Erythropoietin in ophthalmology: A literature review

Aghdam, Kaveh Abri; Sanjari, Mostafa Soltan; Falavarjani, Khalil Ghasemi

doi:10.1016/j.joco.2016.01.008

Cited by 34 publications

(25 citation statements)

References 73 publications

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“…Recently, EPO has revealed neuroprotective properties on the retina in addition to its hematopoietic effect [11,26]. Several investigations have addressed EPO properties to mediate protection against retinal damage through different pathways, including increasing resistance to inflammation, oxide-induced damage, ischemia, degeneration, and permeability [13,27].…”

Section: Discussionmentioning

confidence: 99%

Functional and Structural Effects of Erythropoietin Subconjunctival Administration in Glaucomatous Animals

et al. 2018

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Keywords Erythropoietin · Glaucoma · Subconjunctival route · Retinal ganglion cells · RatAbstract Purpose: The present study aimed to assess functional and structural benefits of erythropoietin (EPO) when administered subconjunctivally in the retina of glaucomatous rats using electroretinography (ERG) and retinal thickness (RT) measurements. Methods: Glaucoma was experimentally induced in 26 Wistar Hannover albino rats. Animals were divided into 2 groups of 13 animals each: a treated group receiving a unique subconjunctival injection of 1,000 IU of EPO and a control group receiving a saline solution. In each group, 7 animals were used for retinal function evaluation (ERG) and 6 animals were used for retinal structural evaluation (histology). RT was measured, dorsally and ventrally, at 500 μm (RT1) and at 1,500 μm (RT2) from the optic nerve. Results: Retinal function evaluation: for both scotopic and photopic conditions, ERG wave amplitudes increased in the treated group. This increase was statistically significant (p < 0.05) in photopic conditions. Structural evaluation: for both locations RT1 and RT2, the retinas were significantly (p < 0.05) thicker in the treated group. Conclusion: Sub- What Is It about?Glaucoma is the leading cause of irreversible blindness worldwide. Erythropoietin (EPO) has revealed neuroprotective properties on the retina, preserving visual function in several glaucoma models. The present study assesses functional and structural benefits of EPO when administered subconjunctivally in the retina of glaucomatous albino rats using electroretinography and retinal thickness measurements. Subconjunctival EPO administration, a mini-invasive and safe periocular route, showed beneficial effects both on retinal structure and on retinal function. This neuroprotective effect should be applied in other animal species, and more studies should be performed to assess EPO kinetics when administered via a subconjunctival route in glaucoma conditions. conjunctival EPO administration showed beneficial effects both on retinal structure and on retinal function in induced glaucoma in albino rats. This neuroprotective effect should be applied in other animal species.

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Section: Discussionmentioning

confidence: 99%

Functional and Structural Effects of Erythropoietin Subconjunctival Administration in Glaucomatous Animals

et al. 2018

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“…It has been shown that erythropoietin inserted exogenously contributes to the preservation of the external blood-retinal barrier, acting on processes at the level of the retinal pigment epithelium. In addition, intravitreal injections of rhEpo have led to the inhibition of VEGF and stabilization of the function of the blood-retinal barrier, and also to a shortterm positive effect on the chronic macular edema that has until then been practically refractory to any potential therapy (43).…”

Section: Discussionmentioning

confidence: 99%

Systemic Erythropoietin Concentration and its Correlation with Stage of Diabetic Retinopathy

Davidović

Babić

Jovanović

et al. 2019

Preprint

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Summary: Background: Erythropoietin (Epo) is one of systemic angiogenic factors, and its role in ocular angiogenesis and in diabetic retinopathy (DR) is not yet fully understood. Latest research data reveal possible correlation of higher EPO concentrations of erythropoietin in blood and in the eye, with more severe of stages of DR. The main aim of this work was to examine the possible influence of serum concentrations of erythropoietin on the development and stages of diabetic retinopathy in patients with diabetes mellitus type 2. Methods: The research involved 90 patients examined at University Eye Clinic in Clinical Center of Vojvodina in Novi Sad, Serbia. First group comprised of 60 patients with diabetes mellitus lasting 10 years or more, with diabetic retinopathy. Second, control group, consisted of 30 healthy individuals. In the first group of 60 diabetic patients, 30 of them had non-proliferative diabetic retinopathy (NPDR), and 30 had proliferative diabetic retinopathy (PDR). Laboratory EPO serum levels were determined, and they were correlated to the stage of DR. Concentration of EPO was assessed by ELISA method at the end of the study. Results: The highest average concentration of EPO in serum (9.95 mIU/ml) was determined in group of diabetics with PDR. The lowest average concentration of EPO in serum (6.90 mIU/ml) was found in control group. The average concentration of Epo in serum in group of diabetics with NPDR was 7.00 mIU/ml. EPO concentration in serum was elevated in group of PDR, and it was directly proportional to the level of clinical stadium of PDR, being significantly higher in moderate and severe subgroup of PDR comparing to control healthy subjects, NPDR and mild PDR (h=9.858, p=0.007). Conclusions: Significantly elevated serum concentration of EPO in advanced stages of DR, and positive correlation between EPO serum concentration and clinical stadium of PDR, suggest that erythropoietin presents one of the important growth factors from blood, which plays role in retinal ischemia and angiogenesis in diabetic retinopathy, especially in the proliferative stage of this disease. Keywords: diabetic retinopathy; erythropoietin; glycated hemoglobin; non-proliferative diabetic retinopathy; proliferative diabetic retinopathy.

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“…The presence of erythropoietin receptors in the retinal layers indicated possible developmental, physiologic, and therapeutic roles of erythropoietin in the eye. [30,31] The erythropoietin seems to have protective effects on the eye and play roles in the biological pathway of many ocular disorders such as diabetic retinopathy, retinopathy of prematurity, glaucoma, age-related MD, optic neuritis, and retinal detachment. [32–34] Recently, the relationship between advanced CKD patients, especially dialysis patients, and MD has been reported using similar national database.…”

Section: Discussionmentioning

confidence: 99%

Association between macular degeneration and mild to moderate chronic kidney disease

et al. 2017

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Chronic kidney disease (CKD) and macular degeneration (MD) are 2 grave diseases leading to significant disability secondary to renal failure and blindness. The 2 diseases share not only common risk factors but also similar pathogenic mechanisms to renal and retinal injuries. Previous epidemiological studies indicated association between these 2 diseases. However, this concept is challenged by recent investigations. Patients with mild to moderate CKD (n = 30,696) between January 1, 1995 and December 31, 2005 were selected from the Taiwan National Health Insurance Database. Controls (n = 122,784) were matched by age, gender, diabetes mellitus type 2, and hypertension status (1:4 ratios). The risk of MD was compared between the 2 groups. The mean age of patients was 54.9 ± 15.7 years. The proportion of MD was 2.7% in mild to moderate CKD patients and 1.9% in normal controls (P < 0.001); and, 0.39% and 0.26% (P < 0.001) in advanced MD. Mild to moderate CKD patients had higher risk for MD [adjusted odds ratio (OR), 1.301; 95% confidence interval (CI), 1.200–1.411; P < 0.001] than normal renal function subjects. The association was more pronounced for advanced MD. From all age strata (10 years increase), the presence of CKD in those patients aged less than 40 years had highest OR for all MD (OR = 2.125, 95% CI: 1.417–3.186, P < 0.001). The results were consistent in interaction terms, highlighting the importance of CKD in young age patient for risk of MD. The high risk for MD in mild to moderate CKD patients remains significant after adjustment for personal habits (alcohol drinking and smoking, model 1; OR: 1.371; 95% CI: 1.265–1.486; P < 0.001), comorbidities (dyslipidemia, cerebrovascular disease, and peripheral vascular disease, model 2; OR: 1.369; 95% CI: 1.264–1.484; P < 0.001) and all these factors (model 3; OR: 1.320, 95% CI: 1.218–1.431, P < 0.001). This association was consistent in the subanalysis, excluding those patients with diabetic retinopathy. Proper diagnosis and timely intervention should be warranted to retard visual loss of these patients.

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Erythropoietin in ophthalmology: A literature review

Cited by 34 publications

References 73 publications

Functional and Structural Effects of Erythropoietin Subconjunctival Administration in Glaucomatous Animals

Functional and Structural Effects of Erythropoietin Subconjunctival Administration in Glaucomatous Animals

Systemic Erythropoietin Concentration and its Correlation with Stage of Diabetic Retinopathy

Association between macular degeneration and mild to moderate chronic kidney disease

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