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International Ophthalmology

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28.07.2020 | Original Paper

Elevated intraocular pressure causes cellular and molecular retinal injuries, advocating a more moderate intraocular pressure setting during phacoemulsification surgery

verfasst von: Zhenni Zhao, Xiaowei Yu, Xue Yang, Jiamin Zhang, Dandan Zhang, Nannan Sun, Zhigang Fan

Erschienen in: International Ophthalmology | Ausgabe 12/2020

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Abstract

Purpose

To evaluate the cellular and molecular retinal injuries induced by various intraocular pressure (IOP) settings in a mouse model of acute ocular hypertension (AOH), and to advise using a more moderate target IOP during phacoemulsification (phaco) surgery.

Methods

A mouse model of AOH that mimics a transient IOP elevation during phacoemulsification cataract surgery was established. Six groups with various settings of target IOP were included. Retinal tissues were assessed with terminal deoxynucleotidyl transferase-mediated 2′-deoxyuridine 5′-triphosphate nick end-labeling (TUNEL) staining for neuron loss, immunofluorescence with Iba1 for microglia activation, and quantitative real-time polymerase chain reaction analysis with tight junction proteins (claudin-3 and claudin-5) or classic inflammation markers (IL-1β and eNOS) for impairment of the blood–retinal barrier (BRB) and inflammatory injury.

Results

Compared with those in the 45-mmHg IOP group, significantly increased number of neurons loss and increased microglia activation were observed in 90-mmHg IOP group. In addition, the expression of claudin-3 and claudin-5 was significantly decreased, while the expression of IL1-β and eNOS was up-regulated, indicating impairment of the BRB and inflammatory injury in the retina. Furthermore, these findings of neuron loss, microglia activation, and inflammation in the 90-mmHg groups were exacerbated when an IOP-induced retinal injury was established 5 days earlier, while those in the 45-mmHg groups remained almost unchanged.

Conclusions

In conclusion, these results showed that a relatively commonly used high IOP setting (90 mmHg) could induce significantly more serious retinal injury. An IOP setting around 45 mmHg is relatively safe and might be recommended in phaco surgery, especially in patients with advanced glaucoma, previous acute angle closure crisis, or other diseases with fragile retina and optic nerve.

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Titel: Elevated intraocular pressure causes cellular and molecular retinal injuries, advocating a more moderate intraocular pressure setting during phacoemulsification surgery
verfasst von: Zhenni Zhao
Xiaowei Yu
Xue Yang
Jiamin Zhang
Dandan Zhang
Nannan Sun
Zhigang Fan
Publikationsdatum: 28.07.2020
Verlag: Springer Netherlands
Erschienen in: International Ophthalmology / Ausgabe 12/2020
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-020-01519-w

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Elevated intraocular pressure causes cellular and molecular retinal injuries, advocating a more moderate intraocular pressure setting during phacoemulsification surgery

Abstract

Purpose

Methods

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Conclusions

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