IOP-lowering effect of isoquinoline-5-sulfonamide compounds in ocular normotensive monkeys

Rho-associated coiled coil-formed protein kinase (ROCK) inhibitors are under development as a new class of antiglaucoma agents. Based on the potent ROCK inhibitor H-1152, previously developed by us, we explored the possibility of related compounds as antiglaucoma agents and synthesized seven types of H-1152-inspired isoquinoline-5-sulfonamide compounds (H-0103–H-0107, H-1001, H-1005). Although all of these compounds potently inhibited ROCK (IC₅₀ = 18–48 nM), only H-0104 and H-0106 exerted strong intraocular pressure (IOP)-lowering effects into the eyes of monkeys. These results suggested the possibility that there is no direct relationship between ROCK inhibition and IOP-lowering effects, indicating that the initial screening of compounds based on ROCK inhibitory activity may be an unsuitable strategy for developing antiglaucoma agents with potent IOP-lowering effects.     

Digoxin Derivatives with Enhanced Selectivity for the α2 Isoform of Na,K-ATPase: EFFECTS ON INTRAOCULAR PRESSURE IN RABBITS*

In the ciliary epithelium of the eye, the pigmented cells express the α1β1 isoform of Na,K-ATPase, whereas the non-pigmented cells express mainly the α2β3 isoform of Na,K-ATPase. In principle, a Na,K-ATPase inhibitor with selectivity for α2 could effectively reduce intraocular pressure with only minimal local and systemic toxicity. Such an inhibitor could be applied topically provided it was sufficiently permeable via the cornea. Previous experiments with recombinant human α1β1, α2β1, and α3β1 isoforms showed that the classical cardiac glycoside, digoxin, is partially α2-selective and also that the trisdigitoxose moiety is responsible for isoform selectivity. This led to a prediction that modification of the third digitoxose might increase α2 selectivity. A series of perhydro-1,4-oxazepine derivatives of digoxin have been synthesized by periodate oxidation and reductive amination using a variety of R-NH₂ substituents. Several derivatives show enhanced selectivity for α2 over α1, close to 8-fold in the best case. Effects of topically applied cardiac glycosides on intraocular pressure in rabbits have been assessed by their ability to either prevent or reverse acute intraocular pressure increases induced by 4-aminopyridine or a selective agonist of the A3 adenosine receptor. Two relatively α2-selective digoxin derivatives efficiently normalize the ocular hypertension, by comparison with digoxin, digoxigenin, or ouabain. This observation is consistent with a major role of α2 in aqueous humor production and suggests that, potentially, α2-selective digoxin derivatives could be of interest as novel drugs for control of intraocular pressure.     

超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼的临床疗效及安全性评价

目的：探讨超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼的临床疗效及安全性。方法：将100例白内障合并青光眼患者按照抽签法随机地均分为对照组与观察组,对照组给予单纯超声乳化人工晶状体植入术,观察组在此基础上给予联合小梁切除术进行治疗。比较两组治疗前后相关指标以及术后并发症发生率等。结果：（1）对照组治疗前后IOP、ACD及AL均无统计学差异,观察组治疗前后IOP与CAD差异具有统计学意义（P〈0．05,P〈0．01）,但该组治疗前后AL无统计学差异;（2）两组术前与术后1周、1个月及3个月平均视野缺损值、平均模式标准差相比,差异均具有统计学意义,且观察组术后与对照组术后相比,差异均具有统计学意义;（3）对照组并发症发生率为20．00％,明显大于观察组（10．00％）。结论：超声乳化白内障吸除、人工晶状体植入联合小梁切除术治疗白内障合并青光眼,疗效显著,不良反应发生率低,值得加以推广并应用。     

多西紫杉醇修饰的人工晶体与眼组织相容性分析

目的：探讨经多西紫杉醇修饰的人工晶体对眼组织相容性的影响。方法：按照随机数字表法将32 只日本大耳兔分为两组： 实验组通过手术植入表面经多西紫杉醇修饰处理后的疏水性人工晶体,对照组植入疏水性人工晶体。比较两组人工晶体亲水角、 术后24 小时光耀斑块计数以及人工晶体周围组织炎症浸润数。结果：实验组的亲水角小于对照组,差异有统计学意义（P<0.05）。 实验组光耀斑块计数低于对照组,差异有统计学意义（P<0.05）。实验组家兔人工晶体周围组织炎症浸润计数低于对照组,差异有 统计学意义（P<0.05）。结论：人工晶体表面经多西紫杉醇修饰后,其亲水性、与眼组织的组织相容性增加,且可缓解光耀斑炎症感 染和降低并发症的发生,有重要的临床参考价值。     

Brain tissue transplanted to the anterior chamber of the eye

Summary Knowing the ontogenesis of the central monoamine neurons of the rat it is possible to obtain, by free-hand dissection from embryos and newly born animals, pieces containing dopamine (DA), noradrenaline (NA), and 5-hydroxytryptamine (5-HT) neurons that are small enough to permit homologous transplantation to the anterior chamber of the eye of adult animals. With this technique it was established that all three types of immature monoamine neurons are able to survive in the anterior chamber. Fluorescence histochemical analysis of whole mount preparations of the sympathetically denervated host irides revealed that both the catecholamine- and the 5-HT-neurons are able to partly reinnervate the irides, forming networks of varicose nerve terminals similar to the normally present sympathetic adrenergic ground plexus.Monoamine nerve cell bodies are attached to the irides but the majority of fluorescent nerve cell bodies is located within the transplants. Serial sectioning of these transplants showed rather well organized brain tissue, containing groups of fluorescent and non-fluorescent cell bodies, many areas being innervated by monoamine nerve terminals. When brain tissue was transplanted before the normal appearance of fluorescent neuroblasts (embryos with a crown-rump length less than 8 mm) monoamine neurons developed and matured within the eye.The amount of newly formed nerves of central origin recovered on the irides increased with time between the 2nd and 4th postoperative week and persisted after 2 months. The yield of new fibers was better using transplants from embryos with a crown-rump length between 15 and 30 mm than using transplants from larger embryos and newly born animals.If embryonic brain tissue known to be devoid of monoamine nerve cell bodies but containing monoamine nerve terminals in the adult state (cortex cerebri and cerebelli, spinal cord) was transplanted to sympathetically non-denervated eyes, the sympathetic adrenergic fibers seemed to be able to innervate the transplants.This work was supported by grants from the Swedish Medical Research Council (14×–3185), Karolinska Institutets fonder, and Magnus Bergvalls Stiftelse. We thank Miss Monica Eliasson, Mrs. Ulla Flyger, Mrs. Barbro Norstedt and Miss Ingrid Strömberg for skilful technical assistance. The generous gifts of Nialamide, Pfizer, and Pargyline, Abbott are gratefully acknowledged.     

Intraocular pressure profile during the modified diurnal tension curve using Goldman applanation tonometry and dynamic contour tonometry

The aim of this study was to compare the intraocular pressure (IOP) profile during the modified diurnal tension curve (mDTC) using Goldman applanation tonometry (GAT) and dynamic contour tonometry (DCT) in treated glaucomatous eyes. Eligible subjects were submitted to the mDTC using GAT and DCT in this sequence. IOP measurements were performed at 8 a.m., 10 a.m., 2 p.m., and 4 p.m.. Central corneal thickness was measured using ultrasound pachymetry in the morning. Statistical analysis was performed using paired Student’s t test and Bland–Altman plot. The mean difference between DCT and GAT measurements was 0.9 mmHg. The mean ± SD IOP measurements during the mDTC were 19.68 ± 4.68, 17.63 ± 4.44, 17.25 ± 5.41, and 17.32 ± 4.25 mmHg using GAT and 19.97 ± 4.75, 18.79 ± 4.61, 19.53 ± 5.30, and 19.43 ± 5.45 mmHg using DCT. IOP measurements were higher in the morning (8 a.m.) and decreased throughout the day using both tonometers. The difference between IOP measurements using GAT and DCT was smaller in the morning and increased throughout the day. The IOP variability using GAT was higher than using DCT. Corneal biomechanical properties might help explain our findings.     

老年白内障患者超声乳化联合人工晶状体植入术1210例临床研究

目的：观察老年白内障患者超声乳化联合人工晶体植入术后的治疗效果,探讨白内障超声乳化人工晶状体植入术术中术后并发症及相应处理措施。方法：对1210例1325眼老年白内障超声乳化人工晶状体植入术患者的临床病例资料进行回顾性分析,统计术后疗效并分析术中术后并发症的原因。结果：1325眼术后视力均有不同程度的提高,发生术中晶状体碎核入玻璃体腔1眼,术后并发症主要为一过性高眼压、角膜水肿、晶状体后囊破裂及视网膜脱落,发生率分别为1．36％、7．47％、0．03％和0．02％。结论：超声乳化联合人工晶体植入术对老年白内障患者治疗效果满意。对于术中及术后发生的各种并发症应分析原因并积极的预防。     

Numerical modelling of corneal biomechanical behaviour

Numerical modelling based on finite element analysis is used to represent the biomechanical behaviour of the cornea. The construction details of the model including the discretisation method, the mesh density, the thickness distribution, the topography idealisation, the boundary conditions and the material properties, are optimised to improve efficiency. Factors which are found to have a considerable effect on model accuracy are considered and those with effect below a certain low threshold are ignored to reduce cost of analysis. The model is validated against laboratory tests involving pressure inflation of corneal trephinates while monitoring their behaviour. To illustrate the potential of the validated model in studying corneal biomechanics, its use in modelling Goldmann applanation tonometry (GAT) is briefly described. In studying GAT, the model is able to accurately trace the behaviour of the cornea under tonometric pressure and monitor the gap closure and the progress of deformation to the point of applanation.     

Adenosine,adenosine receptors and glaucoma: An updated overview

Background

Glaucoma, a leading cause of blindness worldwide, is an optic neuropathy commonly associated with elevated intraocular pressure (IOP). The major goals of glaucoma treatments are to lower IOP and protect retinal ganglion cells. It has been revealed recently that adenosine and adenosine receptors (ARs) have important roles in IOP modulation and neuroprotection.

Scope of review

This article reviews recent studies on the important roles of adenosine and ARs in aqueous humor formation and outflow facility, IOP and retinal neuroprotection.

Major conclusions

Adenosine and several adenosine derivatives increase and/or decrease IOP via A_2A AR. Activation of A₁ AR can reduce outflow resistance and thereby lower IOP, A₃ receptor antagonists prevent adenosine-induced activation of Cl⁻ channels of the ciliary non-pigmented epithelial cells and thereby lower IOP. A₁ and A_2A agonists can reduce vascular resistance and increase retina and optic nerve head blood flow. A₁ agonist and A_2A antagonist can enhance the recovery of retinal function after ischemia attack. Adenosine acting at A₃ receptors can attenuate the rise in calcium and retinal ganglion cells death accompanying P2X(7) receptor activation.

General significance

Evidence suggested that the adenosine system is one of the potential target systems for therapeutic approaches in glaucoma.