• The Korean Journal of Physiology and Pharmacology
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• v.28 no.4
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• pp.345-359
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• 2024

Deposition of extracellular matrix (ECM) in the trabecular meshwork (TM) increases aqueous humour outflow resistance leading to elevation of intraocular pressure (IOP) in primary open-angle glaucoma, which remains the only modifiable risk factor. Resveratrol has been shown to counteract the steroid-induced increase in IOP and increase the TM expression of ECM proteolytic enzymes; however, its effects on the deposition of ECM components by TM and its associated pathways, such as TGF-β-SMAD signalling remain uncertain. This study, therefore, explored the effects of trans-resveratrol on the expression of ECM components, SMAD signalling molecules, plasminogen activator inhibitor-1 and tissue plasminogen activator in dexamethasone-treated human TM cells (HTMCs). We also studied the nature of molecular interaction of trans-resveratrol with SMAD4 domains using ensemble docking. Treatment of HTMCs with 12.5 µM trans-resveratrol downregulated the dexamethasone-induced increase in collagen, fibronectin and α-smooth muscle actin at gene and protein levels through downregulation of TGF-β1, SMAD4, and upregulation of SMAD7. Downregulation of TGF-β1 signalling by trans-resveratrol could be attributed to its effect on the transcriptional activity due to high affinity for the MH2 domain of SMAD4. These effects may contribute to resveratrol's IOP-lowering properties by reducing ECM deposition and enhancing aqueous humour outflow in the TM.

• Journal of The Korean Ophthalmological Society
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• v.59 no.11
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• pp.1049-1055
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• 2018

Purpose: To investigate the factors associated with glaucoma in patients with pseudoexfoliation syndrome by comparing features of the anterior segments and ocular biometry according to the presence or absence of open-angle glaucoma in pseudoexfoliation syndrome. Methods: We analyzed 96 patients (115 eyes) diagnosed as having pseudoexfoliation syndrome in this study. The patients were divided into two groups of simple pseudoexfoliation syndrome (64 patients, 76 eyes) and pseudoexfoliation glaucoma (32 patients, 39 eyes). We compared the age, sex, underlying disease, location of pseudoexfoliative material, iris change, degree of nuclear cataract, pupil dilatation, corneal endothelial cell counts, central corneal thickness, anterior chamber depth, axial length, corneal curvature, and intraocular pressure (IOP). Results: There were no significant differences between the two groups in terms of age (p = 0.694), sex (p = 0.161), diabetes (p = 0.440), hypertension (p = 0.238), pseudoexfoliative material observed in anterior capsule (p = 0.700), pupillary margin (p = 0.210), iris depigmentation (p = 0.526), pupillary ruff loss (p = 0.708), degree of nuclear cataract (p = 0.617), pupil dilatation (p = 0.526), central corneal thickness (p = 0.097), anterior chamber depth (p = 0.283), axial length (p = 0.095), or horizontal and vertical corneal curvature (p = 0.066 and 0.306, respectively). In pseudoexfoliation glaucoma, significantly higher IOP (p = 0.026), a high frequency of membrane formation (p = 0.047), and decreased corneal endothelial cell counts (p = 0.048) were observed. Conclusions: Pseudoexfoliation syndrome with open-angle glaucoma was shown to be associated with high IOP, decreased corneal endothelial cell counts, and a high frequency of membrane formation. Therefore, when such changes are observed in pseudoexfoliation syndrome patients, a higher risk of open-angle glaucoma should be recognized, and careful attentionis required accordingly.

• Journal of The Korean Ophthalmological Society
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• v.59 no.12
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• pp.1173-1180
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• 2018

Purpose: We evaluated the postoperative accuracy of intraocular lens power prediction for patients undergoing phacotrabeculectomy and identified preoperative factors associated with refractive outcome in those with primary open-angle glaucoma (POAG). Methods: We retrospectively reviewed the medical records of 27 patients who underwent phacotrabeculectomy to treat POAG. We recorded all discrepancies between predicted and actual postoperative refractions. We compared the data to those of an age- and sex-matched control group that underwent uncomplicated cataract surgery during the same time period. Preoperative factors associated with the mean absolute error (MAE) were identified via multivariate regression analyses. Results: The mean refractive error of the 27 eyes that underwent phacotrabeculectomy was comparable to that of the 27 eyes treated via phacoemulsification (+0.02 vs. -0.01 D, p = 0.802). The phacotrabeculectomy group exhibited a significantly higher MAE (0.65 vs. 0.35 D, p = 0.035) and more postoperative astigmatism (-1.07 vs. -0.66 D, p = 0.020) than the phacoemulsification group. The preoperative anterior chamber depth (ACD) and the changes in the postoperative intraocular pressure (IOP) were significantly associated with a greater MAE after phacotrabeculectomy. Conclusions: POAG treatment via combined phacoemulsification/trabeculectomy was associated with greater error in terms of final refraction prediction, and more postoperative astigmatism. As both a shallow preoperative ACD and a greater postoperative change in IOP appear to increase the predictive error, these two factors should be considered when planning phacotrabeculectomy.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.610-613
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• 2010

An 8-year-old male dog weighing 7.9 kg was referred to us for evaluation of exophthalmos and corneal edema of the left eye, on which cataract surgery had been performed 3 years prior. On ophthalmic examination, the left eye showed an extremely high intraocular pressure (47 mmHg), with no menace response, dazzle reflex, or pupillary light reflex. The dog was treated with systemic and topical glaucoma medications. After treatment, corneal edema decreased but IOP did not return to within acceptable limits. Seventeen months later, the dog presented with hyphema, episcleral congestion, and corneal edema attributable to accidental trauma. The owner wished to maintain an attractive ocular appearance, and an intraocular silicone prosthesis (ISP) was thus inserted after the evisceration. Three months postoperatively, a corneal ulcer was detected, but this resolved successfully after prescription of appropriate medication. One year after surgery, no complications related to surgery were evident.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.55-62
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• 1994

The use of intraoperative application of Mitomycin C at the filtration site has been known to improve the surgical outcome in glaucomatous eyes with high risk for failure of trabeculectomy. The author performed trabeculectomies with intraoperative Mitomycin C on 25 eyes of 20 patients with poor surgical prognosis to study the efficacy and safety of this technique in glaucomatous patients with high risk for failure of trabeculectomy. After the preparation of a scleral flap, 0.2mg/ml solution of Mitomycin C was applied between Tenon's capsule and the sclera for 2 minutes. The exposed area was then irrigated with 200 ml of balanced salt solution. The follow-up period was from 1 to 7 months (mean 3.8 months). The mean preoperative intraocular pressure (IOP) was $38.6{\pm}6.6mmHg$. The mean final postoperative IOP was $11.7{\pm}3.8mmHg$. Twenty three (88%) of the 25 eyes were successfully controlled with the IOP of less than or equal to 20 mmHg without glaucoma medication. There were early postoperative complications of hyphema in 5 eyes (20%), shallow anterior chamber in 4 eyes(16%), punctate keratopathy in 3 eyes (12%), aqueous leaking from conjunctival wound in 2 eyes (8%), encapsulated bleb in 1 eye (4%) and choroidal detachment in 1 eye (4%), and 4 eyes had long term hypotony lasting more than 2 months. Although Mitomycin C is simple to use and effective adjunct to trabeculectomy, further study will be needed to determine the mechanism of action, indication, dosage and optimal exposure time of Mitomycin C.

• Journal of The Korean Ophthalmological Society
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• v.59 no.12
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• pp.1122-1128
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• 2018

Purpose: To compare the measurements of the rebound tonometer (RT), Goldmann applanation tonometer (GAT) and noncontact tonometer (NCT) in patients who underwent penetrating keratoplasty (PKP), and to evaluate the reproducibility of the RT measurements. Methods: This study included 19 PKP eyes and 28 normal eyes. We compared the intraocular pressure (IOP) measurements of the GAT and NCT with the RT in both groups using Spearman's correlation analysis and the Wilcoxon signed-rank test. The IOP, as measured with an RT in each group, was assessed with respect to reproducibility using the intraclass correlation coefficient (ICC). Results: In normal eyes, there was no significant difference in the measurements obtained with the RT, GAT, and NCT (p > 0.050). In the patient group, the RT measurements were not significantly different from those of the GAT (p = 0.872), but they were significantly lower than those obtained with the NCT (p = 0.011). However, the RT measurements showed a relatively high correlation with those of the GAT and NCT (r = 0.770 and 0.879, respectively). The ICC of the RT was 0.986 for the PKP eye group and 0.961 for the normal eye group, both of which were highly reproducible. Conclusions: In PKP eyes, the measurements obtained with the RT showed a relatively high correlation with those of the GAT and NCT, and the repeatability of the RT measurements was high and similar to those for normal eyes. The RT can therefore be considered a useful method for measuring the IOP in PKP eyes.

• Journal of The Korean Ophthalmological Society
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• v.59 no.11
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• pp.1091-1096
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• 2018

Purpose: We report a case of bilateral nonarteritic anterior ischemic optic neuropathy (NAION) following acute angle-closure crisis (AACC). Case summary: A 76-year-old female visited our clinic because of a 1-day history of ocular pain and vision loss in both eyes. The visual acuity was 0.02 in both eyes and her intraocular pressure (IOP) was 52 mmHg in the right eye (RE) and 50 mmHg in the left eye (LE). She had corneal edema and a shallow anterior chamber in both eyes, with 4 mm fixed dilated pupils. After decreasing the IOP with intravenous mannitol, laser iridotomy was performed. However, 2 days later, visual acuity was further reduced to finger counting at 10 cm RE and at 50 cm LE, and her optic disc was swollen. Bilateral NAION following AACC was diagnosed. One month later, visual acuity slightly improved to 0.02 RE and 0.04 LE, and the optic disc edema resolved. A small cup-disc ratio, optic disc pallor, and atrophy were observed. Humphrey visual fields demonstrated superior and inferior altitudial visual field defects in the LE, and almost total scotoma in the RE. Conclusions: AACC can be a predisposing factor for NAION, so the relative afferent pupillary defect, papilledema, and presentation of other risk factors are important clues to a diagnosis of NAION.

• Journal of Veterinary Clinics
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• v.25 no.4
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• pp.292-294
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• 2008

The purpose of this study was to evaluate the cause of lens luxation and to determine the frequency of vision loss, glaucoma, cataract, and corneal edema before and after intracapsular lens extraction (ICLE). The medical records of 8 dogs underwent ICLE for the correction of anterior lens luxation at the Veterinary Medical Teaching Hospital of Seoul National University from August 2005 to September 2007 were reviewed. The most frequently affected breed was Miniature Poodle (n = 3). The mean age was $10.8{\pm}2.1$ years. Preoperatively, 5 eyes (67.5%) with anterior luxation had secondary glaucoma, 7 eyes (87.5%) had vision loss, and all eyes (100.0%) had corneal edema. Four weeks after ICLE, 6 eyes (75.0%) had normal intraocular pressure (IOP), and 4 eyes (50.0%) regained vision. Corneal edema was reduced after ICLE in all eyes, but still remained in 4 eyes. It was considered that ICLE was beneficial in the management of anterior lens luxation, but the eyes without glaucoma before ICLE had more favorable prognosis than eyes with.

• Journal of The Korean Ophthalmological Society
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• v.59 no.12
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• pp.1142-1151
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• 2018

Purpose: We assessed the visual and anatomical outcomes, and the safety profile of long-term intravitreal anti-vascular endothelial growth factor (VEGF) injections (aflibercept, ranibizumab, and bevacizumab) given to treat neovascular age-related macular degeneration (NAMD). Methods: We analyzed medical records collected over 7 years of treatment-naive NAMD patients who received outpatient clinic-based intravitreal anti-VEGF injections. All were treated employing either "treat-and-extend" or "as needed" protocols at the discretion of the retinal specialist. The number of injections, adverse events associated with injection, and measures of visual acuity (VA), central foveal thickness (CFT), and intraocular pressure (IOP) were recorded. Results: Overall, we assessed 196 eyes of 196 patients (average age $68.6{\pm}9.6years$; 77 females). Patients received an average of $17.3{\pm}13.5$ injections over $78.0{\pm}16.5months$ of clinical follow-up. The initial mean VA (logMAR) was $0.75{\pm}0.58$ and the CFT was $349.7{\pm}152.6{\mu}m$. Both parameters exhibited maximal improvements at the 6-month visit (p < 0.05). However, the clinical outcomes worsened over the 7-year clinical course; the best-corrected visual acuity (BCVA) was $0.91{\pm}0.78$ and the CFT was $284.5{\pm}105.8{\mu}m$ at 7 years. The BCVA at 7 years was significantly correlated with the initial BCVA. IOP-related events increased 11-fold and anterior chamber reactions increased 3-fold over the years, but no significant complications such as endophthalmitis were recorded. Conclusions: The use of intravitreal anti-VEGF agents was associated with initial visual improvements over 6 months but did not prevent the worsening of NAMD over 5 years. The BCVA at the initial visit was a strong predictor of the final BCVA. A more intensive injection schedule might improve long-term outcomes.