Neuroimmunological Aspects in Glaucoma

Hohberger, Bettina

doi:10.1055/a-1264-8139

Cited by 2 publications

(2 citation statements)

References 23 publications

(46 reference statements)

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“…The more common primary optic neuropathy, GON, causes progressive optic atrophy and a corresponding visual field (VF) defect 4 . GON pathogenesis is primarily caused by translaminar pressure gradient insults to vulnerable optic nerve axons at the lamina cribrosa 5 , 6 . CON can be more diverse 7 .…”

Section: Introductionmentioning

confidence: 99%

Structural and functional differentiation between compressive and glaucomatous optic neuropathy

Laowanapiban¹,

Sathianvichitr

Chirapapaisan

2022

Sci Rep

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Clinical diagnoses of slow, progressive, painless visual losses with various degrees of visual field (VF) losses and disc atrophy are often confused between suprasellar compressive optic neuropathy (CON) and open-angle glaucomatous optic neuropathy (GON). We plotted the thickness of the peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GCIPL) against the mean deviation (MD) of the VF of 34 eyes of CON at diagnosis, 30 eyes of CON after therapy, 29 eyes of GON, and 60 eyes of healthy controls in a cross-sectional investigation. At diagnosis, a disproportionally early pattern of structural thinning compared with the corresponding VF losses was unique to CON. GON- and CON-specific thinning parameters were generally useful in differentiating GON and CON from moderate to severe MD losses, but early MD losses (0 to − 6 dB) overlapped with GON in a CON-stage specific manner. GON-specific thinning parameters, RNFL in the inferior sector, and inferior to temporal macular GCIPL ratio showed overlap with posttreatment CON in the early MD losses with AUCs of 0.916 (95% CI 0.860–0.971; P < 0.001) and 0.890 (95% CI 0.811–0.968; P < 0.001), respectively. In comparison, CON-specific thinning parameters, superonasal, and inferonasal GCIPL showed overlap with CON at diagnosis for early MD losses. Overall, the nasal-to-temporal macular GCIPL ratio showed good discrimination between CON and GON throughout the MD range, with an AUC of 0.923 (95% CI 0.870–0.976; P < 0.001). Comparing GON with all stages of CON, the cut-point of 0.95 showed the lower nasal-to-temporal GCIPL ratio had a sensitivity of 72% and specificity of 90% for CON. However, the cut-point of 1.10 showed the superior-to-inferior GCIPL ratio had a sensitivity of 60% and specificity of 98% for GON.

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Section: Introductionmentioning

confidence: 99%

Structural and functional differentiation between compressive and glaucomatous optic neuropathy

Laowanapiban¹,

Sathianvichitr

Chirapapaisan

2022

Sci Rep

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“…An increased intraocular pressure (IOP) has been established as a major risk factor in the multifactorial pathogenesis. Additionally, an altered blood flow, genetic alterations, oxidative stress and immune phenomena are involved in this complex interplay [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Erlanger Glaucoma Registry: Effect of a Long-Term Therapy with Statins and Acetyl Salicylic Acid on Glaucoma Conversion and Progression

Thiermeier

Laemmer

Mardin

et al. 2021

Biology

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Purpose: Drugs with cardiovascular protective properties (statins, acetylsalicylic acid (ASS)) were assumed to have positive effects on patients suffering from glaucoma disease. The present retrospective study aimed to investigate the influence of statins, ASS or a combination of both on the glaucoma conversion and progression rate in glaucoma suspects and glaucoma patients with a 20-year follow-up period. Methods: A retrospective analysis of 199 eyes of 120 patients (63 male, 57 female) of the Erlanger Glaucoma Registry (EGR; ClinicalTrials.gov Identifier: NCT00494923; ISSN 2191-5008, CS-2011) was performed considering systemic therapy with statins, ASS or a combination of both: 107 eyes with ocular hypertension (OHT) and 92 eyes with pre-perimetric primary open-angle glaucoma (pre-POAG). All patients received an ophthalmological examination including morphometric and functional glaucoma diagnostics. Glaucoma conversion was defined as the conversion of OHT to pre-POAG. Glaucoma progression was defined as confirmed visual field loss. Data were shown as percentages. Statistical analysis was performed by Chi-Quadrat tests. Results: 1. Glaucoma conversion/progression was observed in 46.7% of the subjects, additionally in combination with hypercholesterinemia in 76.8%. 2. Statins: 27.3% of eyes under systemic statin therapy showed a conversion/progression. Patients taking statins ≥ 10 years yielded a reduced conversion/progression rate (p = 0.028, non-significant after Bonferroni–Holm). 3. ASS: 34.7% of eyes under systemic ASS therapy showed a conversion/progression. A significantly lower conversion/progression rate was observed after ASS therapy ≥ 12 years (p = 0.017, significant after Bonferroni–Holm). 4. ASS and statins: 25.0% of eyes under combined therapy showed a conversion/progression. A significantly reduced conversion/progression rate was reached after 8 years of combined therapy (p = 0.049, non-significant after Bonferroni–Holm). Conclusions: Patients with ocular hypertension and early glaucoma seem to benefit from adjuvant cardiovascular protective therapy. However, the benefits and disadvantages of treatment with statins and/or ASS should be kept in mind. Thus, a thorough risk–benefit evaluation has to be performed for each patient individually to avoid unwanted side effects.

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Neuroimmunological Aspects in Glaucoma

Cited by 2 publications

References 23 publications

Structural and functional differentiation between compressive and glaucomatous optic neuropathy

Structural and functional differentiation between compressive and glaucomatous optic neuropathy

Erlanger Glaucoma Registry: Effect of a Long-Term Therapy with Statins and Acetyl Salicylic Acid on Glaucoma Conversion and Progression

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