AIM: To describe the anticipation and anti-glaucoma drugs response of a Chinese family with juvenile-onset open angle glaucoma(JOAG) caused by the Pro370Leu myocilin(MYOC) mutation. ·METHODS: Fifteen members of a...AIM: To describe the anticipation and anti-glaucoma drugs response of a Chinese family with juvenile-onset open angle glaucoma(JOAG) caused by the Pro370Leu myocilin(MYOC) mutation. ·METHODS: Fifteen members of a three-generation Chinese family with JOAG were recruited to this study. They all underwent ophthalmic common examinations. Patients suspected to have JOAG got an assessment of visual field and optical coherence tomography. Intraocular pressures(IOPs) of four patients were measured at 8,10,12,14,17 o’clock respectively after using anti-glaucoma drugs. Mutation screening of all MYOC gene coding exons of the participants was performed by using direct sequencing of PCR products. ·RESULTS: Clinical examinations and pedigree analysis revealed eight family members were suffered from JOAG. Apparent genetics anticipation phenomenon was observed in this family. Their clinical features included elevated IOP of 35-55mmHg,loss of visual field,thinning of retinal nerve fiber layer,and glaucomatous optic disc damage. Noticeably,their intraocular pressure levels could be controlled within normal range at 8 and 10 o’clock by anti-glaucoma drugs,but their IOPs would elevate 】21mmHg after 12 o’clock. Seven patients received trabeculectomy produced thin-walled,pale,and saccate filtering blebs maintaining lower intraocular pressure efficiently. Mutation screening indentified aheterozygous C→T missense mutation in the MYOC gene at position 1 109 in exon 3,corresponding to a substitution of a highly conserved proline to leucine at codon 370 in the olfactomedin domain of MYOC. ·CONCLUSION: The clinical characteristics of JOAG in this family were 1) genetics anticipation; 2) high IOP; 3) temporay response to anti-glaucoma drugs; 4) filtering surgery produced thin-walled and saccate filtering blebs,helping maintain lower IOP.展开更多
Background： Long-term use of benzalkonium chloride （BAC）-preserved drugs is often associated with ocular surface toxicity. Ocular surface symptoms had a substantial impact on the glaucoma patients＇ quality of life...Background： Long-term use of benzalkonium chloride （BAC）-preserved drugs is often associated with ocular surface toxicity. Ocular surface symptoms had a substantial impact on the glaucoma patients＇ quality of life and compliance. This study aimed to investigate the effects of sodium hyaluronate （SH） on ocular surface toxicity induced by BAC-preserved anti-glaucoma medications treatment. Methods： Filly-eight patients （101 eyes）, who received topical BAC-preserved anti-glaucoma medications treatment and met the severe dry eye criteria, were included in the analysis. All patients were maintained the original topical anti-glaucoma treatment. In the SH-treated group （56 eyes）, unpreserved 0.3% SH eye drops were administered with 3 times daily for 90 days. In the control group （55 eyes）, phosphate-butTered saline were administered with 3 times daily for 90 days. Ocular Surface Disease Index （OSDI） questionnaire, break-up time （BUT） test, corneal fluorescein staining, corneal and conjunctival rose Bengal staining, Schirmer test, and conjunctiva impression cytology were pertbrmed sequentially on days 0 and 91. Results： Compared with the control group, SH-treated group showed decrease in OSDI scores （Kruskal-Wallis test： H = 38.668, P 〈 0.001 ）, fluorescein and rose Bengal scores （Wilcoxon signed-ranks test： z = -3.843, P 〈 0.001, and z = 3.508, P 〈 0.001, respectively）, increase in tear fihn BUT （t-test： t - -10.994, P 〈 0.001 ） and aqueous tear production （t-test： t = -10.328, P 〈 0.001 ） on day 91. The goblet cell density was increased （t-test： t = -9.981, P 〈 0.001）, and the morphology of the conjunctival epithelium were also improved after SH treatment. Conclusions： SH significantly improved both symptoms and signs of ocular surface damage in patients with BAC-preserved anti-glaucoma medications treatment. SH could be proposed as a new attempt to reduce ocular surface toxicity, and alleviate symptoms of ocular surface damage in BAC-preserved anti-glaucoma medications treatment.展开更多
Background:Heliotropium indicum is used as a traditional remedy for hypertension in Ghana.The aim of the study was to evaluate the anti-glaucoma potential of an aqueous whole plant extract of H.indicum to manage exper...Background:Heliotropium indicum is used as a traditional remedy for hypertension in Ghana.The aim of the study was to evaluate the anti-glaucoma potential of an aqueous whole plant extract of H.indicum to manage experimentally-induced glaucoma.Methods:The percentage change in intraocular pressure(IOP),after inducing acute glaucoma(15 mLkg^(−1) of 5%dextrose,i.v.),in New Zealand White rabbits pretreated with Heliotropium indicum aqueous extract(HIE)(30–300 mgkg^(−1)),acetazolamide(5 mgkg^(−1)),and normal saline(10 mLkg^(−1))per os were measured.IOPs were also monitored in chronic glaucoma in rabbits(induced by 1%prednisolone acetate drops,12 hourly for 21 days)after treatments with the same doses of HIE,acetazolamide,and normal saline for 2 weeks.The anti-oxidant property of the extract was assessed by assaying for glutathione levels in the aqueous humour.Glutamate concentration in the vitreous humour was also determined using ELISA technique.Histopathological assessment of the ciliary bodies was made.Results:The extract significantly reduced intraocular pressure(p≤0.05–0.001)in acute and chronic glaucoma,preserved glutathione levels and glutamate concentration(p≤0.01–0.001).Histological assessment of the ciliary body showed a decrease in inflammatory infiltration in the extract and acetazolamide-treated group compared with the normal saline-treated group.Conclusion:The aqueous whole plant extract of Heliotropium indicum has ocular hypotensive,anti-oxidant and possible neuro-protective effects,which therefore underscore its plausible utility as an anti-glaucoma drug with further investigation.展开更多
基金Medical Scientific Research Foundation of Guangdong Province(No.A2013215)
文摘AIM: To describe the anticipation and anti-glaucoma drugs response of a Chinese family with juvenile-onset open angle glaucoma(JOAG) caused by the Pro370Leu myocilin(MYOC) mutation. ·METHODS: Fifteen members of a three-generation Chinese family with JOAG were recruited to this study. They all underwent ophthalmic common examinations. Patients suspected to have JOAG got an assessment of visual field and optical coherence tomography. Intraocular pressures(IOPs) of four patients were measured at 8,10,12,14,17 o’clock respectively after using anti-glaucoma drugs. Mutation screening of all MYOC gene coding exons of the participants was performed by using direct sequencing of PCR products. ·RESULTS: Clinical examinations and pedigree analysis revealed eight family members were suffered from JOAG. Apparent genetics anticipation phenomenon was observed in this family. Their clinical features included elevated IOP of 35-55mmHg,loss of visual field,thinning of retinal nerve fiber layer,and glaucomatous optic disc damage. Noticeably,their intraocular pressure levels could be controlled within normal range at 8 and 10 o’clock by anti-glaucoma drugs,but their IOPs would elevate 】21mmHg after 12 o’clock. Seven patients received trabeculectomy produced thin-walled,pale,and saccate filtering blebs maintaining lower intraocular pressure efficiently. Mutation screening indentified aheterozygous C→T missense mutation in the MYOC gene at position 1 109 in exon 3,corresponding to a substitution of a highly conserved proline to leucine at codon 370 in the olfactomedin domain of MYOC. ·CONCLUSION: The clinical characteristics of JOAG in this family were 1) genetics anticipation; 2) high IOP; 3) temporay response to anti-glaucoma drugs; 4) filtering surgery produced thin-walled and saccate filtering blebs,helping maintain lower IOP.
文摘Background： Long-term use of benzalkonium chloride （BAC）-preserved drugs is often associated with ocular surface toxicity. Ocular surface symptoms had a substantial impact on the glaucoma patients＇ quality of life and compliance. This study aimed to investigate the effects of sodium hyaluronate （SH） on ocular surface toxicity induced by BAC-preserved anti-glaucoma medications treatment. Methods： Filly-eight patients （101 eyes）, who received topical BAC-preserved anti-glaucoma medications treatment and met the severe dry eye criteria, were included in the analysis. All patients were maintained the original topical anti-glaucoma treatment. In the SH-treated group （56 eyes）, unpreserved 0.3% SH eye drops were administered with 3 times daily for 90 days. In the control group （55 eyes）, phosphate-butTered saline were administered with 3 times daily for 90 days. Ocular Surface Disease Index （OSDI） questionnaire, break-up time （BUT） test, corneal fluorescein staining, corneal and conjunctival rose Bengal staining, Schirmer test, and conjunctiva impression cytology were pertbrmed sequentially on days 0 and 91. Results： Compared with the control group, SH-treated group showed decrease in OSDI scores （Kruskal-Wallis test： H = 38.668, P 〈 0.001 ）, fluorescein and rose Bengal scores （Wilcoxon signed-ranks test： z = -3.843, P 〈 0.001, and z = 3.508, P 〈 0.001, respectively）, increase in tear fihn BUT （t-test： t - -10.994, P 〈 0.001 ） and aqueous tear production （t-test： t = -10.328, P 〈 0.001 ） on day 91. The goblet cell density was increased （t-test： t = -9.981, P 〈 0.001）, and the morphology of the conjunctival epithelium were also improved after SH treatment. Conclusions： SH significantly improved both symptoms and signs of ocular surface damage in patients with BAC-preserved anti-glaucoma medications treatment. SH could be proposed as a new attempt to reduce ocular surface toxicity, and alleviate symptoms of ocular surface damage in BAC-preserved anti-glaucoma medications treatment.
文摘Background:Heliotropium indicum is used as a traditional remedy for hypertension in Ghana.The aim of the study was to evaluate the anti-glaucoma potential of an aqueous whole plant extract of H.indicum to manage experimentally-induced glaucoma.Methods:The percentage change in intraocular pressure(IOP),after inducing acute glaucoma(15 mLkg^(−1) of 5%dextrose,i.v.),in New Zealand White rabbits pretreated with Heliotropium indicum aqueous extract(HIE)(30–300 mgkg^(−1)),acetazolamide(5 mgkg^(−1)),and normal saline(10 mLkg^(−1))per os were measured.IOPs were also monitored in chronic glaucoma in rabbits(induced by 1%prednisolone acetate drops,12 hourly for 21 days)after treatments with the same doses of HIE,acetazolamide,and normal saline for 2 weeks.The anti-oxidant property of the extract was assessed by assaying for glutathione levels in the aqueous humour.Glutamate concentration in the vitreous humour was also determined using ELISA technique.Histopathological assessment of the ciliary bodies was made.Results:The extract significantly reduced intraocular pressure(p≤0.05–0.001)in acute and chronic glaucoma,preserved glutathione levels and glutamate concentration(p≤0.01–0.001).Histological assessment of the ciliary body showed a decrease in inflammatory infiltration in the extract and acetazolamide-treated group compared with the normal saline-treated group.Conclusion:The aqueous whole plant extract of Heliotropium indicum has ocular hypotensive,anti-oxidant and possible neuro-protective effects,which therefore underscore its plausible utility as an anti-glaucoma drug with further investigation.
