Glucocorticoid therapy and ocular hypertension

Dibas, Adnan; Yorio, Thomas

doi:10.1016/j.ejphar.2016.06.018

Cited by 55 publications

(37 citation statements)

References 226 publications

(251 reference statements)

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“…Synthetic GCs are available in different formulations (oral, intravenous or intramuscular, inhalation and topical). Unfortunately, their therapeutic actions are counterbalanced by adverse side effects associated with high doses and long-term use, such as osteoporosis, skin atrophy, diabetes, hypertension, abdominal obesity, acne, infection, and growth retardation [ 8 ], as well as ocular hypertension [ 9 ]. Indeed, the so called “iatrogenic Cushing’s syndrome” related to exogenous administration of GCs, represents the most frequent cause of hypercortisolism [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Treatment with Synthetic Glucocorticoids and the Hypothalamus-Pituitary-Adrenal Axis

Paragliola

Papi

Pontecorvi

et al. 2017

IJMS

130

104

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Chronic glucocorticoid (GC) treatment represents a widely-prescribed therapy for several diseases in consideration of both anti-inflammatory and immunosuppressive activity but, if used at high doses for prolonged periods, it can determine the systemic effects characteristic of Cushing’s syndrome. In addition to signs and symptoms of hypercortisolism, patients on chronic GC therapy are at risk to develop tertiary adrenal insufficiency after the reduction or the withdrawal of corticosteroids or during acute stress. This effect is mediated by the negative feedback loop on the hypothalamus-pituitary-adrenal (HPA) axis, which mainly involves corticotropin-release hormone (CRH), which represents the most important driver of adrenocorticotropic hormone (ACTH) release. In fact, after withdrawal of chronic GC treatment, reactivation of CRH secretion is a necessary prerequisite for the recovery of the HPA axis. In addition to the well-known factors which regulate the degree of inhibition of the HPA during synthetic GC therapy (type of compound, method of administration, cumulative dose, duration of the treatment, concomitant drugs which can increase the bioavailability of GCs), there is a considerable variation in individual physiology, probably related to different genetic profiles which regulate GC receptor activity. This may represent an interesting basis for possible future research fields.

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Section: Introductionmentioning

confidence: 99%

Treatment with Synthetic Glucocorticoids and the Hypothalamus-Pituitary-Adrenal Axis

Paragliola

Papi

Pontecorvi

et al. 2017

IJMS

130

104

View full text Add to dashboard Cite

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“… 1 Given its importance and multifacets, the mechanisms underlying glaucoma have been studied extensively but are not yet fully understood. 2 – 7 We recently reported the first evidence that Schlemm's canal, a critical structure involved in aqueous humor drainage, expresses Prox-1, the master control gene for lymphatic development. 8 This novel finding aligns well with several succeeding reports showing that Schlemm's canal is a VEGF-C/VEGFR-3 responsive lymphatic-like vessel and Prox-1 determines its integrity and identity.…”

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confidence: 99%

Establishment and Characterization of an Acute Model of Ocular Hypertension by Laser-Induced Occlusion of Episcleral Veins

Zhang

Shi

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeThis study was designed to develop and characterize a laser-induced model of acute intraocular hypertension that permits the study of the anterior segment of the eye.MethodsCD1 mice aged 5 and 8 weeks were examined for elevation of IOP induced by laser photocoagulation. We compared between occlusion of episcleral veins alone and when combined with 270° limbal vessel occlusion. Anterior chamber angle, corneal thickness, and retinal nerve fiber layer (RNFL) thickness were evaluated by anterior- and posterior-segment optical coherence tomography (OCT). Additionally, at day 7 post-procedure, the anterior segment was evaluated for inflammatory cellular presentation by histologic analysis and OCT, and limbal vessels and whole-mount retina were immunostained for CD31 and Brn3a, respectively. Brn3a-positive retinal ganglion cells (RGCs) were quantified with ImageJ software.ResultsAfter single or combined laser treatment in mice aged 5 or 8 weeks, IOP was significantly elevated for 5 to 6 days before returning to the baseline by day 7 post-procedure. Anterior segment assessment indicated less synechiae in the anterior chamber angle and better preserved limbal vessels with single versus combined laser treatment. Corneal thickness was significantly increased after single or combined treatment. No inflammatory cells were detected in the anterior chamber. The thickness of the RNFL and the density of RGCs were both significantly reduced after single or combined treatment.ConclusionsLaser photocoagulation of episcleral veins alone in CD1 mice aged 5 to 8 weeks may be used to induce ocular hypertension resulting in RNFL thinning and ganglion cell loss. This model permits the study of the anterior as well as the posterior segment of the eye.

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“…It may also indicate inadequate control of systemic disease [9, 10]. Treatment strategies for SLE include hydroxychloroquine (HCQ) or chloroquine (CQ) and systemic glucocorticoids (GCs), both correlated with a possible risk of visual impairment [11-13]. Retinal toxicity from HCQ and CQ has been recognized for many years.…”

Section: Introductionmentioning

confidence: 99%

Evidence for the Detection of Subclinical Retinal Involvement in Systemic Lupus Erythematosus and Sjögren Syndrome: A Potential Association with Therapies

Conigliaro

Triggianese

Draghessi

et al. 2018

Int Arch Allergy Immunol

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Background: Retinal involvement in systemic lupus erythematosus (SLE) and Sjögren syndrome (SS) may be subclinical and thus underdiagnosed. Objectives: We aimed at evaluating morphological and functional visual abnormalities in a cohort of SLE and SS patients in the absence of an overt clinical visual impairment. We also investigated potential associations between retinal disorders and disease activity, organ involvement, and treatment with steroid and/or hydroxychloroquine. Methods: The study comprised 42 SLE and 36 primary SS patients and 76 healthy controls (HC). Ophthalmological examination, standard automated perimetry, spectral-domain optical coherence tomography, and fundus perimetry were performed. Results: Retinal thickness of the posterior pole was not different between SLE and HC groups, but it was reduced in the SS group compared with both the HC and the SLE group. In SLE and SS patients, mean defect and pattern standard deviation by standard automated perimetry were higher than in HC. Visual field index values were lower in both SLE and SS patients than in HC. SLE patients with nephritis displayed increased mean defect and pattern standard deviation and reduced visual field index values compared to patients without nephritis. In SLE and SS patients, fundus perimetry differential sensitivity was reduced, and mean defect values were higher than in HC. Disturbances in fundus perimetry in the SLE group were more prevalent in steroid-naïve patients and in SS patients who received a cumulative hydroxychloroquine dose > 1,000 g. Conclusions: Functional eye impairment was demonstrated in SLE patients, possibly associated with kidney involvement. In SLE, corticosteroids might exert a protective role. Morphological alterations and functional impairment were detected in SS patients, which may be linked to hydroxychloroquine toxicity.

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Glucocorticoid therapy and ocular hypertension

Cited by 55 publications

References 226 publications

Treatment with Synthetic Glucocorticoids and the Hypothalamus-Pituitary-Adrenal Axis

Treatment with Synthetic Glucocorticoids and the Hypothalamus-Pituitary-Adrenal Axis

Establishment and Characterization of an Acute Model of Ocular Hypertension by Laser-Induced Occlusion of Episcleral Veins

Evidence for the Detection of Subclinical Retinal Involvement in Systemic Lupus Erythematosus and Sjögren Syndrome: A Potential Association with Therapies

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