chondroitin-sulfates and Glaucoma

Sixty-two patients undergoing penetrating keratoplasty were randomized to receive Healon (1% sodium hyaluronate) or Viscoat (3% sodium hyaluronate and 4% chondroitin sulfate) as a means of maintaining the anterior chamber during surgery. Neither viscoelastic agent was irrigated from the eye at the end of the procedure. Intraocular pressures (IOPs) were measured at 4, 10, 24, and 72 hours postoperatively. For the Healon group, IOPs were 16.52, 23.50, 28.31, 23.27, and 16.03 mm Hg at baseline and at the four follow-up periods, respectively. For the Viscoat group, they were 19.10, 28.33, 23.48, 18.62, and 16.17 mm Hg at those points, respectively. IOPs were significantly elevated over baseline in the Healon group at 4, 10, and 24 hours, and in the Viscoat group at 4 and 10 hours. There were no statistically significant differences between the Healon and Viscoat groups at 4, 10, and 72 hours. At 24 hours, the Healon group had a mean pressure rise over baseline of 6.5 mm Hg, while the Viscoat group had returned to baseline levels (P = .02). We conclude that both Healon and Viscoat raise postoperative IOPs, but that Healon appears to elevate IOPs for a longer period after surgery than Viscoat.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Chondroitin; Chondroitin Sulfates; Drug Combinations; Female; Follow-Up Studies; Glaucoma; Humans; Hyaluronic Acid; Intraocular Pressure; Keratoplasty, Penetrating; Male; Middle Aged; Ocular Hypertension; Prospective Studies

Glaucoma is one of the most frequent causes of visual impairment worldwide, and involves selective damage to retinal ganglion cells (RGCs) and their axons. We analyzed the effect of enriched environment (EE) housing on the optic nerve, and retinal alterations in an induced model of ocular hypertension. For this purpose, male Wistar rats were weekly injected with vehicle or chondroitin sulfate (CS) into the eye anterior chamber for 10 weeks and housed in standard environment or EE. EE housing prevented the effect of experimental glaucoma on visual evoked potentials, retinal anterograde transport, phosphorylated neurofilament-immunoreactivity, axon number, microglial/macrophage reactivity (ionized calcium binding adaptor molecule 1-immunoreactivity), and astrocytosis (glial fibrillary acidic protein-immunostaining), as well as oligodendrocytes alterations (luxol fast blue staining, and myelin basic protein-immunoreactivity) in the proximal portion of the optic nerve. Moreover EE prevented the increase in ionized calcium binding adaptor molecule-1 levels, and RGC loss (Brn3a-immunoreactivity) in the retina from hypertensive eyes. EE increased retinal brain-derived neurotrophic factor levels. When EE housing started after 6 weeks of ocular hypertension, a preservation of visual evoked potentials amplitude, axon, and Brn3a(+) RGC number was observed. Taken together, these results suggest that EE preserved visual functions, reduced optic nerve axoglial alterations, and protected RGCs against glaucomatous damage.

Topics: Animals; Cholera Toxin; Chondroitin Sulfates; Disease Models, Animal; Environment; Evoked Potentials, Visual; Glaucoma; Housing, Animal; Male; Neuroprotection; Ocular Hypertension; Optic Nerve; Rats; Rats, Wistar; Retinal Ganglion Cells; Vision Disorders

To determine the medium-term outcomes for patients with advanced glaucoma undergoing viscocanalostomy.. All patients with advanced glaucoma (mean deviation (MD) - 12.00 dB or above) and patients with poor visual acuity secondary to advanced glaucoma which precluded formal visual field assessment undergoing viscocanalostomy (VC) and phaco-viscocanalostomy between 2010 and 2014 under the care of a single surgical team were included. Intraocular pressure (IOP), visual acuity (VA) and visual field outcomes were assessed from data prospectively collected into a surgical outcome database. Success was defined at two IOP cut-off points: IOP ≤ 21 and ≤ 16 mmHg with (qualified) or without (complete) medications.. One hundred thirty-five patients were included. Mean IOP changed from 23.6 ± 6.4 mmHg pre-operatively to 15.3, 15.8 and 14.8 mmHg at 1, 2 and 3 years, a change of 35, 33.5 and 39% respectively. Qualified success for an IOP ≤ 21 mmHg was achieved in 95.66, 90.6 and 80% and complete success in 52.5, 48.6 and 30.6% at year 1, 2 and 3. Qualified success for an IOP ≤ 16 mmHg was achieved in 66.6, 66.05 and 60% and complete success in 44.8, 37.6 and 30.6% at year 1, 2 and 3. The cumulative probability for achieving an IOP ≤ 21 mmHg with or without drops was 86.1, 81.4 and 81.4% at 12, 24 and 36 months. Eleven patients (8.1%) failed to achieve adequate IOP control and needed further surgical intervention. Eleven (8.1%) patients needed an intervention (Yag goniopuncture) following VC. Four patients (2.9%) had some post-operative complications, which resolved within 2 weeks following surgery. Nine patients (6.7%) lost more than 2 Snellen lines. There was no significant change in the MD across time points.. Viscocanalostomy and viscocanalostomy combined with phacoemulsification is a safe and effective method of controlling IOP in the medium term in patients with advanced glaucoma.

Topics: Adult; Aged; Aged, 80 and over; Chondroitin Sulfates; Conjunctiva; Descemet Membrane; Drug Combinations; Female; Filtering Surgery; Glaucoma; Humans; Hyaluronic Acid; Intraocular Pressure; Male; Middle Aged; Phacoemulsification; Retrospective Studies; Treatment Outcome; Viscoelastic Substances; Visual Acuity; Visual Fields

Glaucoma is a disease in which damage to the optic nerve leads to progressive, irreversible vision loss. The intraocular pressure (IOP) is the only modifiable risk factor for glaucoma and its lowering is considered a useful strategy for preventing or slowing down the progression of glaucomatous neuropathy. Elevated intraocular pressure associated with glaucoma is due to increased aqueous humor outflow resistance, primarily through the trabecular meshwork (TM) of the eye. Current in vitro models of the trabecular meshwork are oversimplified and do not capture the organized and complex three-dimensional nature of this tissue that consists primarily of collagen and glycoasaminoglycans. In this work, collagen and collagen-chondroitin sulfate (CS) scaffolds were fabricated via unidirectional freezing and lyophilization to induce the formation of aligned pores. Scaffolds were characterized by scanning electron microscopy, dynamic mechanical analysis, and a chondroitin sulfate quantification assay. Scaffold characterization confirmed the formation of aligned pores, and also that the CS was leaching out of the scaffolds over time. Primary porcine trabecular meshwork (TM) cells were seeded onto the surface of scaffolds and their gene expression, proliferation, viability, migration into the scaffolds, and morphology were examined. The TM cells were viable and proliferated 2 weeks after seeding. The cells migrated down into the internal scaffold structure and their morphology reflected the topography and alignment of the scaffold structure. This work is a promising step toward the development of a three dimensional in vitro model of the TM that can be used for testing of glaucoma pharmacological agents in future experimentation and to better our understanding of the trabecular meshwork and its complex physiology. Biotechnol. Bioeng. 2017;114: 915-923. © 2016 Wiley Periodicals, Inc.

Topics: Animals; Biocompatible Materials; Biomimetic Materials; Cell Culture Techniques; Chondroitin Sulfates; Collagen; Glaucoma; Humans; Porosity; Swine; Tissue Scaffolds; Trabecular Meshwork

Glaucoma is a leading cause of blindness worldwide, characterized by retinal ganglion cell degeneration and damage to the optic nerve. We investigated the non-image forming visual system in an experimental model of glaucoma in rats induced by weekly injections of chondroitin sulphate (CS) in the eye anterior chamber. Animals were unilaterally or bilaterally injected with CS or vehicle for 6 or 10 weeks. In the retinas from eyes injected with CS, a similar decrease in melanopsin and Thy-1 levels was observed. CS injections induced a similar decrease in the number of melanopsin-containing cells and superior collicular retinal ganglion cells. Experimental glaucoma induced a significant decrease in the afferent pupil light reflex. White light significantly decreased nocturnal pineal melatonin content in control and glaucomatous animals, whereas blue light decreased this parameter in vehicle- but not in CS-injected animals. A significant decrease in light-induced c-Fos expression in the suprachiasmatic nuclei was observed in glaucomatous animals. General rhythmicity and gross entrainment appear to be conserved, but glaucomatous animals exhibited a delayed phase angle with respect to lights off and a significant increase in the percentage of diurnal activity. These results indicate the glaucoma induced significant alterations in the non-image forming visual system.

Topics: Animals; Anterior Eye Segment; Blotting, Western; Cell Count; Chondroitin Sulfates; Eye; Glaucoma; Immunohistochemistry; Injections; Intraocular Pressure; Light; Male; Melatonin; Motor Activity; Ocular Physiological Phenomena; Pineal Gland; Proto-Oncogene Proteins c-fos; Rats; Rats, Wistar; Reflex, Pupillary; Retinal Ganglion Cells; Superior Colliculi; Suprachiasmatic Nucleus; Vision, Ocular

American Glaucoma Society members were surveyed to determine the pattern of use of viscoelastics for anterior chamber reformation at the slit-lamp in the post-operative clinical management of patients who have undergone trabeculectomy in order to give ophthalmologists an indication of how these materials are being used by their colleagues.. We surveyed 196 members of the American Glaucoma Society regarding the following; (1) whether they inject viscoelastic post-operatively at the slit-lamp as an in-office procedure, (2) the type of viscoelastic used most often, (3) the criteria for injection of viscoelastic, (4) the time to first follow-up, (5) the average number of injections, and (6) the occurrence of post-injection endophthalmitis.. One hundred twenty-five (64%) of the 196 mailed surveys were answered and returned. Ninety-four (75%) of the respondents reported injecting viscoelastics in the postoperative period at the slit-lamp as an in-office procedure. Healon (60%) (Pharmacia & Upjohn Co, Kalamazoo, MI), Viscoat (17%) (Alcon, Ft. Worth, TX), and Healon GV (7%) (Pharmacia & Upjohn Co, Kalamazoo, MI) were the three most often used viscoelastics. Hypotony, iriscornea touch, and lens-cornea touch were given as criteria for injection 19%, 47%, and 88% of the time, respectively. Range of time to first follow-up was 1 hour to 7 days, with a mean time of 1 day. Range of average number of injections was 1 to 3 with a mean of 2 injections for patients requiring injection. Only one respondent reported an incidence of endophthalmitis.. The use of viscoelastic materials in the postoperative trabeculectomy patient in the office at the slit-lamp for anterior chamber reformation is a prevalent practice. Healon is the most commonly used viscoelastic postoperatively and lens-corneal touch is the most common criterion for injection. The average number of injections is 2, with a mean and mode follow-up time of 1 day. Endophthalmitis is a rare complication.

Topics: Anterior Chamber; Chondroitin; Chondroitin Sulfates; Drug Combinations; Follow-Up Studies; Glaucoma; Humans; Hyaluronic Acid; Injections; Intraocular Pressure; Practice Patterns, Physicians'; Societies, Medical; Surveys and Questionnaires; Trabeculectomy; United States

To define the architecture and extracellular matrix composition of the lamina cribrosa in rodents, normal, adult pigmented rat and guinea pig eyes were frozen and sectioned for light microscopic immunohistochemistry. Antibodies specific for collagens I, III, IV and VI, laminin, elastin, and chondroitin and dermatan sulfate proteoglycans were exposed to longitudinal and cross-sections of optic nerve heads and their binding distributions observed with the avidin-biotin-peroxidase complex technique. Cross-sections of the intraocular portion of the rat optic nerve head revealed a horizontally oval shape with distinct, vertically oriented, laminar beams. The guinea pig optic nervehead cross-section was circular, with randomly oriented beams. In both animals, collagens I, III and VI were found throughout the laminar beams, along with elastin fibrils. Collagen IV and laminin antibodies deposited along laminar beam margins and within the beams, representing astrocytic and vascular endothelial cell basement membranes. Both animals showed evidence for dermatan and chondroitin sulfate-containing proteoglycans in all connective tissue structures of the nerve head. In the rat, chondroitin-4 sulfate proteoglycans appeared localized to the sclera and laminar beams. The rat and the guinea pig optic nerve head possess an identifiable lamina cribrosa with structural proteins nearly identical to that of the primate. Both animals may provide affordable alternative animal models for in vivo studies on the role of the lamina cribrosa in glaucomatous optic nerve damage.

Topics: Animals; Chondroitin Sulfates; Collagen; Dermatan Sulfate; Disease Models, Animal; Glaucoma; Guinea Pigs; Immunoenzyme Techniques; Optic Disk; Rats; Rats, Inbred BN

The distribution of the sulfated proteoglycans in the lamina cribrosa of normal monkey eyes and monkey eyes with laser-induced glaucoma were analysed by electron microscopy after cuprolinic blue dye binding. Three types of cuprolinic blue-positive filaments, CB-1, CB-2 and CB-3, were identified in the laminar beams of normal monkey eyes. CB-1 and CB-2 were both small filaments representing chondroitin and dermatan sulfate proteoglycan copolymers. The former lined up perpendicularly to the long axis of collagen fibrils, whereas the latter ran axially parallel to collagen fibrils. The large CB-3 filaments, representing chondrotin sulfate proteoglycans, were located around collagen bundles or in loose spaces within the beams. In addition, small CB-4 filaments or punctate structures representing heparan sulfate proteoglycans were found aligned on the basal laminae of blood vessels and glial cells. In the glaucomatous eyes, accumulation and enlargement of collagen-associated proteoglycan filaments were seen, accompanied by the destruction of collagenous beams. Accumulation of chondroitin sulfate proteoglycans was most evident. Prominent filamentous heparan sulfate/heparin proteoglycans were also noted in thickened astrocytic and vascular basal laminae. These may be alterations secondary to the destruction of collagen bundles. They may also represent cellular responses related to intraocular pressure elevation.

Topics: Animals; Chondroitin Sulfates; Dermatan Sulfate; Glaucoma; Histocytochemistry; Lasers; Macaca; Microscopy, Electron; Optic Disk; Proteoglycans

We evaluated histochemically the distribution of proteoglycans in the trabecular tissue of goniodysgenetic (developmental) glaucoma. Nine trabecular tissue specimens obtained at trabeculectomy from seven patients with goniodysgenetic glaucoma were stained with either cuprolinic blue or cupromeronic blue in combination with a series of enzyme and nitrous acid treatments. Within the extracellular matrix of the trabecular meshwork, many cupromeronic blue- or cuprolinic blue-positive filaments were observed in association with collagen fibrils, basal lamina, and basal lamina-like material. The extracellular matrices of elastin-like fibers, fine fibrillar materials, and fine granular materials were free from any reaction products. The enzyme and nitrous acid treatments disclosed that the reaction products associated with collagen fibrils represented both chondroitin sulfate and dermatan sulfate types, while those with basal lamina and basal lamina-like material represented heparan sulfate-type proteoglycans. Extensive accumulations of basal lamina-like material contained a great deal of heparan sulfate-type proteoglycans in the thick subcanalicular tissue of goniodysgenetic glaucoma. These results indicate that the class and distribution of proteoglycans in the goniodsygenetic trabecular tissues are virtually the same as that in the normal tissues. However, the large accumulation of basal lamina-like material with heparan sulfate-type proteoglycans can be one of the causes of the intraocular pressure increase in goniodysgenetic glaucoma.

Topics: Adolescent; Adult; Anterior Eye Segment; Child; Child, Preschool; Chondroitin Sulfates; Dermatan Sulfate; Glaucoma; Heparitin Sulfate; Humans; Indicators and Reagents; Indoles; Infant; Male; Organometallic Compounds; Trabecular Meshwork; Trabeculectomy