Mei-Lan Ko

Patterns of retinal ganglion cell survival after brain-derived neurotrophic factor administration in hypertensive eyes of rats.

We investigated the effect of brain-derived neurotrophic factor (BDNF) on retinal ganglion cell (RGC) survival after intraocular pressure (IOP) elevation at various time intervals. In adult Wistar rats, RGCs were labeled with 5% Fluorogold. Animals with 1.8-2.5-fold increase in IOP after cauterization of three episcleral vessels, were divided into three BDNF groups and three vehicle control groups, each receiving one, two or three injections. The RGC survival percentage on RGCs of the first, second and third injections were 93.9% (n = 7), 91.3% (n = 7), 82.7% (n = 5), respectively in BDNF groups; 91.6% (n = 6), 84.1% (n = 6) and 73.5% (n = 5), respectively in vehicle controls. The second and third injections of BDNF showed statistically significant survival effects. These findings demonstrated that BDNF has partial neuroprotection on RGCs in whole retina and enhances RGC survival in moderately chronic hypertensive eyes.

Epigallocatechin-3-gallate reduces retinal ischemia/reperfusion injury by attenuating neuronal nitric oxide synthase expression and activity.

Retinal ischemia/reperfusion (IR) injury causes profound tissue damage, especially retinal ganglion cell death. The aims of the study were twofold: (1) to investigate the benefits of epigallocatechin-3-gallate (EGCG), the major catechin found in tea, after IR challenge, and (2) to elucidate the mechanism of EGCG inhibition of nitric oxide synthase (NOS) expression. Wistar female rats were divided into four groups: normal control, EGCG with sham operation, retinal IR, and EGCG with IR groups. EGCG (50mg/kg) was administered by intraperitoneal injection 30 min before the experiment. IR injury to a rats retina was induced by raising intraocular pressure to 150 mmHg for 60 min. With EGCG pretreatment, retinal ganglion cell death from IR was reduced by approximately 10% 3 days afterward. EGCG significantly downregulated IR-induced glial fibrillary acidic protein expression. EGCG treatment also reduced TUNEL-positive cells after IR in the inner retina as well as IR-induced lipid peroxidation. Histological analyses showed fewer neuronal NOS and nicotinamide adenine dinucleotide phosphate diaphorase-positive cells in the retina after IR with EGCG administration. Therefore, EGCG is effective in protecting retinal ganglion cells from IR challenge by ameliorating retinal nitrosactive stress and by regulating cell death through apoptotic pathways.

Effects of epigallocatechin-3-gallate on rat retinal ganglion cells after optic nerve axotomy.

The purpose of this study was to investigate the effects of epigallocatechin-3-gallate (EGCG) in axotomized eyes and the pathways related to its action. Wistar rats received intracranial optic nerve (ON) axotomy 2 mm behind the globe in left eyes, whereas right eyes received sham operations. EGCG was administrated via intraperitoneal injection 30 min before and 4 days after axotomy. The density of retinal ganglion cell (RGC) was examined by a retrograde labeling technique. Western blot analysis was used to assess the expression of neuronal nitric oxide synthase (nNOS), Bax, Bcl-2, ERK and Akt. Optic nerve axotomy caused 54% RGC loss 7 days following surgery, and EGCG treatment reduced RGC loss by 12% (P = 0.017). The expression of the nNOS and pro-apoptotic Bax proteins were increased 5 days after axotomy, while EGCG treatment significantly blunted the up-regulation of the above two proteins (P = 0.04 and 0.02, respectively). Axotomy-induced p-ERK 1/2 and p-Akt proteins expression 5 days and 3 days following injury, respectively. Treatment with EGCG further enhanced p-ERK 1/2 and p-Akt expressions after axotomy. Inhibition of ERK and Akt pathways attenuated the protection of EGCG on RGC against axotomy damage. Thus, we demonstrated that administration of EGCG prior to axotomy promotes RGC survival. The neuroprotective capacity of EGCG appears to act through mediating nitric oxide, anti-apoptotic, and cell survival signaling pathways.

Simvastatin upregulates Bcl-2 expression and protects retinal neurons from early ischemia/reperfusion injury in the rat retina

Simvastatin has been shown to enhance the survival of retinal ganglion cells (RGCs) following ischemia-reperfusion (IR) injury by mediating the expression of stress proteins. The purpose of this study was to investigate the effect of simvastatin on retinal neurons and the expression of apoptotic proteins in a rat IR model. Wistar rats received intravitreal injection of simvastatin immediately after retinal reperfusion. Retinal ischemia was induced by increasing intraocular pressure to 150 mm Hg for 60 min. The number of viable RGCs was measured after retrograde labeling with Fluoro-Gold. Ischemia-induced apoptotic cell death was studied using terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL). We found that simvastatin treatment enhanced RGC survival after retinal ischemia by approximately 40% and decreased retinal neuronal apoptosis. Using western blot analysis, we found that simvastatin upregulated the expression of Bcl-2 in the retina. In contrast, the level of the protein Bax was unaffected by simvastatin treatment. Our results suggest that RGC loss induced by retinal IR may be prevented by simvastatin and that the mechanism underlying this process possibly involves an alteration in the apoptotic pathway.

Haem oxygenase-1 gene transfer protects retinal ganglion cells from ischaemia/reperfusion injury

RGC (retinal ganglion cell) death following ischaemic insult is the major cause of a number of vision-threatening diseases, including glaucoma. The aim of the present study was to evaluate the role of HO-1 (haem oxygenase-1) in the retina against IR (ischaemia/reperfusion) injury. Adenovirus-mediated HO-1 gene transfer (Adv-HO-1) was carried out by injection into the vitreous body to induce HO-1 overexpression. At 3 weeks after transfection, levels of HO-1 expression, as measured by Western blot analysis, immunohistochemical staining and activity assay, were drastically up-regulated. Transient retinal ischaemia was induced by raising the intraocular pressure to 150 mmHg for 60 min. Untreated IR caused a significant decrease in RGC numbers at 3 and 7 days after reperfusion (76.1 and 67.2% of control eyes with sham IR respectively; P<0.001). Eyes pretreated with Adv-HO-1 had less RGC loss on day 3 and 7 following reperfusion compared with control eyes injected with Adv-GFP (adenovirus containing a gene for green fluorescent protein; 94.3 and 88.2% respectively; P=0.007 and 0.001). SnP (tin protoporphyrin), an HO-1 inhibitor, counteracted the effects of Adv-HO-1. In conclusion, these findings provide evidence that augmentation of HO-1 enzyme overexpression by intravitreal injection is able to protect RGCs against IR-induced damage.

Pharmacological preconditioning by low dose cobalt protoporphyrin induces heme oxygenase-1 overexpression and alleviates retinal ischemia-reperfusion injury in rats

Purpose: Retinal ischemia-induced neuronal death plays a crucial role in certain severe visual impairment diseases. The aims of this study were to investigate the effects of low dose cobalt protoporphyrin IX (CoPP), an inducer of heme oxygenase-1 (HO-1), on the retina of rats against ischemia-reperfusion (IR) injury. Methods: Retinal IR was achieved in rats by raising intraocular pressure for 60u2009min. CoPP (1u2009mg/u200akg) was injected intraperitoneally 24u2009hr before IR. Retinal injury was assessed by the number of retinal ganglion cells (RGCs) seven days after reperfusion. TUNEL assay was used to detect the appearance of apoptotic cells 24u2009hr after reperfusion. The expressions of the HO-1 and Bax proteins were evaluated by Western blot. Results: Both HO-1 expression, examined by Western blot, and enzyme activity were increased strongly after CoPP administration. Rats treated with CoPP before IR had more RGCs (pu2009=u20090.034) and less apoptotic cells (pu2009=u20090.04) together with downregulated Bax protein levels (pu2009=u20090.03) compared to ischemic rats without CoPP. The protective effects of CoPP were HO-1 dependent because the upregulation of HO-1 and the RGC protection were both abolished by the HO-1 inhibitor tin protoporphyrin (SnPP). Conclusions: In this study, we demonstrated that induction of HO-1 expression by low dose CoPP ameliorated retinal damage from IR injury. The favorable effect appears to be related with modulations of the apoptotic pathway.

Dietary deficiency of vitamin E aggravates retinal ganglion cell death in experimental glaucoma of rats.

Purpose: Investigate the effect of dietary vitamin E (Vit E) on the retinas of a rat model of induced glaucoma, in which surgically induced elevation of intraocular pressure (IOP) is associated with an increase in reactive oxygen species. Methods: Rats were fed a standard chow, Vit E-supplemented diet, or Vit E-deficient diet and subjected to surgically induced IOP elevation (or sham surgery) for five weeks. The retinal ganglion cells (RGCs) were subjected to retrograde fluorescent tracer labeling. Results: The mean number of RGCs of rats on the standard chow, Vit E-supplemented diet, and Vit E-deficient diet were 79.6%, 78.6%, and 71.3% of controls, respectively. Lipid peroxidation of the retinas of rats given a Vit E-deficient diet were significantly higher after IOP elevation for three days (14.42u2009±u20090.25 μM, Pu2009=u20090.016) and five weeks (10.46u2009±u20090.11 μM, pu2009=u20090.042), compared to rats given standard chow (11.37u2009±u20090.31 μM; 8.95u2009±u20090.16 μM). Compared with rats given standard chow, rats given a Vit E-deficient diet had significantly elevated concentrations of glutathione (pu2009=u20090.032), but no significant differences in the levels of total superoxide dismutase (SOD), Cu/Zn SOD, or catalase activities three days after IOP elevation. Conclusions: Rats fed a Vit E-deficient diet with surgically induced IOP elevation experience significantly more RGC death than rats fed a normal diet. This phenomenon may be related to the increased level of lipid peroxidation in Vit E-deficient rats.

Retinal nerve fibre layer thickness and optic nerve head size measured in high myopes by optical coherence tomography.

The retinal nerve fibre layer (RNFL) thickness is reportedly decreased in myopia; however, magnification adjustment is an important consideration when using optical coherence tomography (OCT) to evaluate myopic eyes. In this study, RNFL thickness and optic nerve head (ONH) size were measured in highly myopic eyes with and without magnification adjustments. The measurements were compared with magnification‐adjusted OCT measurements of emmetropic control eyes.

Age and axial length on peripapillary retinal nerve fiber layer thickness measured by optical coherence tomography in nonglaucomatous Taiwanese participants

Purpose This study investigates the influence of age and axial length (AL) on the peripapillary retinal nerve fiber layer (RNFL) thickness, as measured by optical coherence tomography (OCT). Methods Healthy patients visiting an eye clinic at a county hospital were recruited. All participants underwent comprehensive ophthalmologic examinations, and their retinas were scanned using 3D OCT-1000. In total, 223 patients with 446 eyes were included. The mean age and AL were 42.07 ± 13.16 (21–76) years and 25.38 ± 1.73 (21.19–30.37) mm, respectively. Results The average RNFL thickness decreased by 2.71 μm for every 10-year increase in age (P < 0.001). Age-related RNFL thinning was more significant in participants older than 41 years (-0.24μm/year; P = 0.015). The earliest sector showing a significant decline in RNFL thickness was after 35 years of age (-0.70μm/year; P = 0.011) at the superior quadrant and at the 1–2 o’clock hour (-1.42μm/year; P = 0.009). Meanwhile, the maximal rate of age-associated RNFL decay was observed in these two regions as well. The reduction of RNFL with age progression did not differ in eyes with long AL (> 27 mm; -0.16μm/year) or those with short AL (< 25 mm; -0.22μm/year). For every 1-mm-greater AL, RNFL was thinner by 1.78 μm (P < 0.001). The inferior quadrant showed the greatest tendency of RNFL decline with longer AL (4.46 μm/mm; P < 0.001). Conclusions The factors of age and AL should be considered when interpreting the results. Significantly age-associated RNFL thinning was found in participants older than 41 years. Reduction of RNFL thickness with increasing age was not affected by AL. Topographic variations in RNFL thinning were observed in that the maximal decline of RNFL thickness with advancing age at the superior quadrant whereas with elongation of AL at the inferior quadrant.

Design and analysis of wearable pupillometer for autonomic neuropathy of diabetic patients

Diabetes is a familiar disease in modern society. In the early stage of diabetes, symptoms are unobvious, but they usually induce diabetic autonomic neuropathy or, worse, cardiovascular autonomic neuropathy. Pupillometers are effective instruments for observing human pupils. This article presents a novel wearable pupillometer design, without external light artifacts, and an embedded algorithm with blinking elimination, which investigates autonomic neuropathy through recording pupil dynamics triggered by an external sensitive invisible light source. The pupillometer is experimented on 36 healthy subjects and 10 diabetic patients under four different colors (white, red, green, and blue) as well as two different light intensities: 50 and 500 mcd. Ten parameters derived from pupil diameter, pupil response time, and pupil response speed will be evaluated for the healthy subjects and diabetic patients. The results show that three in four parameters related to pupil diameters, one in four related to light intensities, and one in two related to pupil response speed could have significant differences (p<0.05) between healthy subjects and diabetic patients. These parameters obtain over 85% sensitivity, 83% specificity, and 88% accuracy. The pupillometer is proven reliable, effective, portable, and inexpensive for diagnosing diabetes in an early stage.