Neuroprotective effect of systemic and/or intravitreal rosuvastatin administration in rat glaucoma model

AIM： To evaluate the neuroprotective effect of rosuvastatin, in a rat experimental glaucoma model. METHODS： Ocular hypertension was induced in right eyes of Long-Evans rats （n=30） by cauterization of three episcleral veins. Left eyes were defined as controls. Rats were divided into five groups： oral rosuvastatin, intravitreal rosuvastatin, oral ＋intravitreal rosuvastatin, intravitreal sham and glaucoma without intervention. Rats were sacrificed at day 14. Retinal ganglion cell （RGC） number was assessed by histopathological analysis. Terminal deoxynucleotidyl transferase-mediated dUTP-nick end-labeling （TUNEL） staining and the expression of glial fibrillary acidic protein （GFAP） in RGC layer was also examined. RESULTS： A significant intraocular pressure （lOP） elevation was seen （P=0.002）. Elevated lOP resulted in a significant decrease in number of RGCs in group 5 （70.33 ±8.2 cells/mm2） when compared with controls （92.50 ±13.72 cells/mm2; P=0.03）. The RGC number in group 1 （92.4±7.3 cells/mm2） was significantly higher than group 5 （ρ=0.03）. The numbers of RGC in groups 2, 3 （57.3±8.2 cells/mm2, 60.5±12.9 cells/mm2） were comparable with that of group 5 （ρ=0.18 and P=0.31）. The apoptosis rates with TUNEL staining were also parallel to RGC number. Animals with experimentally induced glaucoma showed an increase in retinal GFAP immunoreacUvity. CONCLUSION： Decrease in RGC loss and apoptosis suggest the neuroprotective potential of oral rosuvastatin treatment in a rat model of ocular hypertension. Howeverintravitreal rosuvastatin showed a contrary effect and further studies are required.

Trabeculectomy with large area mitomycin-C application as a first-line treatment in advanced glaucoma: retrospective review

AIM: To evaluate the outcomes of trabeculectomy with large area mitomycin-C(MMC) application as a first line treatment in advanced glaucoma. ·METHODS: The records of 55 patients with severe visual field defects undergoing trabeculectomy were retrospectively reviewed. The patients were classified as first-line therapy to either early trabeculectomy(initial trabeculectomy-Group 1) or long term medical therapy followed by trabeculectomy(primary trabeculectomy-Group 2). Trabeculectomy was performed with large-area MMC application. Intraocular pressure(IOP) values,visual acuities,mean deviations,morphology and function of the blebs,necessity for anti-glaucomatous medications and surgical complications were reported. ·RESULTS: There were 20 eyes of 18 patients in Group 1 and 37 eyes of 37 patients in Group 2. The mean preoperative IOPs in Groups 1 and 2 were 40.2±10.0mmHg(27-68mmHg) and 29.0±4.4mmHg(21-41mmHg),respectively(P=0.001). Average preoperative mean deviations(MD) in Groups 1 and 2 were 17.4±2.8dB(13.3-23dB) and 17.9± 2.4dB(13.7-23.2dB),respectively(P=0.441). Postoperative IOPs significantly decreased and were comparable in both Groups. The mean number of medications was significantly higher in Group 2(P =0.005). No cystic bleb formation was observed in Group 1,whereas 4 patients from Group 2(10.8%) developed cystic bleb(P =0.040). No visually devastating complication has occurred in both Groups. ·CONCLUSION: Initial trabeculectomy with large areaMMC application might be applied in patients with advanced glaucoma with low complication rates. Long-term topically applied anti-glaucomatous medications seem to increase the risk of cystic bleb formation.

Apoptosis in the iris and trabecular meshwork of medically treated and untreated primary open angle glaucoma patients

AIM:To compare the trabecular meshwork(TM)and iris apoptosis of treated and untreated primary open angle glaucoma(POAG)patients.METHODS:Eight treatment-naive,newly diagnosed(group 1)and 11 medlcaiy treated(group 2)patients with POAG were included in the study.Each patient underwent a limbus-based trabeculectomy.The TM and peripheral iris specimens were dissected out and were snap-frozen in liquid nitrogen and stored at-80t until they were assayed.Apoptosis in each group was assesed by TUNEL method.RESULTS:The mean patient age was 60.6±5.8 years(53-68 years)vs 58.9±8.9 years(47-70 years)in group 1and group 2(P=0.859).The mean treatment time in group 2 was 22.2±7.3 months(12-34 months).Apoptotic indexes in TM and iris were significantly higher in POAG patients using medication(group 2)compared to treatment-naive POAG patients(group 1)(P=0.004,0.015;respectively).CONCLUSION:Long term administration of topical antiglaucoma medications causes additional toxic effects on TM.

Retinal vessel diameters and their correlation with retinal nerve fiber layer thickness in patients with pseudoexfoliation syndrome

AIM: To compare retinal artery-vein diameters(RAVDs)of patients with pseudoexfoliation(PSX) syndrome with healthy controls and investigate the correlations between retinal nerve fiber layer(RNFL) thickness parameters and RAVDs.METHODS: Seventeen eyes with PSX and 17 eyes of age-matched controls were included in the study. All participants underwent routine ophthalmological examination, Humphrey visual field and RNFL examination by using Stratus OCT. Retinal images were obtained by using a retinal camera(Topcon 501X).RAVDs were measured from inferior nasal, inferior temporal, superior nasal and superior temporal arcuates by using IMAGEnet software. Superior, inferior, nasal,temporal and average RNFL thicknesses were recorded.RAVDs and RNFL parameters in groups and correlations were analyzed by Mann-Whitney U and Spearmann correlation tests.RESULTS: Only inferior quadrant and average RNFL thickness were detected thinner in the PSX group compared with control group(P =0.009, P =0.038,respectively). No statistically significant difference regarding RAVDs was found between two groups.CONCLUSION: RAVDs seems to be comparable in the PSX and control group. RNFL is thinner in the inferior quadrant in the PSX group. RNFL thickness and RAVDs show significant correlations in both groups. This correlation doesn’t seem to be specific to PSX.