Saffar Mansoor

Diabetic Retinopathy and VEGF

Diabetic retinopathy remains the leading vascular-associated cause of blindness throughout the world. Its treatment requires a multidisciplinary interventional approach at both systemic and local levels. Current management includes laser photocoagulation, intravitreal steroids, and anti-vascular endothelial growth factor (VEGF) treatment along with systemic blood sugar control. Anti-VEGF therapies, which are less destructive and safer than laser treatments, are being explored as primary therapy for the management of vision-threatening complications of diabetic retinopathy such as diabetic macular edema (DME). This review provides comprehensive information related to VEGF and describes its role in the pathogenesis of diabetic retinopathy, and in addition, examines the mechanisms of action for different antiangiogenic agents in relation to the management of this disease. Medline (Pubmed) searches were carried out with keywords “VEGF”, “diabetic retinopathy”, and “diabetes” without any year limitation to review relevant manuscripts used for this article.

Intraocular Sustained-Release Delivery Systems for Triamcinolone Acetonide

Recently, the use of triamcinolone acetonide (TA) injection has increased dramatically in treatment for several ocular diseases. Among them, macular diseases such as macular edema due to diabetic retinopathy, venous occlusive diseases, ocular inflammation and age-related macular degeneration (AMD) are very common vision threatening disorders and are great challenges to treat. In these types of chronic retinal diseases, repeated intraocular injections of TA are often required which increases the likelihood of complications. In order to achieve sustained-release, maintain therapeutic levels of TA over longer times and reduce frequency of intravitreal injections, researchers are investigating different implantable devices or injectable systems. However, as of yet, there is no sustained-release product for TA available on the commercial market. This review discusses and compares different sustained-release devices or injectable systems that are currently being developed.

Effects of light on retinal pigment epithelial cells, neurosensory retinal cells and Müller cells treated with Brilliant Blue G

The aim of this study is to evaluate the safety profile of Brilliant Blue G (BBG) with and without exposure to light (L) on three different retinal cell lines.

Effects of triamcinolone acetonide on human trabecular meshwork cells in vitro.

Aim: To study the effects of triamcinolone acetonide (TA) on cultured human trabecular meshwork (HTM) cells. Materials and Methods: HTM cells were cultured and treated with 125, 250, 500 and 1000 μg/mL concentration of TA for 24 h. The cells were treated with both crystalline TA (TA-C) (commercial preparation) and solubilized TA (TA-S). Cell viability was measured by a trypan blue dye exclusion test. The activity of caspse-3/7 was measured by a fluorescence caspase kit and DNA laddering was evaluated by electrophoresis on 3% agarose gel. Levels of lactate dehydrogenase (LDH) were assessed with LDH cytotoxicity assay kit-II. Results: Mean cell viabilities of HTM cells after 24 h exposure to TA-C 125, 250, 500, and 1000 μg/mL were 75.4 ±2.45% (P < 0.0001), 49.43 ± 1.85% (P < 0.0001), 17.07 ± 2.39% (P < 0.0001), and 3.7 ± 0.9% (P < 0.0001), respectively, compared with the untreated HTM cells 92.49 ± 1.21%. The mean cell viabilities with 125, 250, 500, and 1000 μg/mL of TA-S were 94.47 ± 1.60% (P > 0.05), 90.13 ± 0.40% (P < 0.01), 85.57 ± 0.47% (P < 0.001), and 71.67 ± 3.30% (P < 0.0001), respectively, compared to DMSO-equivalent cultures. Untreated HTM control had a cell viability of 96.57 ± 1.98%. DMSO-treated controls of 125, 250, 500, and 1000 μg/mL had a cell viability of 94.73 ± 0.57%, 96.97 ± 1.08%, 93.97 ± 1.85%, and 97.27 ± 1.15%, respectively. There was no increase of caspase-3/7 activity in cultures treated with either TA-C or TA-S. DNA laddering showed no bands in the TA-C or TA-S treated cultures. There were significantly higher LDH release rates at all concentrations of TA-C compared to TA-S. Conclusions: Results show that the effect of TA-C and TA-S on HTM cells is due to cell death by necrosis at all concentrations except 125 μg/mL of TA-S. Elevated levels of LDH confirmed necrotic cell death. Our study also infers the relative safety of TA-S over TA-C.

Protective effects of 17β-estradiol on Benzo(e)pyrene[B(e)P]-induced toxicity in ARPE-19 cells

Purpose: The aim of this study was to examine the effect of 17β-estradiol on Benzo(e)pyrene [B(e)P]-induced toxicity in ARPE-19 cells. Methods: We pretreated ARPE-19 cells with 20 nM and 40 nM 17β-estradiol for 6 hours, followed by addition of 300 μM B(e)P for additional 24 hours. Cell viability was measured using Trypan blue dye-exclusion assay. JC-1 assay was performed to measure mitochondrial membrane potential (ΔΨm). For a quantitative estimation of cell death, apoptotic markers such as caspase-3/7, caspase-9, and caspase-12 were measured. Results: Our results demonstrated that when treated with B(e)P, the viability and ΔΨm of ARPE-19 cells declined by 25% and 63%, respectively (P < 0.05). However, pretreating with 17β-estradiol increased the viability of ARPE-19 cells by 21% (20 nM) and 10% (40 nM) (P < 0.05). Furthermore, the significantly reduced ΔΨm in βE+B(e)P treated cells ARPE-19 cells was restored by pre-treatment with 17β-estradiol- ΔΨm was increased by 177% (20 nM) and 158% (40 nM) (P < 0.05). We further observed a significant up-regulation in the activity of Caspases-3/7, -9, and -12 in B(e)P-treated ARPE-19 cells. However, 17β-estradiol treatment significantly reduced the activity of all apoptotic markers (P < 0.05). Conclusion: In conclusion, our results demonstrate that 17β-estradiol protects ARPE-19 cells against B(e)P-induced toxicity by decreasing apoptosis, preventing cell death, and restoring mitochondrial membrane potential.

Protecting retinal cells against cigarette smoke components

Aim: Bone marrow transplantation is a treatment procedure usually applied for the patients suffering from leukemia. It is observed that some of these patients complain from partial vision loss some months after the operation whereas the routine visual examination of these patients are normal, therefore the aim of present work is to examine the visual pathway of these patients to search for the probable visual pathway degeneration of these patients using visual evoked potential (VEP). Method: 10 patients following bone marrow transplantation were selected randomly. These patients had this operation for at least one year before. Routine ophthalmological examination of these patients was normal or at most they have refractive error problem which could be corrected by suitable spectacles. Visual evoked potential was recorded in these patients. Latency (msec) and amplitude (μV) of VEP, P100 Peak was noted for each patient. Beside these patients10 human being with healthy visual system was selected to compare the result of VEP in patients with healthy group following VEP recording. Result: It is observed that 4 patients had abnormal VEP pattern which was reflected either in latency or amplitude of VEP, P100 Peak. Conclusion: From the result of present work, one can conclude that VEP examination of patients following bone marrow transplantation is necessary prior to operation so that if at all any unexplained visual loss is observed after operation; the medical staff can follow the case for the probable reason for this malfunction.Purpose: The aim of this study is to evaluate the effectiveness of combining tectonic/therapeutic and optical lamellar keratoplasty to restore eye in threatening conditions and vision. Method: This is a retrospective review of 5 patients (7 eyes) with peripheral ulcerative keratitis and progressive degenerations that threatened the eye’s integrity. All eyes underwent a peripheral tectonic-therapeutic lamellar keratoplasty (LK) to restore its integrity followed 8-12 weeks later by a central optical LK to restore their vision. All surgeries were performed by a single surgeon. Results: After peripheral therapeutic LK the integrity of all eyes was accomplished. Central optical lamellar keratoplasty reduced significantly the refractive error, improved uncorrected and best corrected visual acuity as well as quality of vision. Conclusion: The combination of tectonic-therapeutic and optical lamellar keratoplasty for treating patients with peripheral corneal progressive thinning disease that threatens the eye and rehabilitating their vision is a reliable and trustable procedure. Although each case has its independent possible complications and difficulties, the combination of this procedure gives patients a high percentage grade of success for both tectonic and optical results.