Expression of glucose transporters in the prelaminar region of the optic-nerve head of the pig as determined by immunolabeling and tissue culture.

BACKGROUND: To develop the use of cultured tissue of the prelaminar optic nerve of the pig to explore possible alterations of the astrocyte-axon metabolic pathways in glaucoma, we map the distribution of the glucose transporters GLUT1 and GLUT3 in fresh and cultured tissue. METHODS: We monitor cell survival in cultures of the prelaminar optic-nerve tissue, measuring necrosis and apoptosis markers biochemically as well as morphologically, and establish the presence of the glucose transporters GLUT1 and GLUT3. We map the distribution of these transporters with immunolabeling in histological sections of the optic nerve using confocal and electronic transmission microscopy. RESULTS: We find that the main death type in prelaminar culture is apoptosis. Caspase 7 staining reveals an increment in apoptosis from day 1 to day 4 and a reduction from day 4 to day 8. Western blotting for GLUT1 shows stability with increased culture time. CLSM micrographs locate GLUT1 in the columnar astrocytes and in the area of axonal bundles. Anti-GLUT3 predominantly labels axonal bundles. TEM immunolabeling with colloidal gold displays a very specific distribution of GLUT-1 in the membranes of vascular endothelial cells and in periaxonal astrocyte expansions. The GLUT-3 isoform is observed with TEM only in axons in the axonal bundles. CONCLUSIONS: Tissue culture is suitable for apoptosis-induction experiments. The results suggest that glucose is transported to the axonal cleft intracytoplasmically and delivered to the cleft by GLUT1 transporters. As monocarboxylate transporters have been reported in the prelaminar region of the optic-nerve head, this area is likely to use both lactate and glucose as energy sources.

Toxicidad ocular y recuperación visual funcional en una paciente tratada con hidroxicloroquina / Ocular toxicity and functional vision recovery in a patient treated with hydroxychloroquine

Caso clínico: Presentamos un paciente de 64 años, del sexo femenino, con artritis reumatoide y síndrome de Sjögren, tratada durante 48 meses con hidroxicloroquina, a la que se le suspendió dicho tratamiento tras una revisión oftalmológica, en la que se detectó pérdida de la visión en ambos ojos asociada a defecto campimétrico paracentral, alteraciones fundoscópicas maculares pigmentarias y electrorretinograma multifocal (ERGmf) central disminuido en ambos ojos. A los 12 meses de la retirada del tratamiento, la agudeza visual y el ERGmf central habían mejorado sorprendentemente. Se trata de un caso inusual de recuperación funcional tras la retirada del tratamiento. Consideramos que el ERGmf central es una prueba más sensible que el electrorretinograma patrón en la detección de toxicidad retiniana y en la detección de mejorías visuales funcionales tras la retirada del tratamiento con hidroxicloroquina (AU)

Case report: We report the case of a 64-year-old woman with rheumatoid arthritis and Sjögren’s syndrome, treated during 48 months with hydroxychloroquine that was removed after an ophthalmological evaluation showed bilateral vision loss associated with paracentral scotoma in the visual field, fundoscopic macular pigmentary changes, and severely impaired central multifocal electrorretinogram (mfERG). Twelve months after treatment withdrawal, visual acuity and central mfERG had surprisingly improved. This is an unusual case of functional recovery after treatment withdrawal. We consider that central mfERG is a more sensitive test than pattern electrorretinogram in the detection of retinal toxicity and functional vision recovery after hydroxychloroquine treatment cessation (AU)

Ocular toxicity and functional vision recovery in a patient treated with hydroxychloroquine.

CASE REPORT: We report the case of a 64-year-old woman with rheumatoid arthritis and Sjögren's syndrome, treated during 48 months with hydroxychloroquine that was removed after an ophthalmological evaluation showed bilateral vision loss associated with paracentral scotoma in the visual field, fundoscopic macular pigmentary changes, and severely impaired central multifocal electrorretinogram (mfERG). Twelve months after treatment withdrawal, visual acuity and central mfERG had surprisingly improved. This is an unusual case of functional recovery after treatment withdrawal. We consider that central mfERG is a more sensitive test than pattern electrorretinogram in the detection of retinal toxicity and functional vision recovery after hydroxychloroquine treatment cessation.

Maculopatía en paciente con lupus eritematoso sistémico tratado con hidroxicloroquina / Maculopathy in patient with systemic lupus erythematosus treated with hydroxychloroquine

Una mujer de 50 años con lupus eritematoso sistémico, tratada 13 años con hidroxicloroquina y desde hace 5 años con nefropatía e hipertensión arterial, refirió en la revisión periódica pérdida moderada de visión en el ojo derecho. La fundoscopia mostró solo alteraciones de la pigmentación macular en el ojo derecho. El campo visual 10-2 fue normal en ambos ojos. La tomografía de coherencia óptica mostró en la mácula derecha un engrosamiento foveal hiperreflectivo, con cavidad hiporreflectiva subyacente, y fue normal en la mácula izquierda. La angiografía fluoresceínica no mostró patrón en ojo de buey, sino microaneurismas en arcadas vasculares. El electrorretinograma multifocal central estaba disminuido en el ojo derecho y el electrorretinograma patrón moderadamente disminuido en ambos ojos. En conclusión, las alteraciones del ojo derecho fueron indicativas de maculopatía isquémica, pero no de toxicidad cloroquínica (AU)

A 50-years-old woman with systemic lupus erythematosus treated for 13 years with hydroxychloroquine developed nephropathy and high blood pressure five years ago as well as moderate loss of vision in her right eye. Fundoscopy showed alterations of macular pigmentation only in the right eye. Visual fields 10-2 were normal in both eyes. Optical coherence tomography showed hyperreflective foveal thickening with a hyporreflective cavity underlying in the right macula, and was normal in left macula. Fluorescein angiography showed no bulls-eye pattern, but did show microaneurysms in vascular arcades. Multifocal central electroretinogram was diminished in right eye and the electrorretinogram pattern was diminished in both eyes. We concluded that the alterations of the right eye were suggestive of ischemic maculopathy, not hydroxychloroquine toxicity (AU)

Maculopathy in patient with systemic lupus erythematosus treated with hydroxychloroquine.

A 50-years-old woman with systemic lupus erythematosus treated for 13 years with hydroxychloroquine developed nephropathy and high blood pressure five years ago as well as moderate loss of vision in her right eye. Fundoscopy showed alterations of macular pigmentation only in the right eye. Visual fields 10-2 were normal in both eyes. Optical coherence tomography showed hyperreflective foveal thickening with a hyporreflective cavity underlying in the right macula, and was normal in left macula. Fluorescein angiography showed no bulls-eye pattern, but did show microaneurysms in vascular arcades. Multifocal central electroretinogram was diminished in right eye and the electrorretinogram pattern was diminished in both eyes. We concluded that the alterations of the right eye were suggestive of ischemic maculopathy, not hydroxychloroquine toxicity.

Ocular involvement in Takayasu's arteritis: response to cyclophosphamide therapy.

PURPOSE: To report a Takayasu's arteritis (TA) case with an intense ocular involvement and the response to monthly bolus of Cyclophosphamide. METHODS: Case report and literature review. RESULTS: Cyclophosphamide was useful to improve the TA symptoms without any additional treatment and any secondary effects. When this therapy was discontinued the ocular symptoms progressed. CONCLUSION: Although no definitive therapy has been established, Cyclophosphamide intravenous bolus may be useful to improve ocular symptoms of Takayasu's Arteritis, specially in early stages. There are not adequate descriptions in the literature concerning the effect of this treatment on the ocular manifestations of TA.