AIM:To identify early biomarkers associated with glaucomatous visual field(VF)progression in patients with normal-tension glaucoma(NTG).METHODS:This study included patients were divided into two groups based on diseas...AIM:To identify early biomarkers associated with glaucomatous visual field(VF)progression in patients with normal-tension glaucoma(NTG).METHODS:This study included patients were divided into two groups based on disease progression status.Tear samples were collected for proteomic analysis.Dataindependent acquisition(DIA)mass spectrometry combined with bioinformatic analyses was performed to identify and validate potential protein biomarkers for NTG progression.Additionally,differentially expressed proteins(DEPs)were evaluated using mediating effect models and receiver operating characteristic(ROC)curve analysis.RESULTS:A total of 19 patients(20 eyes)with NTG participated in this study,including 10 patients(4 males and 6 females;10 eyes)in the progression group with mean age of 67.70±9.03y and 10 patients(4 males and 6 females;10 eyes)in the non-progression group with mean age of 68.60±7.58y.A total of 158 significantly differentially expressed proteins were detected.UniProt database annotation identified 3 upregulated proteins and 12 downregulated proteins.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis showed that these DEPs were mainly enriched in pathways such as oocyte meiosis.Gene Ontology(GO)enrichment analysis revealed functional clusters related to cellular processes.Weighted gene coexpression network analysis(WGCNA)indicated that the core proteins were primarily involved in the neurodegenerationmultiple diseases pathway and cellular processes.Mediating effect analysis identified PRDX4(L)as a potential protein biomarker.ROC curve analysis showed that GNAI1 had the largest area under the curve(AUC=0.889).CONCLUSION:This study identifies 15 differentially expressed proteins in the tear fluid of NTG patients,including PRDX4(L).PRDX4(L)plays a key role in oxidative stress.展开更多
AIM： To investigate the change of anterior chamber angle morphology and intraocular pressure （lOP） reduction after cataract surgery in patients with normal-tension glaucoma （NTG） using swept-source optical cohere...AIM： To investigate the change of anterior chamber angle morphology and intraocular pressure （lOP） reduction after cataract surgery in patients with normal-tension glaucoma （NTG） using swept-source optical coherence tomography （SS-OCT）. METHODS： This prospective, comparative, observational study recruited patients into two groups. Group 1 was the control group including normal subjects except those with cataracts （cataract group, n=67 eyes of 67 patients）, and group 2 was NTG group including patients who were diagnosed with NTG and cataracts （n=43 eyes of 43 patients）, which were treated with phacoemulsification and intraocular lens implantation. Before surgery, and at postoperative 1 and 6too, anterior chamber angles were evaluated by SS-OCT under dark conditions using three- dimensional angle analysis scan protocol. Angle opening distance （AOD）, angle recess area （ARA）, and trabecular- iris surface area （TISA） at four quadrants （temporal, nasal, superior, and inferior） were calculated automatically by SS-OGT, after the observer marked scleral spurs. RESULTS： A total of 106 patients （54 males and 52 females） were enrolled in the study. Angle parameters, AOD, ARA, and TISA were increased after surgery in both groups. However, changes of angle parameters were only significant in group 2. In group 2, preoperative lOP was 13.2＋2.9 mm Hg, and postoperative lOP at 1 and 6mo were 10.5＋3.0 and 10.7＋2.8 mm Hg, respectively. In group 1, preoperative lOP was 12.42.8 mm Hg, and postoperative lOP at 1 and 6mo were 11.6＋2.5 and 12.0＋2.8 mm Hg, respectively. After cataract surgery, angle parameters changed significantly while IOP significantly reduced and was maintained in group 2 （P〈0.001）. The changes in angle parameters （＆AOD500, ATISAS00 at temporal; ＆AOD500, S, RA500 at nasal） were linearly correlated with postoperative IOP changes. CONCLUSION： Cataract surgery may have improved antedor chamber angle parameters and decreased lOP in NTG patients.展开更多
Glaucoma and dysfunction of axonal transport:One of the leading causes of irreversible blindness worldwide is glaucoma,with increased intraocula r pressu re(IOP)being the most common risk factor.However,in some glauco...Glaucoma and dysfunction of axonal transport:One of the leading causes of irreversible blindness worldwide is glaucoma,with increased intraocula r pressu re(IOP)being the most common risk factor.However,in some glaucoma patients it has been shown that the IOP does not differ from that of the normal population.In Japan,normal-tension glaucoma(NTG),which accounts for 92%of primary open-angle glaucoma,has been shown to be more frequent in the population.展开更多
This comprehensive review embarks on a captivating journey into the complex relationship between cardiology and normal-tension glaucoma(NTG),a condition that continues to baffle clinicians and researchers alike.NTG,ch...This comprehensive review embarks on a captivating journey into the complex relationship between cardiology and normal-tension glaucoma(NTG),a condition that continues to baffle clinicians and researchers alike.NTG,characterized by optic nerve damage and visual field loss despite normal intraocular pressure,has long puzzled clinicians.One emerging perspective suggests that alterations in ocular blood flow,particularly within the optic nerve head,may play a pivotal role in its pathogenesis.While NTG shares commonalities with its high-tension counterpart,its unique pathogenesis and potential ties to cardiovascular health make it a fascinating subject of exploration.It navigates through the complex web of vascular dysregulation,blood pressure and perfusion pressure,neurovascular coupling,and oxidative stress,seeking to uncover the hidden threads that tie the heart and eyes together in NTG.This review explores into the intricate mechanisms connecting cardiovascular factors to NTG,shedding light on how cardiac dynamics can influence ocular health,particularly in cases where intraocular pressure remains within the normal range.NTG's enigmatic nature,often characterized by seemingly contradictory risk factors and clinical profiles,underscores the need for a holistic approach to patient care.Drawing parallels to cardiac health,we examine into the shared vascular terrain connecting the heart and the eyes.Cardiovascular factors,including systemic blood flow,endothelial dysfunction,and microcirculatory anomalies,may exert a profound influence on ocular perfusion,impacting the delicate balance within the optic nerve head.By elucidating the subtle clues and potential associations between cardiology and NTG,this review invites clinicians to consider a broader perspective in their evaluation and management of this elusive condition.As the understanding of these connections evolves,so too may the prospects for early diagnosis and tailored interventions,ultimately enhancing the quality of life for those living with NTG.展开更多
To the Editor:Normal-tension glaucoma(NTG)is a progressive optic neuropathy characterized by irreversible blindness with statistically normal intraocular pressure(IOP)(≤21 mmHg),^([1,2])which makes early-stage diagno...To the Editor:Normal-tension glaucoma(NTG)is a progressive optic neuropathy characterized by irreversible blindness with statistically normal intraocular pressure(IOP)(≤21 mmHg),^([1,2])which makes early-stage diagnosis in the clinical practice difficult.Pathophysiological pathways underlying NTG include vascular dysregulation,toxic metabolite accumulation,and elevated translaminar cribrosa pressure difference(TLCPD).^([3])Although various small animal models have provided evidence of different pathophysiological mechanisms,the complicated clinical phenotype cannot be fully imitated by secondary disease models,and the gap between rodents and humans weakens their translational potential.Thus,the pathological changes associated with NTG remain unclear.展开更多
AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glauc...AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glaucoma(PEXG).METHODS:This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023,and 45 eyes underwent goniotomy combined with phacoemulsification,and 15 eyes underwent goniotomy as a stand-alone procedure.Postoperatively,intraocular pressure(IOP)and the number of medications were collected at 1,3,6,and 12 mo.The side effects of surgery were recorded 1 d,1 wk,and 1,3,6,and 12 mo postoperatively.The primary outcomes were a reduction in IOP of at least 20%from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively.The secondary outcome was surgical success,defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.RESULTS:At the end of 1 a,78%of patients achieved both a>20%reduction in IOP and a reduction in the number of medications used.Overall success was achieved in 63%of patients.Microhyphaema was the most common complication,none of the patients experienced a complication requiring surgical intervention.CONCLUSION:Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG,and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.展开更多
AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current resea...AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current research international trends and hot topics in this area.METHODS:Bibliometric analysis was conducted on 9128 articles in the Web of Science Core Collection(WoSCC;Clarivate)database.Quantitative and qualitative analysis was employed using VOSviewer(v1.6.18),Pajek(v1.0.0.0),and CiteSpace(v6.1.R2)software.RESULTS:The 9128 papers relating to glaucoma treatment were published from April 2013 to April 2023,of which 7482 articles(82%)were original research articles and 1464(18%)were review articles.The United States(2867)and Johns Hopkins University(166)were the most productive country and institution,respectively,but the University College London had the highest h-index(54).The Journal of Glaucoma was the most productive and Ophthalmology had the highest h-index compared with other journals.The Keywords of interest included treatment surgery,cyclophotocoagulation,minimally invasive glaucoma surgery(MIGS),trabeculectomy,baerveldt,epidemiology,medication adherence,nanoparticle,optical coherence tomography(OCT),gene therapy,and artificial intelligence(AI).Glaucoma surgery appeared as a current research hotspot through the analysis of keywords.CONCLUSION:This study provides insights into the research trends and potential research hotspots in the treatment of glaucoma.This will help researchers to evaluate research policies and to promote international cooperation.展开更多
Globally,glaucoma stands as a primary cause of irreversible blindness,marked by intricate pathophysiological processes in which neuroinflammation plays a pivotal role.As the principal immune cells within the central n...Globally,glaucoma stands as a primary cause of irreversible blindness,marked by intricate pathophysiological processes in which neuroinflammation plays a pivotal role.As the principal immune cells within the central nervous system,microglia play a dual function in the progression of glaucoma.Under standard physiological states,microglia safeguard the retina by offering neurotrophic support and removing cellular debris.In the pathological progression of glaucoma,microglia become activated and release significant levels of inflammatory factors,resulting in retinal ganglion cell injury,cell death,and impaired neuroregeneration.This review focuses on examining the dual functions of microglia in glaucoma,evaluating their influence on retinal neurodegeneration and repair,and suggesting that modulating microglial activity could serve as a promising therapeutic strategy.Understanding the mechanisms of microglial action in glaucoma is crucial for unveiling the complex pathophysiological processes of the disease and developing new therapeutic strategies.展开更多
AIM:To investigate the etiology and clinical characteristics of hospitalized secondary glaucoma(SG)patients in northwestern China.METHODS:A cross-sectional study was conducted involving SG patients hospitalized betwee...AIM:To investigate the etiology and clinical characteristics of hospitalized secondary glaucoma(SG)patients in northwestern China.METHODS:A cross-sectional study was conducted involving SG patients hospitalized between July 2024 and January 2025.Clinical data were collected,including medical history,best-corrected visual acuity(BCVA),intraocular pressure(IOP),slit-lamp examination,gonioscopic findings,and fundus examination.Demographic characteristics,etiological factors,and treatment modalities were analyzed.RESULTS:A total of 67 patients(82 eyes)were enrolled,aged 7 to 90y.Males accounted for 54.0%(36/67),and 22.4%(15/67)of patients had bilateral involvement.The predominant etiologies of SG were neovascular glaucoma(NVG;25.4%),traumatic glaucoma(23.9%),uveitic glaucoma(20.9%),and lens-induced glaucoma(14.9%),collectively accounting for 85.1%of all cases.The peak age-specific incidence occurred in the 50-59 years age group(32.8%,22/67),while NVG was prevalent across the 40-79 years age range.IOP of the 82 affected eyes was stratified into five severity tiers:22-29 mm Hg(15 eyes,18.3%),30-39 mm Hg(14 eyes,17.1%),40-49 mm Hg(13 eyes,15.9%),50-59 mm Hg(20 eyes,24.4%),and≥60 mm Hg(20 eyes,24.4%).The overall mean IOP was 45.2±12.3 mm Hg,indicating a significant pathological elevation.Surgical intervention was required in 46.3%of cases,predominantly for NVG,lensinduced glaucoma,and traumatic glaucoma—conditions prone to rapid IOP elevation.The etiologies with the highest surgical intervention rates were malignant glaucoma,pigmentary glaucoma,lens-induced glaucoma,and NVG.In contrast,uveitic glaucoma cases were primarily managed with targeted anti-inflammatory therapy,which effectively controlled IOP in the early disease stages and potentially obviated the need for surgery.CONCLUSION:This study identifies NVG,traumatic glaucoma,uveitic glaucoma,and lens-induced glaucoma as the four leading etiologies of SG in Northwestern China.These findings emphasize the critical need for targeted prevention strategies and evidence-based health education programs among high-risk populations.Implementation of such initiatives will improve early detection,enable ophthalmologists to deliver timely therapeutic interventions,and ultimately reduce preventable vision loss in this region.展开更多
AIM:To perform a bibliometric analysis of publications focusing on inflammatory mechanisms in glaucoma,thereby comprehensively understanding the current research status and identifying potential frontier directions fo...AIM:To perform a bibliometric analysis of publications focusing on inflammatory mechanisms in glaucoma,thereby comprehensively understanding the current research status and identifying potential frontier directions for future studies.METHODS:A systematic search was conducted in the Web of Science Core Collection(WoSCC)database to retrieve relevant literature published from January 1,2000,to August 31,2025(data accessed on September 12,2025).Multiple data visualization tools were employed to conduct in-depth analyses of the included publications,covering aspects such as publication quantity and quality,evolutionary trends of research hotspots,keyword cooccurrence networks,and collaborative patterns among countries/regions,institutions,and authors.RESULTS:A total of 3381 articles related to glaucoma inflammation were extracted from WoSCC.The analysis showed that the USA had the highest research output in this field(29.04%,n=982),followed by China(18.40%,n=622)and UK(6.01%,n=203).Based on citation frequency and burst intensity,the USA also ranked as the most influential country.Baudouin C and Sun X were identified as the most productive authors,while Journal of Glaucoma and Investigative Ophthalmology&Visual Science were the journals with the highest number of published relevant articles.Additionally,keyword analysis revealed that“neuroinflammation”,“retinal ganglion cells(RGCs)”,“pathophysiology”,and“traditional Chinese medicine”are emerging research hotspots in the field of immuneinflammatory responses in glaucoma.CONCLUSION:This study presents a comprehensive bibliometric overview of research on glaucoma-related inflammation,indicating that this field has received extensive scientific attention with a steady upward trend in research activity.Furthermore,it establishes a theoretical basis for the development of neuroinflammation-targeted therapeutic strategies for glaucoma and emphasizes the necessity of strengthening interdisciplinary collaboration to promote the clinical translation of research findings.展开更多
AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and ...AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and randomized controlled trial was conducted.Patients diagnosed as CACG and cataract were randomly allocated into either GM group or GG group.In GM group,the range of peripheral anterior synechiae(PAS)was confirmed through gonio-lens after phacoemulsification with intraocular lens implantation(PEI).PAS was separated only under a microscope.After separating the closed angle of 360°by this method,we used a surgical gonioscope to confirm the PAS range.If any remaining PAS was present,we would separate them with an iris repositor under the direct gonio-lens until angle of 360°was reopened.In GG group,PAS was separated under direct gonioscopy after PEI until angle of 360°was reopened.The range of residual PAS after GSLs was the primary outcome.Intraoperative complications(hyphema),intraocular pressure(IOP)and anti-glaucoma medication usage after operation were the secondary outcomes.RESULTS:Sixty eyes were included,each group comprising 30 eyes.The average age[GM group:66.3±6.8y(12 males),GG group:67.6±8.9y(7 males),P=0.550],the baseline IOP(GM group:29.6±11.5 mm Hg,GG group:32.4±12.2 mm Hg,P=0.366)and the average initial PAS extent(GM group:8.9±2.6h,GG group:9.4±2.5h,P=0.425)were similar in the two groups.In GM group,the PAS range reduced from 8.9±2.6h before operation to 7.2±2.9h after PEI and 3.3±2.2h after GSL.In GG group,the PAS range reduced from 9.4±2.5h before operation to 7.5±2.9h after PEI and 0.1±0.3h after GSL.The PAS after PEI was significantly reduced compared to the preoperative PAS in both groups(all P<0.001).The extent of residual PAS after GSL in GM group was larger than that in GG group with significant statistical difference(P<0.001).Patients who underwent GSL without a gonioscope were more likely to develop hyphema than those who underwent GSL under direct gonioscopy.The difference of hyphema grade between the two groups was statistically significant(P=0.019).CONCLUSION:PEI alone can not open 360°of angle completely.PEI+GSL significantly reduced PAS range.But for patients with CACG,GSL under a microscope alone is more difficult to separate stable PAS completely and adequately than GSL under direct gonioscopy.展开更多
Interaction between Müller cells and microglia aggravates neuroinflammation,resulting in retinal ganglion cell(RGC)death in glaucoma.Here,we investigated how tumor necrosis factor-alpha(TNF-α)produced by activat...Interaction between Müller cells and microglia aggravates neuroinflammation,resulting in retinal ganglion cell(RGC)death in glaucoma.Here,we investigated how tumor necrosis factor-alpha(TNF-α)produced by activated microglia mediates the crosstalk between Müller cells and microglia and impacts RGC injury in a chronic ocular hypertension(COH)glaucoma model.In COH retinas,elevated TNF-αinduced the activation of Müller cells and microglia,and recruited microglia to the ganglion cell layer.Co-culture with Müller cells enhanced TNF-α-induced microglial activation,migration,and proliferation.Both in vivo and in vitro experiments confirmed that chemokine C-C motif ligand 2(CCL2),primarily released from Müller cells,mediated the TNF-α-induced effects on microglia in COH retinas.Knockdown of CCL2 attenuated RGC damage and vision loss.Our results demonstrate that TNF-αreleased from microglia induces the secretion of CCL2 from Müller cells,thus inducing microglial activation and migration,exacerbating retinal neuroinflammation and RGC injury in glaucoma.展开更多
Glaucoma is characterized by chronic progressive optic nerve damage and retinal ganglion cell death.Although extensive research has been conducted on neuroprotection for retinal ganglion cells,there is still no treatm...Glaucoma is characterized by chronic progressive optic nerve damage and retinal ganglion cell death.Although extensive research has been conducted on neuroprotection for retinal ganglion cells,there is still no treatment for clinical use.Recent evidence shows that extracellular vesicles isolated from a variety of stem cells are efficacious in retinal ganglion cell neuroprotection.In this study,we tested the novel extracellular vesicle source of the retinal progenitor R-28 cell line in vitro and in vivo.We isolated and characterized extracellular vesicles from R-28 cells and tested their therapeutic efficacy in terms of retinal ganglion cell survival in vitro and in an in vivo glaucoma model,measuring retinal ganglion cell survival and preservation of their axons.Additionally,we tested extracellular vesicles for their neuroprotective capacity in retinal ganglion cells differentiated from human embryonic stem cells.Finally,we investigated miRNA changes in retinal ganglion cells with R-28 extracellular vesicle treatment,and predicted possible pathways that may be modulated.R-28 extracellular vesicles improved retinal ganglion cell survival but failed to preserve axons significantly.Moreover,the results also illustrated the neuroprotection of R-28 extracellular vesicles on human retinal ganglion cells.Finally,we also showed changes in hsa-miRNA-4443,hsa-miRNA-216a-5p,hsa-let-7e-5p,hsa-miRNA-374b-5p,hsa-miRNA-331-3p,and hsa-miRNA-421 expressions,which may have neuroprotective potential on retinal ganglion cell degeneration.This study will pave the way for miRNA and extracellular vesicle-based neuroprotective therapies for glaucoma.展开更多
AIM:To build a functional generalized estimating equation(GEE)model to detect glaucomatous visual field progression and compare the performance of the proposed method with that of commonly employed algorithms.METHODS:...AIM:To build a functional generalized estimating equation(GEE)model to detect glaucomatous visual field progression and compare the performance of the proposed method with that of commonly employed algorithms.METHODS:Totally 716 eyes of 716 patients with primary open angle glaucoma(POAG)with at least 5 reliable 24-2 test results and 2y of follow-up were selected.The functional GEE model was used to detect perimetric progression in the training dataset(501 eyes).In the testing dataset(215 eyes),progression was evaluated the functional GEE model,mean deviation(MD)and visual field index(VFI)rates of change,Advanced Glaucoma Intervention Study(AGIS)and Collaborative Initial Glaucoma Treatment Study(CIGTS)scores,and pointwise linear regression(PLR).RESULTS:The proposed method showed the highest proportion of eyes detected as progression(54.4%),followed by the VFI rate(34.4%),PLR(23.3%),and MD rate(21.4%).The CIGTS and AGIS scores had a lower proportion of eyes detected as progression(7.9%and 5.1%,respectively).The time to detection of progression was significantly shorter for the proposed method than that of other algorithms(adjusted P≤0.019).The VFI rate displayed moderate pairwise agreement with the proposed method(k=0.47).CONCLUSION:The functional GEE model shows the highest proportion of eyes detected as perimetric progression and the shortest time to detect perimetric progression in patients with POAG.展开更多
AIM:To study the relationships between amplitude of low-frequency fluctuations(ALFF)changes and clinical ophthalmic parameters in patients with primary open angle glaucoma(POAG)and analyze the diagnostic value of ALFF...AIM:To study the relationships between amplitude of low-frequency fluctuations(ALFF)changes and clinical ophthalmic parameters in patients with primary open angle glaucoma(POAG)and analyze the diagnostic value of ALFF.METHODS:Twenty-four POAG patients and 24 healthy controls(HCs)underwent resting-state functional magnetic resonance imaging(rs-fMRI).Nonparametric rank-sum tests were used to compare the ALFF values in the slow-4 and slow-5 bands,and Spearman or Pearson correlation analysis was used to assess the correlation between ALFF changes and clinical ophthalmic parameters in POAG patients.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic performance of the ALFF.RESULTS:There were 16 males in POAG patients(median age 48y)and 12 males in HCs(median age 39y).Compared with HCs,POAG patients presented increased or decreased ALFF values in different brain regions,and similar changes were observed in mild POAG patients.The ALFF values were correlated with retinal nerve fiber layer(RNFL)thickness,inner limiting membrane-retinal pigment epithelium thickness changes and the degree of visual field defects.Analysis of the diagnostic value of the ALFF via ROC curves revealed that the right medial frontal gyrus[area under the curve(AUC)=0.9063]and superior frontal gyrus(AUC=0.9097)had better diagnostic value than did the optic disc area(AUC=0.8019),visual field index(VFI%,AUC=0.8988)and macular parameters.CONCLUSION:POAG patients present altered cortical function that is significantly correlated with the optic nerve and retinal thickness and had good diagnostic value,which may reflect the underlying neuropathological mechanism of POAG.展开更多
Neurodegenerative diseases account for a large and increasing health and economic burden worldwide.With an increasingly aged population,this burden is set to increase.Optic neuropathies make up a large proportion of n...Neurodegenerative diseases account for a large and increasing health and economic burden worldwide.With an increasingly aged population,this burden is set to increase.Optic neuropathies make up a large proportion of neurodegenerative diseases with glaucoma being highly prevalent.Glaucoma is characterized by the progressive dysfunction and loss of retinal ganglion cells and their axons which make up the optic nerve.It is the leading cause of irreversible vision loss and affects an estimated 80 million people.The mammalian central nervous system is non-regenerative and,once lost or injured,retinal ganglion cells cannot regenerate an axon into the optic nerve under basal conditions.Thus,strategies that provide neuroprotection to stressed,dysfunctional,or dying retinal ganglion cells are likely to be of high therapeutic and translational value.Advancing age,genetics,and elevated intraocular pressure are all major risk factors for glaucoma,however,all clinically available glaucoma treatments focus on intraocular pressure management and do not directly address the neurodegenerative component of glaucoma.展开更多
Dear Editor,We reported a Chinese family carrying a novel Crumbs homologue 1(CRB1)variant(c.1737_1755del).Consanguineous marriage resulted in a homozygous mutation,leading to the onset of Leber congenital amaurosis(LC...Dear Editor,We reported a Chinese family carrying a novel Crumbs homologue 1(CRB1)variant(c.1737_1755del).Consanguineous marriage resulted in a homozygous mutation,leading to the onset of Leber congenital amaurosis(LCA)in their offspring.展开更多
AIM:To explore the mechanical indices used for differential diagnosis and to investigate the relationship between ocular biomechanics and glaucoma severity within each group.METHODS:This cross-sectional study included...AIM:To explore the mechanical indices used for differential diagnosis and to investigate the relationship between ocular biomechanics and glaucoma severity within each group.METHODS:This cross-sectional study included 185 eyes from 185 subjects:62 normal controls,91 hightension glaucoma(HTG),and 32 normal-tension glaucoma(NTG)patients.All participants underwent a comprehensive ophthalmic examination that involved ocular biomechanical measurements.Glaucoma severity was assessed using visual field index(VFI),mean deviation(MD),pattern standard deviation(PSD)and retinal nerve fiber layer(RNFL)thickness.Multivariable models were used to compare fifteen biomechanical parameters among the three groups adjusting for age,gender,intraocular pressure(IOP),central corneal thickness(CCT),and axial length(AL).The generalized linear model was utilized for multifactor comparison.RESULTS:Significant differences in first applanation time(AT1),highest concavity time(HC time),stress strain index(SSI),and HC deflection were found among the three groups(P<0.05).AT1 was significantly higher in the HTG group compared to controls(P<0.05),and SSI was higher in HTG than NTG(P<0.05).HC deflection in the HTG group was significantly smaller than in NTG(P<0.05).Furthermore,AT1 levels were observed to be significantly higher in primary open angle glaucoma(POAG)patients compared to controls(P<0.05).Receiver operating charactristic(ROC)analysis showed HC deflection had an area under the curve(AUC)of 0.802 between HTG and NTG.A negatively significant correlation was observed between SSI and VFI in POAG patients.CONCLUSION:Biomechanical analysis reveals that corneas in POAG patients are stiffer than normal controls,with increased corneal stiffness correlating with more severe glaucomatous damage.Interestingly,stiffer corneas in NTG patients appeares protective.In addition,HC deflection may be useful for differentiating HTG and NTG.展开更多
AIM:To assess the efficacy and safety of ultrasound cycloplasty(UCP)in lowering intraocular pressure(IOP)among Chinese patients suffering from refractory glaucoma.METHODS:In this 12-month retrospective study,28 patien...AIM:To assess the efficacy and safety of ultrasound cycloplasty(UCP)in lowering intraocular pressure(IOP)among Chinese patients suffering from refractory glaucoma.METHODS:In this 12-month retrospective study,28 patients with refractory glaucoma(IOP≥25 mm Hg)were treated with 8-second UCP using either 8 or 10 probe sectors.The principal measure of efficacy was the decrease in IOP at the following intervals after UCP:1d,1,3,6,and 12mo,with each measurement compared to baseline.RESULTS:Mean IOP(in mm Hg)was reduced from 46.8±8.9 to 24.5±3.2,27.0±4.8,29.1±4.6,26.1±4.5,and 28.3±4.8 at 1d,1,3,6,and 12mo postoperatively,respectively.Compared to baseline,IOP reductions at these time points were 45.0%,39.9%,35.3%,41.4%,and 36.7%,respectively.Most patients experienced relief from ocular pain after surgery.No cases of choroidal detachment or hypotony was observed.CONCLUSION:UCP is effective in reducing IOP among Chinese patients with refractory glaucoma and shows a favorable safety profile.展开更多
Given the alarmingly increasing rates of glaucoma worldwide and the lack of satisfactory treatments,there is a dire need to explore more feasible treatment options.Magnesium(Mg)is an essential element in maintaining t...Given the alarmingly increasing rates of glaucoma worldwide and the lack of satisfactory treatments,there is a dire need to explore more feasible treatment options.Magnesium(Mg)is an essential element in maintaining the functional and structural integrity of vital ocular tissues,but Mg and its alloys are rarely mentioned in ophthalmic applications.Our previous research found that hydroxyapatite-coated Mg(Mg@HA)shows the best biocompatibility and bioactivity,and exhibits the effect of inhibiting fibrosis after filtration surgery in the rabbit model,which is expected to be a promising material for glaucoma drainage device.In this study,we further demonstrated the anti-fibrosis effect of Mg@HA from the molecular signal level and the efficacy of implantation in the rabbit filtration surgery model.In vitro experiments showed the surface modification of Mg affects the adhesion behavior and the reorganization of cytoskeleton of Human Western blot analysis and immunofluorescence found that Mg@HA regulates the adhesion and motility of human Tenon’s capsule fibroblasts mainly by down-regulating the phosphorylation of Smad2 and Smad3 in the canonical transforming growth factor-beta(TGF-β)signaling pathway.By observing and recording the condition of filtering blebs and intraocular pressure after surgery,the effectiveness of Mg@HA applied in the rabbit filtration surgery model was further evaluated.In conclusion,the application of hydroxyapatite-coated Mg in the eye has good biocompatibility and has the potential to resist postoperative glaucoma filtration fibrosis,which may be mediated by the regulation of the TGFβ/Smad signaling pathway.展开更多
基金Supported by The Eye Hospital of Wenzhou Medical University(No.KYQD20220304)The Fifth Batch of Provincial Ten Thousand Personnel Program Outstanding Talents Funding(No.474092204)+1 种基金Innovative Talents and Teams(2024)-The Fifth Batch of Funding Funds for Scientific and Technological Innovation Leading Talents Under the Provincial Ten Thousand Personnel Program(No.4240924003G)The Key R&D Program of Zhejiang(No.2022C03112).
文摘AIM:To identify early biomarkers associated with glaucomatous visual field(VF)progression in patients with normal-tension glaucoma(NTG).METHODS:This study included patients were divided into two groups based on disease progression status.Tear samples were collected for proteomic analysis.Dataindependent acquisition(DIA)mass spectrometry combined with bioinformatic analyses was performed to identify and validate potential protein biomarkers for NTG progression.Additionally,differentially expressed proteins(DEPs)were evaluated using mediating effect models and receiver operating characteristic(ROC)curve analysis.RESULTS:A total of 19 patients(20 eyes)with NTG participated in this study,including 10 patients(4 males and 6 females;10 eyes)in the progression group with mean age of 67.70±9.03y and 10 patients(4 males and 6 females;10 eyes)in the non-progression group with mean age of 68.60±7.58y.A total of 158 significantly differentially expressed proteins were detected.UniProt database annotation identified 3 upregulated proteins and 12 downregulated proteins.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analysis showed that these DEPs were mainly enriched in pathways such as oocyte meiosis.Gene Ontology(GO)enrichment analysis revealed functional clusters related to cellular processes.Weighted gene coexpression network analysis(WGCNA)indicated that the core proteins were primarily involved in the neurodegenerationmultiple diseases pathway and cellular processes.Mediating effect analysis identified PRDX4(L)as a potential protein biomarker.ROC curve analysis showed that GNAI1 had the largest area under the curve(AUC=0.889).CONCLUSION:This study identifies 15 differentially expressed proteins in the tear fluid of NTG patients,including PRDX4(L).PRDX4(L)plays a key role in oxidative stress.
文摘AIM： To investigate the change of anterior chamber angle morphology and intraocular pressure （lOP） reduction after cataract surgery in patients with normal-tension glaucoma （NTG） using swept-source optical coherence tomography （SS-OCT）. METHODS： This prospective, comparative, observational study recruited patients into two groups. Group 1 was the control group including normal subjects except those with cataracts （cataract group, n=67 eyes of 67 patients）, and group 2 was NTG group including patients who were diagnosed with NTG and cataracts （n=43 eyes of 43 patients）, which were treated with phacoemulsification and intraocular lens implantation. Before surgery, and at postoperative 1 and 6too, anterior chamber angles were evaluated by SS-OCT under dark conditions using three- dimensional angle analysis scan protocol. Angle opening distance （AOD）, angle recess area （ARA）, and trabecular- iris surface area （TISA） at four quadrants （temporal, nasal, superior, and inferior） were calculated automatically by SS-OGT, after the observer marked scleral spurs. RESULTS： A total of 106 patients （54 males and 52 females） were enrolled in the study. Angle parameters, AOD, ARA, and TISA were increased after surgery in both groups. However, changes of angle parameters were only significant in group 2. In group 2, preoperative lOP was 13.2＋2.9 mm Hg, and postoperative lOP at 1 and 6mo were 10.5＋3.0 and 10.7＋2.8 mm Hg, respectively. In group 1, preoperative lOP was 12.42.8 mm Hg, and postoperative lOP at 1 and 6mo were 11.6＋2.5 and 12.0＋2.8 mm Hg, respectively. After cataract surgery, angle parameters changed significantly while IOP significantly reduced and was maintained in group 2 （P〈0.001）. The changes in angle parameters （＆AOD500, ATISAS00 at temporal; ＆AOD500, S, RA500 at nasal） were linearly correlated with postoperative IOP changes. CONCLUSION： Cataract surgery may have improved antedor chamber angle parameters and decreased lOP in NTG patients.
文摘Glaucoma and dysfunction of axonal transport:One of the leading causes of irreversible blindness worldwide is glaucoma,with increased intraocula r pressu re(IOP)being the most common risk factor.However,in some glaucoma patients it has been shown that the IOP does not differ from that of the normal population.In Japan,normal-tension glaucoma(NTG),which accounts for 92%of primary open-angle glaucoma,has been shown to be more frequent in the population.
文摘This comprehensive review embarks on a captivating journey into the complex relationship between cardiology and normal-tension glaucoma(NTG),a condition that continues to baffle clinicians and researchers alike.NTG,characterized by optic nerve damage and visual field loss despite normal intraocular pressure,has long puzzled clinicians.One emerging perspective suggests that alterations in ocular blood flow,particularly within the optic nerve head,may play a pivotal role in its pathogenesis.While NTG shares commonalities with its high-tension counterpart,its unique pathogenesis and potential ties to cardiovascular health make it a fascinating subject of exploration.It navigates through the complex web of vascular dysregulation,blood pressure and perfusion pressure,neurovascular coupling,and oxidative stress,seeking to uncover the hidden threads that tie the heart and eyes together in NTG.This review explores into the intricate mechanisms connecting cardiovascular factors to NTG,shedding light on how cardiac dynamics can influence ocular health,particularly in cases where intraocular pressure remains within the normal range.NTG's enigmatic nature,often characterized by seemingly contradictory risk factors and clinical profiles,underscores the need for a holistic approach to patient care.Drawing parallels to cardiac health,we examine into the shared vascular terrain connecting the heart and the eyes.Cardiovascular factors,including systemic blood flow,endothelial dysfunction,and microcirculatory anomalies,may exert a profound influence on ocular perfusion,impacting the delicate balance within the optic nerve head.By elucidating the subtle clues and potential associations between cardiology and NTG,this review invites clinicians to consider a broader perspective in their evaluation and management of this elusive condition.As the understanding of these connections evolves,so too may the prospects for early diagnosis and tailored interventions,ultimately enhancing the quality of life for those living with NTG.
基金funded by the National Key R&D Project of China(No.2020YFA0112701)National Natural Science Foundation of China(No.82171057)+2 种基金Science and Technology Program of Guangzhou,China(No.202102010216)National Natural Science Foundation of China(No.GZR-2012-009)Beijing Traditional Chinese Medicine Technology Development Fund Project(No.JJ-2018-50)
文摘To the Editor:Normal-tension glaucoma(NTG)is a progressive optic neuropathy characterized by irreversible blindness with statistically normal intraocular pressure(IOP)(≤21 mmHg),^([1,2])which makes early-stage diagnosis in the clinical practice difficult.Pathophysiological pathways underlying NTG include vascular dysregulation,toxic metabolite accumulation,and elevated translaminar cribrosa pressure difference(TLCPD).^([3])Although various small animal models have provided evidence of different pathophysiological mechanisms,the complicated clinical phenotype cannot be fully imitated by secondary disease models,and the gap between rodents and humans weakens their translational potential.Thus,the pathological changes associated with NTG remain unclear.
文摘AIM:To investigate the efficacy and safety of 90°inferonasal sectoral goniotomy with an micro-vitreoretinal(MVR)blade in patients with mild-to-moderate primary open-angle glaucoma(POAG)and pseudoexfoliation glaucoma(PEXG).METHODS:This retrospective study included data from 60 patients(60 eyes)who underwent stand-alone goniotomy or goniotomy with phacoemulsification between August 2021 and January 2023,and 45 eyes underwent goniotomy combined with phacoemulsification,and 15 eyes underwent goniotomy as a stand-alone procedure.Postoperatively,intraocular pressure(IOP)and the number of medications were collected at 1,3,6,and 12 mo.The side effects of surgery were recorded 1 d,1 wk,and 1,3,6,and 12 mo postoperatively.The primary outcomes were a reduction in IOP of at least 20%from baseline and a decrease in the number of antiglaucomatous medications in 1 a postoperatively.The secondary outcome was surgical success,defined as an IOP<18 mmHg with(qualified)or without(complete)antiglaucomatous medication at 1 a postoperatively.RESULTS:At the end of 1 a,78%of patients achieved both a>20%reduction in IOP and a reduction in the number of medications used.Overall success was achieved in 63%of patients.Microhyphaema was the most common complication,none of the patients experienced a complication requiring surgical intervention.CONCLUSION:Sectoral inferonasal goniotomy with an MVR blade significantly reduced IOP and the number of medications required in patients with POAG and PEXG,and 1-year follow-up after goniotomy showed that the need for filtering surgery was either eliminated or delayed in a significant number of patients.
基金Suppotred by Tianjin Key Medical Discipline Construction Project(No.TJYXZDXK-3-004A-2).
文摘AIM:To present an overview of the research on global glaucoma treatment in the last decade in terms of publication year,journals,countries/regions,organizations,references,and keywords,to investigate the current research international trends and hot topics in this area.METHODS:Bibliometric analysis was conducted on 9128 articles in the Web of Science Core Collection(WoSCC;Clarivate)database.Quantitative and qualitative analysis was employed using VOSviewer(v1.6.18),Pajek(v1.0.0.0),and CiteSpace(v6.1.R2)software.RESULTS:The 9128 papers relating to glaucoma treatment were published from April 2013 to April 2023,of which 7482 articles(82%)were original research articles and 1464(18%)were review articles.The United States(2867)and Johns Hopkins University(166)were the most productive country and institution,respectively,but the University College London had the highest h-index(54).The Journal of Glaucoma was the most productive and Ophthalmology had the highest h-index compared with other journals.The Keywords of interest included treatment surgery,cyclophotocoagulation,minimally invasive glaucoma surgery(MIGS),trabeculectomy,baerveldt,epidemiology,medication adherence,nanoparticle,optical coherence tomography(OCT),gene therapy,and artificial intelligence(AI).Glaucoma surgery appeared as a current research hotspot through the analysis of keywords.CONCLUSION:This study provides insights into the research trends and potential research hotspots in the treatment of glaucoma.This will help researchers to evaluate research policies and to promote international cooperation.
基金supported by the Deutsche Forschungsgemeinschaft(DFG)with grants PR1569/1-1 and PR 1569/1-3(to VP).
文摘Globally,glaucoma stands as a primary cause of irreversible blindness,marked by intricate pathophysiological processes in which neuroinflammation plays a pivotal role.As the principal immune cells within the central nervous system,microglia play a dual function in the progression of glaucoma.Under standard physiological states,microglia safeguard the retina by offering neurotrophic support and removing cellular debris.In the pathological progression of glaucoma,microglia become activated and release significant levels of inflammatory factors,resulting in retinal ganglion cell injury,cell death,and impaired neuroregeneration.This review focuses on examining the dual functions of microglia in glaucoma,evaluating their influence on retinal neurodegeneration and repair,and suggesting that modulating microglial activity could serve as a promising therapeutic strategy.Understanding the mechanisms of microglial action in glaucoma is crucial for unveiling the complex pathophysiological processes of the disease and developing new therapeutic strategies.
基金Supported by the National Natural Science Foundation of China(No.82070964,No.82571210)Shaanxi Science Fund for Distinguished Young Scholars(No.2022JC-60)+3 种基金the International Scientific and Technological Cooperation Projects(No.2024GH-YBXM-20)the Open Research Funds of the State Key Laboratory of Ophthalmology(No.83000-32030002)Education Department of Shaanxi Provincial Government for Youth Innovation Team Research Program Project(No.23JP151,No.23JP150)General Projects of Hospital-level Research Topics in the Second Affiliated Hospital of Xi’an Medical University(No.22KY0111).
文摘AIM:To investigate the etiology and clinical characteristics of hospitalized secondary glaucoma(SG)patients in northwestern China.METHODS:A cross-sectional study was conducted involving SG patients hospitalized between July 2024 and January 2025.Clinical data were collected,including medical history,best-corrected visual acuity(BCVA),intraocular pressure(IOP),slit-lamp examination,gonioscopic findings,and fundus examination.Demographic characteristics,etiological factors,and treatment modalities were analyzed.RESULTS:A total of 67 patients(82 eyes)were enrolled,aged 7 to 90y.Males accounted for 54.0%(36/67),and 22.4%(15/67)of patients had bilateral involvement.The predominant etiologies of SG were neovascular glaucoma(NVG;25.4%),traumatic glaucoma(23.9%),uveitic glaucoma(20.9%),and lens-induced glaucoma(14.9%),collectively accounting for 85.1%of all cases.The peak age-specific incidence occurred in the 50-59 years age group(32.8%,22/67),while NVG was prevalent across the 40-79 years age range.IOP of the 82 affected eyes was stratified into five severity tiers:22-29 mm Hg(15 eyes,18.3%),30-39 mm Hg(14 eyes,17.1%),40-49 mm Hg(13 eyes,15.9%),50-59 mm Hg(20 eyes,24.4%),and≥60 mm Hg(20 eyes,24.4%).The overall mean IOP was 45.2±12.3 mm Hg,indicating a significant pathological elevation.Surgical intervention was required in 46.3%of cases,predominantly for NVG,lensinduced glaucoma,and traumatic glaucoma—conditions prone to rapid IOP elevation.The etiologies with the highest surgical intervention rates were malignant glaucoma,pigmentary glaucoma,lens-induced glaucoma,and NVG.In contrast,uveitic glaucoma cases were primarily managed with targeted anti-inflammatory therapy,which effectively controlled IOP in the early disease stages and potentially obviated the need for surgery.CONCLUSION:This study identifies NVG,traumatic glaucoma,uveitic glaucoma,and lens-induced glaucoma as the four leading etiologies of SG in Northwestern China.These findings emphasize the critical need for targeted prevention strategies and evidence-based health education programs among high-risk populations.Implementation of such initiatives will improve early detection,enable ophthalmologists to deliver timely therapeutic interventions,and ultimately reduce preventable vision loss in this region.
基金Supported by the National Natural Science Foundation of China(No.82074500)Beijing Natural Science Foundation(No.7252273)+2 种基金CACMS Innovation Fund(No.CI2021A02605)Administration of Traditional Chinese Medicine of Zhejiang Province(No.2024ZR029)Science and Technology Program of Wenzhou City(No.Y2023210).
文摘AIM:To perform a bibliometric analysis of publications focusing on inflammatory mechanisms in glaucoma,thereby comprehensively understanding the current research status and identifying potential frontier directions for future studies.METHODS:A systematic search was conducted in the Web of Science Core Collection(WoSCC)database to retrieve relevant literature published from January 1,2000,to August 31,2025(data accessed on September 12,2025).Multiple data visualization tools were employed to conduct in-depth analyses of the included publications,covering aspects such as publication quantity and quality,evolutionary trends of research hotspots,keyword cooccurrence networks,and collaborative patterns among countries/regions,institutions,and authors.RESULTS:A total of 3381 articles related to glaucoma inflammation were extracted from WoSCC.The analysis showed that the USA had the highest research output in this field(29.04%,n=982),followed by China(18.40%,n=622)and UK(6.01%,n=203).Based on citation frequency and burst intensity,the USA also ranked as the most influential country.Baudouin C and Sun X were identified as the most productive authors,while Journal of Glaucoma and Investigative Ophthalmology&Visual Science were the journals with the highest number of published relevant articles.Additionally,keyword analysis revealed that“neuroinflammation”,“retinal ganglion cells(RGCs)”,“pathophysiology”,and“traditional Chinese medicine”are emerging research hotspots in the field of immuneinflammatory responses in glaucoma.CONCLUSION:This study presents a comprehensive bibliometric overview of research on glaucoma-related inflammation,indicating that this field has received extensive scientific attention with a steady upward trend in research activity.Furthermore,it establishes a theoretical basis for the development of neuroinflammation-targeted therapeutic strategies for glaucoma and emphasizes the necessity of strengthening interdisciplinary collaboration to promote the clinical translation of research findings.
基金Supported by the Program for Zhejiang Leading Talent of S&T Innovation(No.2021R52012)Key Research and Development Projects of Zhejiang Province(No.2022C03112).
文摘AIM:To compare the efficacy of goniosynechialysis(GSL)under a microscope alone(GM)and under direct gonioscopy(GG)for chronic angle-closure glaucoma(CACG)coexisted with cataract.METHODS:A prospective,single-center,and randomized controlled trial was conducted.Patients diagnosed as CACG and cataract were randomly allocated into either GM group or GG group.In GM group,the range of peripheral anterior synechiae(PAS)was confirmed through gonio-lens after phacoemulsification with intraocular lens implantation(PEI).PAS was separated only under a microscope.After separating the closed angle of 360°by this method,we used a surgical gonioscope to confirm the PAS range.If any remaining PAS was present,we would separate them with an iris repositor under the direct gonio-lens until angle of 360°was reopened.In GG group,PAS was separated under direct gonioscopy after PEI until angle of 360°was reopened.The range of residual PAS after GSLs was the primary outcome.Intraoperative complications(hyphema),intraocular pressure(IOP)and anti-glaucoma medication usage after operation were the secondary outcomes.RESULTS:Sixty eyes were included,each group comprising 30 eyes.The average age[GM group:66.3±6.8y(12 males),GG group:67.6±8.9y(7 males),P=0.550],the baseline IOP(GM group:29.6±11.5 mm Hg,GG group:32.4±12.2 mm Hg,P=0.366)and the average initial PAS extent(GM group:8.9±2.6h,GG group:9.4±2.5h,P=0.425)were similar in the two groups.In GM group,the PAS range reduced from 8.9±2.6h before operation to 7.2±2.9h after PEI and 3.3±2.2h after GSL.In GG group,the PAS range reduced from 9.4±2.5h before operation to 7.5±2.9h after PEI and 0.1±0.3h after GSL.The PAS after PEI was significantly reduced compared to the preoperative PAS in both groups(all P<0.001).The extent of residual PAS after GSL in GM group was larger than that in GG group with significant statistical difference(P<0.001).Patients who underwent GSL without a gonioscope were more likely to develop hyphema than those who underwent GSL under direct gonioscopy.The difference of hyphema grade between the two groups was statistically significant(P=0.019).CONCLUSION:PEI alone can not open 360°of angle completely.PEI+GSL significantly reduced PAS range.But for patients with CACG,GSL under a microscope alone is more difficult to separate stable PAS completely and adequately than GSL under direct gonioscopy.
基金supported by the National Natural Science Foundation of China(32471057,32271043,82301215,and 82171047)the Shanghai Municipal Science and Technology Major Project(2018SHZDZX01)ZJLab,the Shanghai Center for Brain Science and Brain-Inspired Technology.
文摘Interaction between Müller cells and microglia aggravates neuroinflammation,resulting in retinal ganglion cell(RGC)death in glaucoma.Here,we investigated how tumor necrosis factor-alpha(TNF-α)produced by activated microglia mediates the crosstalk between Müller cells and microglia and impacts RGC injury in a chronic ocular hypertension(COH)glaucoma model.In COH retinas,elevated TNF-αinduced the activation of Müller cells and microglia,and recruited microglia to the ganglion cell layer.Co-culture with Müller cells enhanced TNF-α-induced microglial activation,migration,and proliferation.Both in vivo and in vitro experiments confirmed that chemokine C-C motif ligand 2(CCL2),primarily released from Müller cells,mediated the TNF-α-induced effects on microglia in COH retinas.Knockdown of CCL2 attenuated RGC damage and vision loss.Our results demonstrate that TNF-αreleased from microglia induces the secretion of CCL2 from Müller cells,thus inducing microglial activation and migration,exacerbating retinal neuroinflammation and RGC injury in glaucoma.
基金supported by a Ph.D.scholarship from the YLSY program of the Republic of Turkiye,Ministry of National Educationfunded by Fight for Sight UK,grant reference#5183/5184。
文摘Glaucoma is characterized by chronic progressive optic nerve damage and retinal ganglion cell death.Although extensive research has been conducted on neuroprotection for retinal ganglion cells,there is still no treatment for clinical use.Recent evidence shows that extracellular vesicles isolated from a variety of stem cells are efficacious in retinal ganglion cell neuroprotection.In this study,we tested the novel extracellular vesicle source of the retinal progenitor R-28 cell line in vitro and in vivo.We isolated and characterized extracellular vesicles from R-28 cells and tested their therapeutic efficacy in terms of retinal ganglion cell survival in vitro and in an in vivo glaucoma model,measuring retinal ganglion cell survival and preservation of their axons.Additionally,we tested extracellular vesicles for their neuroprotective capacity in retinal ganglion cells differentiated from human embryonic stem cells.Finally,we investigated miRNA changes in retinal ganglion cells with R-28 extracellular vesicle treatment,and predicted possible pathways that may be modulated.R-28 extracellular vesicles improved retinal ganglion cell survival but failed to preserve axons significantly.Moreover,the results also illustrated the neuroprotection of R-28 extracellular vesicles on human retinal ganglion cells.Finally,we also showed changes in hsa-miRNA-4443,hsa-miRNA-216a-5p,hsa-let-7e-5p,hsa-miRNA-374b-5p,hsa-miRNA-331-3p,and hsa-miRNA-421 expressions,which may have neuroprotective potential on retinal ganglion cell degeneration.This study will pave the way for miRNA and extracellular vesicle-based neuroprotective therapies for glaucoma.
基金Supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI),funded by the Ministry of Health&Welfare,Republic of Korea(No.HR20C0026)the National Research Foundation of Korea(NRF)(No.RS-2023-00247504)the Patient-Centered Clinical Research Coordinating Center,funded by the Ministry of Health&Welfare,Republic of Korea(No.HC19C0276).
文摘AIM:To build a functional generalized estimating equation(GEE)model to detect glaucomatous visual field progression and compare the performance of the proposed method with that of commonly employed algorithms.METHODS:Totally 716 eyes of 716 patients with primary open angle glaucoma(POAG)with at least 5 reliable 24-2 test results and 2y of follow-up were selected.The functional GEE model was used to detect perimetric progression in the training dataset(501 eyes).In the testing dataset(215 eyes),progression was evaluated the functional GEE model,mean deviation(MD)and visual field index(VFI)rates of change,Advanced Glaucoma Intervention Study(AGIS)and Collaborative Initial Glaucoma Treatment Study(CIGTS)scores,and pointwise linear regression(PLR).RESULTS:The proposed method showed the highest proportion of eyes detected as progression(54.4%),followed by the VFI rate(34.4%),PLR(23.3%),and MD rate(21.4%).The CIGTS and AGIS scores had a lower proportion of eyes detected as progression(7.9%and 5.1%,respectively).The time to detection of progression was significantly shorter for the proposed method than that of other algorithms(adjusted P≤0.019).The VFI rate displayed moderate pairwise agreement with the proposed method(k=0.47).CONCLUSION:The functional GEE model shows the highest proportion of eyes detected as perimetric progression and the shortest time to detect perimetric progression in patients with POAG.
基金Supported by National Natural Science Foundation of China(No.82260203).
文摘AIM:To study the relationships between amplitude of low-frequency fluctuations(ALFF)changes and clinical ophthalmic parameters in patients with primary open angle glaucoma(POAG)and analyze the diagnostic value of ALFF.METHODS:Twenty-four POAG patients and 24 healthy controls(HCs)underwent resting-state functional magnetic resonance imaging(rs-fMRI).Nonparametric rank-sum tests were used to compare the ALFF values in the slow-4 and slow-5 bands,and Spearman or Pearson correlation analysis was used to assess the correlation between ALFF changes and clinical ophthalmic parameters in POAG patients.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic performance of the ALFF.RESULTS:There were 16 males in POAG patients(median age 48y)and 12 males in HCs(median age 39y).Compared with HCs,POAG patients presented increased or decreased ALFF values in different brain regions,and similar changes were observed in mild POAG patients.The ALFF values were correlated with retinal nerve fiber layer(RNFL)thickness,inner limiting membrane-retinal pigment epithelium thickness changes and the degree of visual field defects.Analysis of the diagnostic value of the ALFF via ROC curves revealed that the right medial frontal gyrus[area under the curve(AUC)=0.9063]and superior frontal gyrus(AUC=0.9097)had better diagnostic value than did the optic disc area(AUC=0.8019),visual field index(VFI%,AUC=0.8988)and macular parameters.CONCLUSION:POAG patients present altered cortical function that is significantly correlated with the optic nerve and retinal thickness and had good diagnostic value,which may reflect the underlying neuropathological mechanism of POAG.
基金supported by St.Erik Eye Hospital philanthropic donations,Vetenskapsrådet 2022-00799(to PAW).
文摘Neurodegenerative diseases account for a large and increasing health and economic burden worldwide.With an increasingly aged population,this burden is set to increase.Optic neuropathies make up a large proportion of neurodegenerative diseases with glaucoma being highly prevalent.Glaucoma is characterized by the progressive dysfunction and loss of retinal ganglion cells and their axons which make up the optic nerve.It is the leading cause of irreversible vision loss and affects an estimated 80 million people.The mammalian central nervous system is non-regenerative and,once lost or injured,retinal ganglion cells cannot regenerate an axon into the optic nerve under basal conditions.Thus,strategies that provide neuroprotection to stressed,dysfunctional,or dying retinal ganglion cells are likely to be of high therapeutic and translational value.Advancing age,genetics,and elevated intraocular pressure are all major risk factors for glaucoma,however,all clinically available glaucoma treatments focus on intraocular pressure management and do not directly address the neurodegenerative component of glaucoma.
基金Supported by the National Natural Science Foundation of China(No.81970804)Natural Science Foundation of Hunan Province(No.2021JJ30949).
文摘Dear Editor,We reported a Chinese family carrying a novel Crumbs homologue 1(CRB1)variant(c.1737_1755del).Consanguineous marriage resulted in a homozygous mutation,leading to the onset of Leber congenital amaurosis(LCA)in their offspring.
基金Supported by the Science&Technology Department of Sichuan Province(China)Funding Project(No.2021YFS0221,No.2023YFS0179)1.3.5 Project for Disciplines of ExcellenceWest China Hospital,Sichuan University(No.2022HXFH032,ZYJC21058,2021-023,2022-014).
文摘AIM:To explore the mechanical indices used for differential diagnosis and to investigate the relationship between ocular biomechanics and glaucoma severity within each group.METHODS:This cross-sectional study included 185 eyes from 185 subjects:62 normal controls,91 hightension glaucoma(HTG),and 32 normal-tension glaucoma(NTG)patients.All participants underwent a comprehensive ophthalmic examination that involved ocular biomechanical measurements.Glaucoma severity was assessed using visual field index(VFI),mean deviation(MD),pattern standard deviation(PSD)and retinal nerve fiber layer(RNFL)thickness.Multivariable models were used to compare fifteen biomechanical parameters among the three groups adjusting for age,gender,intraocular pressure(IOP),central corneal thickness(CCT),and axial length(AL).The generalized linear model was utilized for multifactor comparison.RESULTS:Significant differences in first applanation time(AT1),highest concavity time(HC time),stress strain index(SSI),and HC deflection were found among the three groups(P<0.05).AT1 was significantly higher in the HTG group compared to controls(P<0.05),and SSI was higher in HTG than NTG(P<0.05).HC deflection in the HTG group was significantly smaller than in NTG(P<0.05).Furthermore,AT1 levels were observed to be significantly higher in primary open angle glaucoma(POAG)patients compared to controls(P<0.05).Receiver operating charactristic(ROC)analysis showed HC deflection had an area under the curve(AUC)of 0.802 between HTG and NTG.A negatively significant correlation was observed between SSI and VFI in POAG patients.CONCLUSION:Biomechanical analysis reveals that corneas in POAG patients are stiffer than normal controls,with increased corneal stiffness correlating with more severe glaucomatous damage.Interestingly,stiffer corneas in NTG patients appeares protective.In addition,HC deflection may be useful for differentiating HTG and NTG.
基金Supported by the Shanghai Science and Technology Committee Project Foundation(No.21Y11909700)Guangci Innovative Technology Sailing Plan(Ruijin Hospital 2022).
文摘AIM:To assess the efficacy and safety of ultrasound cycloplasty(UCP)in lowering intraocular pressure(IOP)among Chinese patients suffering from refractory glaucoma.METHODS:In this 12-month retrospective study,28 patients with refractory glaucoma(IOP≥25 mm Hg)were treated with 8-second UCP using either 8 or 10 probe sectors.The principal measure of efficacy was the decrease in IOP at the following intervals after UCP:1d,1,3,6,and 12mo,with each measurement compared to baseline.RESULTS:Mean IOP(in mm Hg)was reduced from 46.8±8.9 to 24.5±3.2,27.0±4.8,29.1±4.6,26.1±4.5,and 28.3±4.8 at 1d,1,3,6,and 12mo postoperatively,respectively.Compared to baseline,IOP reductions at these time points were 45.0%,39.9%,35.3%,41.4%,and 36.7%,respectively.Most patients experienced relief from ocular pain after surgery.No cases of choroidal detachment or hypotony was observed.CONCLUSION:UCP is effective in reducing IOP among Chinese patients with refractory glaucoma and shows a favorable safety profile.
基金supported by the National Natural Science Foundation of China(Grant No.81670860 and 81700836)Natural Science Foundation of Chongqing(Grant No.cstc2018jcyjAX0034 and cstc2018jcyjAX0016).
文摘Given the alarmingly increasing rates of glaucoma worldwide and the lack of satisfactory treatments,there is a dire need to explore more feasible treatment options.Magnesium(Mg)is an essential element in maintaining the functional and structural integrity of vital ocular tissues,but Mg and its alloys are rarely mentioned in ophthalmic applications.Our previous research found that hydroxyapatite-coated Mg(Mg@HA)shows the best biocompatibility and bioactivity,and exhibits the effect of inhibiting fibrosis after filtration surgery in the rabbit model,which is expected to be a promising material for glaucoma drainage device.In this study,we further demonstrated the anti-fibrosis effect of Mg@HA from the molecular signal level and the efficacy of implantation in the rabbit filtration surgery model.In vitro experiments showed the surface modification of Mg affects the adhesion behavior and the reorganization of cytoskeleton of Human Western blot analysis and immunofluorescence found that Mg@HA regulates the adhesion and motility of human Tenon’s capsule fibroblasts mainly by down-regulating the phosphorylation of Smad2 and Smad3 in the canonical transforming growth factor-beta(TGF-β)signaling pathway.By observing and recording the condition of filtering blebs and intraocular pressure after surgery,the effectiveness of Mg@HA applied in the rabbit filtration surgery model was further evaluated.In conclusion,the application of hydroxyapatite-coated Mg in the eye has good biocompatibility and has the potential to resist postoperative glaucoma filtration fibrosis,which may be mediated by the regulation of the TGFβ/Smad signaling pathway.
