Cultured trabecular meshwork (TM) cells are a valuable model system to study the cellular mechanisms involved in the regulation of conventional outflow resistance and thus intraocular pressure; and their dysfunction resulting in ocular hypertension. In this review, we describe the standard procedures used for the isolation of TM cells from several animal species including humans, and the methods used to validate their identity. Having a set of standard practices for TM cells will increase the scientific rigor when used as a model, and enable other researchers to replicate and build upon previous findings.
PURPOSE. There is considerable evidence for systemic vascular dysfunction in primary openangle glaucoma (POAG). We performed nailfold capillary video microscopy to observe directly the nature of nonocular microvasculature abnormalities in POAG.
METHODS.We enrolled 199 POAG patients and 124 control subjects from four sites. We used JH-1004 capillaroscopes to perform nailfold capillary video microscopy on the fourth and fifth digits of each subject's nondominant hand. Videos were evaluated for hemorrhages, dilated capillary loops > 50 lm, and avascular zones > 100 lm by graders masked to case status. Multivariable odds ratios (ORs) and 95% confidence intervals (CIs) for POAG were obtained by means of logistic regression analyses that were applied to data from all cases and controls. Corresponding estimates of moderate or severe POAG versus mild POAG (based on the Hodapp-Anderson-Parrish scale) were obtained among cases only.
RESULTS.After controlling for demographic factors, family history of glaucoma, systemic diseases, and use of anticoagulation and antiplatelet therapy, for each 100 nailfold capillaries assessed, all types of microvascular abnormalities were significantly associated with POAG. Specifically, the presence of any dilated capillaries (OR ¼ 2.9; 95% CI, 1.6-5.6), avascular zones (OR ¼ 4.4; 95% CI, 1.7-11.3) and hemorrhages (OR ¼ 12.2; 95% CI, 5.9-25.1) were associated with POAG. Among cases, the frequency of microvascular abnormalities was not associated with glaucoma severity (P ‡ 0.43).CONCLUSIONS. These data provided support for nonocular capillary bed abnormalities in POAG. Comparable vascular abnormalities in the optic nerve may render it susceptible to glaucomatous damage.
The use of glaucoma drainage devices has increased significantly in recent years for both primary treatment of glaucoma and refractory glaucoma. The efficacy and safety of glaucoma drainage devices has been well established, so they are a viable surgical option in patients who fail medical therapy. With the increased use of these devices, understanding their complications is essential in managing these patients. The prevention and management of complications associated with glaucoma drainage device insertion has some similarities to that of a trabeculectomy. The glaucoma drainage devices have additional complications associated with the fact that hardware is left within the eye. There have been no definitive answers as to the perfect surgical technique to prevent complications but careful surgical performance, tube placement and use of a double-layered graft over the tube are likely to lead to a better outcome. The rate of complications also dictates careful follow up to identify these complications early in their process as early intervention will likely lead to better outcomes.
sCD44 concentration in the aqueous of POAG patients correlated with the severity of visual field loss in all stages in white patients and in mild to moderate stages in African American patients. sCD44 concentration in aqueous is a possible protein biomarker of visual field loss in POAG.
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