Somatostatin,a naturally produced neuroprotective peptide,depresses excitatory neurotransmission and exerts anti-proliferative and anti-inflammatory effects on the retina.In this review,we summarize the progress of so...Somatostatin,a naturally produced neuroprotective peptide,depresses excitatory neurotransmission and exerts anti-proliferative and anti-inflammatory effects on the retina.In this review,we summarize the progress of somatostatin treatment of diabetic retinopathy through analysis of relevant studies published from February 2019 to February 2023 extracted from the PubMed and Google Scholar databases.Insufficient neuroprotection,which occurs as a consequence of declined expression or dysregulation of retinal somatostatin in the very early stages of diabetic retinopathy,triggers retinal neurovascular unit impairment and microvascular damage.Somatostatin replacement is a promising treatment for retinal neurodegeneration in diabetic retinopathy.Numerous pre-clinical and clinical trials of somatostatin analog treatment for early diabetic retinopathy have been initiated.In one such trial(EUROCONDOR),topical administration of somatostatin was found to exert neuroprotective effects in patients with pre-existing retinal neurodysfunction,but had no impact on the onset of diabetic retinopathy.Overall,we concluded that somatostatin restoration may be especially beneficial for the growing population of patients with early-stage retinopathy.In order to achieve early prevention of diabetic retinopathy initiation,and thereby salvage visual function before the appearance of moderate non-proliferative diabetic retinopathy,several issues need to be addressed.These include the needs to:a)update and standardize the retinal screening scheme to incorporate the detection of early neurodegeneration,b)identify patient subgroups who would benefit from somatostatin analog supplementation,c)elucidate the interactions of somatostatin,particularly exogenously-delivered somatostatin analogs,with other retinal peptides in the context of hyperglycemia,and d)design safe,feasible,low cost,and effective administration routes.展开更多
Background/aim: Competing levels of cytokines, either locally within the eye o r systemically, may influence the eventual out-come of ocular inflammation. Pol ymorphism in the promoter part of the genes controlling cy...Background/aim: Competing levels of cytokines, either locally within the eye o r systemically, may influence the eventual out-come of ocular inflammation. Pol ymorphism in the promoter part of the genes controlling cytokine production may result in either higher or lower production of the relevant cytokine to a given stimulus. The authors hypothesised that such polymorphisms may relate to visual outcome in patients with idiopathic intermediate uveitis. Methods: DNA was obtai ned from 125 patients with idiopathic intermediate uveitis and analysed for the interleukin 10 IL-10-1082G/Aand IL-10-819C/T, and interferon γIFNγ874T/A g ene polymorphisms. Associations with disease were calculated by both allelic fre quency and haplotype analysis, and associations between ocular disease outcomes and the presence of polymorphismswere identified. A bad outcome was defined as l oss of vision <6/12 Snellen in both eyes at 5 years from presentation when the e yes were quiet. Results: An initial screen showed that the 874T allele of the IF Nγgene was more prevalent in patients than controls (χ2=7.9; p=0.004 OR 1.7; 9 5%CI 1.2 to 2.6 (Pc=0.02), whereas the IL-10-1082/-819 AT haplotype of the i nterleukin 10 (IL-10) gene was not. Analysis of disease outcome showed an assoc iation between IL-10-1082 AA homozygosity and bad outcome (χ2 =13; p=0.0003). Moreover, the two cytokine polymorphisms taken together showed that up to 75%o f patients with a poor visual outcome had the combined IFNγ874TA or TT genotype together with the IL-10-1082AA genotype (χ2=13.2 p=0.0008 OR 6.4; 95%CI 1.8 5 to 23.6 Pc=0.1). Conclusion: These results show that disease outcome in interm ediate uveitis may be partly determined by a complex interplay between cytokine genes and these results may have implications for future treatment with biologic al agents that target these cytokines.展开更多
PURPOSE. To investigate the test- retest variability of multifocal visual evoked potential (mfVEP) and threshold perimetry in glaucoma, and to examine the relationship between the two techniques. METHODS. Data were re...PURPOSE. To investigate the test- retest variability of multifocal visual evoked potential (mfVEP) and threshold perimetry in glaucoma, and to examine the relationship between the two techniques. METHODS. Data were recorded using the AccuMap mfVEP and SITA standard program of the Humphrey Field Analyzer. Data were obtained twice within a 4- week period from both eyes of 74 patients with varying amounts of glaucomatous visual field loss. The number of defective test locations (those falling beyond a given probability value of being normal) were calculated for mfVEP and SITA, using databases incorporated within the instruments software. Reliability measures and test times were recorded along with patient test preference. RESULTS. Both tests showed a large degree of test- retest variability in the number of defective test locations (95% limits of agreement for mfVEP and SITA being 13.39 and 9.88, respectively). A “ fair to moderate” degree of spatial agreement was found between mfVEP and SITA. The number of mfVEP defective locations was dependent on the signal amplitude. No relationship was found between test- retest variability and the reliability indices for either test. The mean time taken to perform mfVEP and SITA standard was 33 and 20 minutes, respectively, and 73 of the 74 patients preferred the mfVEP test. CONCLUSIONS. Test- retest variability was found to be slightly greater for mfVEP. The processing of mfVEP signals needs to be changed to remove the relationship between the number of defective locations and signal amplitude. The majority of patients preferred mfVEP to conventional perimetiy although mfVEP takes longer to perform.展开更多
基金supported by the Natural Science Foundation of Chongqing of China,Nos.cstc2020jcyj-msxmX0698(to YF),cstc2021jcyjbshX0147(to KO)a grant from Chongqing Jiangjin District Bureau of Science and Technology,No.Y2022017(to YF).
文摘Somatostatin,a naturally produced neuroprotective peptide,depresses excitatory neurotransmission and exerts anti-proliferative and anti-inflammatory effects on the retina.In this review,we summarize the progress of somatostatin treatment of diabetic retinopathy through analysis of relevant studies published from February 2019 to February 2023 extracted from the PubMed and Google Scholar databases.Insufficient neuroprotection,which occurs as a consequence of declined expression or dysregulation of retinal somatostatin in the very early stages of diabetic retinopathy,triggers retinal neurovascular unit impairment and microvascular damage.Somatostatin replacement is a promising treatment for retinal neurodegeneration in diabetic retinopathy.Numerous pre-clinical and clinical trials of somatostatin analog treatment for early diabetic retinopathy have been initiated.In one such trial(EUROCONDOR),topical administration of somatostatin was found to exert neuroprotective effects in patients with pre-existing retinal neurodysfunction,but had no impact on the onset of diabetic retinopathy.Overall,we concluded that somatostatin restoration may be especially beneficial for the growing population of patients with early-stage retinopathy.In order to achieve early prevention of diabetic retinopathy initiation,and thereby salvage visual function before the appearance of moderate non-proliferative diabetic retinopathy,several issues need to be addressed.These include the needs to:a)update and standardize the retinal screening scheme to incorporate the detection of early neurodegeneration,b)identify patient subgroups who would benefit from somatostatin analog supplementation,c)elucidate the interactions of somatostatin,particularly exogenously-delivered somatostatin analogs,with other retinal peptides in the context of hyperglycemia,and d)design safe,feasible,low cost,and effective administration routes.
文摘Background/aim: Competing levels of cytokines, either locally within the eye o r systemically, may influence the eventual out-come of ocular inflammation. Pol ymorphism in the promoter part of the genes controlling cytokine production may result in either higher or lower production of the relevant cytokine to a given stimulus. The authors hypothesised that such polymorphisms may relate to visual outcome in patients with idiopathic intermediate uveitis. Methods: DNA was obtai ned from 125 patients with idiopathic intermediate uveitis and analysed for the interleukin 10 IL-10-1082G/Aand IL-10-819C/T, and interferon γIFNγ874T/A g ene polymorphisms. Associations with disease were calculated by both allelic fre quency and haplotype analysis, and associations between ocular disease outcomes and the presence of polymorphismswere identified. A bad outcome was defined as l oss of vision <6/12 Snellen in both eyes at 5 years from presentation when the e yes were quiet. Results: An initial screen showed that the 874T allele of the IF Nγgene was more prevalent in patients than controls (χ2=7.9; p=0.004 OR 1.7; 9 5%CI 1.2 to 2.6 (Pc=0.02), whereas the IL-10-1082/-819 AT haplotype of the i nterleukin 10 (IL-10) gene was not. Analysis of disease outcome showed an assoc iation between IL-10-1082 AA homozygosity and bad outcome (χ2 =13; p=0.0003). Moreover, the two cytokine polymorphisms taken together showed that up to 75%o f patients with a poor visual outcome had the combined IFNγ874TA or TT genotype together with the IL-10-1082AA genotype (χ2=13.2 p=0.0008 OR 6.4; 95%CI 1.8 5 to 23.6 Pc=0.1). Conclusion: These results show that disease outcome in interm ediate uveitis may be partly determined by a complex interplay between cytokine genes and these results may have implications for future treatment with biologic al agents that target these cytokines.
文摘PURPOSE. To investigate the test- retest variability of multifocal visual evoked potential (mfVEP) and threshold perimetry in glaucoma, and to examine the relationship between the two techniques. METHODS. Data were recorded using the AccuMap mfVEP and SITA standard program of the Humphrey Field Analyzer. Data were obtained twice within a 4- week period from both eyes of 74 patients with varying amounts of glaucomatous visual field loss. The number of defective test locations (those falling beyond a given probability value of being normal) were calculated for mfVEP and SITA, using databases incorporated within the instruments software. Reliability measures and test times were recorded along with patient test preference. RESULTS. Both tests showed a large degree of test- retest variability in the number of defective test locations (95% limits of agreement for mfVEP and SITA being 13.39 and 9.88, respectively). A “ fair to moderate” degree of spatial agreement was found between mfVEP and SITA. The number of mfVEP defective locations was dependent on the signal amplitude. No relationship was found between test- retest variability and the reliability indices for either test. The mean time taken to perform mfVEP and SITA standard was 33 and 20 minutes, respectively, and 73 of the 74 patients preferred the mfVEP test. CONCLUSIONS. Test- retest variability was found to be slightly greater for mfVEP. The processing of mfVEP signals needs to be changed to remove the relationship between the number of defective locations and signal amplitude. The majority of patients preferred mfVEP to conventional perimetiy although mfVEP takes longer to perform.
