Publication: Estudio del perfil de citoquinas en la lágrima y el humor acuoso de pacientes con glaucoma
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2022-10-17
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Universidad Complutense de Madrid
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Abstract
El glaucoma es la pérdida adquirida de células ganglionares y axones del nervio óptico, que resulta en alteraciones características de la cabeza del nervio óptico y del campo visual. El glaucoma es la segunda causa de ceguera irreversible en países desarrollados. El glaucoma primario de ángulo abierto (GPAA) constituye el tipo más frecuente de glaucoma en Europa, mientras que el glaucoma pseudoexfoliativo (GPX) es la primera causa de glaucoma secundario de ángulo abierto. Aunque el principal factor de riesgo es la presión intraocular (PIO), es probable que la inflamación de bajo grado participe en la patogenia. Los modelos animales demuestran una inflamación en la retina y el nervio óptico. También, mecanismos inflamatorios similares en la cámara anterior podrían explicar la disfunción de la malla trabecular. El tratamiento se basa en el uso de fármacos hipotensores tópicos, indicándose una cirugía cuando la terapia médica no es eficaz o hay riesgo de progresión de la enfermedad. La trabeculectomía es la técnica quirúrgica principal y la cicatrización de la esclera y la conjuntiva es un factor crucial en su éxito dado que determina la filtración de la ampolla. Además, es posible que las características del humor acuoso puedan afectar a la cicatrización tras la cirugía. En los últimos años, se ha detectado que niveles intraoculares aumentados de múltiples citoquinas proinflamatorias podrían contribuir a la patogénesis de algunas enfermedades oftalmológicas y aportar información relevante sobre la fisiopatología de la enfermedad, su tratamiento, su gravedad y el pronóstico de la cirugía...
Glaucoma is defined as the acquired loss of ganglion cells and axons of the optic nerve, resulting in characteristic alterations of the optic nerve head and the visual field. It is the second cause of irreversible blindness in developed countries. Primary open-angle glaucoma (POAG) is the most common type of glaucoma in Europe, while pseudoexfoliative glaucoma (PXG) is the leading cause of secondary open-angle glaucoma. Although intraocular pressure (IOP) is the main risk factor, low-grade inflammation likely plays a role in its pathogenesis. Glaucoma animal models have demonstrated inflammation in the retina and optic nerve. Furthermore, similar inflammatory mechanisms in the anterior chamber could explain the trabecular meshwork dysfunction and an increase in IOP. Treatment is based on the use of topical hypotensive drugs; surgery being considered when medical therapy is not effective or there is risk of glaucoma progression. Trabeculectomy is the gold standard surgical technique, and the healing of the sclera and conjunctiva are a crucial factor in its success. In addition, the characteristics of the aqueous humor could affect healing after surgery.In recent years, it has been detected that increased intraocular levels of multiple proinflammatory cytokines could contribute to the pathogenesis of some ophthalmological diseases and provide relevant information on the pathophysiology of the disease, its treatment, its severity and the prognosis of surgery...
Glaucoma is defined as the acquired loss of ganglion cells and axons of the optic nerve, resulting in characteristic alterations of the optic nerve head and the visual field. It is the second cause of irreversible blindness in developed countries. Primary open-angle glaucoma (POAG) is the most common type of glaucoma in Europe, while pseudoexfoliative glaucoma (PXG) is the leading cause of secondary open-angle glaucoma. Although intraocular pressure (IOP) is the main risk factor, low-grade inflammation likely plays a role in its pathogenesis. Glaucoma animal models have demonstrated inflammation in the retina and optic nerve. Furthermore, similar inflammatory mechanisms in the anterior chamber could explain the trabecular meshwork dysfunction and an increase in IOP. Treatment is based on the use of topical hypotensive drugs; surgery being considered when medical therapy is not effective or there is risk of glaucoma progression. Trabeculectomy is the gold standard surgical technique, and the healing of the sclera and conjunctiva are a crucial factor in its success. In addition, the characteristics of the aqueous humor could affect healing after surgery.In recent years, it has been detected that increased intraocular levels of multiple proinflammatory cytokines could contribute to the pathogenesis of some ophthalmological diseases and provide relevant information on the pathophysiology of the disease, its treatment, its severity and the prognosis of surgery...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 19-04-2022