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

Area of Science:

• Ophthalmology
• Pharmacology
• Epigenetics

Background:

• Glaucoma filtration surgery (GFS) success depends on filtration bleb survival.
• Ocular scarring can impede GFS outcomes.
• Histone deacetylase inhibitors (HDIs) like SAHA have epigenetic activity that may modulate scarring.

Purpose of the Study:

• To evaluate suberoylanilide hydroxamic acid (SAHA) as an adjunct therapy to improve filtration bleb survival after GFS.
• To compare SAHA's efficacy against balanced saline solution (BSS) and mitomycin-C (MMC) in a rabbit model.

Main Methods:

• New Zealand White rabbits underwent GFS.
• Rabbits received subconjunctival SAHA, BSS, or intraoperative topical MMC.
• Filtration bleb survival and histological outcomes were assessed.

Main Results:

• SAHA injection resulted in a mean bleb survival of 23.2 days, not significantly different from BSS (19.7 days).
• Intraoperative topical MMC significantly prolonged bleb survival (32.5 days) compared to both BSS and SAHA.
• SAHA was well tolerated with no significant adverse histological effects.

Conclusions:

• A single intraoperative injection of SAHA did not significantly enhance filtration bleb survival in this rabbit model.
• While SAHA showed promise as an epigenetic adjunct, further research into different administration protocols and dosages is warranted to optimize its efficacy in GFS.