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J Curr Glaucoma Pract. 2019 Jan-Apr;13(1):37-41. doi: 10.5005/jp-journals-10078-1246.

Modulating Ocular Scarring in Glaucoma Filtration Surgery Using the Epigenetic Adjunct Suberoylanilide Hydroxamic Acid.

Author information

1
Department of Ophthalmology, University of Florida, Gainesville, Florida, USA; Department of Ophthalmology, University of Kansas School of Medicine, Kansas City, Kansas, USA.
2
Department of Ophthalmology, University of Florida, Gainesville, Florida, USA; Department of Ophthalmology, Medical College of Georgia-Augusta University, Augusta, Georgia, USA.
3
Department of Ophthalmology, University of Florida, Gainesville, Florida, USA; Massachusetts General Hospital, Boston, Massachusetts, USA.
4
Department of Ophthalmology, University of Florida, Gainesville, Florida, USA; Department of Dermatology, University of Florida, Gainesville, Florida, USA.
5
Department of Ophthalmology, University of Florida, Gainesville, Florida, USA.
6
Department of Ophthalmology, West Virginia University, Morgantown, West Virginia, USA.
7
Department of Obstetrics and Gynecology, University of Florida, Gainesville, Florida, USA.

Abstract

Aim:

The aim of this study is to assess the effectiveness of suberoylanilide hydroxamic acid (SAHA), a histone deacetylase inhibitor (HDI) with a broad spectrum epigenetic activity, in improving filtration bleb survival as an adjunct therapy to glaucoma filtration surgery (GFS) in the rabbit model.

Materials and methods:

Eighteen New Zealand White rabbits underwent GFS in the left eye and were randomized to receive either a subconjunctival (SC) injection of 0.1 mL SAHA (9.25 μg/mL) or balanced saline solution (BSS) at the end of surgery, or a 3-minute intraoperative topical application of 0.4 mg/mL mitomycin-C (MMC). Bleb survival and histology were compared.

Results:

Blebs of rabbits receiving injections of SAHA survived an average (mean ± SD) of 23.2 ± 2.7 days. SAHA rabbits showed a nonsignificant improvement over rabbits that received an injection of BSS, which had a mean survival time of 19.7 ± 2.7 days (p = 0.38) according to a one-way analysis of variance (ANOVA). Eyes receiving intraoperative topical MMC survived an average of 32.5 ± 3.3 days, which is significantly longer than both the control group treated with BSS (p = 0.01) and the experimental group treated with the SAHA (p = 0.0495). SAHA was well tolerated and showed no significant avascularity, necrosis, or conjunctival thinning.

Conclusion:

Although it was well tolerated, a single intraoperative injection of SAHA did not significantly prolong bleb survival in the rabbit model.

Clinical significance:

Epigenetic adjuncts hold promise for improving GFS outcome; however, future studies must continue to examine different administration protocols and dosages to substantiate their efficacy.

How to cite this article:

Rodgers CD, Lukowski ZL, et al. Modulating Ocular Scarring in Glaucoma Filtration Surgery Using the Epigenetic Adjunct Suberoylanilide Hydroxamic Acid. J Curr Glaucoma Pract 2019;13(1):37-41.

KEYWORDS:

Epigenetics; Glaucoma; Glaucoma filtration surgery; SAHA; Suberoylanilide hydroxamic acid; Trabeculectomy; Vorinostat

Conflict of interest statement

Source of support: This study was supported in part by an unrestricted grant from Research to Prevent Blindness (New York, NY), to the Department of Ophthalmology, University of Florida, USA Conflict of interest: None

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