Intraocular pressure elevation in uveitis

Din, Norshamsiah Md; Isa, Hazlita Mohd; Taylor, Simon; Barton, Keith; Lightman, Susan

doi:10.1586/eop.11.75

Cited by 11 publications

(7 citation statements)

References 111 publications

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“…Trabeculitis and clogging of the TM with inflammatory cells (most commonly seen in viral uveitis) may lead to a reduced AH outflow and acute IOP elevation with open angles ( 67 ). The chronic changes in the TM outflow pathway (ECM deposition, changing the structure or function in TM cells) occurring during inflammatory activity ( 68 ) and corticosteroid treatment are thought to be responsible for uveitis glaucoma ( 69 ). The change in the phenotype of macrophages and the underlying function, as presented herein, may play an important role in the development and deterioration of uveitis glaucoma.…”

Section: Discussionmentioning

confidence: 99%

Increased Hydrostatic Pressure Promotes Primary M1 Reaction and Secondary M2 Polarization in Macrophages

et al. 2020

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Patients with chronic anterior uveitis are at particularly high risk of developing secondary glaucoma when corticosteroids [e.g., dexamethasone (Dex)] are used or when inflammatory activity has regressed. Macrophage migration into the eye increases when secondary glaucoma develops and may play an important role in the development of secondary glaucoma. Our aim was to evaluate in vitro if increased hydrostatic pressure and corticosteroids could induce changes in macrophages phenotype. By using a pressure chamber cell culture system, we assessed the effect of increased hydrostatic pressure (HP), inflammation, and immunosuppression (Dex) on the M1/M2 phenotype of macrophages. Bone marrow-derived macrophages (BMDMs) were stimulated with medium, lipopolysaccharide (LPS, 100 ng/ml), Dex (200 ng/ml), or LPS + Dex and incubated with different HP (0, 20, or 60 mmHg) for 2 or 7 days. The numbers of CD86+/CD206− (M1 phenotype), CD86–/CD206+ (M2 phenotype), CD86+/CD206+ (intermediate phenotype), F4/80+/TNF-α+, and F4/80+/IL-10+ macrophages were determined by flow cytometry. TNF-α and IL-10 levels in cell culture supernatants were quantified by ELISA. TNF-α, IL-10, fibronectin, and collagen IV expression in BMDMs were detected by immunofluorescence microscopy. Higher HP polarizes macrophages primarily to an M1 phenotype (LPS, 60 vs. 0 mmHg, d2: p = 0.0034) with less extra cellular matrix (ECM) production and secondary to an M2 phenotype (medium, 60 vs. 0 mmHg, d7: p = 0.0089) (medium, 60 vs. 20 mmHg, d7: p = 0.0433) with enhanced ECM production. Dex induces an M2 phenotype (Dex, medium vs. Dex, d2: p < 0.0001; d7: p < 0.0001) with more ECM production. Higher HP further increased M2 polarization of Dex-treated macrophages (Dex, 60 vs. 0 mmHg, d2: p = 0.0417; d7: p = 0.0454). These changes in the M1/M2 phenotype by high HP or Dex treatment may play a role in the pathogenesis of secondary uveitic glaucoma- or glucocorticoid (GC)-induced glaucoma.

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Section: Discussionmentioning

confidence: 99%

Increased Hydrostatic Pressure Promotes Primary M1 Reaction and Secondary M2 Polarization in Macrophages

et al. 2020

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“…IOP was lower when W-OCT detected cells, however this was not observed when "Ophthalmoscopic findings" detected cells. Uveitis is known to increase IOP [17], however the underlying mechanisms are variable. On the other hand, inflammation in the eye decreases aqueous humor production, reducing IOP [18].…”

Section: Plos Onementioning

confidence: 99%

Relationship between ultra-widefield optical coherence tomography and ophthalmoscopy for detecting posterior inflammation in posterior uveitis and panuveitis

Misawa¹,

Tagami²,

Sakai³

et al. 2023

PLoS ONE

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Purpose To confirm the utility of ultra-widefield optical coherence tomography (W-OCT) for diagnosing uveitis. Method We retrospectively studied patients who had been diagnosed with uveitis and had undergone W-OCT. All patients had visited at Osaka Metropolitan University between January 2019 and January 2022. On W-OCT, vitreous opacity (“W-OCT VO”) and the presence of vitreous cells (“W-OCT Cells”) were identified by three specialists. We compared findings from ophthalmoscopy (“Ophthalmoscopic findings”) and fluorescein angiography (“FAG findings”) with those from W-OCT. Results This study investigated 132 eyes from 68 patients (34 males, 34 females; mean age, 53.97±22.71 years). Vitreous cells in posterior uveitis and panuveitis differed significantly between “W-OCT Cells” and “Ophthalmoscopic findings” for all cases (P = 0.00014). Vitreous opacities in posterior uveitis and panuveitis did not differ significantly between “W-OCT VO” and “Ophthalmoscopic findings” (P = 0.144) for all cases. Compared to “Ophthalmoscopic findings”, “W-OCT Cells” offered 51.1% sensitivity and 66.7% specificity for all cases (p<0.01). Compared to “Ophthalmoscopic findings”, “W-OCT VO” offered 78.6% sensitivity and 30% specificity for all cases (p = 0.19). In addition, “W-OCT Cells” did not differ significantly from “FAG findings” for all cases (P = 0.424). Conclusion W-OCT was shown to offer significantly greater sensitivity than ophthalmoscopy for detecting vitreous cells. The results of this study may add an option for the evaluation of uveitis.

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“…Glaucoma is the third most common complication of uveitis after cystoid macular edema and cataract, and it is seen in 10-20% of uveitic patients. 1,2 The underlying mechanism of uveitic glaucoma (UG) has not been fully understood. 1 Etiology of uveitis, inflammatory mechanisms, and steroid treatment have impacts on glaucoma development.…”

Section: Introductionmentioning

confidence: 99%

“…1 Trabeculectomy is the most widely performed surgical procedure in refractory glaucomas, but its long-term success rate is limited in UG because of early bleb failure secondary to accelerated healing response. 2 Landers et al 4 reported 20-year results of trabeculectomy in different types of glaucomas and they have found that UG has significantly lower success rate after trabeculectomy than other types of glaucomas. Uveitic eyes are also prone to develop hypotony in the early postoperative period secondary to ciliary body shutdown.…”

Section: Introductionmentioning

confidence: 99%

Assessment of conditions affecting surgical success of Ahmed glaucoma valve implants in glaucoma secondary to different uveitis etiologies in adults

Sungur

Yakin

Ekşioğlu

et al. 2017

Eye

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PurposeThere is little known about the long-term efficacy and safety of Ahmed glaucoma valve (AGV) implant and about the conditions affecting surgical success in uveitic glaucoma (UG).Patients and methodsThe charts of adult patients with UG who underwent AGV implantation from 2006 to 2015 were reviewed retrospectively.ResultsData of 46 eyes of 39 patients were evaluated. Mean follow-up was 51.93±23.08 months. Mean preoperative IOP was 37.05±9.62 mm Hg and mean number of preoperative topical anti-glaucomatous medications was 2.98±0.27. One eye (2%) was defined as failure because of implant extraction surgery. In the rest of the eyes, intraocular pressure (IOP) was under control with or without anti-glaucomatous medications during follow-up. The cumulative probability of complete success (IOP control without medications) was 78% at 6 months, 76% at 1 year, 71% at 2 years, 66% at 3 years, and 63% at 4 years (95% confidence interval, 61.24-87.81). The cumulative probability of eyes without complication was 64% at 6 months, 48% at 12 months, 44% at 24 months, 41% at 36 months, and 38% at 48 months (95% confidence interval, 34.64-62.85). Complete success was lower in eyes with previous ocular surgery than the eyes without (P=0.061) and it was lower in eyes with active inflammation at the time of surgery than the eyes without (P=0.011).ConclusionAGV implantation is an effective and safe alternative method in the management of UG, especially when it is performed as a primary surgical option and when no inflammation is present preoperatively.

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Intraocular pressure elevation in uveitis

Cited by 11 publications

References 111 publications

Increased Hydrostatic Pressure Promotes Primary M1 Reaction and Secondary M2 Polarization in Macrophages

Increased Hydrostatic Pressure Promotes Primary M1 Reaction and Secondary M2 Polarization in Macrophages

Relationship between ultra-widefield optical coherence tomography and ophthalmoscopy for detecting posterior inflammation in posterior uveitis and panuveitis

Assessment of conditions affecting surgical success of Ahmed glaucoma valve implants in glaucoma secondary to different uveitis etiologies in adults

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