1
|
Yucel Gencoglu A, Irkec M, Kocabeyoglu S, Dikmen ZG, Karakaya J, Konstas AGP. Plasma levels of sirtuin and adiponectin in patients with primary open-angle glaucoma, exfoliative glaucoma, and healthy controls. Eur J Ophthalmol 2021; 32:2893-2898. [PMID: 34878321 DOI: 10.1177/11206721211065216] [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: 11/17/2022]
Abstract
PURPOSE To compare plasma levels of sirtuin 1 (SIRT1) and adiponectin (APN) in patients with primary open-angle glaucoma (POAG), exfoliative glaucoma (XFG), and healthy control subjects. METHODS This prospective case-control study collected plasma samples from 118 participants. All subjects underwent a comprehensive ophthalmologic examination before the acquisition of a plasma sample. Plasma samples were obtained from 40 POAG, 38 XFG, and 40 healthy control subjects without any evidence of systemic or ocular disease. Serum SIRT1 and APN levels were estimated by an enzyme-linked immunosorbent assay, ELISA (Elabscience, Houston, USA) method. Statistical analysis of results relied on Kolmogorov-Smirnov, Kruskal-Wallis, Chi-square, analysis of variance (ANOVA) tests, and linear regression analysis, where appropriate. RESULTS A significant decrease in SIRT1 levels was observed in POAG patients compared to healthy controls (p = 0.004, Dunn's test). In contrast, no difference was detected between XFG and POAG patients or healthy controls (p = 0.32 and p = 0.34, respectively, Dunn's test). There was no significant difference in plasma APN levels between the three groups under investigation (p = 0.59, ANOVA). CONCLUSION Alterations in serum level of SIRT1 may suggest a possible role in POAG via potential effects in neuroprotection and oxidative stress.
Collapse
Affiliation(s)
- Aysun Yucel Gencoglu
- Department of Ophthalmology, 64005University of Health Sciences, 64113Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Murat Irkec
- Department of Ophthalmology, 64005Hacettepe University School of Medicine, Ankara, Turkey
| | - Sibel Kocabeyoglu
- Department of Ophthalmology, 64005Hacettepe University School of Medicine, Ankara, Turkey
| | - Z Gunnur Dikmen
- Department of Biochemistry, 64005Hacettepe University School of Medicine, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, 64005Hacettepe University School of Medicine, Ankara, Turkey
| | | |
Collapse
|
2
|
Mansour AM, Konstas AGP, Mansour HA, Charbaji AR, El Jawhari KM. A Case-Cohort Study of Exfoliation Risk Factors and Literature Review. Middle East Afr J Ophthalmol 2021; 28:36-50. [PMID: 34321821 PMCID: PMC8270020 DOI: 10.4103/meajo.meajo_358_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 02/08/2021] [Accepted: 02/16/2021] [Indexed: 12/27/2022] Open
Abstract
The purpose of the study is to evaluate the risk factors associated with exfoliation in a case-cohort setting and literature review. This single-center, prospective, case-cohort study was carried out from January 2010 to April 2020 on patients operated for cataract surgery by a single surgeon in Lebanon. Forty-nine consecutive patients with exfoliation syndrome (XFS) and 62 consecutive control patients were identified and further investigated for selected systemic (diabetes mellitus, systemic hypertension, asthma, or atopy) and ocular variables (baseline vision, severity of nuclear sclerosis, glaucoma, eye rubbing, history of dry eye, or allergic eye disease). The mean baseline Snellen visual acuity was 20/283 in XFS versus 20/145 in control cases (P = 0.012). XFS also demonstrated significantly denser nuclear sclerosis than controls (P = 0.00958). By univariate analysis, allergic conjunctivitis (15 [30.6%] vs. 2 [3.2%]; P < 0.001), dry eye (20 [40.8%] vs. 13 [21.0%]; P = 0.0133), and habitual rubbing of the eyes (33 [67.3%] vs. 19 [30.6%]; P < 0.001) were associated with the presence of XFS. Habitual ocular rubbing was closely associated with allergic conjunctivitis (odds ratio [OR] = 13.0; 95% confidence interval [CI]: 2.8–58.8; P = 0.032). After multivariable analysis, the following variables showed significant results: glaucoma (OR = 34.5; 95% CI: 4.4–250; P = 0.010), duration of surgery (OR = 5.6; 95% CI 2.43–12.9; P < 0.001), and habitual ocular rubbing (OR = 4.42; 95% CI: 1.97–9.90; P = 0.029). This study shows a novel potential correlation between eye rubbing and XFS in a Lebanese cohort. Chronic eye rubbing induces or may exacerbate preexistent zonular damage in subjects with XFS, hence the need to better manage concurrent ocular surface disorder in these patients.
Collapse
Affiliation(s)
- Ahmad M Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.,Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon
| | | | - Hana A Mansour
- Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
| | - Abdul R Charbaji
- Department of Statistics and Research Methodology, Lebanese American University, Beirut, Lebanon.,Department of Statistics and Research Methodology, Lebanese University, Beirut, Lebanon
| | | |
Collapse
|
3
|
Li Z, Wang Z, Lee MC, Zenkel M, Peh E, Ozaki M, Topouzis F, Nakano S, Chan A, Chen S, Williams SEI, Orr A, Nakano M, Kobakhidze N, Zarnowski T, Popa-Cherecheanu A, Mizoguchi T, Manabe SI, Hayashi K, Kazama S, Inoue K, Mori Y, Miyata K, Sugiyama K, Higashide T, Chihara E, Ideta R, Ishiko S, Yoshida A, Tokumo K, Kiuchi Y, Ohashi T, Sakurai T, Sugimoto T, Chuman H, Aihara M, Inatani M, Mori K, Ikeda Y, Ueno M, Gaston D, Rafuse P, Shuba L, Saunders J, Nicolela M, Chichua G, Tabagari S, Founti P, Sim KS, Meah WY, Soo HM, Chen XY, Chatzikyriakidou A, Keskini C, Pappas T, Anastasopoulos E, Lambropoulos A, Panagiotou ES, Mikropoulos DG, Kosior-Jarecka E, Cheong A, Li Y, Lukasik U, Nongpiur ME, Husain R, Perera SA, Álvarez L, García M, González-Iglesias H, Fernández-Vega Cueto A, Fernández-Vega Cueto L, Martinón-Torres F, Salas A, Oguz Ç, Tamcelik N, Atalay E, Batu B, Irkec M, Aktas D, Kasim B, Astakhov YS, Astakhov SY, Akopov EL, Giessl A, Mardin C, Hellerbrand C, Cooke Bailey JN, Igo RP, Haines JL, Edward DP, Heegaard S, Davila S, Tan P, Kang JH, Pasquale LR, Kruse FE, Reis A, Carmichael TR, Hauser M, Ramsay M, Mossböck G, Yildirim N, Tashiro K, Konstas AGP, Coca-Prados M, Foo JN, Kinoshita S, Sotozono C, Kubota T, Dubina M, Ritch R, Wiggs JL, Pasutto F, Schlötzer-Schrehardt U, Ho YS, Aung T, Tam WL, Khor CC. Association of Rare CYP39A1 Variants With Exfoliation Syndrome Involving the Anterior Chamber of the Eye. JAMA 2021; 325:753-764. [PMID: 33620406 PMCID: PMC7903258 DOI: 10.1001/jama.2021.0507] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Exfoliation syndrome is a systemic disorder characterized by progressive accumulation of abnormal fibrillar protein aggregates manifesting clinically in the anterior chamber of the eye. This disorder is the most commonly known cause of glaucoma and a major cause of irreversible blindness. OBJECTIVE To determine if exfoliation syndrome is associated with rare, protein-changing variants predicted to impair protein function. DESIGN, SETTING, AND PARTICIPANTS A 2-stage, case-control, whole-exome sequencing association study with a discovery cohort and 2 independently ascertained validation cohorts. Study participants from 14 countries were enrolled between February 1999 and December 2019. The date of last clinical follow-up was December 2019. Affected individuals had exfoliation material on anterior segment structures of at least 1 eye as visualized by slit lamp examination. Unaffected individuals had no signs of exfoliation syndrome. EXPOSURES Rare, coding-sequence genetic variants predicted to be damaging by bioinformatic algorithms trained to recognize alterations that impair protein function. MAIN OUTCOMES AND MEASURES The primary outcome was the presence of exfoliation syndrome. Exome-wide significance for detected variants was defined as P < 2.5 × 10-6. The secondary outcomes included biochemical enzymatic assays and gene expression analyses. RESULTS The discovery cohort included 4028 participants with exfoliation syndrome (median age, 78 years [interquartile range, 73-83 years]; 2377 [59.0%] women) and 5638 participants without exfoliation syndrome (median age, 72 years [interquartile range, 65-78 years]; 3159 [56.0%] women). In the discovery cohort, persons with exfoliation syndrome, compared with those without exfoliation syndrome, were significantly more likely to carry damaging CYP39A1 variants (1.3% vs 0.30%, respectively; odds ratio, 3.55 [95% CI, 2.07-6.10]; P = 6.1 × 10-7). This outcome was validated in 2 independent cohorts. The first validation cohort included 2337 individuals with exfoliation syndrome (median age, 74 years; 1132 women; n = 1934 with demographic data) and 2813 individuals without exfoliation syndrome (median age, 72 years; 1287 women; n = 2421 with demographic data). The second validation cohort included 1663 individuals with exfoliation syndrome (median age, 75 years; 587 women; n = 1064 with demographic data) and 3962 individuals without exfoliation syndrome (median age, 74 years; 951 women; n = 1555 with demographic data). Of the individuals from both validation cohorts, 5.2% with exfoliation syndrome carried CYP39A1 damaging alleles vs 3.1% without exfoliation syndrome (odds ratio, 1.82 [95% CI, 1.47-2.26]; P < .001). Biochemical assays classified 34 of 42 damaging CYP39A1 alleles as functionally deficient (median reduction in enzymatic activity compared with wild-type CYP39A1, 94.4% [interquartile range, 78.7%-98.2%] for the 34 deficient variants). CYP39A1 transcript expression was 47% lower (95% CI, 30%-64% lower; P < .001) in ciliary body tissues from individuals with exfoliation syndrome compared with individuals without exfoliation syndrome. CONCLUSIONS AND RELEVANCE In this whole-exome sequencing case-control study, presence of exfoliation syndrome was significantly associated with carriage of functionally deficient CYP39A1 sequence variants. Further research is needed to understand the clinical implications of these findings.
Collapse
Affiliation(s)
| | - Zheng Li
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Zhenxun Wang
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Mei Chin Lee
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Matthias Zenkel
- Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Esther Peh
- Bioprocessing Technology Institute, Agency for Science, Technology and Research, Singapore
| | | | - Fotis Topouzis
- First Department of Ophthalmology, Faculty of Health Sciences, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
- iScreen Research Team, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Satoko Nakano
- Department of Ophthalmology, Faculty of Medicine, Oita University, Oita, Japan
| | - Anita Chan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| | - Shuwen Chen
- Bioprocessing Technology Institute, Agency for Science, Technology and Research, Singapore
| | - Susan E I Williams
- Division of Ophthalmology, Department of Neurosciences, University of Witwatersrand, Johannesburg, South Africa
| | - Andrew Orr
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Masakazu Nakano
- Department of Genomic Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Tomasz Zarnowski
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University, Lublin, Poland
| | - Alina Popa-Cherecheanu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- Department of Ophthalmology, University Emergency Hospital, Bucharest, Romania
| | | | | | | | | | | | | | | | - Kazuhisa Sugiyama
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Tomomi Higashide
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | | | | | - Satoshi Ishiko
- Department of Medicine and Engineering Combined Research Institute, Asahikawa Medical University, Asahikawa, Japan
| | - Akitoshi Yoshida
- Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan
| | - Kana Tokumo
- Department of Ophthalmology and Visual Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Sciences, Hiroshima University, Hiroshima, Japan
| | | | | | - Takako Sugimoto
- Department of Ophthalmology, Miyazaki Medical College Hospital, Miyazaki, Japan
| | - Hideki Chuman
- Department of Ophthalmology, Miyazaki Medical College Hospital, Miyazaki, Japan
| | - Makoto Aihara
- Department of Ophthalmology, University of Tokyo, Tokyo, Japan
| | - Masaru Inatani
- Department of Ophthalmology, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Kazuhiko Mori
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoko Ikeda
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Morio Ueno
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Daniel Gaston
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Paul Rafuse
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lesya Shuba
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Joseph Saunders
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marcelo Nicolela
- Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | - Panayiota Founti
- First Department of Ophthalmology, Faculty of Health Sciences, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
- Glaucoma Unit, Moorfields Eye Hospital NHS Foundation Trust, London, England
| | - Kar Seng Sim
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Wee Yang Meah
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Hui Meng Soo
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Xiao Yin Chen
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Anthi Chatzikyriakidou
- Laboratory of Medical Biology-Genetics, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Christina Keskini
- First Department of Ophthalmology, Faculty of Health Sciences, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Theofanis Pappas
- First Department of Ophthalmology, Faculty of Health Sciences, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Eleftherios Anastasopoulos
- First Department of Ophthalmology, Faculty of Health Sciences, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Alexandros Lambropoulos
- Laboratory of Medical Biology-Genetics, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Evangelia S Panagiotou
- First Department of Ophthalmology, Faculty of Health Sciences, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Dimitrios G Mikropoulos
- First Department of Ophthalmology, Faculty of Health Sciences, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Ewa Kosior-Jarecka
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University, Lublin, Poland
| | - Augustine Cheong
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
| | - Yuanhan Li
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Urszula Lukasik
- Department of Diagnostics and Microsurgery of Glaucoma, Medical University, Lublin, Poland
| | - Monisha E Nongpiur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| | - Rahat Husain
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Shamira A Perera
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Lydia Álvarez
- Fernández-Vega University Institute and Foundation of Ophthalmological Research, University of Oviedo, Oviedo, Spain
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
| | - Montserrat García
- Fernández-Vega University Institute and Foundation of Ophthalmological Research, University of Oviedo, Oviedo, Spain
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
| | - Héctor González-Iglesias
- Fernández-Vega University Institute and Foundation of Ophthalmological Research, University of Oviedo, Oviedo, Spain
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
| | - Andrés Fernández-Vega Cueto
- Fernández-Vega University Institute and Foundation of Ophthalmological Research, University of Oviedo, Oviedo, Spain
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
| | - Luis Fernández-Vega Cueto
- Fernández-Vega University Institute and Foundation of Ophthalmological Research, University of Oviedo, Oviedo, Spain
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
| | - Federico Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago and GENVIP Research Group, Instituto de Investigación Sanitaria, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Antonio Salas
- Unidade de Xenética, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigación Sanitaria, Hospital Clínico Universitario de Santiago, Galicia, Spain
| | - Çilingir Oguz
- Department of Genetics, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Nevbahar Tamcelik
- Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Eray Atalay
- Department of Ophthalmology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Bilge Batu
- Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Murat Irkec
- Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Dilek Aktas
- DAMAGEN Genetic Diagnostic Center, Ankara, Turkey
| | - Burcu Kasim
- Department of Ophthalmology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Yury S Astakhov
- Department of Ophthalmology, Pavlov First Saint Petersburg State Medical University, St Petersburg, Russia
| | - Sergei Y Astakhov
- Department of Ophthalmology, Pavlov First Saint Petersburg State Medical University, St Petersburg, Russia
| | - Eugeny L Akopov
- Department of Ophthalmology, Pavlov First Saint Petersburg State Medical University, St Petersburg, Russia
| | - Andreas Giessl
- Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Christian Mardin
- Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Claus Hellerbrand
- Institute of Biochemistry, Emil-Fischer-Zentrum, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Jessica N Cooke Bailey
- Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Robert P Igo
- Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Jonathan L Haines
- Institute for Computational Biology, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Deepak P Edward
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Department of Ophthalmology and Visual Sciences, University of Illinois College of Medicine, Chicago
| | - Steffen Heegaard
- Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Eye Pathology Section, Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Sonia Davila
- SingHealth Duke-NUS Institute of Precision Medicine, Singapore
- Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore
| | - Patrick Tan
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
- SingHealth Duke-NUS Institute of Precision Medicine, Singapore
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
| | - Jae H Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Friedrich E Kruse
- Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - André Reis
- Institute of Human Genetics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Trevor R Carmichael
- Division of Ophthalmology, Department of Neurosciences, University of Witwatersrand, Johannesburg, South Africa
| | - Michael Hauser
- Department of Medicine, Duke University, Durham, North Carolina
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Michele Ramsay
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Georg Mossböck
- Department of Ophthalmology, Medical University Graz, Graz, Austria
| | - Nilgun Yildirim
- Department of Ophthalmology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Kei Tashiro
- Department of Genomic Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Anastasios G P Konstas
- First and Third Departments of Ophthalmology, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Miguel Coca-Prados
- Fernández-Vega University Institute and Foundation of Ophthalmological Research, University of Oviedo, Oviedo, Spain
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
- Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, Connecticut
| | - Jia Nee Foo
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Shigeru Kinoshita
- Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toshiaki Kubota
- Department of Ophthalmology, Faculty of Medicine, Oita University, Oita, Japan
| | - Michael Dubina
- State Research Institute of Highly Pure Biopreparations FMBA Russia, St Petersburg, Russia
| | - Robert Ritch
- Einhorn Clinical Research Center, New York Eye and Ear Infirmary of Mount Sinai, New York, New York
| | - Janey L Wiggs
- Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston
| | - Francesca Pasutto
- Institute of Human Genetics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Ursula Schlötzer-Schrehardt
- Department of Ophthalmology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ying Swan Ho
- Bioprocessing Technology Institute, Agency for Science, Technology and Research, Singapore
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wai Leong Tam
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
- Nanyang Technological University School of Biological Sciences, Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chiea Chuen Khor
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| |
Collapse
|
4
|
Quaranta L, Bruttini C, Micheletti E, Konstas AGP, Michelessi M, Oddone F, Katsanos A, Sbardella D, De Angelis G, Riva I. Glaucoma and neuroinflammation: An overview. Surv Ophthalmol 2021; 66:693-713. [PMID: 33582161 DOI: 10.1016/j.survophthal.2021.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [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: 05/10/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 12/13/2022]
Abstract
Glaucoma is an optic neuropathy characterized by well-defined optic disc morphological changes (i.e., cup enlargement, neuroretinal border thinning, and notching, papillary vessel modifications) consequent to retinal ganglion cell loss, axonal degeneration, and lamina cribrosa remodeling. These modifications tend to be progressive and are the main cause of functional damage in glaucoma. Despite the latest findings about the pathophysiology of the disease, the exact trigger mechanisms and the mechanism of degeneration of retinal ganglion cells and their axons have not been completely elucidated. Neuroinflammation may play a role in both the development and the progression of the disease as a result of its effects on retinal environment and retinal ganglion cells. We summarize the latest findings about neuroinflammation in glaucoma and examine the connection between risk factors, neuroinflammation, and retinal ganglion cell degeneration.
Collapse
Affiliation(s)
- Luciano Quaranta
- Department of Surgical & Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, University of Pavia - IRCCS Fondazione Policlinico San Matteo, Pavia, Italy.
| | - Carlo Bruttini
- Department of Surgical & Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, University of Pavia - IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Eleonora Micheletti
- Department of Surgical & Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, University of Pavia - IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Anastasios G P Konstas
- 1st and 3rd University Departments of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Andreas Katsanos
- Department of Ophthalmology, University of Ioannina, Ioannina, Greece
| | | | - Giovanni De Angelis
- Department of Surgical & Clinical, Diagnostic and Pediatric Sciences, Section of Ophthalmology, University of Pavia - IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | | |
Collapse
|
5
|
Holló G, Katsanos A, Boboridis KG, Irkec M, Konstas AGP. Preservative-Free Prostaglandin Analogs and Prostaglandin/Timolol Fixed Combinations in the Treatment of Glaucoma: Efficacy, Safety and Potential Advantages. Drugs 2018; 78:39-64. [PMID: 29196953 DOI: 10.1007/s40265-017-0843-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Glaucoma therapy-related ocular surface disease (OSD) is a serious pathology with a broad spectrum of insidious clinical presentations and complex pathogenesis that undermines long-term glaucoma care. Preservatives, especially benzalkonium chloride (BAK), contained in topical intraocular pressure-lowering medications frequently cause or aggravate OSD in glaucoma. Management of these patients is challenging, and to date often empirical due to the scarcity of controlled long-term clinical trials. Most of the available data are extracted from case series and retrospective analysis. Preservative-free prostaglandins and prostaglandin/timolol fixed combinations are novel options developed to remove the harmful impact of preservatives, especially BAK, upon ocular tissues. Based on what is currently known on the value of preservative-free antiglaucoma therapies it is tempting to speculate how these new therapies may affect the future medical management of all glaucoma patients. This article provides a comprehensive and critical review of the current literature on preservative-free prostaglandins and preservative-free prostaglandin/timolol fixed combinations.
Collapse
Affiliation(s)
- Gábor Holló
- Department of Ophthalmology, Semmelweis University, Maria u. 39, Budapest, 1085, Hungary.
| | - Andreas Katsanos
- Ophthalmology Department, University of Ioannina, Ioannina, Greece
| | - Kostas G Boboridis
- Third Ophthalmology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Murat Irkec
- Department of Ophthalmology, Faculty of Ophthalmology, Hacettepe University, Ankara, Turkey
| | - Anastasios G P Konstas
- 1st University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.,3rd University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
6
|
Abstract
INTRODUCTION Ocular surface disease (OSD) is a highly prevalent symptomatic condition caused by dry eye disease (DED), intrinsic, environmental, or iatrogenic causes. It affects patient's visual function and quality of life. Its pathophysiology is centered on tear hyperosmolarity, inflammation, and epithelial damage. Current management is suboptimal and includes artificial tear supplementation and short-term use of topical steroids in severe cases. The recent approval of cyclosporine 0.1% has transformed management strategies of severe DED and moderate-to-severe OSD. Areas covered: This review summarizes existing information on the efficacy, safety, and tolerability of the new cyclosporine 0.1% formulation. Expert opinion: Topical cyclosporine A 0.1% represents a promising, novel medication for the management of DED, Meibomian gland dysfunction, and inflammatory OSD. It is primarily beneficial for those patients requiring topical immunomodulatory therapy. This topical formulation also has the potential to meaningfully improve the management of moderate-to-severe glaucoma therapy-related OSD. Currently there is limited published clinical data concerning the efficacy of topical cyclosporine. There are, however, theoretical advantages when comparing this cyclosporine formulation with other established commercial preparations. Future research is needed to delineate the precise role and value of this medication.
Collapse
Affiliation(s)
- Konstadinos G Boboridis
- a 1st and 3rd University Departments of Ophthalmology , Aristotle University , Thessaloniki , Greece
| | - Anastasios G P Konstas
- a 1st and 3rd University Departments of Ophthalmology , Aristotle University , Thessaloniki , Greece
| |
Collapse
|
7
|
Katsanos A, Gorgoli K, Mikropoulos DG, Arranz-Marquez E, Athanasopoulos GP, Teus MA, Konstas AGP. Assessing the role of ranibizumab in improving the outcome of glaucoma filtering surgery and neovascular glaucoma. Expert Opin Biol Ther 2018; 18:719-724. [PMID: 29781319 DOI: 10.1080/14712598.2018.1479395] [Citation(s) in RCA: 2] [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: 10/16/2022]
Abstract
INTRODUCTION Ranibizumab was the first anti-vascular endothelial growth factor (VEGF) agent approved for the treatment of neovascular age-related macular degeneration. The use of ranibizumab and other anti-VEGF medications in recent years has revolutionized the treatment of several sight-threatening retinal disorders. Emerging evidence has demonstrated that anti-VEGF treatment can offer advantages in the management of other ocular conditions where VEGFs play a key role: ocular scarring following glaucoma filtering surgery and neovascular glaucoma (NVG). Areas covered: We critically review available evidence on the use of ranibizumab as a wound healing modulator in glaucoma filtering surgery and as an adjunct in the management of NVG. Expert opinion: Based on the available evidence and the authors' clinical experience, ranibizumab is a valuable adjunct in the management of NVG. In glaucoma filtering surgery, however, the role of ranibizumab is less clear and does not provide a significant advantage over mitomycin C. Drawbacks for its use in glaucoma include cost, its off-label use, uncertainty and limited evidence on the various routes of administration, the optimal dosing schemes and its toxicity profile. Future advances in ranibizumab delivery systems allowing less frequent dosing may change this treatment paradigm.
Collapse
Affiliation(s)
- Andreas Katsanos
- a Ophthalmology Department , University of Ioannina , Ioannina , Greece
| | - Kostantina Gorgoli
- b Sussex Eye Hospital , Brighton and Sussex University Hospitals NHS Trust , Brighton , UK
| | | | - Esther Arranz-Marquez
- d Clínica Novovisión , Madrid , Spain.,e Ophthalmology Department , Rey Juan Carlos Universitary Hospital , Móstoles, Madrid , Spain
| | | | - Miguel A Teus
- d Clínica Novovisión , Madrid , Spain.,g Department of Ophthalmology , Hospital Universitario "Principe de Asturias", University of Alcalá , Alcalá de Henares , Spain
| | - Anastasios G P Konstas
- c 3rd University Department of Ophthalmology , AHEPA Hospital , Thessaloniki , Greece.,f 1st University Department of Ophthalmology , Aristotle University , Thessaloniki , Greece
| |
Collapse
|
8
|
Konstas AGP, Hollo G, Astakhov YS, Teus MA, Akopov EL, Jenkins JN, Stewart WC. Presentation and Long-Term follow-up of Exfoliation Glaucoma in Greece, Spain, Russia, and Hungary. Eur J Ophthalmol 2018; 16:60-6. [PMID: 16496247 DOI: 10.1177/112067210601600111] [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] [Indexed: 11/17/2022]
Abstract
Purpose To evaluate clinical presentation and long-term follow-up of exfoliation glaucoma in separate European population groups. Methods A four-center, retrospective, case series analysis in which 200 charts of patients with exfoliation glaucoma or patients with elevated intraocular pressure (IOP) associated with exfoliation syndrome in at least one eye with at least 5 years of follow-up were consecutively reviewed. Results This study found an average follow-up time of 6.0±2.1 years. Patients in Hungary and Spain statistically presented at an older age (79 years) than Greek patients (67 years). Patients with exfoliation glaucoma in Greece and Hungary had more glaucomatous damage, had more severe glaucoma, had a higher untreated IOP (31.8 to 32.1 mmHg), and were more difficult to control, showing a greater number of changes in medicines during the follow-up period, a greater number of medicines at the end of the follow-up period, and more progression. On long-term follow-up, Greek, Russian, and Hungarian patients also had the highest mean IOP (18.8 to 20.8 mmHg) and the greatest incidence of progression (approximately 50%). Spanish patients demonstrated the lowest mean IOP (17.6±3.6 mmHg) and the lowest rate of progression (28%) during the follow-up period and the fewest number of medications per patient (0.7) to control the IOP at the end of the follow-up period. Conclusions The severity of exfoliation glaucoma presentation and its course may differ within distinct geographic populations in Europe.
Collapse
Affiliation(s)
- A G P Konstas
- University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | | | | | | | | | | | | |
Collapse
|
9
|
Quaranta L, Riva I, Gerardi C, Oddone F, Floriani I, Konstas AGP. Erratum to: Quality of Life in Glaucoma: A Review of the Literature. Adv Ther 2016; 33:982. [PMID: 27167620 PMCID: PMC4920837 DOI: 10.1007/s12325-016-0342-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Luciano Quaranta
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
| | - Ivano Riva
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Chiara Gerardi
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | - Irene Floriani
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Anastasios G P Konstas
- 1st and 3rd University Departments of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
10
|
Abstract
The ultimate goal of glaucoma management is the preservation of patients’ visual function and quality of life (QoL). The disease itself as well as the medical or surgical treatment can have an enormous impact on a patient’s QoL. Even the mere diagnosis of a chronic, irreversible, potentially blinding disorder can adversely affect the patient’s sense of well-being and QoL by eliciting significant anxiety. Patients with primary open-angle glaucoma rarely present with visual symptoms, at least early in the course of the disease. A better understanding of patient-reported QoL can improve patient–physician interaction and enhance treatment adherence by customizing treatment options based on individual patient profile, thus optimizing long-term prognosis. These aspects are summarized and critically appraised in this article.
Collapse
Affiliation(s)
- Luciano Quaranta
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
| | - Ivano Riva
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Chiara Gerardi
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | - Irene Floriani
- IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Anastasios G P Konstas
- 1st and 3rd University Departments of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
11
|
Konstas AGP, Holló G. Preservative-free tafluprost/timolol fixed combination: a new opportunity in the treatment of glaucoma. Expert Opin Pharmacother 2016; 17:1271-83. [DOI: 10.1080/14656566.2016.1182983] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
12
|
Konstas AGP, Quaranta L, Bozkurt B, Katsanos A, Garcia-Feijoo J, Rossetti L, Shaarawy T, Pfeiffer N, Miglior S. 24-h Efficacy of Glaucoma Treatment Options. Adv Ther 2016; 33:481-517. [PMID: 26909513 PMCID: PMC4846688 DOI: 10.1007/s12325-016-0302-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Indexed: 11/28/2022]
Abstract
Current management of glaucoma entails the medical, laser, or surgical reduction of intraocular pressure (IOP) to a predetermined level of target IOP, which is commensurate with either stability or delayed progression of visual loss. In the published literature, the hypothesis is often made that IOP control implies a single IOP measurement over time. Although the follow-up of glaucoma patients with single IOP measurements is quick and convenient, such measurements often do not adequately reflect the untreated IOP characteristics, or indeed the quality of treated IOP control during the 24-h cycle. Since glaucoma is a 24-h disease and the damaging effect of elevated IOP is continuous, it is logical that we should aim to understand the efficacy of all treatment options throughout the 24-h period. This article first reviews the concept and value of diurnal and 24-h IOP monitoring. It then critically evaluates selected available evidence on the 24-h efficacy of medical, laser and surgical therapy options. During the past decade several controlled trials have significantly enhanced our understanding on the 24-h efficacy of all glaucoma therapy options. Nevertheless, more long-term evidence is needed to better evaluate the 24-h efficacy of glaucoma therapy and the precise impact of IOP characteristics on glaucomatous progression and visual prognosis.
Collapse
Affiliation(s)
- Anastasios G P Konstas
- 1st University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
- 3rd University Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | | | - Banu Bozkurt
- Department of Ophthalmology, Selcuk University, Konya, Turkey
| | - Andreas Katsanos
- Department of Ophthalmology, University of Ioannina, Ioannina, Greece
| | | | - Luca Rossetti
- Eye Clinic, San Paolo Hospital, University of Milan, Milan, Italy
| | - Tarek Shaarawy
- Glaucoma Sector, University of Geneva, Geneva, Switzerland
| | | | - Stefano Miglior
- Department of Ophthalmology, University Bicocca of Milan, Milan, Italy
| |
Collapse
|
13
|
Tranos PG, Stavrakas P, Vakalis AN, Asteriadis S, Lokovitis E, Konstas AGP. Persistent Subretinal Fluid After Successful Full-Thickness Macular Hole Surgery: Prognostic Factors, Morphological Features and Implications on Functional Recovery. Adv Ther 2015; 32:705-14. [PMID: 26183390 DOI: 10.1007/s12325-015-0227-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 05/11/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The present study aimed to identify preoperative factors that predispose the development of subretinal fluid (SRF) following successful macular hole (MH) surgery. METHODS Thirty-four eyes of 33 consecutive patients that underwent pars plana vitrectomy for idiopathic full-thickness MH surgery were included in this retrospective study. Best corrected visual acuity (BCVA), and spectral domain-optical coherence tomography (OCT) images were evaluated pre- and postoperatively in all cases. Patient's demographic characteristics, stage of MH, measurements of base diameter and minimum aperture diameter of the MH, preoperative foveal vitreomacular traction and selected intra-operative parameters were correlated with the development of postoperative SRF. RESULTS Postoperative SRF was observed in 15 cases (48%). Total absorption of SRF was observed in 73% of affected eyes and was most commonly seen between the third and the fifth postoperative month. One patient developed lamellar hole leading to full-thickness MH. Postoperative BCVA was similar between the eyes that did and the eyes that did not develop postoperative SRF (0.31 ± 0.2 vs 0.35 ± 0.2; p ≥ 0.05). Development of postoperative SRF was significantly associated with the presence of preoperative foveal vitreomacular traction (p = 0.048), stage II MH (p = 0.017) and smaller size of the closest distance between the MH edges (p = 0.046). CONCLUSIONS Postoperative SRF is a common occurrence following successful MH surgery. Meticulous evaluation of preoperative clinical and OCT findings may disclose risk factors associated with this condition. Based on our observations, idiopathic holes of early stage appear to be at a higher risk of developing postoperative SRF. This could be a point of interest with the advancing use of enzymatic proteolysis.
Collapse
|
14
|
Quaranta L, Riva I, Katsanos A, Floriani I, Centofanti M, Konstas AGP. Safety and efficacy of travoprost solution for the treatment of elevated intraocular pressure. Clin Ophthalmol 2015; 9:633-43. [PMID: 25914522 PMCID: PMC4401333 DOI: 10.2147/opth.s61444] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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] [Indexed: 11/23/2022] Open
Abstract
Travoprost is a prostaglandin analogue widely used for reducing intraocular pressure (IOP) in patients affected with glaucoma and ocular hypertension. It exerts its ocular hypotensive effect through the prostaglandin FP receptors, located in the ciliary muscle and the trabecular meshwork. Several studies have shown that topical administration of travoprost induces a mean IOP reduction ranging from 25% to 32%, and sustained throughout the 24-hour cycle. When compared with timolol, travoprost is more effective at reducing IOP, while generally no difference has been found in the head-to-head comparison with other prostaglandin analogues. The fixed combination of travoprost and timolol has demonstrated a hypotensive efficacy comparable to the concomitant administration of the two drugs. Recently, a new preservative-free formulation of travoprost 0.004% has been marketed for reducing tolerability-related problems in subjects affected with ocular surface disease. Low rates of topical and systemic adverse reactions, strong ocular hypotensive efficacy, and once-a-day dosing make travoprost a first-line treatment for patients affected with elevated IOP.
Collapse
Affiliation(s)
- Luciano Quaranta
- Centre for the Study of Glaucoma, University of Brescia, Brescia, Italy
| | - Ivano Riva
- Centre for the Study of Glaucoma, University of Brescia, Brescia, Italy
| | - Andreas Katsanos
- Ophthalmology Department, University of Ioannina, Ioannina, Greece
| | - Irene Floriani
- Laboratory of Clinical Research, IRCCS, Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | | | - Anastasios G P Konstas
- Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| |
Collapse
|
15
|
Konstas AGP, Voudouragkaki IC, Boboridis KG, Haidich AB, Paschalinou E, Giannopoulos T, Dragoumis ND, Makridis AK, Kahook MY. 24-hour efficacy of travoprost/timolol BAK-free versus latanoprost/timolol fixed combinations in patients insufficiently controlled with latanoprost. Adv Ther 2014; 31:592-603. [PMID: 24919410 DOI: 10.1007/s12325-014-0125-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 04/07/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION To compare the 24-h intraocular pressure (IOP) control and tolerability of travoprost/timolol benzalkonium chloride (BAK)-free (TTFC) vs. latanoprost/timolol fixed combination preserved with BAK (LTFC) in open-angle glaucoma patients insufficiently controlled with latanoprost 0.005% monotherapy given once in the evening. METHODS The authors have conducted a prospective, observer-masked, active-controlled, cross-over, comparison study. Qualified open-angle glaucoma patients who demonstrated a latanoprost-treated morning IOP (10:00 ± 1 h) greater than 20 mmHg on two separate visits were randomized for 3 months to receive either TTFC or LTFC. Patients were then crossed over to the opposite treatment for another 3 months. At the end of the latanoprost run-in and after each 3-month therapy period patients underwent 24-h IOP monitoring in the habitual position using Goldmann applanation tonometry in the sitting position during the day (10:00, 14:00, 18:00 and 22:00) and Perkins tonometry in the supine position at night (02:00 and 06:00). Selected ocular surface parameters were evaluated after each therapy period. RESULTS Forty-two open-angle glaucoma patients completed the study. The mean 24-h baseline IOP on latanoprost was 21.5 ± 1.6 mmHg. Both fixed combinations significantly reduced the IOP at each time point, for the mean, peak and fluctuation of 24-h IOP compared with latanoprost monotherapy (P < 0.01). When the two fixed combinations were compared directly, TTFC provided significantly lower mean 24-h IOP (18.9 ± 2.2 mmHg) vs. LTFC (19.3 ± 2.3 mmHg) (P = 0.004) and significantly lower IOP at 18:00 (18.6 ± 2.5 vs. 19.5 ± 2.7 mmHg for LTFC) (P < 0.001). Further, TTFC demonstrated significantly better tear film break-up time (5.15 vs. 4.65 s), corneal stain (1.5 vs. 1.8) and Schirmer I test (9.9 vs. 9.2 mm) compared with LTFC after 3 months of therapy (P < 0.01 for all comparisons). CONCLUSION The mean 24-h IOP lowering of TTFC was statistically more significant compared to LTFC in patients insufficiently controlled with latanoprost monotherapy. Measurement of ocular surface health and tear film status favored the BAK-free TTFC compared to LTFC.
Collapse
Affiliation(s)
- Anastasios G P Konstas
- 1st University Department of Ophthalmology, Aristotle University of Thessaloniki, 1 Kyriakidi Street, 546 36, Thessaloniki, Greece,
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Quaranta L, Riva I, Mazziotti G, Porcelli T, Floriani I, Katsanos A, Giustina A, Konstas AGP. Elevated intraocular pressure in patients with acromegaly. Graefes Arch Clin Exp Ophthalmol 2014; 252:1133-9. [DOI: 10.1007/s00417-014-2650-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 04/07/2014] [Accepted: 04/13/2014] [Indexed: 01/26/2023] Open
|
17
|
Kymionis GD, Mikropoulos DG, Portaliou DM, Boboridis KG, Voudouragkaki IC, Dragoumis ND, Konstas AGP. New perspectives on lamellar keratoplasty. Adv Ther 2014; 31:494-511. [PMID: 24846543 DOI: 10.1007/s12325-014-0121-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [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: 03/26/2014] [Indexed: 11/28/2022]
Abstract
Lamellar (anterior and posterior) keratoplasty entails the surgical replacement of diseased-only corneal tissue, while healthy host corneal tissue is preserved. Selective keratoplasty offers several advantages in comparison to penetrating keratoplasty such as a lower rate of graft rejection, less endothelial cell loss, faster/superior visual rehabilitation and enhanced resistance to closed injury. The surgical approach of "partial corneal transplantation" may be divided into anterior and posterior: techniques including superficial and deep anterior lamellar keratoplasty (SALK and DALK, respectively) and endothelial keratoplasty as well as Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK). These novel surgical procedures are rapidly becoming the preferred therapy option for specific corneal dysfunctions involving the corneal stroma (SALK, DALK), or corneal endothelium (DSAEK, DMEK). During the past decade, the continuing advancement of surgical techniques and the development of innovative surgical instruments have significantly enhanced corneal transplantation. Lamellar keratoplasty techniques facilitate corneal surgery, provide patients with superior outcomes and can successfully restore vision in corneal-related blindness. Nevertheless, more long-term evidence is needed to better evaluate these promising new techniques.
Collapse
Affiliation(s)
- George D Kymionis
- Vardinoyiannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | | | | | | | | | | | | |
Collapse
|
18
|
Kymionis GD, Mikropoulos DG, Portaliou DM, Voudouragkaki IC, Kozobolis VP, Konstas AGP. An overview of corneal collagen cross-linking (CXL). Adv Ther 2013; 30:858-69. [PMID: 24170589 DOI: 10.1007/s12325-013-0065-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [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: 09/24/2013] [Indexed: 11/27/2022]
Abstract
Corneal collagen cross-linking (CXL) was first described over a decade ago and is now considered to be one of the most important surgical innovations of modern ophthalmology. Prior to its introduction, no interventions were available to arrest, or slow down ectatic disease progression, with corneal transplantation required in the majority of cases. Unlike earlier treatments of corneal ectasias that attempted to only improve the consequences of the disease, CXL aims to address the corneal biomechanical weakening itself. The long-term safety and efficacy of CXL have been established in several studies that have documented significant improvements in all outcome measures (visual acuity, spherical equivalent, astigmatism, and keratometric findings). The emerging combination of CXL with other interventions (termed 'CXL plus') optimizes the visual and topographic outcomes. This, along with the expansion of the techniques' indications for other clinical conditions, such as microbial keratitis, highlights the continuous improvement of the initial technique and confirms its wide acceptance. Overall, CXL has already demonstrated much promise and has several clinical indications, representing a clear example of recent advances in ocular therapy.
Collapse
Affiliation(s)
- George D Kymionis
- Faculty of Medicine, Institute of Vision and Optics, University of Crete, Heraklion, Greece
| | | | | | | | | | | |
Collapse
|
19
|
Konstas AGP, Holló G, Haidich AB, Mikropoulos DG, Giannopoulos T, Voudouragkaki IC, Paschalinou E, Konidaris V, Samples JR. Comparison of 24-Hour Intraocular Pressure Reduction Obtained with Brinzolamide/Timolol or Brimonidine/Timolol Fixed-Combination Adjunctive to Travoprost Therapy. J Ocul Pharmacol Ther 2013; 29:652-7. [DOI: 10.1089/jop.2012.0195] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Gábor Holló
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Anna-Bettina Haidich
- Department of Hygiene, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Theodoros Giannopoulos
- Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | - Irini C. Voudouragkaki
- Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | - Eleni Paschalinou
- Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | - Vassilios Konidaris
- Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | | |
Collapse
|
20
|
Konstas AGP, Quaranta L, Katsanos A, Riva I, Tsai JC, Giannopoulos T, Voudouragkaki IC, Paschalinou E, Floriani I, Haidich AB. Twenty-four hour efficacy with preservative free tafluprost compared with latanoprost in patients with primary open angle glaucoma or ocular hypertension. Br J Ophthalmol 2013; 97:1510-5. [DOI: 10.1136/bjophthalmol-2012-303026] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
21
|
Quaranta L, Katsanos A, Floriani I, Riva I, Russo A, Konstas AGP. Circadian Intraocular Pressure and Blood Pressure Reduction With Timolol 0.5% Solution and Timogel 0.1% in Patients With Primary Open-Angle Glaucoma. J Clin Pharmacol 2013; 52:1552-7. [DOI: 10.1177/0091270011420254] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
22
|
Mikropoulos DG, Mallini P, Michopoulou A, Giannopoulos T, Arranz-Marquez E, Koliakos GG, Konstas AGP. Asymmetric Dimethyloarginin (ADMA) Concentration in the Aqueous Humor of Patients with Exfoliation Syndrome or Exfoliative Glaucoma. Curr Eye Res 2013; 38:266-70. [DOI: 10.3109/02713683.2012.757325] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
23
|
Mocan MC, Irkec M, Mikropoulos DG, Bozkurt B, Orhan M, Konstas AGP. In VivoConfocal Microscopic Evaluation of the Inflammatory Response in Non-epithelial Herpes Simplex Keratitis. Curr Eye Res 2012; 37:1099-106. [DOI: 10.3109/02713683.2012.707270] [Citation(s) in RCA: 26] [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] [Indexed: 11/13/2022]
|
24
|
Abstract
INTRODUCTION Glaucoma is the second leading cause of blindness globally, representing a significant public health concern. More than 60 million people are affected by glaucoma worldwide; as this population ages, the number is expected to increase. Glaucoma is a collection of heterogeneous diseases sharing common clinical characteristics. The goal of treatment is to prevent significant visual dysfunction through reduction of intraocular pressure (IOP). AREAS COVERED This is a review of the current literature about combination therapeutic regimens for the reduction of IOP, focusing on the risk : benefit profile of a fixed-combination therapy using travoprost and timolol. EXPERT OPINION Since the debut of prostaglandin analogues in the 1990s, only modest innovation has occurred in glaucoma pharmacology. A growing body of research has established that the preservative benzalkonium chloride (BAK) might not be the benign contributor expected of excipient ingredients. Thus, BAK-free treatments were developed, with the goal of IOP reduction without furthering ocular surface disease symptoms. The BAK-free travoprost/timolol combination represents an important addition to glaucoma medication options and may fill an unmet need in this therapeutic arena.
Collapse
Affiliation(s)
- Anastasios G P Konstas
- 1st University Department of Ophthalmology, AHEPA Hospital, Glaucoma Unit, Thessaloniki, Greece.
| | | | | |
Collapse
|
25
|
Konstas AGP, Quaranta L, Mikropoulos DG, Nasr MB, Russo A, Jaffee HA, Stewart JA, Stewart WC. Peak intraocular pressure and glaucomatous progression in primary open-angle glaucoma. J Ocul Pharmacol Ther 2011; 28:26-32. [PMID: 22004074 DOI: 10.1089/jop.2011.0081] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To evaluate the effect of 24-h peak intraocular pressure (IOP) on the progression of primary open-angle glaucoma (POAG) and the 24 h time points that best predict peak pressure. METHODS A retrospective analysis of clinical data evaluating long-term glaucomatous progression in patients with POAG who were previously in a 24-h study of the authors (IOP readings at 2/6/10 A.M. and 2/6/10 PM); had ≥3 treated 10 A.M. (±1 h) IOP measurements over 5-years after an untreated 24-h baseline; and had a treated 24-h curve with a 10 A.M. IOP±2 mmHg within the 10 A.M. mean IOP over 5-years. RESULTS We included 98 nonprogressed and 53 progressed patients with POAG (n=151). The mean 24-h peak IOP (mmHg) was 19.9±2.7 for progressed and 18.3±2.0 for nonprogressed patients (P<0.001). Progressed patients also showed a higher mean 24-h IOP. Generally, patients with a mean or peak daytime (readings at 10 A.M., 2 and 6 P.M.) or 24-h peak IOP of ≤18 remained nonprogressed in 75%-78% of cases. Further, measuring IOP at night found a higher peak in only 20% of cases, which was ≤2 of the daytime peak in 98% of cases. A multivariate regression analysis showed only 24-h peak IOP as an independent risk factor for progression (P=0.002). CONCLUSIONS This study suggests that daytime peak IOP may be clinically important in predicting long-term glaucomatous progression. Further, daytime peak IOP may assist, as much as daytime mean IOP and, in most cases, 24-h peak IOP, in helping to guide long-term treatment in POAG.
Collapse
Affiliation(s)
- Anastasios G P Konstas
- Glaucoma Unit, 1st University, Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Konstas AGP, Quaranta L, Yan DB, Mikropoulos DG, Riva I, Gill NK, Barton K, Haidich AB. Twenty-four hour efficacy with the dorzolamide/timolol-fixed combination compared with the brimonidine/timolol-fixed combination in primary open-angle glaucoma. Eye (Lond) 2011; 26:80-7. [PMID: 21960068 DOI: 10.1038/eye.2011.239] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
AIM The aim of this study is to compare the 24-hour efficacy of dorzolamide/timolol-fixed combination (DTFC) and brimonidine/timolol-fixed combination (BTFC) in primary open-angle glaucoma (POAG). METHODS One eye each of 77 POAG patients was included in this prospective, observer-masked, crossover comparison. Following a 2-month timolol run-in period, patients had three intraocular pressure (IOP) measurements at 1000, 1200 and 1400 h while on timolol treatment. Patients showing at least a 20% IOP reduction on timolol were randomised to 3 months of therapy with DTFC or BTFC, and then were crossed over to the opposite therapy. RESULTS Sixty POAG patients completed the study. The mean 24-hour IOP was significantly reduced with both the fixed combinations compared with the timolol-treated diurnal IOP (P < 0.001). When the two fixed combinations were compared directly, DTFC demonstrated a lower mean 24-hour IOP level as compared with BTFC (mean difference: -0.7 mm Hg, 95% confidence interval (CI): (-1.0, -0.3), P < 0.001). At two individual time points, DTFC significantly reduced IOP more than BTFC: at 1800 h (-1.0 mm Hg, 95% CI (-1.6,-0.5), P = 0.001) and at 0200 (-0.9 mm Hg, 95% CI: (-1.4,-0.5), P = 0.001). No significant difference existed for the other time points. CONCLUSION Both the fixed combinations significantly reduce 24-hour IOP in POAG. DTFC provided significantly better 24-hour efficacy.
Collapse
Affiliation(s)
- A G P Konstas
- Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece.
| | | | | | | | | | | | | | | |
Collapse
|
27
|
Abstract
Kaposi's sarcoma is an uncommon endothelial malignant tumor, first described by Moricz Kaposi in 1872. It is commonly encountered in patients with acquired immunodeficiency syndrome (AIDS), immunosuppression or organ transplantation. Conjunctival Kaposi's sarcoma is a rare tumor, mostly in patients with AIDS. We present a selected case with a superior bulbar conjunctival lesion in a patient who is HIV negative and immunocompetent, with an unremarkable general medical history. The lesion was surgically excised with no adjunctive treatment, and histological examination confirmed the diagnosis. There was no recurrence or metastasis 5 years after surgery.
Collapse
Affiliation(s)
- Dimitris Mikropoulos
- First Ophthalmology Department, Aristotle University of Thessaloniki, Thessaloniki, Athens, Greece
| | | | | | | | | |
Collapse
|
28
|
Paliobei VP, Psillas GK, Mikropoulos DG, Haidich AB, Constantinidis J, Konstas AGP. Hearing Evaluation in Patients with Exfoliative and Primary Open-Angle Glaucoma. Otolaryngol Head Neck Surg 2011; 145:125-30. [DOI: 10.1177/0194599811401206] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. The aim of this prospective study was to audiologically evaluate consecutive glaucoma patients with or without exfoliation. Study Design. Prospective study. Setting. Glaucoma Unit and Audiology Department at a university hospital. Subjects and Methods. Consecutive subjects with exfoliative glaucoma (XFG) or primary open-angle glaucoma (POAG) aged between 50 and 70 years were enrolled. Auditory thresholds at 0.5, 1.0, 2.0, 4.0, and 8.0 Hz were measured bilaterally. Cochlear activity was assessed by recording distortion product otoacoustic emissions (DPOEs). Functional changes in the retrocochlear auditory pathway were evaluated by auditory brainstem responses (ABRs). Results. One hundred and ten patients with XFG and 85 patients with POAG who presented in a glaucoma clinic were investigated. The mean age of study patients was 66.2 ± 5.6 years; range, 50-70 years). The odds of pathologic ABR central transmission time (interpeak latencies I-III, III-V, and I-V and waves I, III, and V) were 4.34 times higher in patients with XFG than in patients with POAG (95% confidence interval [CI], 2.22-8.49; P < .001). This significant association remained after adjusting for sex and age (odds ratio [OR] 4.12; 95% CI, 2.07-8.22; P < .001). Furthermore, the odds of ABR remained significantly higher in patients with XFG than in patients with POAG (OR 4.36; 95% CI, 2.10-9.06; P < .001) after controlling for systemic diseases (arterial hypertension, coronary heart disease, high cholesterol, and stroke). Conclusion. In the first study to compare XFG and POAG monitoring of the peripheral and central auditory pathway, it has been documented that XFG patients show a greater prevalence of retrocochlear pathology.
Collapse
Affiliation(s)
| | | | | | - Anna-Bettina Haidich
- Department of Hygiene, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | |
Collapse
|
29
|
Stewart WC, Konstas AGP, Quaranta L, Rossetti L, Garcia-Feijoo J, O'Brien C, Nasr MB, Fogagnolo P, Demos CM, Stewart JA. Response to Weinreb et al. Eye (Lond) 2010. [DOI: 10.1038/eye.2010.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
30
|
Konstas AGP, Mikropoulos DG, Embeslidis TA, Dimopoulos AT, Papanastasiou A, Haidich AB, Stewart WC. 24-h Intraocular pressure control with evening-dosed travoprost/timolol, compared with latanoprost/timolol, fixed combinations in exfoliative glaucoma. Eye (Lond) 2010; 24:1606-13. [DOI: 10.1038/eye.2010.100] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
31
|
Ritch R, Prata TS, de Moraes CGV, Vessani RM, Costa VP, Konstas AGP, Liebmann JM, Schlötzer-Schrehardt U. Association of exfoliation syndrome and central retinal vein occlusion: an ultrastructural analysis. Acta Ophthalmol 2010; 88:91-5. [PMID: 19725816 DOI: 10.1111/j.1755-3768.2009.01578.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE To evaluate prospectively the frequency with which exfoliation syndrome (XFS) occurs in patients with central retinal vein occlusion (CRVO) by clinical examination and ultrastructural examination of conjunctival biopsy specimens. METHODS Prospective observational case series. Thirty-six eyes of 36 consecutive patients with CRVO were investigated for XFS by slit-lamp examination and conjunctival biopsy when XFS was not clinically visible on examination. RESULTS A clinical diagnosis of XFS or a positive biopsy result for exfoliation material (XFM) was present in 22 of the 36 patients (61%; 95% confidence interval 45-75%). Twelve of these 22 patients (54%) had a clinical diagnosis of XFS. Aggregates of XFM were identified ultrastructurally in the biopsy specimens in 10 of 24 patients with no clinical signs of XFS (42%). Patients with and without XFS had similar distribution of age, gender, race and prevalence of systemic disorders. Twelve of the 22 (54%) XFS patients had neither glaucoma nor ocular hypertension prior to the CRVO. CONCLUSION In accordance with previous retrospective and histological studies, this prospective, in vivo study suggests that CRVO is commonly associated with XFS.
Collapse
Affiliation(s)
- Robert Ritch
- Department of Ophthalmology, Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York City 10003, USA.
| | | | | | | | | | | | | | | |
Collapse
|
32
|
Wirtz MK, Samples JR, Toumanidou V, Charlesworth J, Mikropoulos DG, Kaltsos K, Economou A, Dimopoulos A, Georgiadou IN, Moumtzis G, Papanastasiou A, Kramer PL, Dyer T, Blangero J, Konstas AGP. Association of POAG risk factors and the Thr377Met MYOC mutation in an isolated Greek population. Invest Ophthalmol Vis Sci 2010; 51:3055-60. [PMID: 20107173 DOI: 10.1167/iovs.09-4652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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 characterize the MYOC genotype correlation with phenotypes in an isolated Greek population with a high incidence of glaucoma. METHODS Five hundred thirty-one villagers were enrolled in the study. Participants underwent a comprehensive ophthalmic examination. All three exons of myocilin were bidirectionally sequenced. Power calculations and measured genotype analysis was conducted using the genetic variance analysis program, SOLAR version 4.2, to account for the relatedness between individuals. RESULTS The participants, 376 of whom were linked in a single 11-generation pedigree, ranged in age from 10 to 95 years with a mean age of 49. Sixty-five individuals had POAG, and 27 of those carried the Thr377Met MYOC mutation. Both peak intraocular pressure and vertical cup-to dis- ratio were significantly associated with the MYOC Thr377Met variant (P = 9 x 10(-14) and P = 9 x 10(-8), respectively), whereas central corneal thickness showed no significant association (P < 0.7). CONCLUSIONS This village had a high frequency of glaucoma, with 12% of the participants aged 10 to 95 years having the disease. In this cohort, the Thr377Met MYOC mutation was significantly associated with both high intraocular pressures and high vertical cup-to-disc ratios. No association was found with central corneal thickness.
Collapse
Affiliation(s)
- Mary K Wirtz
- Department of Ophthalmology, Casey Eye Institute, Oregon Health and Sciences University, Portland, Oregon, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Quaranta L, Konstas AGP, Rossetti L, Garcia-Feijoo J, O'Brien C, Nasr MB, Fogagnolo P, Demos CM, Stewart JA, Stewart WC. Untreated 24-h intraocular pressures measured with Goldmann applanation tonometry vs nighttime supine pressures with Perkins applanation tonometry. Eye (Lond) 2009; 24:1252-8. [DOI: 10.1038/eye.2009.300] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
|
34
|
Konstas AGP, Pikilidou MI, Tsironi S, Mikropoulos D, Kozobolis VP, Sarafidis PA, Lasaridis AN, Nelson LA, Stewart WC. 24-hour intraocular pressure and blood pressure levels with latanoprost/timolol fixed combination versus timolol. Curr Eye Res 2009; 34:369-77. [PMID: 19401880 DOI: 10.1080/02713680902850075] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE To evaluate 24-hr intraocular pressure (IOP) and blood pressure (BP) with timolol or latanoprost/timolol fixed combination (LTFC). METHODS Patients with primary open-angle glaucoma or ocular hypertension with normal blood pressure were randomized to LTFC, dosed each evening, or timolol dosed twice daily in a cross-over design for 8 weeks and the opposite medicine for 8 weeks. IOP was measured at 02:00, 06:00, 10:00, 14:00, 18:00 and 22:00 hours in the sitting position with Goldmann applanation tonometry and BP monitoring every 30 min while awake and every hour while asleep at the end of each 8-week treatment period. RESULTS Twenty-nine patients had a 24-hr baseline IOP of 26.3 +/- 2.5 mmHg, systolic BP (SBP) of 121.4 +/- 12.4 mmHg, diastolic BP (DBP) 72.9 +/- 7.1 mmHg, and ocular perfusion pressure (OPP) of 33.9 +/- 5.7 mmHg. No statistical differences were found between untreated and treated 24-hr SBP, DBP, mean BP (MBP), heart rate, or nocturnal BP dipping status with either medication. LTFC lowered IOP more at each timepoint compared to timolol (difference between treatments 2.7 mmHg, p = 0.0002). CONCLUSIONS Neither timolol or evening-dosed LTFC reduced SBP, DBP, MBP, OPP, or increased nocturnal dipping. LTFC was more effective than timolol in decreasing IOP.
Collapse
Affiliation(s)
- A G P Konstas
- 1st Department of Medicine, [corrected] AHEPA Hospital, Thessaloniki, Greece
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Konstas AGP, Tsironi S, Vakalis AN, Nasr MB, Stewart JA, Nelson LA, Stewart WC. Intraocular pressure control over 24 hours using travoprost and timolol fixed combination administered in the morning or evening in primary open-angle and exfoliative glaucoma. Acta Ophthalmol 2009; 87:71-6. [PMID: 19178390 DOI: 10.1111/j.1755-3768.2007.01145.x] [Citation(s) in RCA: 35] [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] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate intraocular pressure (IOP) control over 24 hours using travoprost and timolol fixed combination (TTFC) administered in the morning or evening in primary open-angle and exfoliative glaucoma. METHODS Patients were randomized to TTFC administered in either the morning or evening for 8 weeks. Previously treated patients underwent an untreated washout period of 4-6 weeks, after which baseline IOP was required to be > 25 mm Hg and < 38 mmHg (in two readings taken at 10.00 +/- 1 hours). During the treatment period, IOP was measured at 10.00, 14.00, 18.00, 22.00, 02.00 and 06.00 hours. Patients were then treated with the opposite dosing regimen for 8 weeks and IOP measurements were repeated. RESULTS In 32 subjects who completed the study, the untreated baseline IOP following washout was 27.7 +/- 3.5 mmHg. Both dosing regimens reduced IOP from baseline at each time-point and throughout the 24-hour diurnal curve (p < 0.0001). When treatments were compared directly, evening dosing (18.4 +/- 3.3 mmHg) provided a statistically significant lower 24-hour curve than morning dosing (19.2 +/- 3.5 mmHg; p = 0.001). Evening dosing also resulted in a lower 24-hour IOP fluctuation (3.8 +/- 1.6 mmHg) than morning dosing (5.1 +/- 1.6 mmHg; p = 0.0002) and lower peak IOP (p = 0.0003). CONCLUSIONS Both morning and evening administration of TTFC provide effective 24-hour IOP reduction, but evening dosing demonstrates better 24-hour pressure control.
Collapse
|
36
|
Konstas AGP, Mikropoulos D, Haidich AB, Ntampos KS, Stewart WC. Twenty-four-hour intraocular pressure control with the travoprost/timolol maleate fixed combination compared with travoprost when both are dosed in the evening in primary open-angle glaucoma. Br J Ophthalmol 2008; 93:481-5. [PMID: 19019932 DOI: 10.1136/bjo.2008.147322] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the 24 h efficacy and safety of the travoprost/timolol maleate fixed combination (TTFC) versus travoprost when both are dosed in the evening in primary open-angle glaucoma patients. METHODS Prospective, double-masked, crossover, active-controlled, randomised 24 h comparison. After a 6 week medicine-free period, patients were randomised to either TTFC or travoprost for 8 weeks and were then switched to the opposite treatment for another 8 weeks. At the end of the washout and treatment periods, a 24 h pressure curve was performed. RESULTS Thirty-two patients completed the study. The TTFC group demonstrated a lower absolute intraocular pressure level (2.4 mm Hg) for the 24 h curve and at all time points, compared with travoprost (p</=0.047). The pressure reduction from untreated baseline was significantly different between treatments for all time points (p = 0.018). The mean 24 h pressure fluctuation was lower with TTFC (3.0 mm Hg) compared with travoprost (4.0 mm Hg, p = 0.001). No statistical difference existed between the two treatment groups for any adverse event (p>0.05). CONCLUSIONS This study suggests that when both drugs are dosed in the evening the TTFC provides improved intraocular pressure reduction, compared with travoprost, over the 24 h curve and for each individual time point in primary open-angle glaucoma patients.
Collapse
Affiliation(s)
- A G P Konstas
- PRN Pharmaceutical Research Network, LLC, 5001 LBJ Freeway, Suite 700, Dallas, TX 75244, USA.
| | | | | | | | | |
Collapse
|
37
|
Yan DB, Battista RA, Haidich AB, Konstas AGP. Comparison of morning versus evening dosing and 24-h post-dose efficacy of travoprost compared with latanoprost in patients with open-angle glaucoma . Curr Med Res Opin 2008; 24:3023-7. [PMID: 18826749 DOI: 10.1185/03007990802426813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare the IOP-lowering efficacy of a.m.-dosed travoprost and latanoprost at 24-h post-dose. RESEARCH DESIGN AND METHODS Open-angle glaucoma patients not naïve to prostaglandin therapy and currently controlled on p.m.-dosed (2100) latanoprost (n = 21) or travoprost (n = 30) had baseline IOPs measured at 0900. In a randomized, single-masked, crossover design, patients received travoprost (Travatan † ) or latanoprost (Xalatan ‡ ) at 0900 for 4 weeks, then were crossed over to receive the second prostaglandin for another 4 weeks. Treatment IOP was measured at 0900 prior to morning dose at both 4 and 8 week visits. Patient dosing preference (a.m./p.m.) was surveyed on exit. MAIN OUTCOME MEASURE Intraocular pressure (IOP). † Travatan is a registered trade name of Alcon Laboratories, Inc., Fort Worth, TX, USA ‡ Xalatan is a registered trade name of Pfizer, New York, NY, USA. RESULTS The mean IOP in the first period when all patients were dosed in the evening was assessed 12 h after dosing at 09:00 and it was similar in the two treatment groups (mean ± standard deviation: 17.9 ± 2.7 mmHg for travoprost versus 17.7 ± 2.5 mmHg for latanoprost, p = 0.812). In the a.m.-dosing crossover comparison, the 24-h post-dose IOP was significantly lower ( p < 0.001) on travoprost (16.9 ± 3.1 mmHg) compared to latanoprost (18.6 ± 3.3 mmHg). In the exit survey, 51% of patients preferred a.m.-dosing. CONCLUSIONS a.m.-dosed travoprost is superior to a.m.-dosed latanoprost by 1.7 mmHg at 24-h post-dose.
Collapse
|
38
|
Affiliation(s)
- Rania Tabet
- University of Texas Health Science Center-Houston, Houston, Texas, USA
| | | | | | | |
Collapse
|
39
|
Konstas AGP, Mikropoulos D, Dimopoulos AT, Moumtzis G, Nelson LA, Stewart WC. Second-line therapy with dorzolamide/timolol or latanoprost/timolol fixed combination versus adding dorzolamide/timolol fixed combination to latanoprost monotherapy. Br J Ophthalmol 2008; 92:1498-502. [PMID: 18703549 DOI: 10.1136/bjo.2008.145219] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate open-angle glaucoma patients, who were insufficiently controlled on latanoprost monotherapy, to determine the 24 h intraocular pressure (IOP) efficacy and safety when changing them to dorzolamide/timolol (DTFC) or latanoprost/timolol fixed combination (LTFC) or adding DTFC. METHODS A prospective, observer-masked, placebo-controlled, crossover, comparison. Consecutive adults with primary open-angle or exfoliative glaucoma who exhibit a mean baseline IOP >21 mm Hg on latanoprost monotherapy were randomised for 3 months to: DTFC, LTFC or DTFC and latanoprost. Patients were then crossed over to the next treatment for periods 2 and 3. At the end of the latanoprost run-in and after each 3-month treatment period, patients underwent 24 h IOP monitoring. RESULTS 31 patients completed this study. All three adjunctive therapies significantly reduced the IOP at each time point and for the mean 24 h curve, except at 18:00 and 02:00 with DTFC and 02:00 with LTFC. When the three treatments were compared directly, the DTFC and latanoprost therapy demonstrated lower IOPs versus the other treatment groups, including: the mean 24 h pressure, maximum as well as minimum levels and individual time points following a modified Bonferroni correction (p<0.0032). CONCLUSIONS This study showed DTFC, LTFC and the addition of DTFC to latanoprost significantly decrease the IOP compared with latanoprost alone, but the latter therapy regime yields the greatest IOP reduction.
Collapse
Affiliation(s)
- A G P Konstas
- Department Ophthalmology, Glaucoma Unit, 1st University, Thessaloniki, Greece
| | | | | | | | | | | |
Collapse
|
40
|
Quaranta L, Pizzolante T, Riva I, Haidich AB, Konstas AGP, Stewart WC. Twenty-four-hour intraocular pressure and blood pressure levels with bimatoprost versus latanoprost in patients with normal-tension glaucoma. Br J Ophthalmol 2008; 92:1227-31. [PMID: 18586898 DOI: 10.1136/bjo.2008.138024] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To evaluate 24 h intraocular pressure (IOP) and blood pressure (BP) with bimatoprost or latanoprost in patients with normal-tension glaucoma. DESIGN Prospective, randomised, crossover, active-controlled, observer-masked study. METHODS After a 6-week medicine-free period, we randomised patients to either latanoprost or bimatoprost for 8 weeks and then to the opposite medicine for 8 weeks. At baseline, and at the end of each treatment period, we evaluated IOP and BP at 08:00 and then every 2 h over the 24 h day. Diastolic ocular perfusion pressure (DOPP) was calculated from the above parameters. RESULTS Forty completed patients had a 24 h untreated baseline IOP of 15.5 (2.3) mm Hg, and a DOPP of 59.2 (6.1) mm Hg. Both treatments lowered IOP at each time point (p<0.006), and over the 24 h curve (p<0.001, both medicines 13.1 mm Hg, 16% decrease). No difference existed between treatments in absolute IOP, at each time point, and over the 24 h curve (p>or=0.26). Additionally, no differences were found between treated 24 h systolic (p>or=0.29) and diastolic BP (p>or=0.12). The mean 24 h DOPP for latanoprost was increased from baseline (3%, p = 0.031) but not for bimatoprost (2%, p = 0.21). However, no difference in DOPP existed between treatments at any time point or over the 24 h curve (p>or=0.17). No difference was observed between treatments for any adverse event (p>0.05). CONCLUSIONS In patients with normal-tension glaucoma, both bimatoprost and latanoprost reduce the 24 h intraocular pressure from untreated baseline to a similar extent. Latanoprost is associated with slightly improved ocular diastolic perfusion pressure over 24 h but similar absolute perfusion levels to that of bimatoprost.
Collapse
Affiliation(s)
- L Quaranta
- Department of Ophthalmology, University of Brescia, Brescia, Italy
| | | | | | | | | | | |
Collapse
|
41
|
Quaranta L, Miglior S, Floriani I, Pizzolante T, Konstas AGP. Effects of the timolol-dorzolamide fixed combination and latanoprost on circadian diastolic ocular perfusion pressure in glaucoma. Invest Ophthalmol Vis Sci 2008; 49:4226-31. [PMID: 18502991 DOI: 10.1167/iovs.08-1744] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [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 evaluate the effect of the timolol-dorzolamide fixed combination (TDFC) and latanoprost 0.005% on 24-hour intraocular pressure (IOP), systolic (SBP) and diastolic (DBP) blood pressure, and diastolic ocular perfusion pressure (DOPP) in patients with primary open-angle glaucoma (POAG). METHODS This was an institutional, randomized clinical trial. After a 24-hour assessment without treatment, 27 previously untreated patients with POAG were randomized to 6 weeks' treatment with twice-daily TDFC (8 AM and 8 PM) followed by once-daily latanoprost 0.005% (8 PM), or vice versa. One eye was analyzed per patient. The mean values of IOP, DBP, SBP, and DOPP (difference between DBP and IOP) were recorded at each time point, and the 24-hour data are the mean values of each patient's measurements over the 24-hour period. The differences between the values of the first treatment period and the baseline and the second treatment period and washout were calculated and analyzed by means of an analysis of variance model that tested the effects of sequence and treatment. RESULTS Both treatments significantly reduced 24-hour IOP (P < 0.0001), but TDFC led to lower 24-hour pressure (mean +/- SD: 15.4 +/- 1.9 vs. 16.7 +/- 1.7 mm Hg; P = 0.004). Latanoprost did not lead to any significant reduction in mean 24-hour SBP and DBP (SBP: P = 0.952; DBP: P = 0.831), but TDFC did (SBP and DBP: P < 0.0001). Both treatments significantly increased 24-hour DOPP (P < 0.0001), with no difference between the two medications (P = 0.09). CONCLUSIONS In previously untreated patients with POAG, TDFC, and latanoprost equally enhanced 24-hour DOPP: the former by counteracting the decrease in DBP with a substantial reduction in IOP and the latter by not affecting DBP and significantly reducing IOP. (isrctn.org number, ISRCTN67123277.).
Collapse
Affiliation(s)
- Luciano Quaranta
- Clinica Oculistica, Università degli Studi Brescia, Brescia, Italy.
| | | | | | | | | |
Collapse
|
42
|
Wirtz MK, Konstas AGP, Samples JR, Kaltsos K, Economou A, Dimopoulos A, Georgiadou I, Petersen MB. Myocilin variations and familial glaucoma in Taxiarchis, a small Greek village. Mol Vis 2008; 14:774-81. [PMID: 18449353 PMCID: PMC2358920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Accepted: 04/03/2008] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To initiate a prospective study of glaucoma in a Greek village reported over 30 years ago to have several large families with primary open-angle glaucoma (POAG). METHODS A random group of 126 villagers from Taxiarchis, Greece was examined in the village community center. The detailed evaluation included ophthalmic and general history, measurement of blood pressure, intraocular pressure (IOP), and central corneal thickness (CCT) as well as evaluation of the optic nerve status. RESULTS The incidence of glaucoma approached 18% in this small isolated village. Myocilin variants were present in almost half of the individuals screened with Arg76Lys and Thr377Met being the most common finding (25% and 17%, respectively). Over half of the individuals with the Thr377Met mutation were diagnosed with glaucoma. Two of these patients were homozygous for the Thr377Met mutation. Three individuals with the Arg76Lys polymorphism had glaucoma; however, two of these individuals also had the Thr377Met mutation. Only two patients with pseudoexfoliation were identified. CONCLUSIONS The incidence of glaucoma and the Thr377Met MYOC mutation in this population is much higher than that reported for other European populations.
Collapse
Affiliation(s)
- Mary K. Wirtz
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Sciences University, Portland, OR
| | | | - John R. Samples
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Sciences University, Portland, OR
| | - Kostantinos Kaltsos
- Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | - Athanasios Economou
- Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | - Antonios Dimopoulos
- Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | - Irene Georgiadou
- Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | | |
Collapse
|
43
|
Stewart WC, Konstas AGP, Nelson LA, Kruft B. Meta-analysis of 24-hour intraocular pressure studies evaluating the efficacy of glaucoma medicines. Ophthalmology 2008; 115:1117-1122.e1. [PMID: 18082886 DOI: 10.1016/j.ophtha.2007.10.004] [Citation(s) in RCA: 128] [Impact Index Per Article: 8.0] [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: 03/08/2007] [Revised: 09/07/2007] [Accepted: 10/02/2007] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To evaluate efficacy and safety data of currently available ocular hypotensive medicines derived from 24-hour studies, of similar design, in patients with primary open-angle glaucoma (POAG), exfoliative glaucoma, or ocular hypertension (OH). DESIGN Meta-analysis of published articles evaluating patients with POAG, exfoliative glaucoma, or OH. METHODS We included articles that were randomized, prospective, single- or double-masked, comparative studies of ocular hypotensive therapies over 24 hours. Each article selected contained an untreated baseline, >or=4-week treatment period, >/=20 patients per treatment arm, and >or=6 time points not spaced >5 hours apart and used Goldmann applanation or Tonopen tonometry (supine measurements) to measure intraocular pressure (IOP). MAIN OUTCOME MEASURE Twenty-four-hour IOP efficacy. RESULTS This analysis included 864 separate 24-hour treatment curves from 386 patients in 28 treatment arms from 11 studies. A statistical difference in the mean diurnal pressure decrease existed between monotherapy treatments for POAG/OH patients, with bimatoprost (29%) and travoprost (27%) showing the greatest 24-hour reduction (P = 0.026). Timolol 0.5% was less effective than latanoprost (24% vs. 19% reduction) but decreased the pressure at each night time point (P = 0.0003). Dorzolamide showed a 19% 24-hour pressure reduction and brimonidine 0.2% a 14% one. In exfoliative glaucoma patients, latanoprost and travoprost showed higher baseline and treatment pressures, although the pressure reductions (29% and 31%, respectively) were greater generally than observed with POAG/OH. An evening-dosed latanoprost/timolol fixed combination reduced the pressure 33%, and the dorzolamide/timolol fixed combination (DTFC), 26%. However, the power to detect a difference for this specific comparison was probably low, due to the limited number of patients (n = 20) in the DTFC group. A statistical difference between evening-dosed (24%) and morning-dosed (18%) latanoprost (P<0.0001) was noted, but not between evening (27%) and morning (26%) travoprost (P = 0.074). The mean reduction of night time points was statistically lower than day time points for latanoprost (P = 0.031), timolol (P = 0.032), and brimonidine (P = 0.050), but not for dorzolamide. Dorzolamide (P = 0.60), travoprost (P = 0.064), and bimatoprost (P = 0.057) did not demonstrate nighttime pressures lower than daytime ones. The mean reduction of night time points was statistically lower than that of day time points for latanoprost (P = 0.031), timolol (P = 0.032), and brimonidine (P = 0.050), but not for dorzolamide (P = 0.60), bimatoprost (P = 0.057), travoprost (P = 0.064). CONCLUSIONS Similar relative efficacies generally exist in various classes of ocular hypotensive agents during night and day hours.
Collapse
|
44
|
Konstas AGP, Kozobolis VP, Tsironi S, Makridaki I, Efremova R, Stewart WC. Comparison of the 24-hour intraocular pressure-lowering effects of latanoprost and dorzolamide/timolol fixed combination after 2 and 6 months of treatment. Ophthalmology 2008; 115:99-103. [PMID: 18166407 DOI: 10.1016/j.ophtha.2007.03.007] [Citation(s) in RCA: 28] [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: 08/25/2006] [Revised: 02/28/2007] [Accepted: 03/01/2007] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To evaluate the 24-hour intraocular pressure (IOP)-lowering effect of latanoprost and the dorzolamide/timolol fixed combination (DTFC) after 2 and 6 months of treatment. DESIGN Randomized, prospective, crossover comparison. PARTICIPANTS Thirty-nine patients had primary open-angle glaucoma, and 14 patients had ocular hypertension. METHODS After a 6-week washout period, patients were randomized to either 6 months of treatment with the DTFC twice daily or latanoprost every evening and then crossed over to the opposite treatment for an additional 6 months. MAIN OUTCOME MEASURE Mean 24-hour IOP after 2 and 6 months of treatment. RESULTS Fifty-three patients had an average 24-hour baseline IOP of 25.2+/-2.3 mmHg. After 6 months of treatment, 24-hour IOPs were 18.1+/-1.9 mmHg for the DTFC and 18.3+/-1.9 mmHg for latanoprost. Compared with 2 months of therapy, at 6 months the DTFC showed no significant change in mean 24-hour IOP, whereas latanoprost demonstrated a reduction of 0.3 mmHg (P = 0.01). The DTFC had more burning (P<0.001) and bitter taste (P = 0.01), whereas the latanoprost had more hypertrichosis (P = 0.02). CONCLUSIONS After 6 months of therapy, the DTFC and latanoprost have clinically similar 24-hour IOP-lowering efficacies.
Collapse
Affiliation(s)
- Anastasios G P Konstas
- Glaucoma Unit, First University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | | | | | | | | | | |
Collapse
|
45
|
Affiliation(s)
- Anthony P Wells
- Ophthalmology Unit, Wellington School of Medicine, Wellington, New Zealand.
| | | | | |
Collapse
|
46
|
Konstas AGP, Katsimpris IE, Kaltsos K, Georgiadou I, Kordelou A, Nelson LA, Stewart WC. Twenty-four-hour efficacy of the brimonidine/timolol fixed combination versus therapy with the unfixed components. Eye (Lond) 2007; 22:1391-7. [PMID: 17571086 DOI: 10.1038/sj.eye.6702906] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate the 24-h intraocular pressure (IOP) control of brimonidine/timolol fixed combination (BTFC) versusthe unfixed combination of its individual components, each dosed twice daily, in patients with primary open-angle glaucoma or ocular hypertension. METHODS An observer-masked, randomized, crossover, active-controlled, two-centre comparison. Following a 6-week medicine-free period, patients were randomized to BTFC or to the unfixed combination of brimonidine and timolol for 3 months. Patients then were crossed over to the opposite treatment for another 3 months. At the end of the medicine-free period, and each treatment period, patients underwent 24-h IOP measurements at 0600, 1000, 1400, 1800, 2200, and 0200 hours. RESULTS Twenty-eight patients completed this study. Both BTFC and the unfixed components showed a significant IOP reduction from untreated baseline (P<0.0001), and were statistically equal when compared directly, for each individual time point and for the 24-h IOP curve (P>0.05). The mean 24-h IOP was 24.6+/-1.9 for baseline, 19.2+/-1.9 for BTFC, and 19.2+/-1.6 mmHg for the unfixed components (P=1.0). Four patients were discontinued due to side effects. The most common ocular adverse event was ocular hyperaemia (n=3 with BTFC and n=5 with the unfixed components, P=0.7) and systemic adverse events were rare. CONCLUSION This study suggests that both BTFC and the unfixed components of brimonidine and timolol provide a significant 24-h IOP reduction from untreated baseline, and statistically equal control when compared directly, at each time point and for the 24-h pressure curve.
Collapse
Affiliation(s)
- A G P Konstas
- Glaucoma Unit, 1st University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | | | | | | | | | | | | |
Collapse
|
47
|
Konstas AGP, Kozobolis VP, Katsimpris IE, Boboridis K, Koukoula S, Jenkins JN, Stewart WC. Efficacy and Safety of Latanoprost versus Travoprost in Exfoliative Glaucoma Patients. Ophthalmology 2007; 114:653-7. [PMID: 17197028 DOI: 10.1016/j.ophtha.2006.07.064] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [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: 04/18/2006] [Revised: 06/23/2006] [Accepted: 07/04/2006] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To evaluate 24-hour intraocular pressure (IOP) efficacy of latanoprost versus travoprost, each given every evening, in exfoliative glaucoma patients. DESIGN Prospective, observer-masked, crossover comparison. PARTICIPANTS Forty patients with exfoliation glaucoma. METHODS Patients with a pressure of >24 mmHg were randomized to latanoprost or travoprost for an 8-week treatment period after a 6-week medicine-free period. Patients were then switched to the opposite treatment for the second period. At untreated baseline and at the end of each treatment period the IOP was measured at 6 am, 10 am, 2 pm, 6 pm, 10 pm, and 2 am. MAIN OUTCOME MEASURE Diurnal IOP. RESULTS The mean 24-hour IOP was 25.1+/-2.5 mmHg at baseline, 17.8+/-2.1 mmHg on latanoprost, and 17.3+/-2.2 mmHg on travoprost (P = 0.001). Individual time points were similar between treatments, except at 6 pm when travoprost provided lower IOP (16.7+/-2.6 vs 17.9+/-2.5 mmHg, P<0.001). Adverse events showed more conjunctival hyperemia with travoprost (n = 15) than latanoprost (n = 6; P = 0.03). CONCLUSIONS Latanoprost and travoprost both significantly reduce the 24-hour IOP from baseline in exfoliative glaucoma, but travoprost may demonstrate a greater hypotensive efficacy in the late afternoon.
Collapse
|
48
|
Konstas AGP, Lake S, Economou AI, Kaltsos K, Jenkins JN, Stewart WC. 24-Hour control with a latanoprost-timolol fixed combination vs timolol alone. ACTA ACUST UNITED AC 2006; 124:1553-7. [PMID: 17102001 DOI: 10.1001/archopht.124.11.1553] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To evaluate 24-hour intraocular pressure (IOP) control with an evening-dosed latanoprost-timolol maleate fixed combination vs timolol alone in patients with primary open-angle glaucoma. METHODS After a medicine-free period, qualified patients were randomized to either placebo dosed in the morning with a latanoprost-timolol fixed combination dosed in the evening or timolol alone dosed twice daily for 8 weeks. Patients were then switched to the opposite treatment for 8 weeks. At baseline and at the end of each treatment period, patients underwent IOP measurements. RESULTS Both treatments reduced the IOP from untreated baseline at each time point and for the 24-hour curve (P<.001). When treatments were compared, the latanoprost-timolol fixed combination decreased the IOP more than timolol alone at each time point and for the 24-hour curve (2.9 mm Hg), and provided a lower absolute IOP at each time point (P<.001) and for the range (fluctuation) in IOP (P = .003) and for the 24-hour curve. Several adverse effects were observed more often with the latanoprost-timolol fixed combination, including ocular stinging (P = .05), conjunctival hyperemia (P = .02), and ocular itching (P = .04). CONCLUSION The evening-dosed latanoprost-timolol fixed combination may provide better IOP control than timolol alone over 24 hours and may demonstrate a narrower range of IOP fluctuation in patients with primary open-angle glaucoma.
Collapse
Affiliation(s)
- Anastasios G P Konstas
- Glaucoma Unit, A University Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece
| | | | | | | | | | | |
Collapse
|
49
|
Konstas AGP, Holló G, Irkec M, Tsironi S, Durukan I, Goldenfeld M, Melamed S. Diurnal IOP control with bimatoprost versus latanoprost in exfoliative glaucoma: a crossover, observer-masked, three-centre study. Br J Ophthalmol 2006; 91:757-60. [PMID: 17124241 PMCID: PMC1955604 DOI: 10.1136/bjo.2006.106690] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To evaluate the diurnal intraocular pressure (IOP) control and safety of bimatoprost versus latanoprost in exfoliative glaucoma (XFG). METHODS One eye of 129 consecutive patients with XFG (mean (SD) age 66.5 (8.3) years) was included in this prospective, observer-masked, three-centre, crossover comparison. After a 4-6 week medicine-free period patients were randomised to bimatoprost or latanoprost monotherapy for 3 months. Patients were then switched to the opposite treatment for another 3 months. At the end of the washout and the treatment periods diurnal IOP was measured at 0800, 1300, and 1800. RESULTS At baseline the IOP (mean (SD)) was 28.0 (4.0), 26.9 (3.6), and 25.9 (3.6) mm Hg, at the three time points, respectively. Both treatments significantly reduced mean diurnal IOP at month 3. Mean diurnal IOP was 26.9 (3.5) mm Hg at baseline, 17.6 (3.3) mm Hg with bimatoprost, and 18.6 (3.6) mm Hg with latanoprost (p<0.0001). Furthermore, lower IOP values were obtained with bimatoprost at all time points (17.9 (3.4), 17.3 (3.3), and 17.6 (3.5) mm Hg, respectively) compared with latanoprost (18.7 (3.6), 18.5 (3.6), and 18.6 (4.1) mm Hg, respectively). The corresponding mean differences (0.8, 1.1, and 1.0 mm Hg, respectively) were all significant (p<0.001 for each comparison). Significantly more patients with XFG obtained a target diurnal IOP <17 mm Hg with bimatoprost than with latanoprost, 55/123 (45%) v 34/123 (28%); (p = 0.001), and significantly fewer patients were non-responders with bimatoprost than with latanoprost (5 v 13, p = 0.021). More patients reported at least one adverse event with bimatoprost than with latanoprost (58 v 41 at 3 months; p = 0.0003). CONCLUSION This crossover study suggests that better diurnal IOP control is obtained with bimatoprost than with latanoprost in patients with XFG.
Collapse
Affiliation(s)
- A G P Konstas
- Glaucoma Unit, "A" University Department of Ophthalmology, AHEPA Hospital, 1 Kyriakidi Str, Thessaloniki 546 36, Greece.
| | | | | | | | | | | | | |
Collapse
|
50
|
Boboridis KG, Konstas AGP, Krassas GE, Georgiadis NS. Viral conjunctivitis interfering with the clinical activity score and management of thyroid ophthalmopathy. Orbit 2006; 25:27-9. [PMID: 16527772 DOI: 10.1080/01676830500505871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The management of Graves' ophthalmopathy is shared between endocrinologists and ophthalmologists. Assessment and treatment of the active inflammatory stage is based on the clinical activity and disease severity scores, often without detailed eye examination by the treating endocrinologist. MATERIALS AND METHODS We report a case of acute viral keratoconjunctivitis occurring during immunosuppressive treatment for Graves' ophthalmopathy which masked the signs, symptoms and response to treatment of the orbitopathy, posing a differential diagnostic challenge. RESULTS The apparent worsening of the ophthalmopathy and the increased clinical activity score led the treating endocrinologist to alter the management decisions. Ophthalmic examination confirmed the diagnosis of viral keratoconjunctivitis and immunosuppressive treatment was continued with significant final improvement of Graves' ophthalmopathy. DISCUSSION Ocular surface conditions, unrecognised by the treating physician, may complicate the assessment of thyroid ophthalmopathy when detailed eye examination is not performed. The diagnostic challenge of Graves' ophthalmopathy requires a combined approach by an endocrinologist and an ophthalmologist working as a team.
Collapse
Affiliation(s)
- K G Boboridis
- Department of Ophthalmology, Aristotle University of Thessaloniki, Greece.
| | | | | | | |
Collapse
|