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Glaucoma: HELP
Articles from San Diego
Based on 535 articles published since 2009

These are the 535 published articles about Glaucoma that originated from San Diego during 2009-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline Imaging and Perimetry Society standards and guidelines. 2011

Sample, Pamela A / Dannheim, Fritz / Artes, Paul H / Dietzsch, Janko / Henson, David / Johnson, Chris A / Ng, Minna / Schiefer, Ulrich / Wall, Michael / Anonymous6480679. ·Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA. ·Optom Vis Sci · Pubmed #21099442.

ABSTRACT: PURPOSE: To provide readers with standards, recommendations, guidelines, and requirements for the application of perimetry to clinical ophthalmic practice and scientific study. METHODS: A working group of perimetry and visual field specialists from many parts of the world constructed a document that would allow current and future perimeters to be assessed by the same criteria. Because hardware and software technology, statistical procedures and clinical conditions are constantly changing, the characteristics in this paper emphasize general concepts rather than specific implementations employed by current devices. RESULTS: Critical aspects of perimetry included indications for perimetry, perimetric techniques, stimulus characteristics, test administration, patient preparation, data display, statistical analysis, interpretation of visual field findings, a glossary of terms and definitions, and standards for comparison of different perimetric tests. Each of these topics is discussed, along with their advantages and disadvantages. CONCLUSIONS: These guidelines serve as a basis for practitioners to evaluate their perimetric needs in relation to their clinical practice and patient population so that informed decisions can be made for visual field testing. In addition, these issues should be used as a cornerstone for future technological and practical improvements to the visual field diagnostic procedures.

2 Editorial Advances in Ocular Imaging. 2019

Weinreb, Robert N / Moghimi, Sasan. ·Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, CA, La Jolla, California, United States. ·Asia Pac J Ophthalmol (Phila) · Pubmed #31037875.

ABSTRACT: -- No abstract --

3 Editorial Potential clinical applications of optical coherence tomography angiography in glaucoma. 2018

Moghimi, Sasan / Weinreb, Robert N. ·Hamilton Glaucoma Center, Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego, CA, United States. · Tehran University of Medical Sciences, Tehran, Iran. ·J Curr Ophthalmol · Pubmed #30197946.

ABSTRACT: -- No abstract --

4 Editorial Structure versus Function in Glaucoma: The Debate That Doesn't Need to Be. 2016

Medeiros, Felipe A / Tatham, Andrew J. ·San Diego, California. Electronic address: fmedeiros@ucsd.edu. · Edinburgh, United Kingdom. ·Ophthalmology · Pubmed #27210598.

ABSTRACT: -- No abstract --

5 Editorial Drugs, Inflammation, and the Eye. 2016

Cunningham, Emmett T / London, Nikolas J S / Moorthy, Ramana / Garg, Sunir J / Zierhut, Manfred. ·a California Pacific Medical Center , San Francisco , California , USA . · b The Department of Ophthalmology , Stanford University School of Medicine , Stanford , California , USA . · c The Francis I. Proctor Foundation, UCSF School of Medicine , San Francisco , California , USA . · d West Coast Retina Medical Group , San Francisco , California , USA . · e Retina Consultants San Diego , La Jolla , California , USA . · f Associated Vitreoretinal and Uveitis Consultants, Indiana University School of Medicine , Indianapolis , Indiana , USA . · g MidAtlantic Retina, The Retina Service of Wills Eye Hospital , Philadelphia , Pennsylvania , USA , and. · h Centre for Ophthalmology, University Tuebingen , Tuebingen , Germany. ·Ocul Immunol Inflamm · Pubmed #27074544.

ABSTRACT: -- No abstract --

6 Editorial Posture, intraocular pressure and visual function. 2014

Liu, John H K / Weinreb, Robert N. ·Department of Ophthalmology, Hamilton Glaucoma Center, University of California, San Diego, , La Jolla, California, USA. ·Br J Ophthalmol · Pubmed #24523148.

ABSTRACT: -- No abstract --

7 Review Review of the measurement and management of 24-hour intraocular pressure in patients with glaucoma. 2019

Mansouri, Kaweh / Tanna, Angelo P / De Moraes, Carlos Gustavo / Camp, Andrew S / Weinreb, Robert N. ·Glaucoma Research Center, Montchoisi Clinic, Swiss Vision Network Lausanne, Switzerland; University of Colorado Department of Ophthalmology, Aurora, Colorado, USA. · Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. · Columbia University Medical Center, New York, New York, USA. · Hamilton Glaucoma Center, Shiley Eye Institute, and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA. · Hamilton Glaucoma Center, Shiley Eye Institute, and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA. Electronic address: rweinreb@ucsd.edu. ·Surv Ophthalmol · Pubmed #31628907.

ABSTRACT: Elevated intraocular pressure (IOP) is a major, and currently the only, modifiable risk factor that has been shown to reduce the risk of glaucoma onset and progression. Diurnal measurements of IOP, usually during office hours, are commonly used for the assessment of IOP variation and the relative success of medical, laser, or surgical IOP-lowering interventions. Such measurements, however, fail to capture variation in IOP over the day/night cycle, which may be influenced by factors such as body position. We examine current evidence in the field of IOP measurement and control-with a focus on 24-hour (circadian) study design and measurement techniques and the 24-hour efficacy of current treatments-in patients with glaucoma and ocular hypertension. We then provide our recommendations for the design of future studies of circadian IOP with the aim of improving the assessment, management, and treatment of patients with glaucoma and ocular hypertension.

8 Review Use of Topical Steroids in Conjunctivitis: A Review of the Evidence. 2019

Holland, Edward J / Fingeret, Murray / Mah, Francis S. ·Cincinnati Eye Institute, Edgewood, KY. · Department of Veterans Affairs, New York Harbor Health Care System, Brooklyn, NY. · Departments of Cornea and External Diseases, Scripps Clinic Torrey Pines, La Jolla, CA. ·Cornea · Pubmed #31276464.

ABSTRACT: PURPOSE: Conjunctivitis, or inflammation of the conjunctiva, is a common condition that can be caused by infectious (eg, bacterial or viral infections) and noninfectious (eg, allergy) etiologies. Treatment involves diagnosis of the underlying cause and use of appropriate therapies. A broad-spectrum therapy that can address multiple etiologies, and also the accompanying inflammation, would be very useful. In this review, we discuss the usefulness of topical ophthalmic corticosteroids and ophthalmic formulations that combine corticosteroids with anti-infectives/antibiotics for treating acute infectious conjunctivitis. METHODS: A review of the published literature and relevant treatment guidelines. RESULTS: Topical corticosteroids are useful in treating ocular inflammation, but most treatment guidelines recommend steroid use generally in severe cases of conjunctivitis. This is partly due to risks associated with steroid use. These risks include potential for prolonging adenoviral infections and potentiating/worsening herpes simplex virus infections, increased intraocular pressure, glaucoma, and cataracts. Most of these perceived risks are not, however, supported by high-quality clinical data. They are also associated with long-term steroid uses that are dissimilar to applications for infectious conjunctivitis. Clinical data show that ophthalmic formulations that combine corticosteroids with broad-spectrum anti-infectives could be effective and well tolerated when used for short-term treatment (≤2 weeks). CONCLUSIONS: Corticosteroids, in combination with anti-infectives, could be a promising treatment option for acute conjunctivitis subject to development of further evidence on their effectiveness and safety in conjunctivitis treatment.

9 Review Canaloplasty in the Treatment of Open-Angle Glaucoma: A Review of Patient Selection and Outcomes. 2019

Riva, Ivano / Brusini, Paolo / Oddone, Francesco / Michelessi, Manuele / Weinreb, Robert N / Quaranta, Luciano. ·IRCCS, Fondazione Bietti, Rome, Italy. · Department of Ophthalmology, "Città di Udine" Health Center, Udine, Italy. · Hamilton Glaucoma Center and Shiley Eye Institute, University of California San Diego, San Diego, CA, USA. · Department of Medical and Surgical Specialties, University of Brescia, Brescia, Italy. luciano.quaranta@unibs.it. ·Adv Ther · Pubmed #30488337.

ABSTRACT: Canaloplasty is a relatively new non-penetrating surgery for the reduction of intraocular pressure in patients affected by glaucoma. The technique uses a microcatheter to perform a 360 º cannulation of Schlemm's canal and leaves in place a tension suture providing an inward distension. It aims to restore the physiological outflow pathways of the aqueous humour and is independent of external wound healing. Several studies have shown that canaloplasty is effective in reducing intraocular pressure and has a low rate of complications, especially compared with trabeculectomy, the gold standard for glaucoma surgery. Currently, canaloplasty is indicated in patients with open-angle glaucoma, having a mild to moderate disease, and the combination with cataract phacoemulsification may provide further intraocular pressure reduction. This article reviews canaloplasty indications, results and complications and analyses its outcomes compared with traditional penetrating and non-penetrating techniques.

10 Review ER stress and unfolded protein response in ocular health and disease. 2019

Kroeger, Heike / Chiang, Wei-Chieh / Felden, Julia / Nguyen, Amanda / Lin, Jonathan H. ·Department of Pathology, University of California San Diego, La Jolla, CA, USA. · Institute for Ophthalmic Research, Centre for Ophthalmology, University of Tübingen, Germany. · VA San Diego Healthcare System, San Diego, CA, USA. ·FEBS J · Pubmed #29802807.

ABSTRACT: The human eye is the organ that is able to react to light in order to provide sharp three-dimensional and colored images. Unfortunately, the health of the eye can be impacted by various stimuli that can lead to vision loss, such as environmental changes, genetic mutations, or aging. Endoplasmic reticulum (ER) stress and unfolded protein response (UPR) signaling have been detected in many diverse ocular diseases, and chemical and genetic approaches to modulate ER stress and specific UPR regulatory molecules have shown beneficial effects in animal models of eye disease. This review highlights specific eye diseases associated with ER stress and UPR activity, based on a recent symposia exploring this theme.

11 Review The Role of Axon Transport in Neuroprotection and Regeneration. 2018

Shah, Sahil H / Goldberg, Jeffrey L. ·Byers Eye Institute, Stanford University, Palo Alto, California. · Neurosciences Graduate Program, University of California, San Diego, California. · Medical Scientist Training Program, University of California, San Diego, California. ·Dev Neurobiol · Pubmed #30027690.

ABSTRACT: Retinal ganglion cells and other central nervous system neurons fail to regenerate after injury. Understanding the obstacles to survival and regeneration, and overcoming them, is key to preserving and restoring function. While comparisons in the cellular changes seen in these non-regenerative cells with those that do have intrinsic regenerative ability has yielded many candidate genes for regenerative therapies, complete visual recovery has not yet been achieved. Insights gained from neurodegenerative diseases, like glaucoma, underscore the importance of axonal transport of organelles, mRNA, and effector proteins in injury and disease. Targeting molecular motor networks, and their cargoes, may be necessary for realizing complete axonal regeneration and vision restoration.

12 Review Regenerating Eye Tissues to Preserve and Restore Vision. 2018

Stern, Jeffrey H / Tian, Yangzi / Funderburgh, James / Pellegrini, Graziella / Zhang, Kang / Goldberg, Jeffrey L / Ali, Robin R / Young, Michael / Xie, Yubing / Temple, Sally. ·Neural Stem Cell Institute, Rensselaer, NY 12144, USA; Kellogg Eye Center, University of Michigan, Ann Arbor, MI 48105, USA. · Colleges of Nanoscale Science and Engineering, SUNY Polytechnic Institute, 257 Fuller Road, Albany, NY 12203, USA. · Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. · Centre for Regenerative Medicine, University of Modena and Reggio Emilia, via G.Gottardi 100, 41125 Modena, Italy. · Shiley Eye Institute and Institute for Engineering in Medicine, University of California, San Diego, La Jolla, CA 92093, USA; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University and Guangzhou Regenerative Medicine and Health Laboratory, Guangzhou 510060, China. · Byers Eye Institute at Stanford University, 2452 Watson Court, Palo Alto, CA 94303, USA. · Department of Genetics, University College London Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK; NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, City Road, London EC1V 2PD, UK; Kellogg Eye Center, University of Michigan, Ann Arbor, MI 48105, USA. · The Schepens Eye Research Institute, Massachusetts Eye and Ear, an affiliate of Harvard Medical School, Boston, MA 02114, USA. · Neural Stem Cell Institute, Rensselaer, NY 12144, USA; Kellogg Eye Center, University of Michigan, Ann Arbor, MI 48105, USA. Electronic address: sallytemple@neuralsci.org. ·Cell Stem Cell · Pubmed #29859174.

ABSTRACT: Ocular regenerative therapies are on track to revolutionize treatment of numerous blinding disorders, including corneal disease, cataract, glaucoma, retinitis pigmentosa, and age-related macular degeneration. A variety of transplantable products, delivered as cell suspensions or as preformed 3D structures combining cells and natural or artificial substrates, are in the pipeline. Here we review the status of clinical and preclinical studies for stem cell-based repair, covering key eye tissues from front to back, from cornea to retina, and including bioengineering approaches that advance cell product manufacturing. While recognizing the challenges, we look forward to a deep portfolio of sight-restoring, stem cell-based medicine. VIDEO ABSTRACT.

13 Review Flavonoids as acetylcholinesterase inhibitors: Current therapeutic standing and future prospects. 2018

Khan, Haroon / Marya, ? / Amin, Surriya / Kamal, Mohammad Amjad / Patel, Seema. ·Department of Pharmacy, Abdul Wali Khan University, Mardan, 23200, Pakistan. Electronic address: haroonkhan@awkum.edu.pk. · Department of Pharmacy, Abdul Wali Khan University, Mardan, 23200, Pakistan. · Department of Botany, Islamia College Peshawar, Pakistan. · King Fahd Medical Research Center, King Abdulaziz University, Saudi Arabia; Enzymoics, 7 Peterlee Place, Hebersham, NSW, 2770, Australia; Novel Global Community Educational Foundation, Australia. · Bioinformatics and Medical Informatics Research Center, San Diego State University, San Diego, CA, 92182, USA. Electronic address: Patel3@rohan.sdsu.edu. ·Biomed Pharmacother · Pubmed #29635895.

ABSTRACT: BACKGROUND: Acetylcholinesterase (AChE), a serine hydrolase, is primarily responsible for the termination of signal transmission in the cholinergic system, owing to its outstanding hydrolyzing potential. Its substrate acetylcholine (ACh), is a neurotransmitter of the cholinergic system, with a predominant effect on motor neurons involved in memory formation. So, by decreasing the activity of this enzyme by employment of specific inhibitors, a number of motor neuron disorders such as myasthenia gravis, glaucoma, Lewy body dementia, and Alzheimer's disease, among others, can be treated. However, the current-available AChE inhibitors have several limitations in terms of efficacy, therapeutic range, and safety. SCOPE AND APPROACH: Primarily due to the non-compliance of current therapies, new, effective and safe inhibitors are being searched for, especially those which act through multiple receptor sites, but do not elicit undesirable effects. In this regard, the evaluation of phytochemicals such as flavonoids, can be a rational approach. The therapeutic potential of flavonoids has already been recognized agaisnt several ailments. This review deals with various plant-derived flavonoids, their preclinical potential as AChE inhibitors, in established assays, possible mechanisms of action, and structural activity relationship (SAR). RESULTS AND CONCLUSIONS: Subsequently, a number of plant-derived flavonoids with outstanding efficacy and potency as AChE inhibitors, the mechanistic, their safety profiles, and pharmacokinetic attributes have been discussed. Through derivatization of these reported flavonoids, some limitation in efficacy or pharmacokinetic parameters can be addressed. The selected flavonoids ought to be tested in clinical studies to discover new neuro-therapeutic candidates.

14 Review Structural and functional imaging of aqueous humour outflow: a review. 2018

Huang, Alex S / Francis, Brian A / Weinreb, Robert N. ·Doheny Eye Institute, Los Angeles, California, USA. · Doheny Eye Centers, Department of Ophthalmology, David Geffen School of Medicine at University of California, Los Angeles, California, USA. · Shiley Eye Institute and Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, California, USA. ·Clin Exp Ophthalmol · Pubmed #28898516.

ABSTRACT: Maintaining healthy aqueous humour outflow (AHO) is important for intraocular cellular health and stable vision. Impairment of AHO can lead to increased intraocular pressure, optic nerve damage and concomitant glaucoma. An improved understanding of AHO will lead to improved glaucoma surgeries that enhance native AHO as well as facilitate the development of AHO-targeted pharmaceuticals. Recent AHO imaging has evolved to live human assessment and has focused on the structural evaluation of AHO pathways and the functional documentation of fluid flow. Structural AHO evaluation is predominantly driven by optical coherence tomography, and functional evaluation of flow is performed using various methods, including aqueous angiography. Advances in structural and functional evaluation of AHO are reviewed with discussion of strengths, weaknesses and potential future directions.

15 Review Will Perimetry Be Performed to Monitor Glaucoma in 2025? 2017

Camp, Andrew S / Weinreb, Robert N. ·Hamilton Glaucoma Center, Shiley Eye Institute and Department of Ophthalmology, University of California-San Diego, La Jolla, California. · Hamilton Glaucoma Center, Shiley Eye Institute and Department of Ophthalmology, University of California-San Diego, La Jolla, California. Electronic address: rweinreb@ucsd.edu. ·Ophthalmology · Pubmed #28865878.

ABSTRACT: Visual field testing has played an essential role in the diagnosis and management of glaucoma for more than a century. Methods to examine the visual field have been refined from early kinetic perimetry to current standard automated perimetry (SAP). Clinicians now use SAP for the diagnosis and management of glaucoma throughout the world. Various testing paradigms and analytic methods have been developed to simplify the diagnosis of glaucoma and the interpretation of progression. Moreover, strategies have been implemented to improve patient experience with visual field testing and to increase reliability. Objective functional tests, such as electroretinography, provide an alternative to subjective visual field testing but are not yet ready for widespread adoption. Standard automated perimetry is being adapted and improved constantly. New devices may allow patients to complete visual field tests at home, which could relieve patients and clinicians from in-office testing and allow for more frequent examinations. Glaucoma detection and progression analysis also are incorporating progressively more information and will be improved as deep learning strategies are applied. Finally, perimetric and structural testing likely will become more closely intertwined as testing platforms and progression analysis incorporate both of these measures. Visual field testing will continue to have an important role in the diagnosis and management of glaucoma.

16 Review Decade-Long Profile of Imaging Biomarker Use in Ophthalmic Clinical Trials. 2017

Villani, Edoardo / Massaro, Domenico / Scaramuzzi, Matteo / Hamrah, Pedram / Medeiros, Felipe A / Nucci, Paolo. ·Department of Clinical Sciences and Community Health, University of Milan, Eye Clinic San Giuseppe Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Multimedica, Milan, Italy. · Department of Ophthalmology, Cornea Service and Boston Image Reading Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts, United States. · Hamilton Glaucoma Center, Visual Performance Laboratory, University of California San Diego, La Jolla, California, United States. ·Invest Ophthalmol Vis Sci · Pubmed #28525561.

ABSTRACT: Purpose: The purpose of this study was to investigate the use of imaging biomarkers in published clinical trials (CTs) in ophthalmology and its eventual changes during the past 10 years. Methods: We sampled from published CTs in the fields of cornea, retina, and glaucoma between 2005-2006 and 2015-2016. Data collected included year of publication, phase, subspecialty, location, compliance with Consolidated Standards for Reporting Trials, impact factor, presence and use of imaging biomarkers (diagnostic, prognostic and predictive; primary and secondary surrogate endpoints), and use of centralized reading centers. Results: We included 652 articles for analysis, equally distributed in three timeframes (2005-2006, 2010-2011, and 2015-2016), mainly reporting phase IV CTs and trials on procedures (42.2% and 35.4%, respectively). Imaging biomarkers were included in 46.3% of the analyzed CTs and their use significantly increased over time (P < 0.05). Optical coherence tomography was the most frequently used device (27.7%), whereas diagnostic biomarkers and secondary surrogate endpoints were the most frequent biomarker types (19.5% and 22.5%, respectively). Early-phase CTs showed an increase in the use of biomarkers for patient selection and stratification over time (P < 0.05), but not in the use of imaging surrogate endpoints (P = 0.90). Only 3 of 59 (5.1%) of phase III CTs included primary surrogate imaging endpoints, whereas secondary surrogate imaging endpoints were present in 50.8% of these trials (P < 0.001). Retinal CTs had the highest prevalence for each type of imaging biomarker (P < 0.001). Reading centers were used in 52 of 302 CTs (17.2%), with no significant time-related increase. Conclusions: Imaging biomarkers are increasingly used in published CTs in ophthalmology. Additional efforts, including centralized reading centers, are needed to improve their validation and use, allowing a wider use of these tools as primary surrogate endpoints in phase III CTs.

17 Review Biomarkers and Surrogate Endpoints: Lessons Learned From Glaucoma. 2017

Medeiros, Felipe A. ·Hamilton Glaucoma Center, Department of Ophthalmology, University of California San Diego, La Jolla, California, United States. ·Invest Ophthalmol Vis Sci · Pubmed #28475699.

ABSTRACT: With the recent progress in imaging technologies for assessment of structural damage in glaucoma, a debate has emerged on whether these measurements can be used as valid surrogate endpoints in clinical trials evaluating new therapies for the disease. A discussion of surrogates should be grounded on knowledge acquired from their use in other areas of medicine as well as regulatory requirements. This article reviews the conditions for valid surrogacy in the context of glaucoma clinical trials and critically evaluates the role of biomarkers such as IOP and imaging measurements as potential surrogates for clinically relevant outcomes. Valid surrogate endpoints must be able to predict a clinically relevant endpoint, such as loss of vision or decrease in quality of life. In addition, the effect of a proposed treatment on the surrogate must capture the effect of the treatment on the clinically relevant endpoint. Despite its widespread use in clinical trials, no proper validation of IOP as a surrogate endpoint has yet been conducted for any class of IOP-lowering treatments. Although strong evidence has accumulated about imaging measurements as predictors of relevant functional outcomes in glaucoma, there is still insufficient evidence to support their use as valid surrogate endpoints. However, imaging biomarkers could potentially be used as part of composite endpoints in glaucoma trials, overcoming weaknesses of the use of structural or functional endpoints in isolation. Efforts should be taken to properly design and conduct studies that can provide proper validation of potential biomarkers in glaucoma clinical trials.

18 Review Steroid-induced glaucoma in the pediatric population. 2017

Nuyen, Brenda / Weinreb, Robert N / Robbins, Shira L. ·Ratner Children's Eye Center at the Shiley Eye Institute, University of California San Diego, La Jolla, California. · Shiley Eye Institute, University of California San Diego, La Jolla, California. · Ratner Children's Eye Center at the Shiley Eye Institute, University of California San Diego, La Jolla, California. Electronic address: srobbins@ucsd.edu. ·J AAPOS · Pubmed #28087345.

ABSTRACT: Steroid medications may cause elevation of intraocular pressure, sometimes with permanent damage to the optic nerve. These therapies, via various routes of administration, are commonly prescribed for children, but the potential sequelae of elevated intraocular pressure and glaucomatous optic nerve damage can be even more severe and devastating in children than in adults. This review discusses the pathophysiology and potential risk factors, including the impact of intraocular pressure elevation via the different common routes of administration of steroids, clinical evaluation, and management of steroid response and steroid-induced glaucoma in children.

19 Review Role of cyclic AMP in the eye with glaucoma. 2017

Shim, Myoung Sup / Kim, Keun-Young / Ju, Won-Kyu. ·Hamilton Glaucoma Center and Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, CA 92037, USA. · Center for Research on Biological Systems, National Center for Microscopy and Imaging Research and Department of Neuroscience, University of California San Diego, La Jolla 92093, CA 92093, USA. ·BMB Rep · Pubmed #27916026.

ABSTRACT: Glaucoma is characterized by a slow and progressive degeneration of the optic nerve, including retinal ganglion cell (RGC) axons in the optic nerve head (ONH), leading to visual impairment. Despite its high prevalence, the biological basis of glaucoma pathogenesis still is not yet fully understood, and the factors contributing to its progression are currently not well characterized. Intraocular pressure (IOP) is the only modifiable risk factor, and reduction of IOP is the standard treatment for glaucoma. However, lowering IOP itself is not always effective for preserving visual function in patients with primary open-angle glaucoma. The second messenger cyclic adenosine 3',5'-monophosphate (cAMP) regulates numerous biological processes in the central nervous system including the retina and the optic nerve. Although recent studies revealed that cAMP generated by adenylyl cyclases (ACs) is important in regulating aqueous humor dynamics in ocular tissues, such as the ciliary body and trabecular meshwork, as well as cell death and growth in the retina and optic nerve, the functional role and significance of cAMP in glaucoma remain to be elucidated. In this review, we will discuss the functional role of cAMP in aqueous humor dynamics and IOP regulation, and review the current medications, which are related to the cAMP signaling pathway, for glaucoma treatment. Also, we will further focus on cAMP signaling in RGC growth and regeneration by soluble AC as well as ONH astrocytes by transmembrane ACs to understand its potential role in the pathogenesis of glaucoma neurodegeneration. [BMB Reports 2017; 50(2): 60-70].

20 Review Primary open-angle glaucoma. 2016

Weinreb, Robert N / Leung, Christopher K S / Crowston, Jonathan G / Medeiros, Felipe A / Friedman, David S / Wiggs, Janey L / Martin, Keith R. ·Shiley Eye Institute, Hamilton Glaucoma Center, Department of Ophthalmology, University of California, San Diego, 9500 Gilman Drive, La Jolla, California 92093, USA. · Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China. · Department of Ophthalmology, Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia. · Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA. · Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA. · Department of Ophthalmology and Cambridge NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK. ·Nat Rev Dis Primers · Pubmed #27654570.

ABSTRACT: Glaucoma is an optic neuropathy that is characterized by the progressive degeneration of the optic nerve, leading to visual impairment. Glaucoma is the main cause of irreversible blindness worldwide, but typically remains asymptomatic until very severe. Open-angle glaucoma comprises the majority of cases in the United States and western Europe, of which, primary open-angle glaucoma (POAG) is the most common type. By contrast, in China and other Asian countries, angle-closure glaucoma is highly prevalent. These two types of glaucoma are characterized based on the anatomic configuration of the aqueous humour outflow pathway. The pathophysiology of POAG is not well understood, but it is an optic neuropathy that is thought to be associated with intraocular pressure (IOP)-related damage to the optic nerve head and resultant loss of retinal ganglion cells (RGCs). POAG is generally diagnosed during routine eye examination, which includes fundoscopic evaluation and visual field assessment (using perimetry). An increase in IOP, measured by tonometry, is not essential for diagnosis. Management of POAG includes topical drug therapies and surgery to reduce IOP, although new therapies targeting neuroprotection of RGCs and axonal regeneration are under development.

21 Review 24-h monitoring devices and nyctohemeral rhythms of intraocular pressure. 2016

Aptel, Florent / Weinreb, Robert N / Chiquet, Christophe / Mansouri, Kaweh. ·Inserm U1042, Hypoxia and Physiopathology Laboratory, University Grenoble Alpes, Grenoble, France; Department of Ophthalmology, University Hospital, CHU Grenoble, Grenoble, France. · Hamilton Glaucoma Center, Shiley Eye Center and Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA. · Glaucoma Center, Montchoisi Clinic, Swiss Vision Network, Lausanne, Switzerland; Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO, USA. Electronic address: kawehm@yahoo.com. ·Prog Retin Eye Res · Pubmed #27477112.

ABSTRACT: Intraocular pressure (IOP) is not a fixed value and varies over both the short term and periods lasting several months or years. In particular, IOP is known to vary throughout the 24-h period of a day, defined as a nyctohemeral rhythm in humans. In clinical practice, it is crucial to evaluate the changes in IOP over 24 h in several situations, including the diagnosis of ocular hypertension and glaucoma (IOP is often higher at night) and to optimize the therapeutic management of glaucoma. Until recently, all evaluations of 24-h IOP rhythm were performed using repeated IOP measurements, requiring individuals to be awakened for nocturnal measurements. This method may be imperfect, because it is not physiologic and disturbs the sleep architecture, and also because it provides a limited number of time point measurements not sufficient to finely asses IOP changes. These limitations may have biased previous descriptions of physiological IOP rhythm. Recently, extraocular and intraocular devices integrating a pressure sensor for continuous IOP monitoring have been developed and are available for use in humans. The objective of this article is to present the contributions of these new 24-h monitoring devices for the study of the nyctohemeral rhythms. In healthy subjects and untreated glaucoma subjects, a nyctohemeral rhythm is consistently found and frequently characterized by a mean diurnal IOP lower than the mean nocturnal IOP, with a diurnal bathyphase - usually in the middle or at the end of the afternoon - and a nocturnal acrophase, usually in the middle or at the end of the night.

22 Review BK Channels in the Central Nervous System. 2016

Contet, C / Goulding, S P / Kuljis, D A / Barth, A L. ·Committee on the Neurobiology of Addictive Disorders, The Scripps Research Institute, La Jolla, CA, United States. Electronic address: contet@scripps.edu. · Committee on the Neurobiology of Addictive Disorders, The Scripps Research Institute, La Jolla, CA, United States. · Carnegie Mellon University, Pittsburgh, PA, United States. ·Int Rev Neurobiol · Pubmed #27238267.

ABSTRACT: Large conductance Ca(2+)- and voltage-activated K(+) (BK) channels are widely distributed in the postnatal central nervous system (CNS). BK channels play a pleiotropic role in regulating the activity of brain and spinal cord neural circuits by providing a negative feedback mechanism for local increases in intracellular Ca(2+) concentrations. In neurons, they regulate the timing and duration of K(+) influx such that they can either increase or decrease firing depending on the cellular context, and they can suppress neurotransmitter release from presynaptic terminals. In addition, BK channels located in astrocytes and arterial myocytes modulate cerebral blood flow. Not surprisingly, both loss and gain of BK channel function have been associated with CNS disorders such as epilepsy, ataxia, mental retardation, and chronic pain. On the other hand, the neuroprotective role played by BK channels in a number of pathological situations could potentially be leveraged to correct neurological dysfunction.

23 Review Management of advanced glaucoma: Characterization and monitoring. 2016

de Moraes, C Gustavo / Liebmann, Jeffrey M / Medeiros, Felipe A / Weinreb, Robert N. ·Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Medical Center, New York, New York, USA. Electronic address: gustavo.demoraes@columbia.edu. · Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Department of Ophthalmology, Columbia University Medical Center, New York, New York, USA. · Shiley Eye Institute, Hamilton Glaucoma Center and Department of Ophthalmology, University of California San Diego, La Jolla, California, USA. ·Surv Ophthalmol · Pubmed #27018149.

ABSTRACT: Recent advances in glaucoma diagnosis focus on diagnosing the disease in early stages. Despite the importance of such efforts, a meaningful proportion of patients present in advanced stages. The cost for treatment and monitoring of advanced glaucoma often exceeds that with earlier disease, not to mention the significant effect of visual impairment on quality of life. Moreover, structural and functional tests used to monitor changes encounter technical limitations in advanced cases that can delay detection of true progression. New technologies and methods to analyze longitudinal data may prove helpful for monitoring patients with advanced glaucoma and reduce the burdens of the disease.

24 Review Strategies to improve early diagnosis in glaucoma. 2015

Tatham, Andrew J / Medeiros, Felipe A / Zangwill, Linda M / Weinreb, Robert N. ·Princess Alexandra Eye Pavilion, Edinburgh, Scotland, UK; Department of Ophthalmology, University of Edinburgh, Edinburgh, Scotland, UK. Electronic address: andrewjtatham@gmail.com. · Hamilton Glaucoma Center, Shiley Eye Center, San Diego, CA, USA; Department of Ophthalmology, University of California, San Diego, CA, USA. ·Prog Brain Res · Pubmed #26518075.

ABSTRACT: Early diagnosis and treatment of glaucoma is important to reduce the risk of progressive and irreversible visual loss. The key to diagnosis is recognition of morphological changes to the optic nerve head and retinal nerve fiber layer, but in some patients, functional abnormalities are detected first. This review describes recent innovations with the potential to improve the early detection of glaucoma. Developments in imaging include novel optic nerve head metrics such as Bruch's membrane opening-minimum rim width, enhanced ability to quantify inner layers of the glaucomatous macula, and ability to image deep optic nerve head structures, including the lamina cribrosa. Developments in detection of early glaucomatous functional loss include novel perimetric tests using frequency-doubling technology and flicker-defined form stimuli. Methods to combine results of structural and functional assessments are also presented that may improve early detection of glaucoma.

25 Review Fundamentals and Advances in Tonometry. 2015

Nuyen, Brenda / Mansouri, Kaweh. ·From the *Hamilton Glaucoma Center and the Department of Ophthalmology, University of California, San Diego, La Jolla, CA; †Glaucoma Sector, Department of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland; and ‡Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO. ·Asia Pac J Ophthalmol (Phila) · Pubmed #26065347.

ABSTRACT: According to the World Health Organization, glaucoma is the leading cause of irreversible blindness worldwide. Although intraocular pressure (IOP) is not considered any more to be a defining feature of the disease, its lowering remains the only treatment option for glaucoma. Therefore, accurate and precise measurement of IOP is the cornerstone of glaucoma. Intraocular pressure is a highly dynamic physiological parameter with individual circadian rhythms. The main limitation of current tonometry methods remains the static and mostly office-based nature of their measurements. This review provides a brief historical overview on tonometry and discusses current tonometry instruments. In recent years, approaches to 24-hour IOP monitoring have been introduced, and there is hope that they may become part of routine clinical management in the future.