Tear Film Cytokine Profile of Patients With the Boston Keratoprosthesis Type 1: Comparing Patients With and Without Glaucoma

Geoffrion, Dominique; Robert, Marie-Claude; Polo, Adriana Di; Koenekoop, Robert K.; Agoumi, Younes; Harissi‐Dagher, Mona

doi:10.1167/iovs.62.4.20

Cited by 10 publications

(6 citation statements)

References 96 publications

(156 reference statements)

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“…As mentioned earlier, several inflammatory cytokines in the aqueous humor of POAG patients have been found to be associated with increased retinal ganglion cell death and elevated IOP [ 22 , 23 ]. The link between ocular pressure and tear cytokine levels also shows a study by Geoffrion et al [ 20 ] that indicates an association between an IOP elevation and an increase in levels of IFNy and IL1β in tear fluid. In our study, however, the level of IOP does not seem to affect the composition of tears between the group of patients with normal IOP and IOP higher than 20 mmHg.…”

Section: Discussionmentioning

confidence: 60%

“…Tears hold an important place in cytokine research as markers of immunoinflammatory response in various eye diseases. This is supported by a result from study suggesting that elevated concentrations of certain inflammatory cytokines such as IL1β or TNFα in the aqueous humor of patients with eye disorders may diffuse from the retina to the anterior chamber where it may end up in the tear fluid through the optic-corneal button interface [ 19 , 20 ]. Most studies examining the levels of cytokines in tears of glaucoma patients do not distinguish between POAG and OHT diagnoses.…”

Section: Discussionmentioning

confidence: 82%

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Comparative analysis of tear cytokines in patients with glaucoma, ocular hypertension, and healthy controls

2023

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Purpose To investigate the ocular surface inflammation in patients with primary open angle glaucoma and ocular hypertension by analyzing tears and to compare findings with healthy controls. Methods Observational case–control study. Tear samples were collected by 5 µl microcapillary tube from 24 patients with glaucoma treated by antiglaucoma drops, 9 non-treated patients with ocular hypertension and 45 healthy controls. Tears were analyzed from right eye by multiplex Bio-Plex system for the presence of 6 cytokines: IL1β, IL10, IL4, IFNγ, MIF and VEGF. Results Significantly higher concentrations of IL1β and IL10 (glaucoma or ocular hypertension vs. healthy controls, p < 0.0001), VEGF (glaucoma vs. ocular hypertension, p < 0.05; ocular hypertension vs. healthy controls, p < 0.02) and MIF (glaucoma vs. healthy controls, p < 0.03) were detected in patients’ tears. Both patient groups have activated to a significantly lower extent the Th1 pathway represented by IFNγ than Th2 pathway represented by IL10 (p < 0.001) and, at the same time, the IFNγ/IL4 ratio was significantly increased in healthy controls (p < 0.001) and patients with ocular hypertension (p < 0.02) compared to glaucoma individuals. Conclusion This study shows that secretion of inflammation-related cytokines by conjunctival cells is increased in both, glaucoma and ocular hypertension patients and can be detected in their tears. Nevertheless, data indicates stronger ocular surface inflammation in non-treated follow-up patients diagnosed with ocular hypertension than in glaucoma subjects treated by antiglaucoma drops.

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Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 82%

Comparative analysis of tear cytokines in patients with glaucoma, ocular hypertension, and healthy controls

2023

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“…While inflammation may also have an important role in KPro‐associated glaucoma, no study has yet investigated ocular fluids from KPro patients with glaucoma. The objective of this study was to compare cytokine levels in the tear film of KPro patients with and without glaucoma, relative to controls and correlate levels with clinical parameters (Geoffrion, Robert, Chodosh, et al, 2021; Geoffrion, Robert, Di Polo, et al, 2021). The long‐term goal was to establish how clinical care can be best tailored to the KPro patient population to improve outcomes despite high prevalence of glaucoma.…”

Section: Introductionmentioning

confidence: 99%

“…We wanted to determine whether this mouse model was a proper model to examine inflammatory mechanisms and retinal ganglion cell apoptosis involved in glaucomatous optic neuropathy after KPro surgery. We investigated whether it was feasible to establish a reproducible animal model of glaucoma post‐KPro with the hope to use it to validate human outcomes in the future (Geoffrion, Robert, Chodosh, et al, 2021; Geoffrion, Robert, Di Polo, et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Probing mechanisms and improving management of glaucoma following Boston keratoprosthesis surgery

Geoffrion

Koenekoop

Harissi‐Dagher

2022

Acta Ophthalmologica

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ENGLISH SUMMARY Corneal blindness is a leading cause of visual impairment worldwide. The most common treatment is to replace the diseased cornea by standard corneal transplantation. In eyes at high risk of graft failure, the Boston keratoprosthesis type 1 (KPro) can be used to restore vision and is currently the most frequently used artificial cornea in the world. However, glaucoma is a well‐known complication of KPro surgery and is the most important threat to vision in KPro‐implanted eyes (paper I). This chronic disease is influenced by elevated intraocular pressure (IOP) and damages the optic nerve, leading to progressive vision loss. In KPro patients, glaucoma is highly prevalent and extremely challenging to manage, yet its exact cause remains unknown. The overall purpose of this PhD Thesis (Geoffrion, 2021) was to better understand the mechanisms and how to improve management of glaucoma after KPro implantation. The approaches used in this thesis included investigating one of the largest KPro patient cohorts in North America, with a total of 157 operated patients at that time, as well as studying KPro surgery and outcomes in mice. The first objective was to identify risk factors for glaucoma development and progression after KPro implantation (paper II). Multivariate logistic regression revealed that high preoperative IOP signals a higher risk for both glaucoma development and progression. Stromal and endothelial corneal disorders were less associated with glaucoma progression, while autoimmune and ocular surface diseases precipitated glaucoma development. Second, there is no objective evidence that indicates the best order for glaucoma surgeries and KPro implantation. By comparing medical and surgical management in KPro eyes with either preexisting or de novo glaucoma (paper III), we showed that glaucoma surgery may be performed before or at the time of KPro in eyes with preexisting glaucoma to limit progression without increasing complications. In eyes with de novo glaucoma, glaucoma surgery did not increase complications compared with medications. Third, among glaucoma surgery interventions, the two most frequently implanted glaucoma drainage devices were compared in KPro patients (paper IV). Compared with the Ahmed glaucoma valve, the Baerveldt glaucoma implant was associated with lower failure rates, without increased postoperative complications. Fourth, even with aggressive management, many KPro patients suffer from progressive optic nerve damage, sometimes despite normal IOP. Inflammatory cytokines play an important role in glaucomatous optic neuropathy, but their role in KPro‐associated glaucoma is still unknown. By analysing tear fluid of KPro patients by multiplex bead immunoassay (paper V), we identified that cytokines TNF‐a, IL‐1b, FGF‐basic and IFN‐g were elevated in KPro patients with glaucoma compared to those without. These cytokines correlated with optic nerve excavation and IOP. For the first time in humans, these results concorded with the elevations of TNF‐a and IL‐1b documented ...

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“…Inflammatory cytokines play an important role in glaucomatous optic neuropathy, but their role in KPro‐associated glaucoma is still unknown. By analysing tear fluid of KPro patients by multiplex bead immunoassay (paper V), we identified that cytokines TNF‐a, IL‐1b, FGF‐basic and IFN‐g were elevated in KPro patients with glaucoma compared to those without (Geoffrion et al, 2021a). These cytokines correlated with optic nerve excavation and IOP.…”

mentioning

confidence: 99%

Probing mechanisms and improving management of glaucoma following Boston keratoprosthesis surgery

Geoffrion

Koenekoop

Harissi‐Dagher

2023

Acta Ophthalmologica

Self Cite

View full text Add to dashboard Cite

Corneal blindness is a leading cause of visual impairment worldwide. The most common treatment is to replace the diseased cornea with standard corneal transplantation. In eyes at high risk of graft failure, the Boston keratoprosthesis type 1 (KPro) can be used to restore vision and is currently the most frequently used artificial cornea in the world. However, glaucoma is a well‐known complication of KPro surgery and is the most important threat to vision in KPro‐implanted eyes. This chronic disease is influenced by elevated intraocular pressure (IOP) and damages the optic nerve, leading to progressive vision loss. In KPro patients, glaucoma is highly prevalent and extremely challenging to manage, yet its exact cause remains unknown.

show abstract

Tear Film Cytokine Profile of Patients With the Boston Keratoprosthesis Type 1: Comparing Patients With and Without Glaucoma

Cited by 10 publications

References 96 publications

Comparative analysis of tear cytokines in patients with glaucoma, ocular hypertension, and healthy controls

Comparative analysis of tear cytokines in patients with glaucoma, ocular hypertension, and healthy controls

Probing mechanisms and improving management of glaucoma following Boston keratoprosthesis surgery

Probing mechanisms and improving management of glaucoma following Boston keratoprosthesis surgery

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