Thesis (M.P.H.)--University of Sydney, 2001. / Includes tables. Title from title screen (viewed Apr. 23, 2008). Submitted in fulfilment of the requirements for the degree of Master of Public Health to the Dept. of Public Health and Community Medicine, Faculty of Medicine. Includes bibliography. Also available in print form.

Thèse (M.Med.Exp.) -- Université Laval, extensionné à l'Université du Québec à Chicoutimi, 1999. / Bibliogr.: f. 70-79. Document électronique également accessible en format PDF. CaQCU

Apart from associated genes, a candidate causative gene NTF4 was screened and two novel putative mutations (Gly157Ala and Ala182Val) detected, likely accounting for 0.29% of POAG. In the exploration of new POAG genes, two functional candidates CNTF and SPARC were screened and excluded. / Differential association profiles were found for SNPs in/near CAV1, CAV2, CYP46A1, LMX1B, PLXDC2, TLR4, TMTC2, ZP4 and 2p16.3. SNPs at CAV1, CAV2, TLR4 and 2p16.3 were associated with POAG, whilst SNPs around other genes were unlikely to be risk factors for the disease, at least in Chinese. TLR4 rs7037117 was associated with HTG in southern Chinese (P=0.0016, OR=2.72, recessive model). SNP rs1533428 at 2p16.3 showed an age-specific association of with late-onset POAG (age at diagnosis >60 years; P=1.14x10-5, OR=2.02, dominant model) but not with juvenile- and adult-onset POAG. Moreover, rs1533428 formed a joint effect with rs7037117 to confer stronger risk to HTG (P=2.8x10 -4, OR=4.53). Besides, rs4236601 near the CAV1 and CAV2 genes was confirmed as a risk factor for POAG and another two protective SNPs rs6975771 and rs959173 were identified; moreover, that the risk and protective alleles were located in different haplotypes suggested multiple roles of the genes. / Glaucoma is a group of degenerative optic neuropathies and the leading cause of irreversible blindness worldwide. Primary open-angle glaucoma (POAG) is a major type of glaucoma in most populations. It is classified into high-tension glaucoma (HTG) and normal-tension glaucoma (NTG) according to the level of intraocular pressure. POAG has complex etiology. It could be monogenic or caused by multiple risk factors. At least 22 linkage loci have been mapped, with 3 genes (MYOC, OPTN, and WDR36 ) identified. Also, more than 30 susceptibility genes have been reported, many of which, however, remain unverified. / In the mapping of the causal gene at GLC1N, a truncation mutation c.1090delT in the MEGF11 gene was found to be cosegregated with glaucoma in the GLC1N-linked pedigree. Subsequent identification of c.1090delT in an unrelated JOAG patient supported that it is a disease-causing mutation. The identification of four splice-site mutations (IVS17+2insT, IVS17-4C>G, IVS17-2A>G and c.2472A>C) exclusively in patients provided further evidence supporting MEGF11 as a causative gene for POAG. Mutations in this gene likely account for approximately 1% of POAG or 2% of JOAG. / This thesis describes our work on the identification of new POAG genes by using a 3-tiered strategy: (1) to identify new genetic profiles of variants around the CAV1, CAV2, CYP46A1, LMX1B, NTF4, PLXDC2, TLR4, TMTC2, ZP4 genes and the 2p16.3 locus; (2) to evaluate CNTF and SPARC as disease genes for POAG; and (3) to map the causal gene at the GLC1N locus for juvenile-onset POAG (JOAG). / Totally 1645 unrelated participants were enrolled, including a Hong Kong cohort of 281 HTG, 311 NTG and 248 controls, a Shantou cohort of 102 HTG, 28 NTG and 298 controls and, a Beijing cohort of 177 HTG and 200 controls. Also involved were members of the GLC1M-linked Philippine pedigree and the GLC1N-linked Hong Kong pedigree with JOAG, which have been previously described. / Chen, Lijia. / Adviser: Chi Pui Pang. / Source: Dissertation Abstracts International, Volume: 73-02, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 185-210). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

Dexamethasone (DEX) and triamcinolone acetonide (TA) are widely used in clinical practice for ocular anti-inflammation. The most common side effect of these two corticosteroids is the rise of intraocular pressure that leads to death of the retinal ganglion cells, a feature of POAG. We investigated the differential gene expression profiles induced by DEX and TA treatment in human trabecular meshwork (hTM) cells using microarray technology. A number of genes differentially expressed in hTM cells were identified under DEX and TA treatment, mainly involving in proteolysis, cell adhesion and acute phase response. Five genes (MYOC, GAS1, SENP1, ZNF343 and SOX30) were commonly differentially expressed in both DEX and TA treatment. It indicates that DEX and TA may share similar effect on hTM cells, which may associate with the onset of ocular hypertension. / In one Chinese juvenile onset POAG (JOAG) family with autosomal dominant inheritance, a novel locus at 15822-q24 (GLC1N) was identified using genome-wide scan, supported by clinical, linkage, and haplotype transmission data. The critical region covered a genetic distance of 16.6 Mb. To search for disease genes within this new JOAG locus, we screened NR2E3, SMAD6 and CLN6 for mutations. However, no mutations was found in the family members. We attempted a new gene-based SNPs genotyping approach to search for susceptibility genes to JOAG in this novel locus by using 97 unrelated JOAG patients and 99 unrelated control subjects. Significant association was identified in a set of 6 adjacent SNPs out of 122 gene-based SNPs. Among them, one non-synonymous SNP rs3743171 in the SLC24A1 gene was incompletely segregated in the JOAG family. Our findings indicate the mutation in other regions of SLC24A1 may be responsible for JOAG in this family, or another gene in this region may be the actual cause of glaucoma. / Primary open angle glaucoma (POAG) is a leading cause of visual impairment and blindness worldwide. Genetic factors play a major role in the etiology of POAG. This thesis describes our investigations of the POAG causative genes using genome-wide DNA scanning by linkage/association analysis and RNA level scanning by microarray technology. / Wang Danyi. / "September 2006." / Adviser: Calvin Chi Pui Pang. / Source: Dissertation Abstracts International, Volume: 68-08, Section: B, page: 5155. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 139-181). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Thesis (M.S.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering, 1982. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND ENGINEERING / Bibliography: leaves 48-50. / by Maura Elizabeth Donnelly. / M.S.

Thesis (Ph. D.)--University of California, San Diego, 1999. / Vita. Includes bibliographical references (leaves 139-141).

The purpose of this study was to investigate morphological changes in the outflow pathway from Schlemm’s canal (SC) to the intrascleral vessels (ISVs) in POAG eyes through comparisons with age-matched, normal control eyes using light microscopy and morphometric analysis. We hypothesized that there would be a reduction in the size and number of ISVs when SC becomes narrower and collapsed in the eyes with POAG and there would be no reduction in size and number of ISVs when SC is open in eyes with POAG. 11 normal eyes from 10 donors (63-92 years old) without a history of ocular diseases and 10 POAG eyes from 6 donors (67-90 years old) with clinically confirmed diagnoses of POAG were acquired. The eyes were fixed and embedded. The sections of anterior chamber angle (2-3 μm in thickness) were cut, stained with sectioning procedures, and imaged using a light microscope. 36 images from 11 normal eyes and 40 images from 10 glaucomatous eyes were examined and analyzed in this study. Cross-sectional area (CSA), width, height of SC and percentage collapse of SC as well as the number and CSA of ISVs were measured within each quadrant of the eye. Statistical analyses were conducted using one-way ANOVA and Kruskal-Wallis test in the IBM SPSS software. A significant reduction in height, width, and CSA of SC, and a significant increase in percentage of SC collapse were found in 70% of POAG eyes, while open SC was found in 30% of POAG eyes when compared to normal eyes. Decreased sizes and number of ISVs were observed in 70% of POAG eyes with narrower and collapsed SC, but these changes did not reach statistical significance. Decreased sizes of ISVs were observed in 30% of POAG eyes with open SC, although these changes did not reach statistical significance. The results suggested that smaller and collapsed SC was found in 70% of eyes with POAG. Ultimately, the decreased size and number of ISVs found in POAG eyes may be secondary to decreased size and collapse of SC in POAG pathology.

INTRODUÇÃO: A trabeculectomia é a técnica de eleição para o tratamento cirúrgico do glaucoma. Entretanto, estudos recentes têm demonstrado perda da eficácia e menor redução da pressão intra-ocular dos pacientes submetidos à cirurgia ao longo dos anos. Esta diminuição decorre do contínuo processo de cicatrização e proliferação de fibroblastos na superfície epiescleral na região da bolha filtrante. Com o objetivo de diminuir esta proliferação fibroblástica e a conseqüente perda de função da trabeculectomia, introduziu-se o uso de antimetabólicos como o 5-fluorouracil e a mitomicina C. O uso dos antimetabólicos, no entanto, com freqüência é acompanhado dos indesejáveis efeitos da filtração excessiva e hipotonia. O uso da membrana amniótica em oftalmologia remonta aos anos de 1940, quando vários autores relataram seus efeitos benéficos no tratamento de doenças da superfície ocular. Além de promover a epitelização de superfícies, a membrana amniótica também é inibidora da fibrose. O efeito inibidor da fibrose pela membrana amniótica é altamente desejável na modulação da cicatrização após a trabeculectomia. O objetivo deste estudo é comparar a eficácia e a segurança do uso da membrana amniótica na trabeculectomia no tratamento cirúrgico do glaucoma primário de ângulo aberto. MATERIAL E MÉTODOS: Foi realizado um estudo prospectivo aberto, aleatório, com grupos paralelos de tratamento. Sessenta e três pacientes com indicação de cirurgia para glaucoma foram selecionados e aleatoriamente divididos em 2 RESUMO grupos. O primeiro grupo foi submetido a trabeculectomia com o uso peroperatório da membrana amniótica (grupo estudo) e o segundo grupo foi submetido a trabeculectomia sem o uso da membrana amniótica (grupo controle), na seção de glaucoma do Departamento de Oftalmologia da Santa Casa de São Paulo. Foram avaliados os efeitos redutores da pressão intraocular, número de medicações, aparência da bolha filtrante e complicações. Todos os pacientes foram acompanhados por 12 meses. RESULTADOS: A média das pressões pré-operatórias foi de 25,19 ± 7,34 mmHg no grupo da membrana amniótica e 25,42 ± 7,71 mmHg no grupo controle. A média das pressões pós-operatórias foi de 13,13 ± 2,50 mmHg no grupo da membrana amniótica e 15,47 ± 2,92 mmHg no grupo controle, diferença estatisticamente significante no seguimento de 1 ano. Não foi encontrada diferença estatisticamente significante entre os grupos controle e estudo em relação ao número de medicações pré e pós-operatória. No final de 12 meses de seguimento, no grupo de estudo, dois entre 31 olhos (6,45%) apresentaram bolha plana e vascularizada, 14 olhos (45,16%) bolha elevada e pouco vascularizada e 15 olhos (48,38 %) bolha fina e avascular. No grupo controle sete entre 32 olhos (21,87%) apresentaram bolha plana vascularizada, 22 olhos (68,75%) bolha elevada e pouco vascularizada e três olhos (9,37%) bolha fina e avascular. Foi encontrada diferença estatisticamente significante entre os grupos estudo e controle quanto a distribuição dos tipos de bolha encontradas. As complicações observadas no grupo de estudo foram um olho com câmara anterior rasa (3,22%) e dois olhos que apresentaram bolha encapsulada (6,45%). No grupo controle, dois olhos apresentaram câmara anterior rasa (6,25%), um olho descolamento de coróide (3,12%) e dois olhos RESUMO com bolha encapsulada (6,25%). CONCLUSÃO: O presente estudo demonstrou que a trabeculectomia com membrana amniótica causou maior redução da pressão intra-ocular e aparência menos vascularizada das bolhas filtrantes. Mostrou-se uma técnica segura e com baixo índice de complicações. / INTRODUCTION: Trabeculectomy is the procedure of choice for the surgical treatment of glaucoma until nowadays. However, recent studies have demonstrated a loss of efficacy and minor reduction of intraocular pressure in patients who underwent surgery over the years. This loss of efficacy of the trabeculectomy is related to the continuous process of healing and fibroblastic proliferation in the episcleral surface inside the filtering bleb. The use of 5-fluorouracil or mitomycin-C can improve the results of trabeculectomy, but they have been associated with an increased incidence of postoperative complications, especially in primary trabeculectomies. The use of amniotic membrane in ophthalmology retraces back to 1940, when some authors showed its beneficial effect in treatment of ocular surface disorders. Amniotic membrane can promote epitelization of ocular surface and act as an inhibitor of fibrosis. The purpose of this study was to compare the safety and efficacy of human preserved amniotic membrane in the trabeculectomy for treatment of primary open angle glaucoma. METHODS: The study was a prospective, randomized clinical trial comparing primary trabeculectomy with amniotic membrane (study group) and without amniotic membrane (control group) in the treatment of the glaucoma. Intraocular pressure (IOP), number of glaucoma medication, appearance of the bleb and complications were compared between the two groups. Sixty-three patients were divided in the study group of 31 patientes and control group of 32 patients and were followed for a period of 12 months in the glaucoma section of Santa Casa de Sao Paulo. RESULTS: The mean pre-operative IOP was 25.19 ± 7.34 mmHg in the amniotic membrane group and 25.42 ± 7.71 mmHg in the control group. The difference of the mean postoperative IOP between groups was statistically significant; in the control group it was 15.47 ± 2.92 mmHg and in the study group 13.13± 2.50 mmHg at one year follow up. Postoperative number of medication decreased in both groups. Analysis shows at the end of 12-month follow-up period in the study group two of 31 eyes (6.45%) exhibited flat vascularized bleb, 14 eyes (45.16%) had elevated but not avascular blebs and 9 eyes (48.38%) showed thin, avascular blebs. In the control group seven of 32 eyes (21.87%) exhibited flat vascularized bleb, 22 eyes (68.75%) had elevated but not avascular blebs and three eyes (9.37%) showed a thin avascular bleb. Complications were: one eye (3.22%) presented with shallow anterior chamber after surgery and two eyes (6.45%) had encapsulated bleb in the study group; in the control group, two eyes (6.25%) presented shallow anterior chamber after surgery, one eye (3.12%) had coroidal detachment and two eyes (6.25%) developed encapsulated bleb. CONCLUSIONS: Trabeculectomy with amniotic membrane and standard trabeculectomy promote lower postoperative IOP and the results showed statistically significant difference between groups in postoperative IOP after one year follow-up. The procedure is safe with low rate of complications.

The general aim of the thesis was to deduce whether selected naturally occurring flavonoids (genistein, epicatechin gallate (EC), epigallocatechin gallate (EGCG), baicalin) attenuate various secondary insults that may cause death of ganglion cells in primary open angle glaucoma (POAG). An ischemic insult to the rat retina significantly causes the inner retina to degenerate indexed by changes of various antigens, proteins and mRNAs located to amacrine and ganglion cells. These changes are blunted in animals treated with genistein as has been shown for ECGC. Studies conducted on cells (RGC-5 cells) in culture showed that hydrogen peroxide, L-buthionine sulfoximine (BSO)/glutamate and serum deprivation (mimicking oxidative stress), rotenone, sodium azide (affecting mitochondria function in specific ways) and light (where the mitochondria are generally affected) all generated reactive oxygen species and caused death of RGC-5 cells. EGCG was able to attenuate cell death caused by hydrogen peroxide, sodium azide and rotenone. Only EC was able to attenuate BSO/glutamate-induced cell death, in addition to cell death caused by hydrogen peroxide and rotenone. Genistein had no positive effect on cell death in experiments carried out on RGC-5 cells. Exposure of RGC-5 cells to flavonoids showed that EC and EGCG increased the mRNA expression of endogenous antioxidants such as HO-l (heme oxygenase 1) and Nrf-2 (nuclear erythroid factor-z-related factor 2). Light insult, rotenone and sodium azide activate the p38 (protein kinase 38) pathway, while only light and rotenone activate the JNK (c-Jun amino-terminal kinase) pathway. Serum deprivation affects mitochondrial apoptotic proteins causing an increase in the ratio of Bax/Bcl2 (Bax: Bcl-2-associated X protein; Bcl-2: B-cell lymphoma 2). An insult of light to RGC-5 cells, unlike that induced by sodium azide, is inhibited by necrostatin-I and causes an activation of AlF (apoptosis-inducing factor) with alpha-fodrin being unaffected. These studies suggest that ganglion cell death caused by insults as may occur in POAG involves various cellular signaling pathways. The selected flavonoids have diverse actions in increasing cellular defense mechanisms, and in negating the effects of ischemia and specific types of oxidative stress. The results argue for the possible use of flavonoids in the treatment of POAG to slow down ganglion cell death.

Submitted by admin tede (tede@pucgoias.edu.br) on 2016-08-18T13:40:01Z No. of bitstreams: 1 Nathalie Borges Costa.pdf: 1419823 bytes, checksum: 9601be4b45901e83f91a699e9111d75f (MD5) / Made available in DSpace on 2016-08-18T13:40:01Z (GMT). No. of bitstreams: 1 Nathalie Borges Costa.pdf: 1419823 bytes, checksum: 9601be4b45901e83f91a699e9111d75f (MD5) Previous issue date: 2011-12-07 / Glaucoma encompasses a group of eye diseases characterized by retinal ganglion cell damage, optical nerve damage and visual field loss. It is a complex optic neuropathy of genetically heterogeneity which can lead to irreversible blindness. The visual field loss is a late manifestation symptom, therefore it is not a reliable symptom to detect glaucoma in its early stages. It is the second biggest cause of blindness worldwide, responsible for 12% of all the cases of complete vision loss, while cataracts are responsible for 48% of reversible blindness worldwide. A positive family history plays an important role as a risk factor for primary openangle glaucoma development. This is the most common form of glaucoma and it typically occurs after 40 years old of age. If the disease is neither detected nor treated properly the risk of blindness is higher. Patients with a positive family history or patients with mutations in genes that are known to be associated with glaucoma should have medical attention in order to prevent later complications. In this way it is extremely important to seek new genes that could be related to glaucoma. Up to this time three genes have been associated with primary open-angle glaucoma, the myocilin gene (MYOC), the optineurin gene (OPTN) and the repeat domain 36 gene (WDR36). The CYP1A1 gene, located at 15q22-q24, encodes an enzyme which is involved in the conversion of chemical substances into highly reactive species leading to unwanted cell damage, cell death or mutation. The m1 polimorphism is related to a high rate of enzyme activity and it comprises increased lung cancer susceptibility. The objective of this paper is to analyze the correlation of 100 patients with primary open-angle glaucoma and 52 normal controls by the RFLP method (Restriction Fragment Length polymorphism). The frequency of the homozygous wild-type (w1/w1) of CYP1A1 gene among patients with primary open-angle glaucoma (n=100) was 16%, for the genotype w1/m1 the frequency of was 77% and for m1/m1 it was 7%. Among the control group (n=52) the frequency of the homozygous wild-type (w1/w1) of CYP1A1 gene was 54%, the frequency of w1/m1 was 46% and m1/m1 was 0%. The qui-square test ( 2) considered the result statistically significant (P<0,0001), and this suggests that the CYP1A1m1 polymorphism is associated with primary open-angle glaucoma. / Glaucoma engloba inúmeras doenças oculares que têm como característica a lesão das células ganglionares da retina, com conseqüente lesão do nervo óptico e perda do campo visual. É considerada uma neuropatia óptica complexa e geneticamente heterogênea, levando à cegueira irreversível. A perda do campo visual é uma manifestação tardia do glaucoma, e portanto não é particularmente adequada para a detecção da doença em seu início. É a segunda causa de cegueira no mundo, respondendo por 12% dos casos, ficando atrás apenas da catarata (48%). A história familiar positiva é um importante fator de risco para o desenvolvimento do glaucoma primário de ângulo aberto, que é a forma mais comum da doença e que se manifesta principalmente após os 40 anos. O glaucoma, quando não diagnosticado e, portanto não tratado, pode levar a um risco maior de cegueira. Sendo assim, indivíduos com histórico familiar ou mesmo alterações nos genes associados ao glaucoma devem ter uma atenção médica mais dirigida aos seus aspectos preventivos, por isso a importância da procura de novos genes associados ao glaucoma. Até o momento foram identificados três genes relacionados ao glaucoma primário de ângulo aberto, o gene myocilin (MYOC ), o optineurin (OPTN) e o gene de domínio de repetição WD 36 (WDR36). O gene CYP1A1, localizado no cromossomo 15q22-q24, codifica enzima que está envolvida na conversão de produtos químicos em moléculas altamente reativas, que podem produzir dano celular indesejado, morte celular ou mutações. O polimorfismo m1 está associado a uma maior atividade enzimática, tendo sido referido como fator genético de suscetibilidade para o câncer de pulmão. Este trabalho teve como objetivo verificar a possível associação entre 100 doentes com glaucoma primário de ângulo aberto e 52 controles por RFLP (polimorfismo de comprimento de fragmentos de restrição). A frequência do gene CYP1A1 entre os pacientes com glaucoma primário de ângulo aberto (n=100) para o genótipo homozigoto selvagem w1/w1 foi de 16%; 77% para o genótipo w1/m1 e 7% para o genótipo m1/m1. Entre os pacientes do grupo controle (n=52) a freqüência do gene CYP1A1 foi de 54% para o genótipo w1/w1, sendo a freqüência para o genótipo w1/m1 igual a 46% e 0% para o genótipo m1/m1. Foi realizado o 2 que mostrou que o resultado deste trabalho é estatisticamente significativo (P<0,0001), sugerindo relação entre o polimorfismo CYP1A1m1 e o glaucoma primário de ângulo aberto.