Recent advances in risk factors associated with ocular exfoliation syndrome

Sharaf, Mehdi Ghaffari; Damji, Karim F.; Unsworth, Larry D.

doi:10.1111/aos.14298

Cited by 14 publications

(5 citation statements)

References 119 publications

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“…Gut microbiota might also play a role in the pathogenesis of this condition. These observations are consistent with the results of previous studies (Koliakos et al, 2008;Erdurmuş et al, 2011;Zenkel et al, 2011;Aboobakar et al, 2017;Borrás, 2018;Papadopoulou et al, 2018;Schlötzer-Schrehardt, 2018;Sharma et al, 2018;Botling Taube et al, 2019;Ghaffari Sharaf et al, 2020).…”

Section: Discussionsupporting

confidence: 94%

“…Carnitines may protect against selenite-induced cataract, and their loss may be a marker of disease development (Ritch, 2007). As postulated recently, the reduced level of carnitines in XFS might reflect mitochondrial dysfunction (Want et al, 2016;Ghaffari Sharaf et al, 2020). Our findings seem to support this theory, as the levels of hydroxybutyrylcarnitine and decatrienoylcarnitine in XFS patients were significantly lower than in the controls.…”

Section: Discussionsupporting

confidence: 85%

“…Chronic oxidative stress may disrupt the balance between matrix metalloproteinases and their tissue inhibitors, which leads to the accumulation of extracellular matrix fibrils constituting pseudoexfoliation material (Zenkel et al, 2011;Schlötzer-Schrehardt, 2012). Enhanced oxidative stress in the eye was also reported by other authors, along with mitochondrial dysfunction (Koliakos et al, 2008;Erdurmuş et al, 2011;Zenkel et al, 2011;Borrás, 2018;Papadopoulou et al, 2018;Schlötzer-Schrehardt, 2018;Sharma et al, 2018;Botling Taube et al, 2019;Ghaffari Sharaf et al, 2020). The latter might play a role in XFS progression.…”

Section: Discussionmentioning

confidence: 73%

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Metabolomics Reveals Differences in Aqueous Humor Composition in Patients With and Without Pseudoexfoliation Syndrome

Dmuchowska

Pietrowska

Krasnicki

et al. 2021

Front. Mol. Biosci.

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Pseudoexfoliation syndrome (XFS) is stress- or inflammation-induced elastosis accompanied by excessive production of microfibrils and their deposition in the anterior segment of the eye. Approximately 60–70 million people are affected by XFS worldwide. It is a component of a systemic disorder, considered a major risk factor for accelerated cataract formation, cataract surgery complications and development of glaucoma, which untreated or inadequately treated may lead to blindness. Moreover, XFS has been associated with cardiovascular and cerebrovascular morbidity, dementia, sensorineural hearing loss and pelvic organ prolapse. The pathogenesis of XFS has not been fully elucidated yet. Aqueous humor (AH) is a transparent fluid filling the anterior and posterior chambers of the eye. Determination of AH metabolites that are characteristic for XFS may provide valuable information about the molecular background of this ocular disorder. The aim of this study was to compare the composition of AH in XFS and non-XFS patients undergoing cataract surgery. The AH samples from 34 patients (15 with XFS and 19 without) were analyzed using liquid chromatography coupled to a Quadrupole Time-of-Flight mass spectrometer (LC-QTOF-MS). The obtained metabolic fingerprints were analyzed using multivariate statistics. Eleven statistically significant metabolites were identified. Compared with the non-XFS group, the AH of patients with XFS contained significantly lower levels of amino acids and their derivatives, for example, arginine (−31%, VIP = 2.38) and homo-arginine (−19%, VIP = 1.38). Also, a decrease in the levels of two acylcarnitines, hydroxybutyrylcarnitine (−29%, VIP = 1.24) and decatrienoylcarnitine (−46%, VIP = 1.89), was observed. However, the level of indoleacetaldehyde in XFS patients was significantly higher (+96%, VIP = 2.64). Other significant metabolites were two well-recognized antioxidants, ascorbic acid (−33%, VIP = 2.11) and hydroxyanthranilic acid (−33%, VIP = 2.25), as well as S-adenosylmethionine, a compound with anti-inflammatory properties (−29%, VIP = 1.93). Metabolic pathway analysis demonstrated that the identified metabolites belonged to eight metabolic pathways, with cysteine and methionine metabolism as well as arginine and proline metabolism being the most frequently represented. XFS can be associated with enhanced oxidative stress and inflammation, as well as with the disturbances of cellular respiration and mitochondrial energy production. Implementation of non-targeted metabolomics provided a better insight into the still not fully understood pathogenesis of XFS.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 73%

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Metabolomics Reveals Differences in Aqueous Humor Composition in Patients With and Without Pseudoexfoliation Syndrome

Dmuchowska

Pietrowska

Krasnicki

et al. 2021

Front. Mol. Biosci.

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“…It is supposed that similar risk factors can be applied for exfoliation glaucoma. However, genetic causes differed between POAG and EXFG 12 . Previous studies have also described risk factors for VF deterioration in POAG.…”

Section: Introductionmentioning

confidence: 95%

Risk factors for visual field progression in newly diagnosed exfoliation glaucoma patients in Sweden

Ayala

2022

Sci Rep

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The present study aimed to identify risk factors for visual field progression in newly diagnosed exfoliation glaucoma patients. Prospective nonrandomized cohort study. The study included patients with newly diagnosed exfoliation glaucoma. All patients were followed for at least 3 years with reliable visual fields. Both risk factors at inclusion and during the 3-year follow-up were considered. For inclusion, five reliable visual fields were needed. Exfoliation glaucoma was defined based on the European Glaucoma Society guidelines. Visual field evaluation was performed using the 24–2 strategy of Humphrey field analysis. Outcomes: Visual field progression. Three different approaches were used: mean deviation, visual field index, and guided progression analysis. Independent variables were tested first in a univariate linear or regression model. The significant variables were retested in a multivariate linear or logistic regression model. The results were different for the MD, VFI and GPA models. The only variable that showed a significant association in the three models was age (p = 0.004; p = 0.006; p = 0.04). Significant variables in the two models were IOP at diagnosis (p = 0.02; p = 0.04), IOP reduction in absolute terms (p = 0.006; p = 0.003), IOP reduction in relative terms (%) (p = 0.04; p = 0.009) and number of medicines (p = 0.02; p = 0.002). Significant variables in one model were family history (p = 0.04), smoking (p = 0.03), cataract surgery (p = 0.04) and SLT treatment (p ≤ 0.001). Exfoliation glaucoma is a fast progressive glaucoma. Age at diagnosis must be considered. Significant IOP reduction must be achieved to slow down progress in exfoliation glaucoma. The use of SLT treatment should be advised in exfoliation glaucoma patients.

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“…[ 7 ] Advanced age appears as a major risk factor as well as some genetic factors. [ 8 ] Some evidence exists for the association between XFS and lysyl oxidase-like 1 (LOXL1) protein gene implicated in elastin formation and maintenance and less so with the calcium channel protein gene CACNA1A, and the extracellular matrix chaperon clusterin protein. Known environmental risk factors for the disease have included solar exposure,[ 9 ] ambient temperature, living at more northern latitudes,[ 10 ] dietary factors,[ 9 11 ] and infectious etiology.…”

Section: Introductionmentioning

confidence: 99%

A case–cohort study of exfoliation risk factors and literature review

Mansour

Konstas

Mansour

et al. 2021

Middle East Afr J Ophthalmol

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The purpose of the study is to evaluate the risk factors associated with exfoliation in a case-cohort setting and literature review. This single-center, prospective, case-cohort study was carried out from January 2010 to April 2020 on patients operated for cataract surgery by a single surgeon in Lebanon. Forty-nine consecutive patients with exfoliation syndrome (XFS) and 62 consecutive control patients were identified and further investigated for selected systemic (diabetes mellitus, systemic hypertension, asthma, or atopy) and ocular variables (baseline vision, severity of nuclear sclerosis, glaucoma, eye rubbing, history of dry eye, or allergic eye disease). The mean baseline Snellen visual acuity was 20/283 in XFS versus 20/145 in control cases ( P = 0.012). XFS also demonstrated significantly denser nuclear sclerosis than controls ( P = 0.00958). By univariate analysis, allergic conjunctivitis (15 [30.6%] vs. 2 [3.2%]; P < 0.001), dry eye (20 [40.8%] vs. 13 [21.0%]; P = 0.0133), and habitual rubbing of the eyes (33 [67.3%] vs. 19 [30.6%]; P < 0.001) were associated with the presence of XFS. Habitual ocular rubbing was closely associated with allergic conjunctivitis (odds ratio [OR] = 13.0; 95% confidence interval [CI]: 2.8–58.8; P = 0.032). After multivariable analysis, the following variables showed significant results: glaucoma (OR = 34.5; 95% CI: 4.4–250; P = 0.010), duration of surgery (OR = 5.6; 95% CI 2.43–12.9; P < 0.001), and habitual ocular rubbing (OR = 4.42; 95% CI: 1.97–9.90; P = 0.029). This study shows a novel potential correlation between eye rubbing and XFS in a Lebanese cohort. Chronic eye rubbing induces or may exacerbate preexistent zonular damage in subjects with XFS, hence the need to better manage concurrent ocular surface disorder in these patients.

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Recent advances in risk factors associated with ocular exfoliation syndrome

Cited by 14 publications

References 119 publications

Metabolomics Reveals Differences in Aqueous Humor Composition in Patients With and Without Pseudoexfoliation Syndrome

Metabolomics Reveals Differences in Aqueous Humor Composition in Patients With and Without Pseudoexfoliation Syndrome

Risk factors for visual field progression in newly diagnosed exfoliation glaucoma patients in Sweden

A case–cohort study of exfoliation risk factors and literature review

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