR (22.05 ± 3.42) in fellow eyes (P = 0.03 and P = 0.01, respectively) in response to short flash. The mean amplitude of d-wave (1.60 ± 0.59) and i-wave (3.13 ± 0.64) was significantly reduced in the lasered eyes than that of d-wave (4.01 ± 0.56) and i-wave (8.79 ± 1.75) in the fellow eyes (P = 0.02 and P = 0.02, respectively) in response to long flash. Conclusions: Reduced OFF-responses are recorded in monkeys with high IOP when dysfunction of photoreceptor is involved. The reduced OFF-responses to long-flash stimulus show evidence of anomalous retinal circuitry in glaucomatous retinopathy.
Collapse
Affiliation(s)
- Ke-Gao Liu
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Xiao-Yan Peng
- Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Zheng Zhang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Hua Sun
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Di-Ya Yang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Ning-Li Wang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| |
Collapse
|
44
|
Abstract
PURPOSE Macular optical coherence tomography (OCT) analysis can be used for quantitative measures of optic nerve atrophy at a location far from the optic nerve head. This recently led to the finding of microcystic macular edema (MME), that is vacuolar inclusions in the macular inner nuclear layer, in some glaucoma patients. The involvement of individual retinal layers is yet unclear in glaucoma. In this study we systematically investigated glaucoma-induced changes in macular layers to evaluate whether glaucoma-associated damage extends beyond the macular ganglion cell layer. PATIENTS AND METHODS We included 218 consecutive patients and 282 eyes with confirmed primary open-angle glaucoma or pseudoexfoliation glaucoma, and macular OCT in a cross-sectional observational study. Eyes were screened for presence of MME. Thickness of individual retinal layers was determined using a semiautomatic segmentation algorithm. Peripapillary nerve fiber layer thickness and mean defect in visual field testing were extracted from OCT and medical records, respectively. Results were compared with a small group of eyes with no apparent glaucoma. RESULTS We found MME in 5 eyes from 5 primary open-angle glaucoma patients and 3 eyes of 3 pseudoexfoliation glaucoma patients (2.8%). MME was confined to the inner nuclear layer in a perifoveal ring and was associated with thinning of the ganglion cell layer and thickening of the macular inner nuclear layer. Glaucoma eyes without MME showed a significant inverse correlation of inner nuclear layer thickness with glaucoma severity. CONCLUSIONS Glaucomatous damage leads to a gradual thickening of the inner nuclear layer, which leads to MME in more severe glaucoma cases. These changes, along with nerve fiber loss and ganglion cell loss, may be summarized as glaucoma-associated retrograde maculopathy.
Collapse
Affiliation(s)
- Jacqueline Brazerol
- *Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland †Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | | | | | | | | | | |
Collapse
|
45
|
Morgan JIW. The fundus photo has met its match: optical coherence tomography and adaptive optics ophthalmoscopy are here to stay. Ophthalmic Physiol Opt 2017; 36:218-39. [PMID: 27112222 DOI: 10.1111/opo.12289] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 01/20/2016] [Indexed: 12/24/2022]
Abstract
PURPOSE Over the past 25 years, optical coherence tomography (OCT) and adaptive optics (AO) ophthalmoscopy have revolutionised our ability to non-invasively observe the living retina. The purpose of this review is to highlight the techniques and human clinical applications of recent advances in OCT and adaptive optics scanning laser/light ophthalmoscopy (AOSLO) ophthalmic imaging. RECENT FINDINGS Optical coherence tomography retinal and optic nerve head (ONH) imaging technology allows high resolution in the axial direction resulting in cross-sectional visualisation of retinal and ONH lamination. Complementary AO ophthalmoscopy gives high resolution in the transverse direction resulting in en face visualisation of retinal cell mosaics. Innovative detection schemes applied to OCT and AOSLO technologies (such as spectral domain OCT, OCT angiography, confocal and non-confocal AOSLO, fluorescence, and AO-OCT) have enabled high contrast between retinal and ONH structures in three dimensions and have allowed in vivo retinal imaging to approach that of histological quality. In addition, both OCT and AOSLO have shown the capability to detect retinal reflectance changes in response to visual stimuli, paving the way for future studies to investigate objective biomarkers of visual function at the cellular level. Increasingly, these imaging techniques are being applied to clinical studies of the normal and diseased visual system. SUMMARY Optical coherence tomography and AOSLO technologies are capable of elucidating the structure and function of the retina and ONH noninvasively with unprecedented resolution and contrast. The techniques have proven their worth in both basic science and clinical applications and each will continue to be utilised in future studies for many years to come.
Collapse
Affiliation(s)
- Jessica I W Morgan
- Department of Ophthalmology, Scheie Eye Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| |
Collapse
|
46
|
Jonnal RS, Kocaoglu OP, Zawadzki RJ, Liu Z, Miller DT, Werner JS. A Review of Adaptive Optics Optical Coherence Tomography: Technical Advances, Scientific Applications, and the Future. Invest Ophthalmol Vis Sci 2017; 57:OCT51-68. [PMID: 27409507 PMCID: PMC4968917 DOI: 10.1167/iovs.16-19103] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose Optical coherence tomography (OCT) has enabled “virtual biopsy” of the living human retina, revolutionizing both basic retina research and clinical practice over the past 25 years. For most of those years, in parallel, adaptive optics (AO) has been used to improve the transverse resolution of ophthalmoscopes to foster in vivo study of the retina at the microscopic level. Here, we review work done over the last 15 years to combine the microscopic transverse resolution of AO with the microscopic axial resolution of OCT, building AO-OCT systems with the highest three-dimensional resolution of any existing retinal imaging modality. Methods We surveyed the literature to identify the most influential antecedent work, important milestones in the development of AO-OCT technology, its applications that have yielded new knowledge, research areas into which it may productively expand, and nascent applications that have the potential to grow. Results Initial efforts focused on demonstrating three-dimensional resolution. Since then, many improvements have been made in resolution and speed, as well as other enhancements of acquisition and postprocessing techniques. Progress on these fronts has produced numerous discoveries about the anatomy, function, and optical properties of the retina. Conclusions Adaptive optics OCT continues to evolve technically and to contribute to our basic and clinical knowledge of the retina. Due to its capacity to reveal cellular and microscopic detail invisible to clinical OCT systems, it is an ideal companion to those instruments and has the demonstrable potential to produce images that can guide the interpretation of clinical findings.
Collapse
Affiliation(s)
- Ravi S Jonnal
- Vision Science and Advanced Retinal Imaging Laboratory University of California-Davis, Sacramento, California, United States
| | - Omer P Kocaoglu
- School of Optometry, Indiana University, Bloomington, Indiana, United States
| | - Robert J Zawadzki
- Vision Science and Advanced Retinal Imaging Laboratory University of California-Davis, Sacramento, California, United States
| | - Zhuolin Liu
- School of Optometry, Indiana University, Bloomington, Indiana, United States
| | - Donald T Miller
- School of Optometry, Indiana University, Bloomington, Indiana, United States
| | - John S Werner
- Vision Science and Advanced Retinal Imaging Laboratory University of California-Davis, Sacramento, California, United States
| |
Collapse
|
47
|
Pircher M, Zawadzki RJ. Review of adaptive optics OCT (AO-OCT): principles and applications for retinal imaging [Invited]. Biomed Opt Express 2017; 8:2536-2562. [PMID: 28663890 PMCID: PMC5480497 DOI: 10.1364/boe.8.002536] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 04/08/2017] [Accepted: 04/09/2017] [Indexed: 05/17/2023]
Abstract
In vivo imaging of the human retina with a resolution that allows visualization of cellular structures has proven to be essential to broaden our knowledge about the physiology of this precious and very complex neural tissue that enables the first steps in vision. Many pathologic changes originate from functional and structural alterations on a cellular scale, long before any degradation in vision can be noted. Therefore, it is important to investigate these tissues with a sufficient level of detail in order to better understand associated disease development or the effects of therapeutic intervention. Optical retinal imaging modalities rely on the optical elements of the eye itself (mainly the cornea and lens) to produce retinal images and are therefore affected by the specific arrangement of these elements and possible imperfections in curvature. Thus, aberrations are introduced to the imaging light and image quality is degraded. To compensate for these aberrations, adaptive optics (AO), a technology initially developed in astronomy, has been utilized. However, the axial sectioning provided by retinal AO-based fundus cameras and scanning laser ophthalmoscope instruments is limited to tens of micrometers because of the rather small available numerical aperture of the eye. To overcome this limitation and thus achieve much higher axial sectioning in the order of 2-5µm, AO has been combined with optical coherence tomography (OCT) into AO-OCT. This enabled for the first time in vivo volumetric retinal imaging with high isotropic resolution. This article summarizes the technical aspects of AO-OCT and provides an overview on its various implementations and some of its clinical applications. In addition, latest developments in the field, such as computational AO-OCT and wavefront sensor less AO-OCT, are covered.
Collapse
Affiliation(s)
- Michael Pircher
- Medical University of Vienna, Center for Medical Physics and Biomedical Engineering, Währinger Gürtel 18-20/4L, 1090 Vienna, Austria
| | - Robert J Zawadzki
- UC Davis RISE Eye-Pod Laboratory, Dept. of Cell Biology and Human Anatomy, University of California Davis, 4320 Tupper Hall, Davis, CA 95616, USA
- Vision Science and Advanced Retinal Imaging Laboratory (VSRI) and Department of Ophthalmology and Vision Science, UC Davis, 4860 Y Street, Ste. 2400, Sacramento, CA 95817, USA
| |
Collapse
|
48
|
Vidal-Sanz M, Galindo-Romero C, Valiente-Soriano FJ, Nadal-Nicolás FM, Ortin-Martinez A, Rovere G, Salinas-Navarro M, Lucas-Ruiz F, Sanchez-Migallon MC, Sobrado-Calvo P, Aviles-Trigueros M, Villegas-Pérez MP, Agudo-Barriuso M. Shared and Differential Retinal Responses against Optic Nerve Injury and Ocular Hypertension. Front Neurosci 2017; 11:235. [PMID: 28491019 PMCID: PMC5405145 DOI: 10.3389/fnins.2017.00235] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 04/07/2017] [Indexed: 12/05/2022] Open
Abstract
Glaucoma, one of the leading causes of blindness worldwide, affects primarily retinal ganglion cells (RGCs) and their axons. The pathophysiology of glaucoma is not fully understood, but it is currently believed that damage to RGC axons at the optic nerve head plays a major role. Rodent models to study glaucoma include those that mimic either ocular hypertension or optic nerve injury. Here we review the anatomical loss of the general population of RGCs (that express Brn3a; Brn3a+RGCs) and of the intrinsically photosensitive RGCs (that express melanopsin; m+RGCs) after chronic (LP-OHT) or acute (A-OHT) ocular hypertension and after complete intraorbital optic nerve transection (ONT) or crush (ONC). Our studies show that all of these insults trigger RGC death. Compared to Brn3a+RGCs, m+RGCs are more resilient to ONT, ONC, and A-OHT but not to LP-OHT. There are differences in the course of RGC loss both between these RGC types and among injuries. An important difference between the damage caused by ocular hypertension or optic nerve injury appears in the outer retina. Both axotomy and LP-OHT induce selective loss of RGCs but LP-OHT also induces a protracted loss of cone photoreceptors. This review outlines our current understanding of the anatomical changes occurring in rodent models of glaucoma and discusses the advantages of each one and their translational value.
Collapse
Affiliation(s)
- Manuel Vidal-Sanz
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| | - Caridad Galindo-Romero
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| | - Francisco J Valiente-Soriano
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| | - Francisco M Nadal-Nicolás
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| | - Arturo Ortin-Martinez
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| | - Giuseppe Rovere
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| | - Manuel Salinas-Navarro
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| | - Fernando Lucas-Ruiz
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| | - Maria C Sanchez-Migallon
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| | - Paloma Sobrado-Calvo
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| | - Marcelino Aviles-Trigueros
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| | - María P Villegas-Pérez
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| | - Marta Agudo-Barriuso
- Departamento de Oftalmología, Facultad de Medicina, Universidad de Murcia and Instituto Murciano de Investigación Biosanitaria Virgen de la ArrixacaMurcia, Spain
| |
Collapse
|
49
|
Salmon AE, Cooper RF, Langlo CS, Baghaie A, Dubra A, Carroll J. An Automated Reference Frame Selection (ARFS) Algorithm for Cone Imaging with Adaptive Optics Scanning Light Ophthalmoscopy. Transl Vis Sci Technol 2017; 6:9. [PMID: 28392976 PMCID: PMC5381332 DOI: 10.1167/tvst.6.2.9] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/28/2017] [Indexed: 01/12/2023] Open
Abstract
PURPOSE To develop an automated reference frame selection (ARFS) algorithm to replace the subjective approach of manually selecting reference frames for processing adaptive optics scanning light ophthalmoscope (AOSLO) videos of cone photoreceptors. METHODS Relative distortion was measured within individual frames before conducting image-based motion tracking and sorting of frames into distinct spatial clusters. AOSLO images from nine healthy subjects were processed using ARFS and human-derived reference frames, then aligned to undistorted AO-flood images by nonlinear registration and the registration transformations were compared. The frequency at which humans selected reference frames that were rejected by ARFS was calculated in 35 datasets from healthy subjects, and subjects with achromatopsia, albinism, or retinitis pigmentosa. The level of distortion in this set of human-derived reference frames was assessed. RESULTS The average transformation vector magnitude required for registration of AOSLO images to AO-flood images was significantly reduced from 3.33 ± 1.61 pixels when using manual reference frame selection to 2.75 ± 1.60 pixels (mean ± SD) when using ARFS (P = 0.0016). Between 5.16% and 39.22% of human-derived frames were rejected by ARFS. Only 2.71% to 7.73% of human-derived frames were ranked in the top 5% of least distorted frames. CONCLUSION ARFS outperforms expert observers in selecting minimally distorted reference frames in AOSLO image sequences. The low success rate in human frame choice illustrates the difficulty in subjectively assessing image distortion. TRANSLATIONAL RELEVANCE Manual reference frame selection represented a significant barrier to a fully automated image-processing pipeline (including montaging, cone identification, and metric extraction). The approach presented here will aid in the clinical translation of AOSLO imaging.
Collapse
Affiliation(s)
- Alexander E Salmon
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Robert F Cooper
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA ; Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA, USA
| | - Christopher S Langlo
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ahmadreza Baghaie
- Department of Electrical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Alfredo Dubra
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA ; Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA ; Current affiliation: Department of Ophthalmology, Stanford University, 2452 Watson Court, Palo Alto, CA, USA
| | - Joseph Carroll
- Department of Cell Biology, Neurobiology, & Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA ; Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
50
|
Dong ZM, Wollstein G, Wang B, Schuman JS. Adaptive optics optical coherence tomography in glaucoma. Prog Retin Eye Res 2017; 57:76-88. [PMID: 27916682 PMCID: PMC5350038 DOI: 10.1016/j.preteyeres.2016.11.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/14/2016] [Accepted: 11/19/2016] [Indexed: 02/07/2023]
Abstract
Since the introduction of commercial optical coherence tomography (OCT) systems, the ophthalmic imaging modality has rapidly expanded and it has since changed the paradigm of visualization of the retina and revolutionized the management and diagnosis of neuro-retinal diseases, including glaucoma. OCT remains a dynamic and evolving imaging modality, growing from time-domain OCT to the improved spectral-domain OCT, adapting novel image analysis and processing methods, and onto the newer swept-source OCT and the implementation of adaptive optics (AO) into OCT. The incorporation of AO into ophthalmic imaging modalities has enhanced OCT by improving image resolution and quality, particularly in the posterior segment of the eye. Although OCT previously captured in-vivo cross-sectional images with unparalleled high resolution in the axial direction, monochromatic aberrations of the eye limit transverse or lateral resolution to about 15-20 μm and reduce overall image quality. In pairing AO technology with OCT, it is now possible to obtain diffraction-limited resolution images of the optic nerve head and retina in three-dimensions, increasing resolution down to a theoretical 3 μm3. It is now possible to visualize discrete structures within the posterior eye, such as photoreceptors, retinal nerve fiber layer bundles, the lamina cribrosa, and other structures relevant to glaucoma. Despite its limitations and barriers to widespread commercialization, the expanding role of AO in OCT is propelling this technology into clinical trials and onto becoming an invaluable modality in the clinician's arsenal.
Collapse
Affiliation(s)
- Zachary M Dong
- University of Pittsburgh Medical Center (UPMC) Eye Center, Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Ophthalmology and Visual Science Research Center, Pittsburgh, PA, United States.
| | - Gadi Wollstein
- New York University (NYU) Langone Eye Center, NYU Langone Medical Center, Department of Ophthalmology, NYU School of Medicine, New York, NY, United States.
| | - Bo Wang
- University of Pittsburgh Medical Center (UPMC) Eye Center, Eye and Ear Institute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Ophthalmology and Visual Science Research Center, Pittsburgh, PA, United States.
| | - Joel S Schuman
- New York University (NYU) Langone Eye Center, NYU Langone Medical Center, Department of Ophthalmology, NYU School of Medicine, New York, NY, United States; Department of Electrical and Computer Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States.
| |
Collapse
|