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Affiliation(s)
- Manuel Saenz-de-Viteri
- Royal Eye Infirmary, University Hospitals Plymouth, Plymouth, United Kingdom
- Department of Ophthalmology, University of Navarra, Pamplona, Spain
| | - Tomas Cudrnak
- Royal Eye Infirmary, University Hospitals Plymouth, Plymouth, United Kingdom
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Fernandez-Robredo P, Recalde S, Hernandez M, Zarranz-Ventura J, Molins B, Casaroli-Marano RP, Adan A, Saenz-de-Viteri M, García-Layana A. Novel Association of High C-Reactive Protein Levels and A69S at Risk Alleles in Wet Age-Related Macular Degeneration Women. Front Immunol 2018; 9:1862. [PMID: 30154790 PMCID: PMC6102554 DOI: 10.3389/fimmu.2018.01862] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/27/2018] [Indexed: 01/10/2023] Open
Abstract
Purpose To explore the relationship between plasma C-reactive protein (CRP) levels, the main ARMS2 gene single nucleotide polymorphism (SNP), and gender in patients with neovascular age-related macular degeneration (wet AMD). Methods Our study included 131 patients with wetAMD [age-related eye disease study (AREDS) category 4] and 153 control participants (AREDS category 1) from two Spanish retinal units. CRP levels were determined on blood samples by high-sensitivity ELISA assay. According to their CRP level, subjects were categorized into three well-established CRP categories: low (<1.00 mg/L, L-CRP), moderate (1–2.99 mg/L, M-CRP), and high (>3.00 mg/L, H-CRP). Genomic DNA was extracted from oral swabs using QIAcube (Qiagen, Hilden, Germany) and the A69S; rs10490924 of ARMS2 gene was genotyped by allelic discrimination with validated TaqMan assays (Applied Biosystems, Foster City, CA, USA). Univariate and multivariate logistic regression adjusted for age was used to analyze the genomic frequencies and to calculate odds ratio (OR) using SNPStats software. Results Considering CRP risk categories, H-CRP group showed a significant [OR 4.0 (1.9–8.3)] association with wetAMD compared to L-CRP group. The risk genotypes of A69S (TT) SNPs showed an association with wetAMD risk [OR 14.0 (4.8–40.8)]. Interestingly, the gender stratification of the CRP categories showed a significant increase in CRP levels in wetAMD women compared with control women [OR 6.9 (2.2–22.3)] and with wetAMD men [OR 4.6 (1.3–16.9)]. In addition, the subgroup analysis of CRP within A69S genotype and gender showed a link in women between the A69S and CRP levels in the AMD group compared to controls [OR 4.2 (1.4–12.6)]. Conclusion Our study shows, for the first time, that a different genetic association related with gender could contribute to AMD risk. As a consequence, the risk of female gender in the different CRP levels and A69S SNP frequencies could be taken into consideration to the established risk relationship of high levels of CRP and its association with risk A69S genotype.
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Affiliation(s)
- Patricia Fernandez-Robredo
- Experimental Ophthalmology Laboratory, Ophthalmology, Clínica Universidad de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Sergio Recalde
- Experimental Ophthalmology Laboratory, Ophthalmology, Clínica Universidad de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Maria Hernandez
- Experimental Ophthalmology Laboratory, Ophthalmology, Clínica Universidad de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Javier Zarranz-Ventura
- Hospital Clínic, Institut Clínic d'Oftalmologia (ICOF), Barcelona, Spain.,Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Blanca Molins
- Hospital Clínic, Institut Clínic d'Oftalmologia (ICOF), Barcelona, Spain
| | | | - Alfredo Adan
- Hospital Clínic, Institut Clínic d'Oftalmologia (ICOF), Barcelona, Spain.,Fundació Clínic per a la Recerca Biomèdica, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Manuel Saenz-de-Viteri
- Ophthalmology, Clínica Universidad de Navarra, Pamplona, Spain.,Royal Eye Infirmary, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
| | - Alfredo García-Layana
- Experimental Ophthalmology Laboratory, Ophthalmology, Clínica Universidad de Navarra, Pamplona, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.,Ophthalmology, Clínica Universidad de Navarra, Pamplona, Spain
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Gonzalez-Salinas R, Garza-Leon M, Saenz-de-Viteri M, Solis-S JC, Gulias-Cañizo R, Quiroz-Mercado H. Comparison of cumulative dissipated energy delivered by active-fluidic pressure control phacoemulsification system versus gravity-fluidics. Int Ophthalmol 2017; 38:1907-1913. [PMID: 28831699 DOI: 10.1007/s10792-017-0674-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 05/25/2017] [Accepted: 08/01/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare the cumulative dissipated energy (CDE), aspiration time and estimated aspiration fluid utilized during phacoemulsification cataract surgery using two phacoemulsification systems . METHODS A total of 164 consecutive eyes of 164 patients undergoing cataract surgery, 82 in the active-fluidics group and 82 in the gravity-fluidics group were enrolled in this study. Cataracts graded NII to NIII using LOCS II were included. Each subject was randomly assigned to one of the two platforms with a specific configuration: the active-fluidics Centurion ® phacoemulsification system or the gravity-fluidics Infiniti ® Vision System. CDE, aspiration time (AT) and the mean estimated aspiration fluid (EAF) were registered and compared. RESULTS A mean age of 68.3 ± 9.8 years was found (range 57-92 years), and no significant difference was evident between both groups. A positive correlation between the CDE values obtained by both platforms was verified (r = 0.271, R 2 = 0.073, P = 0.013). Similarly, a significant correlation was evidenced for the EAF (r = 0.334, R 2 = 0.112, P = 0.046) and AT values (r = 0.156, R 2 = 0.024, P = 0.161). A statistically significantly lower CDE count, aspiration time and estimated fluid were obtained using the active-fluidics configuration when compared to the gravity-fluidics configuration by 19.29, 12.10 and 9.29%, respectively (P = 0.001, P < 0.0001 and P = 0.001). CONCLUSIONS The active-fluidics Centurion ® phacoemulsification system achieved higher surgical efficiency than the gravity-fluidics Infiniti ® IP system for NII and NIII cataracts.
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Affiliation(s)
- Roberto Gonzalez-Salinas
- Research Department, Hospital Luis Sánchez Bulnes, Asociación para Evitar la Ceguera en México I.A.P., Vicente García Torres 46, Barrio San Lucas, Coyoacán, 04030, Mexico City, Mexico.
| | - Manuel Garza-Leon
- Dirección de Ciencias Médicas de la División de Ciencias de la Salud, Universidad de Monterrey, Monterrey, Nuevo León, Mexico
| | | | - Juan C Solis-S
- Biomedical Research Department, Universidad Autónoma de Querétaro, 76170, Querétaro, Mexico
| | - Rosario Gulias-Cañizo
- Research Department, Hospital Luis Sánchez Bulnes, Asociación para Evitar la Ceguera en México I.A.P., Vicente García Torres 46, Barrio San Lucas, Coyoacán, 04030, Mexico City, Mexico.,Centro de Investigación y Estudios Avanzados, I.P.N. (CINVESTAV), 07360, Mexico City, Mexico
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Saenz-de-Viteri M, Fernández-Robredo P, Hernández M, Bezunartea J, Reiter N, Recalde S, García-Layana A. Single- and repeated-dose toxicity study of bevacizumab, ranibizumab, and aflibercept in ARPE-19 cells under normal and oxidative stress conditions. Biochem Pharmacol 2016; 103:129-39. [DOI: 10.1016/j.bcp.2015.12.017] [Citation(s) in RCA: 17] [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] [Received: 10/21/2015] [Accepted: 12/22/2015] [Indexed: 01/29/2023]
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Saenz-de-Viteri M, Sádaba LM. Optical Coherence Tomography Assessment Before and After Vitamin Supplementation in a Patient With Vitamin A Deficiency: A Case Report and Literature Review. Medicine (Baltimore) 2016; 95:e2680. [PMID: 26871796 PMCID: PMC4753891 DOI: 10.1097/md.0000000000002680] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Vitamin A is an essential fat-soluble vitamin important for the function of various body systems. In the eye, vitamin A is essential for the synthesis of visual pigments in photoreceptors. Vitamin A deficiency is a rare condition in the developed countries and might follow bariatric or intestinal bypass surgery.We present the case of a 67-year-old male that complained of visual loss and nyctalopia. Patient had bariatric surgery 15 years before for weight loss. Low serum levels of vitamin A confirmed the diagnosis and patient started vitamin A supplementation. Visual fields, macular thickness, and ganglion cell layer thickness were recorded and monitored 1 month, 6 months, and 1 year after the beginning of therapy. Visual fields were significantly altered and central macular thickness and ganglion cell layer thickness were reduced, but the first 2 showed a significant recovery with vitamin supplementation therapy. By the 1st month of treatment patient referred a complete remission of visual symptoms. Further, we observed hyperreflective material accumulating beneath a partially disrupted ellipsoid band in the high definition optical coherence tomography that also improved progressively with vitamin repletion.Newer and more sophisticated imaging systems have increased our knowledge of the mechanisms responsible for retinal diseases. To our knowledge, this is the first description of the effect of vitamin A deficiency and vitamin supplementation on macular thickness. This case also highlights the importance of considering bariatric bypass surgery as a cause of vitamin A deficiency in developed countries.
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Gonzalez-Salinas R, Guarnieri A, Guirao Navarro MC, Saenz-de-Viteri M. Patient considerations in cataract surgery - the role of combined therapy using phenylephrine and ketorolac. Patient Prefer Adherence 2016; 10:1795-1801. [PMID: 27695298 PMCID: PMC5029911 DOI: 10.2147/ppa.s90468] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Cataract, a degradation of the optical quality of the crystalline lens, progressive and age-related, is the leading cause of treatable blindness worldwide. Cataract surgery is the most common surgical procedure performed by ophthalmologists and is the only effective treatment for cataracts. Advances in the surgical techniques and better postoperative visual outcomes have progressively changed the primary concern of cataract surgery to become a procedure refined to yield the best possible refractive results. Sufficient mydriasis during cataract removal is critical to a successful surgical outcome. Poor pupil dilation can lead to serious sight-threatening complications that significantly increase the cost of surgery and decrease patients comfort. Mydriasis is obtained using anticholinergic and sympathomimetic drugs. Phenylephrine, an α1-adrenergic receptor agonist, can efficiently dilate the pupil when administered by intracameral injection. Additionally, nonsteroidal anti-inflammatory drugs (NSAIDs) like ketorolac, which inhibit the synthesis of prostaglandins, are used to decrease intraoperative miosis, control pain and inflammation associated with cataract surgery, and to prevent the development of cystoid macular edema following surgery. Recently, a new combination of phenylephrine and ketorolac (Omidria®) has been approved by United States Food and Drug Administration for use during cataract surgery to maintain intraoperative mydriasis, prevent miosis, and reduce postoperative pain and inflammation. Clinical trials have shown that this new combination is effective, combining the positive effects of both drugs with a good safety profile and patient tolerability. Moreover, recent reports suggest that this combination is also effective in patients with high risk of poor pupil dilation. In conclusion, cataract is a global problem that significantly affects patients' quality of life. However, they can be managed with a safe and minimally invasive surgery. Advances in surgical techniques and newer pharmacological agents such as the combination of phenylephrine and ketorolac, together with better intraocular lenses, have greatly improved visual outcomes and thus patients' expectations regarding visual recovery are also increasing.
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Affiliation(s)
- Roberto Gonzalez-Salinas
- Department of Biomedical Research, Universidad Autónoma de Querétaro, Querétaro, Mexico
- Department of Research, Asociación para Evitar la Ceguera en México, Mexico City, Mexico
| | - Adriano Guarnieri
- Department of Ophthalmology, Clínica Universidad de Navarra, Pamplona, Spain
| | | | - Manuel Saenz-de-Viteri
- Department of Ophthalmology, Clínica Universidad de Navarra, Pamplona, Spain
- Correspondence: Manuel Saenz-de-Viteri, Ave Pio XII 36, 31008 Pamplona, Navarra, Spain, Tel +34 948 948 25 54 00, Fax +34 948 296 500, Email
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Saenz-de-Viteri M, Fernández-Robredo P, de Nova E, Bonet-Farriol E, Sabater AL, Zarranz-Ventura J, Caire J, Sádaba LM, Salinas-Alamán A, García-Layana A. Comparative study measuring the dilatory effect of a mydriatic device (Mydriasert(®)) versus topical drops. Int J Ophthalmol 2013; 6:801-4. [PMID: 24392328 PMCID: PMC3874519 DOI: 10.3980/j.issn.2222-3959.2013.06.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 08/29/2013] [Indexed: 11/02/2022] Open
Abstract
AIM To compare the mydriatic efficacy of an ophthalmic insert (Mydriasert, MY) versus phenylephrine and tropicamide (PT) eye drops. METHODS Two controlled, prospective, randomized, single-blind studies were performed. In the first study, a total of 80 eyes from 40 outpatient-clinic patients were analyzed. PT drops were applied to the right eye, and a MY device was inserted in the left eye for 30min. Time until maximal pupil dilation for each eye was then assessed. In the second study, 80 eyes from 80 patients undergoing cataract surgery were analyzed. Pupil dilation was achieved using either PT drops three-times for one hour prior to surgery (40 patients), or a MY device was inserted one hour prior to surgery (40 patients). RESULTS In the first study, MY achieved superior mydriasis compared to PT eye drops at 90min (9.04±1.33mm vs 8.78±1.37mm, P=0.012). However MY took longer than PT drops to achieve maximal dilation, and mydriasis was inferior in eyes with MY compared to PT drops at 30min (7.21±1.73mm vs 8.22±1.43mm, P<0.001), the two groups only becoming similar by 60min (8.85±1.44mm vs 8.71±1.27mm, P=0.236). In the second study, both MY and PT achieved similar levels of mydriasis at the beginning of surgery (8.75±0.76mm with MY vs 8.77±0.63mm with PT), and also at the end of surgery (7.96±1.06mm with MY vs 8.32±0.72mm with PT), with no significant difference between groups (P=0.08). MY was well tolerated and cardiovascular effects were not influenced by dilation method. CONCLUSION MY could be a safe and efficacious alternative for mydriasis. The mydriatic effect of MY is as good as conventional PT eye drops after 60min, and is superior after 90min. MY also maintains good pupil dilation during cataract surgery.
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Affiliation(s)
- Manuel Saenz-de-Viteri
- Department of Ophthalmology, University of Navarra, 36th Pio XII Ave, Pamplona 31008, Spain
| | | | - Elisa de Nova
- Department of Ophthalmology, University of Navarra, 36th Pio XII Ave, Pamplona 31008, Spain
| | - Elvira Bonet-Farriol
- Department of Ophthalmology, University of Navarra, 36th Pio XII Ave, Pamplona 31008, Spain
| | - Alfonso L Sabater
- Department of Ophthalmology, University of Navarra, 36th Pio XII Ave, Pamplona 31008, Spain
| | - Javier Zarranz-Ventura
- Department of Ophthalmology, University of Navarra, 36th Pio XII Ave, Pamplona 31008, Spain
| | - Josemaria Caire
- Department of Ophthalmology, University of Navarra, 36th Pio XII Ave, Pamplona 31008, Spain
| | - Luis M Sádaba
- Department of Ophthalmology, University of Navarra, 36th Pio XII Ave, Pamplona 31008, Spain
| | - Angel Salinas-Alamán
- Department of Ophthalmology, University of Navarra, 36th Pio XII Ave, Pamplona 31008, Spain
| | - Alfredo García-Layana
- Department of Ophthalmology, University of Navarra, 36th Pio XII Ave, Pamplona 31008, Spain
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