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Tikhonovich MV, Erdiakov AK, Gavrilova SA. Nonsteroid anti-inflammatory therapy suppresses the development of proliferative vitreoretinopathy more effectively than a steroid one. Int Ophthalmol 2017. [PMID: 28639085 DOI: 10.1007/s10792-017-0594-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE This study proves the possibility of targeted use of the nonsteroidal anti-inflammatory drug lornoxicam to prevent the development of proliferative vitreoretinopathy (PVR). Triamcinolone acetonide (TA) was selected as a reference substance. METHODS Wistar rats (N = 400) were used. PVR was modeled by intravitreal injection of dispase or concanavalin A. Lornoxicam or TA intravitreal administration was performed 20 min later. On the second and the third day, drugs were administrated systemic. Enucleation was performed on the first, third, seventh and 42nd or 56th day of the experiment. RESULTS Pro-inflammatory substances led to the development of sub- and epiretinal membranes. Lornoxicam decreased the incidence of membrane formation by 43 and 31% in dispase and concanavalin models, respectively. Membranes, formed during its use, were smaller and contained less fibrotic components. At the end of the experiment, the thickness of retinal and choroidal layers among the animals which had received the therapy was the same as the thickness of the retina and choroid of intact rats. Lornoxicam administration normalized the cyclooxygenases (COXs) expression in the retina and the choroid at the early stages of the experiment. TA application was less effective in both models. CONCLUSIONS COXs blocking during the development of PVR, overwhelming inflammation in the eye and reducing its consequences, is proved to be a much more effective and safe influence than the suppression of the entire cascade of arachidonic acid metabolism. Lornoxicam did not only improve the condition of the retina and the choroid but also significantly reduced the frequency of membrane formation.
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Affiliation(s)
- Marina V Tikhonovich
- Faculty of Medicine, M. V. Lomonosov Moscow State University, 27/1 Lomonosov Ave., Moscow, Russia, 119192
| | - Aleksei K Erdiakov
- Faculty of Medicine, M. V. Lomonosov Moscow State University, 27/1 Lomonosov Ave., Moscow, Russia, 119192.
| | - Svetlana A Gavrilova
- Faculty of Medicine, M. V. Lomonosov Moscow State University, 27/1 Lomonosov Ave., Moscow, Russia, 119192
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Telander DG, Yu AK, Forward KI, Morales SA, Morse LS, Park SS, Gordon LK. Epithelial Membrane Protein-2 in Human Proliferative Vitreoretinopathy and Epiretinal Membranes. Invest Ophthalmol Vis Sci 2017; 57:3112-7. [PMID: 27294805 PMCID: PMC4913806 DOI: 10.1167/iovs.15-17791] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose To determine the level of epithelial membrane protein-2 (EMP2) expression in preretinal membranes from surgical patients with proliferative vitreoretinopathy (PVR) or epiretinal membranes (ERMs). EMP2, an integrin regulator, is expressed in the retinal pigment epithelium and understanding EMP2 expression in human retinal disease may help determine whether EMP2 is a potential therapeutic target. Methods Preretinal membranes were collected during surgical vitrectomies after obtaining consents. The membranes were fixed, processed, sectioned, and protein expression of EMP2 was evaluated by immunohistochemistry. The staining intensity (SI) and percentage of positive cells (PP) in membranes were compared by masked observers. Membranes were categorized by their cause and type including inflammatory and traumatic. Results All of the membranes stained positive for EMP2. Proliferative vitreoretinopathy–induced membranes (all causes) showed greater expression of EMP2 than ERMs with higher SI (1.81 vs. 1.38; P = 0.07) and PP (2.08 vs. 1.54; P = 0.09). However all the PVR subgroups had similar levels of EMP2 expression without statistically significant differences by Kruskal-Wallis test. Inflammatory PVR had higher expression of EMP2 than ERMs (SI of 2.58 vs. 1.38); however, this was not statistically significant. No correlation was found between duration of PVR membrane and EMP2 expression. EMP2 was detected by RT-PCR in all samples (n = 6) tested. Conclusions All studied ERMs and PVR membranes express EMP2. Levels of EMP2 trended higher in all PVR subgroups than in ERMs, especially in inflammatory and traumatic PVR. Future studies are needed to determine the role of EMP2 in the pathogenesis and treatment of various retinal conditions including PVR.
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Affiliation(s)
- David G Telander
- Department of Ophthalmology University of California, Davis, Sacramento, California, United States
| | - Alfred K Yu
- Department of Ophthalmology University of California, Davis, Sacramento, California, United States
| | - Krisztina I Forward
- Department of Ophthalmology University of California, Davis, Sacramento, California, United States
| | - Shawn A Morales
- Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, United States
| | - Lawrence S Morse
- Department of Ophthalmology University of California, Davis, Sacramento, California, United States
| | - Susanna S Park
- Department of Ophthalmology University of California, Davis, Sacramento, California, United States
| | - Lynn K Gordon
- Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, United States
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The influence of systemic renin-angiotensin-inhibition on ocular cytokines related to proliferative vitreoretinopathy. Graefes Arch Clin Exp Ophthalmol 2017; 255:1721-1725. [PMID: 28600710 DOI: 10.1007/s00417-017-3707-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 05/10/2017] [Accepted: 05/30/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE The renin-angiotensin system is involved in the pathogenesis of fibrosis in several organs via induction of transforming growth factor (TGF) beta. In the pathogenesis of proliferative vitreoretinopathy (PVR) TGF-beta plays a pivotal role, promoting transition of retinal pigment epithelial (RPE) cells into myofibroblasts. We studied the influence of angiotensin converting enzyme-inhibition (ACEI) on cytokines and growth factors, related to PVR in aqueous humor. METHODS We performed a post hoc analysis of a prospectively conducted interventional case series. From patients with rhegmatogenous retinal detachment (RRD) aqueous humor was obtained during primary surgery and analyzed using multiplex bead analysis for interferon gamma, tumor necrosis factor alpha, CC-chemokine ligand (CCL) 2 / monocyte chemoattractant protein (MCP)-1, interleukin (IL)-1 beta, IL-2, IL-4, IL-6, IL-8, vascular endothelial growth factor (VEGF)-A, platelet derived growth factor (PDGF)-aa, TGF-beta 1, TGF-beta 2, TGF-beta 3, fibroblast growth factor (FGF)-aa, and FGF-bb. We recorded information about systemic ACEI from the medical history. RESULTS In the primary study elevated levels of TGF-beta 1 and 2, IL 6 and 8 and CCL2/MCP-1 were a risk factor for later PVR development. Here, systemic ACEI neither influenced levels of these cytokines and growth factors, nor of any other tested in this study (p ≥ 0.438, respectively). Also the incidence of PVR development was unaffected (p = 0.201). CONCLUSION The systemic intake of ACEI for arterial hypertension does not influence levels of profibrotic cytokines/growth factors in aqueous humor. Further studies need to clarify if relevant levels of ACEI accumulate in the eye, and if direct administration of ACEI in experimental PVR could be beneficial.
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Obermann J, Priglinger CS, Merl-Pham J, Geerlof A, Priglinger S, Götz M, Hauck SM. Proteome-wide Identification of Glycosylation-dependent Interactors of Galectin-1 and Galectin-3 on Mesenchymal Retinal Pigment Epithelial (RPE) Cells. Mol Cell Proteomics 2017; 16:1528-1546. [PMID: 28576849 DOI: 10.1074/mcp.m116.066381] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 05/04/2017] [Indexed: 11/06/2022] Open
Abstract
Identification of interactors is a major goal in cell biology. Not only protein-protein but also protein-carbohydrate interactions are of high relevance for signal transduction in biological systems. Here, we aim to identify novel interacting binding partners for the β-galactoside-binding proteins galectin-1 (Gal-1) and galectin-3 (Gal-3) relevant in the context of the eye disease proliferative vitreoretinopathy (PVR). PVR is one of the most common failures after retinal detachment surgeries and is characterized by the migration, adhesion, and epithelial-to-mesenchymal transition of retinal pigment epithelial cells (RPE) and the subsequent formation of sub- and epiretinal fibrocellular membranes. Gal-1 and Gal-3 bind in a dose- and carbohydrate-dependent manner to mesenchymal RPE cells and inhibit cellular processes like attachment and spreading. Yet knowledge about glycan-dependent interactors of Gal-1 and Gal-3 on RPE cells is very limited, although this is a prerequisite for unraveling the influence of galectins on distinct cellular processes in RPE cells. We identify here 131 Gal-3 and 15 Gal-1 interactors by galectin pulldown experiments combined with quantitative proteomics. They mainly play a role in multiple binding processes and are mostly membrane proteins. We focused on two novel identified interactors of Gal-1 and Gal-3 in the context of PVR: the low-density lipoprotein receptor LRP1 and the platelet-derived growth factor receptor β PDGFRB. Addition of exogenous Gal-1 and Gal-3 induced cross-linking with LRP1/PDGFRB and integrin-β1 (ITGB1) on the cell surface of human RPE cells and induced ERK/MAPK and Akt signaling. Treatment with kifunensine, an inhibitor of complex-type N-glycosylation, weakened the binding of Gal-1 and Gal-3 to these interactors and prevented lattice formation. In conclusion, the identified specific glycoprotein ligands shed light into the highly specific binding of galectins to dedifferentiated RPE cells and the resulting prevention of PVR-associated cellular events.
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Affiliation(s)
- Jara Obermann
- From the ‡Research Unit Protein Science, Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), 85764 Neuherberg
| | | | - Juliane Merl-Pham
- From the ‡Research Unit Protein Science, Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), 85764 Neuherberg
| | - Arie Geerlof
- ¶Protein Expression and Purification Facility, Institute of Structural Biology, Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), 85764 Neuherberg
| | | | - Magdalena Götz
- ‖Institute of Stem Cell Research, Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), 85764 Neuherberg.,**Physiological Genomics, Biomedical Center, Ludwig-Maximilians-University, 82152 Munich, Germany
| | - Stefanie M Hauck
- From the ‡Research Unit Protein Science, Helmholtz Center Munich, German Research Center for Environmental Health (GmbH), 85764 Neuherberg;
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Joseph M, Trinh HM, Cholkar K, Pal D, Mitra AK. Recent perspectives on the delivery of biologics to back of the eye. Expert Opin Drug Deliv 2017; 14:631-645. [PMID: 27573097 PMCID: PMC5570518 DOI: 10.1080/17425247.2016.1227783] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Biologics are generally macromolecules, large in size with poor stability in biological environments. Delivery of biologics to tissues at the back of the eye remains a challenge. To overcome these challenges and treat posterior ocular diseases, several novel approaches have been developed. Nanotechnology-based delivery systems, like drug encapsulation technology, macromolecule implants and gene delivery are under investigation. We provide an overview of emerging technologies for biologics delivery to back of the eye tissues. Moreover, new biologic drugs currently in clinical trials for ocular neovascular diseases have been discussed. Areas covered: Anatomy of the eye, posterior segment disease and diagnosis, barriers to biologic delivery, ocular pharmacokinetic, novel biologic delivery system Expert opinion: Anti-VEGF therapy represents a significant advance in developing biologics for the treatment of ocular neovascular diseases. Various strategies for biologic delivery to posterior ocular tissues are under development with some in early or late stages of clinical trials. Despite significant progress in the delivery of biologics, there is unmet need to develop sustained delivery of biologics with nearly zero-order release kinetics to the back of the eye tissues. In addition, elevated intraocular pressure associated with frequent intravitreal injections of macromolecules is another concern that needs to be addressed.
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Affiliation(s)
- Mary Joseph
- Division of Pharmaceutical Sciences, School of Pharmacy, 5258 Health Science Building, University of Missouri-Kansas City, 2464 Charlotte Street, Kansas City, MO, 64108 USA
| | - Hoang M. Trinh
- Division of Pharmaceutical Sciences, School of Pharmacy, 5258 Health Science Building, University of Missouri-Kansas City, 2464 Charlotte Street, Kansas City, MO, 64108 USA
| | - Kishore Cholkar
- Division of Pharmaceutical Sciences, School of Pharmacy, 5258 Health Science Building, University of Missouri-Kansas City, 2464 Charlotte Street, Kansas City, MO, 64108 USA
- RiconPharma LLC, 100 Ford Road, Suite 9, Denville, NJ, 07834 USA
| | - Dhananjay Pal
- Division of Pharmaceutical Sciences, School of Pharmacy, 5258 Health Science Building, University of Missouri-Kansas City, 2464 Charlotte Street, Kansas City, MO, 64108 USA
| | - Ashim K. Mitra
- Division of Pharmaceutical Sciences, School of Pharmacy, 5258 Health Science Building, University of Missouri-Kansas City, 2464 Charlotte Street, Kansas City, MO, 64108 USA
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Kelly MEM, Lehmann C, Zhou J. The Endocannabinoid System in Local and Systemic Inflammation. ACTA ACUST UNITED AC 2017. [DOI: 10.4199/c00151ed1v01y201702isp074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Russo A, Morescalchi F, Donati S, Gambicorti E, Azzolini C, Costagliola C, Semeraro F. Heavy and standard silicone oil: intraocular inflammation. Int Ophthalmol 2017; 38:855-867. [DOI: 10.1007/s10792-017-0489-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 03/06/2017] [Indexed: 01/21/2023]
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Sahanne S, Tuuminen R, Haukka J, Loukovaara S. A retrospective study comparing outcomes of primary rhegmatogenous retinal detachment repair by scleral buckling and pars plana vitrectomy in Finland. Clin Ophthalmol 2017; 11:503-509. [PMID: 28331284 PMCID: PMC5354527 DOI: 10.2147/opth.s128746] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Rhegmatogenous retinal detachment (RRD) is the most common form of retinal detachment and an ophthalmic emergency. Here, we compared outcomes of primary RRD eyes operated with conventional scleral buckling (SB) with cryoretinopexy to those operated with standard pars plana vitrectomy (PPV). Methods This is an institutional, retrospective, register-based, observational, comparative study. Based on the surgical procedure, 319 eyes of 319 patients were divided into two groups: SB plus cryotherapy (n=50) and PPV (n=269). Changes in intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were recorded at 30 days and reoperation rates within 180 days postoperatively. Results Eyes operated with PPV had less reoperations within the first 180 days as compared with SB eyes (P=0.001, log-rank test); however, changes in IOP were more prominent (mean ± standard deviation: +8.1±8.8 vs. +4.4±7.0 mmHg, respectively; P=0.006). Changes in BCVA did not differ between the surgical procedures. Conclusion PPV was associated with higher primary anatomic success rates and lower risk of reoperation but significant IOP elevation when compared to SB. These factors should be case-specifically considered when choosing treatment modality for primary RRD.
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Affiliation(s)
- Sari Sahanne
- Department of Anesthesiology, Helsinki University Central Hospital, Helsinki
| | - Raimo Tuuminen
- Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka
| | - Jari Haukka
- Hjelt Institute, Faculty of Medicine, University of Helsinki
| | - Sirpa Loukovaara
- Unit of Vitreoretinal Surgery, Department of Ophthalmology, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
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Correlation between miR-148 Expression in Vitreous and Severity of Rhegmatogenous Retinal Detachment. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3427319. [PMID: 28261609 PMCID: PMC5316437 DOI: 10.1155/2017/3427319] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 12/04/2016] [Accepted: 12/27/2016] [Indexed: 12/29/2022]
Abstract
Purpose. We had earlier reported positive hsa-miR-148a-3p expression in eyes with rhegmatogenous retinal detachment (RRD) and its involvement in the epithelial-mesenchymal transition of retinal pigment epithelium in vitro. Here we investigated the association of hsa-miR-148a-3p expression levels in the vitreous fluid of patients with RRD with severity of RRD. Methods. The hsa-miR-148a-3p expression levels in the vitreous fluid, range (degree) of retinal detachment (RD), and pixels of retinal break were measured in 27 eyes with RRD. The association of hsa-miR-148a-3p expression levels with other factors was evaluated by multiple regression analysis. Results. The hsa-miR-148a-3p expression levels, time from onset of RRD to vitrectomy, range of RD, and pixels of retinal breaks were 23.68 ± 43.00, 12.07 ± 15.36 days, 155.85 ± 86.67 degrees, and 37000 ± 67100 pixels, respectively. Five eyes with RRD had vitreous hemorrhage preoperatively. The hsa-miR-148a-3p expression levels were significantly associated with pixels of retinal breaks (β = 0.699) and the time from onset of RRD to vitrectomy (β = 0.358) but not with the range of RD or presence of vitreous hemorrhage. Conclusion. The hsa-miR-148a-3p expression levels in the vitreous fluid were significantly associated with the size of retinal break and disease duration.
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Mulder VC, Tode J, van Dijk EH, Purtskhvanidze K, Roider J, van Meurs JC, Treumer F. Preoperative aqueous humour flare values do not predict proliferative vitreoretinopathy in patients with rhegmatogenous retinal detachment. Br J Ophthalmol 2017; 101:1285-1289. [PMID: 28077370 DOI: 10.1136/bjophthalmol-2016-309134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 11/24/2016] [Accepted: 12/19/2016] [Indexed: 01/25/2023]
Abstract
BACKGROUND/AIMS Patients with rhegmatogenous retinal detachment (RRD) who develop postoperative proliferative vitreoretinopathy (PVR) have been found to have higher preoperative laser flare values than patients with RRD who do not develop this complication. Measurement of laser flare has therefore been proposed as an objective, rapid and non-invasive method for identifying high-risk patients. The purpose of our study was to validate the use of preoperative flare values as a predictor of PVR risk in two additional patient cohorts, and to confirm the sensitivity and specificity of this method for identifying high-risk patients. METHODS We combined data from two independent prospective studies: centre 1 (120 patients) and centre 2 (194 patients). Preoperative aqueous humour flare was measured with a Kowa FM-500 Laser Flare Meter. PVR was defined as redetachment due to the formation of traction membranes that required reoperation within 6 months of initial surgery. Logistic regression and receiver operating characteristic analysis determined whether higher preoperative flare values were associated with an increased risk of postoperative PVR. RESULTS PVR redetachment developed in 21/314 patients (6.7%). Median flare values differed significantly between centres, therefore analyses were done separately. Logistic regression showed a small but statistically significant increase in odds with increasing flare only for centre 2 (OR 1.014; p=0.005). Areas under the receiver operating characteristic showed low sensitivity and specificity: centre 1, 0.634 (95% CI 0.440 to 0.829) and centre 2, 0.731 (95% CI 0.598 to 0.865). CONCLUSIONS Preoperative laser flare measurements are inaccurate in discriminating between those patients with RRD at high and low risk of developing PVR.
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Affiliation(s)
- Verena C Mulder
- The Rotterdam Eye Hospital/Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands
| | - Jan Tode
- Department of Ophthalmology, University of Kiel, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Elon Hc van Dijk
- The Rotterdam Eye Hospital/Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands.,Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Konstantine Purtskhvanidze
- Department of Ophthalmology, University of Kiel, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Johann Roider
- Department of Ophthalmology, University of Kiel, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Jan C van Meurs
- The Rotterdam Eye Hospital/Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands.,Department of Ophthalmology, Erasmus University, Rotterdam, The Netherlands
| | - Felix Treumer
- Department of Ophthalmology, University of Kiel, University Medical Center Schleswig-Holstein, Kiel, Germany
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Chen CL, Chen YH, Tai MC, Liang CM, Lu DW, Chen JT. Resveratrol inhibits transforming growth factor-β2-induced epithelial-to-mesenchymal transition in human retinal pigment epithelial cells by suppressing the Smad pathway. DRUG DESIGN DEVELOPMENT AND THERAPY 2017; 11:163-173. [PMID: 28138219 PMCID: PMC5241127 DOI: 10.2147/dddt.s126743] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Proliferative vitreoretinopathy (PVR) is the main cause of failure following retinal detachment surgery. Transforming growth factor (TGF)-β2-induced epithelial-to-mesenchymal transition (EMT) plays an important role in the development of PVR, and EMT inhibition decreases collagen gel contraction and fibrotic membrane formation, resulting in prevention of PVR. Resveratrol is naturally found in red wine and has inhibitory effects on EMT. Resveratrol is widely used in cardioprotection, neuroprotection, chemotherapy, and antiaging therapy. The purpose of this study was to investigate the effects of resveratrol on TGF-β2-induced EMT in ARPE-19 cells in vitro. We found that resveratrol suppressed the decrease of zona occludens-1 (ZO-1) and caused an increase of alpha-smooth muscle actin expression in TGF-β2-treated ARPE-19 cells, assessed using Western blots; moreover, it also suppressed the decrease in ZO-1 and the increase of vimentin expression, observed using immunocytochemistry. Resveratrol attenuated TGF-β2-induced wound closure and cell migration in ARPE-19 cells in a scratch wound test and modified Boyden chamber assay, respectively. We also found that resveratrol reduced collagen gel contraction - assessed by collagen matrix contraction assay - and suppressed the phosphorylation of Smad2 and Smad3 in TGF-β2-treated ARPE-19 cells. These results suggest that resveratrol mediates anti-EMT effects, which could be used in the prevention of PVR.
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Affiliation(s)
- Ching-Long Chen
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan; Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Hao Chen
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan; Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ming-Cheng Tai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chang-Min Liang
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Da-Wen Lu
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan; Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jiann-Torng Chen
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan; Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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112
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Altan T, Ozbilen KT, Cetin T, Kapran Z. Results of Peripheral Vitrectomy Under Air in Rhegmatogenous Retinal Detachment. Ophthalmic Surg Lasers Imaging Retina 2017; 48:51-54. [PMID: 28060394 DOI: 10.3928/23258160-20161219-07] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 11/02/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE To evaluate the safety and efficacy of peripheral vitrectomy under air in rhegmatogenous retinal detachment (RRD). PATIENTS AND METHODS Consecutive patients who underwent 23-gauge pars plana vitrectomy for RRD were included. After removal of core vitreous and drainage of subretinal fluid, peripheral vitreous was removed under air infusion without scleral indentation. Silicone oil or C3F8 gas was used as tamponade. RESULTS Forty-five eyes of 45 patients were evaluated retrospectively. Mean LogMAR, which was 1.65 LogMAR ± 1.44 LogMAR preoperatively, decreased to 0.26 LogMAR ± 0.28 LogMAR (P < .001; paired t-test). Initial and final reattachment rates were 91% and 98%, respectively. Scleral indentation was not necessary in any case. Iatrogenic retinal breaks occurred in three initial cases. Macular hole developed in one case after reoperation. CONCLUSIONS Peripheral vitrectomy under air is safe and effective in cases with RRD. Air eliminates the need for scleral indentation, stabilizes the retina, and allows sufficient clarity for vitrectomy. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:51-54.].
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Kung YH, Wu TT. Risk Factors of Hyphema following Surgeries for Primary Rhegmatogenous Retinal Detachment. Ophthalmologica 2016; 236:159-165. [PMID: 27802426 DOI: 10.1159/000452254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/03/2016] [Indexed: 11/19/2022]
Abstract
PURPOSE This study aimed to evaluate the risk factors for hyphema complicating primary rhegmatogenous retinal detachment (RRD) surgeries and to analyze outcomes. METHODS In this retrospective comparative study, we included 1,011 consecutive eyes. Two groups were compared according to the occurrence of postoperative hyphema. RESULTS Postoperative hyphema occurred in 32 eyes (3.17%). High myopia was significantly related to the occurrence of hyphema (odds ratio [OR] 3.396, 95% confidence interval [CI] 1.502-7.675; p = 0.003). Combined scleral buckling and vitrectomy (SB + VT) was associated with a significantly higher incidence of hyphema (OR 21.266, 95% CI 4.855-93.152; p < 0.001). The final anatomical success rate did not differ significantly between the group with and the group without occurrence of hyphema; however, the primary anatomical success rate was worse in the eyes with hyphema. CONCLUSIONS High myopia and combined SB + VT were risk factors for hyphema after RRD surgeries. The occurrence of hyphema did not affect the final anatomical success rate at 6 months.
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Affiliation(s)
- Ya-Hsin Kung
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
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Cannabinoid 2 receptor is a novel anti-inflammatory target in experimental proliferative vitreoretinopathy. Neuropharmacology 2016; 113:627-638. [PMID: 27569993 DOI: 10.1016/j.neuropharm.2016.08.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 08/18/2016] [Accepted: 08/24/2016] [Indexed: 01/13/2023]
Abstract
Proliferative vitreoretinopathy (PVR) can develop after ocular trauma or inflammation and is a common complication of surgery to correct retinal detachment. Currently, there are no pharmacological treatments for PVR. Cannabinoids acting at cannabinoid 2 receptor (CB2R) can decrease inflammation and fibrosis. The objective of this study was to examine the anti-inflammatory actions of CB2R as a candidate novel therapeutic target in experimental PVR. PVR was induced by intravitreal injection of dispase in wild-type (WT) and CB2R genetic knockout (CB2R-/-) mice. Ocular pathology was studied at 24 h or one week after dispase injection. CB2R modulation was examined in WT mice, using the CB2R agonist, HU308, and the CB2R antagonist, AM630. Histopathological scoring and quantification of microglia was used to evaluate tissue pathology. Quantitative PCR and multiplex assays were used to assess changes in proinflammatory cytokines. Intravital microscopy (IVM) was used to visualize and quantify leukocyte-endothelial adhesion to the iridial microcirculation. Activation of CB2R with HU308 in WT mice with PVR decreased mean histopathological scores, the number of microglia, and leukocyte adhesion compared to vehicle-treated animals. Conversely, an increase in histopathological scores and activated microglia was observed in PVR animals after treatment with AM630. CB2R-/- mice with PVR exhibited exacerbated ocular histopathology, increased microglia numbers, and elevated protein levels of cytokines as compared to WT mice. In conclusion, our results indicate that intervention at early stage PVR with CB2R agonists reduces ocular inflammation and disease severity. CB2R may represent a therapeutic target to prevent PVR progression and vision loss. This article is part of the Special Issue entitled 'Lipid Sensing G Protein-Coupled Receptors in the CNS'.
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Histopathological and ophthalmoscopic evaluation of apocynin on experimental proliferative vitreoretinopathy in rabbit eyes. Int Ophthalmol 2016; 37:599-605. [PMID: 27495951 DOI: 10.1007/s10792-016-0318-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
Abstract
The aim of the current study was to evaluate the effect of apocynin (APO) on the development of proliferative vitreoretinopathy (PVR). New Zealand-type male rabbits were randomly grouped into three as follows: (1) Sham group rabbits which were applied intraperitoneal (i.p.) vehicle without PVR; (2) PVR group rabbits where PVR was created and an i.p. vehicle was administered for 21 successive days; (3) PVR + APO group rabbits where PVR was created and i.p. APO was administered for 21 successive days. Fundus examination was conducted with an indirect ophthalmoscope before starting the experiments and at each visit afterwards. At the end of the work, the rabbits were sacrificed under high-dose anesthesia and then eye tissues were taken for histopathological analyses. In the PVR + APO group, histopathologic and ophthalmoscopic examination revealed significant decrease in PVR formation. As the result, it has been observed that APO at least partially inhibits PVR formation.
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Por ED, Greene WA, Burke TA, Wang HC. Trichostatin A Inhibits Retinal Pigmented Epithelium Activation in an In Vitro Model of Proliferative Vitreoretinopathy. J Ocul Pharmacol Ther 2016; 32:415-24. [PMID: 27494828 PMCID: PMC5011631 DOI: 10.1089/jop.2016.0038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose: Proliferative vitreoretinopathy (PVR) is a blinding disorder that develops after a retinal tear or detachment. Activation of the retinal pigmented epithelium (RPE) is implicated in PVR; however, the mechanisms leading to enhanced RPE proliferation, migration, and contraction remain largely unknown. This study utilized an in vitro model of PVR to investigate the role of acetylation in RPE activation and its contribution to the progression of this disease. Methods: ARPE-19 cells, primary cultures of porcine RPE, and induced pluripotent stem cell-derived RPE (iPS-RPE) were utilized for cellular and molecular analyses. Cells treated with transforming growth factor beta 2 (TGFβ2; 10 ng/mL) alone or in the presence of the broad-spectrum histone deacetylase (HDAC) inhibitor, trichostatin A (TSA; 0.1 μM), were assessed for contraction and migration through collagen contraction and scratch assays, respectively. Western blotting and immunofluorescence analysis were performed to assess α-smooth muscle actin (α-SMA) and β-catenin expression after TGFβ2 treatment alone or in combination with TSA. Results: TGFβ2 significantly increased RPE cell contraction in collagen matrix and this effect was inhibited in the presence of TSA (0.1 μM). In agreement with these data, immunofluorescence analysis of TSA-treated iPS-RPE wounded monolayers revealed decreased α-SMA as compared with control. Scratch assays to assess wound healing revealed TSA inhibited TGFβ2-mediated iPS-RPE cell migration. Conclusions: Our findings indicate a role of acetylation in RPE activation. Specifically, the HDAC inhibitor TSA decreased RPE cell proliferation and TGFβ2-mediated cell contraction and migration. Further investigation of pharmacological compounds that modulate acetylation may hold promise as therapeutic agents for PVR.
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Affiliation(s)
- Elaine D Por
- Ocular Trauma, U.S. Army Institute of Surgical Research , JBSA-Fort Sam Houston, Texas
| | - Whitney A Greene
- Ocular Trauma, U.S. Army Institute of Surgical Research , JBSA-Fort Sam Houston, Texas
| | - Teresa A Burke
- Ocular Trauma, U.S. Army Institute of Surgical Research , JBSA-Fort Sam Houston, Texas
| | - Heuy-Ching Wang
- Ocular Trauma, U.S. Army Institute of Surgical Research , JBSA-Fort Sam Houston, Texas
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Li M, Li H, Liu X, Xu D, Wang F. MicroRNA-29b regulates TGF-β1-mediated epithelial–mesenchymal transition of retinal pigment epithelial cells by targeting AKT2. Exp Cell Res 2016; 345:115-24. [DOI: 10.1016/j.yexcr.2014.09.026] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/17/2014] [Accepted: 09/18/2014] [Indexed: 11/29/2022]
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Di Lauro S, Kadhim MR, Charteris DG, Pastor JC. Classifications for Proliferative Vitreoretinopathy (PVR): An Analysis of Their Use in Publications over the Last 15 Years. J Ophthalmol 2016; 2016:7807596. [PMID: 27429798 PMCID: PMC4939352 DOI: 10.1155/2016/7807596] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/24/2016] [Indexed: 11/25/2022] Open
Abstract
Purpose. To evaluate the current and suitable use of current proliferative vitreoretinopathy (PVR) classifications in clinical publications related to treatment. Methods. A PubMed search was undertaken using the term "proliferative vitreoretinopathy therapy". Outcome parameters were the reported PVR classification and PVR grades. The way the classifications were used in comparison to the original description was analyzed. Classification errors were also included. It was also noted whether classifications were used for comparison before and after pharmacological or surgical treatment. Results. 138 papers were included. 35 of them (25.4%) presented no classification reference or did not use any one. 103 publications (74.6%) used a standardized classification. The updated Retina Society Classification, the first Retina Society Classification, and the Silicone Study Classification were cited in 56.3%, 33.9%, and 3.8% papers, respectively. Furthermore, 3 authors (2.9%) used modified-customized classifications and 4 (3.8%) classification errors were identified. When the updated Retina Society Classification was used, only 10.4% of authors used a full C grade description. Finally, only 2 authors reported PVR grade before and after treatment. Conclusions. Our findings suggest that current classifications are of limited value in clinical practice due to the inconsistent and limited use and that it may be of benefit to produce a revised classification.
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Affiliation(s)
- Salvatore Di Lauro
- IOBA (Eye Institute), University of Valladolid, 47011 Valladolid, Spain
- Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | | | | | - J. Carlos Pastor
- IOBA (Eye Institute), University of Valladolid, 47011 Valladolid, Spain
- Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
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Dealings between Cataract and Retinal Reattachment Surgery in PVR. J Ophthalmol 2016; 2016:2384312. [PMID: 27034821 PMCID: PMC4789506 DOI: 10.1155/2016/2384312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/20/2016] [Indexed: 11/20/2022] Open
Abstract
Introduction. To evaluate the impact of the eye lens status and oil side effects on the outcome of vitreoretinal surgery in retinal detachment with proliferative vitreoretinopathy (PVR) and a temporary silicone oil tamponade (SOT). Methods. 101 eyes were analyzed retrospectively and 103 eyes prospectively in regard to their retinal reattachment success rate and key factors for the outcome. Subgroup analysis of 27 eyes with Scheimpflug lens photography (SLP) before and after retinal reattachment service with SOT was performed. For SLP (65% phakic eyes) a Pentacam densitometry reference body with 3 mm diameter was chosen and 3 segments (anterior/mid/posterior) were evaluated separately after a quality check. Results. The retinal reattachment rate was highest in the prospective pseudophakic group (p = 0.039). Lens transparency loss occurred earlier in middle aged patients than in younger patients. Besides the nucleus, layers posterior and anterior to it showed specific transparency changes. The emulsification rate was higher when eyes had been operated on in the anterior chamber before retinal reattachment service. Conclusions. Retinal reattachment surgery seems to benefit from preoperative cataract removal. We found significant lens changes in the nucleus as well as in the layers anterior and posterior to it. This corresponds to the histology of the lens epithelium published before.
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Lin X, Sun X, Wang Z, Jiang Z, Liu Y, Wang P, Gao Q. Three-Year Efficacy and Safety of a Silicone Oil-Filled Foldable-Capsular-Vitreous-Body in Three Cases of Severe Retinal Detachment. Transl Vis Sci Technol 2016; 5:2. [PMID: 26855843 PMCID: PMC4736667 DOI: 10.1167/tvst.5.1.2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 10/12/2015] [Indexed: 11/30/2022] Open
Abstract
Purpose We previously designed a novel foldable capsular vitreous body (FCVB) to treat severe retinal detachment and evaluated its performance in a 1-year follow up study. The purpose of this study was to determine the efficacy and safety of a silicone oil (SO)-filled FCVB in a 3-year follow-up. Methods Standard three-port pars plana vitrectomy was performed, and the FCVB was triple folded and implanted in the vitreous cavity of three eyes. The SO then was injected into the capsule to support the retina. The eyes were examined using Goldmann applanation tonometry, fundus photography, optical coherence tomography (OCT), noncontact specular microscopy, and ultrasound biomicroscopy over a 3-year implantation period. Results At the 3-year follow-up, retinal reattachment was achieved in all three cases, with steady intraocular pressure. The visual acuity showed slight fluctuations, and it was slightly increased compared to baseline. Optical coherence tomography revealed decreased retinal thickness and an altered retinal structure in the implanted eyes compared to the control eyes. No keratopathy, glaucoma, SO leakage, SO emulsification, or other apparent complications occurred during the observation period. Conclusion The SO-filled FCVB was effective and safe as a vitreous substitute in three eyes over a 3-year observation period. Translational Relevance Silicone oil emulsification is a severe complication after retinal detachment surgery. On the basis of animal experiments, we investigated a new strategy and product, the FCVB, to overcome this complication. In this pilot study, FCVB limited SO emulsification and migration. This study could lay the foundation for a further multicenter clinical trial.
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Affiliation(s)
- Xiaofeng Lin
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xuyuan Sun
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhenfang Wang
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhaoxin Jiang
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yaqin Liu
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Peijuan Wang
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Qianying Gao
- State Key Laboratory of Ophthalmology Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Sarfare S, Dacquay Y, Askari S, Nusinowitz S, Hubschman JP. Biocompatibility of a Synthetic Biopolymer for the Treatment of Rhegmatogenous Retinal Detachment. ACTA ACUST UNITED AC 2016; 6. [PMID: 26744635 DOI: 10.4172/2155-9570.1000475] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of this study is to evaluate the retinal safety and toxicity of a novel synthetic biopolymer to be used as a patch to treat rhegmatogenous retinal detachment. METHODS Thirty one adult wild type albino mice were divided in 2 groups. In Group A (n=9) 0.2 μl balanced salt solution (BSS) and in Group B (n=22), 0.2 μl biopolymer was injected in the subretinal space. Trans-scleral subretinal injection was performed in one eye and the fellow eye was used as control. In both groups, in vivo color fundus photography, electroretinogram (ERG), spectral domain optical coherence tomography (SD-OCT) were performed before injection and at days 7 and 14 post-intervention. Histological analysis was performed following euthanization at days 1, 7 and 21 post-injection. RESULTS The biopolymer was visualized in the subretinal space in vivo by SD-OCT and post-life by histology up to 1 week after the injection. There were no significant differences in ERG parameters between the two groups at 1 and 2 weeks post-injection. Minimal inflammatory response and loss of photoreceptor cells was only observed in the immediate proximity of the site of scleral perforation, which was similar in both groups. Overall integrity of the outer, inner retina and retinal pigment epithelial (RPE) layers was unaffected by the presence of the biopolymer in the subretinal space. CONCLUSIONS Functional and histological evaluation suggests that the synthetic biopolymer is non-inflammatory and non-toxic to the eye. It may represent a safe therapeutic agent in the future, for the treatment of rhegmatogenous retinal detachment.
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Affiliation(s)
- Shanta Sarfare
- Jules Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California 90095, USA
| | - Yann Dacquay
- Jules Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California 90095, USA
| | - Syed Askari
- Medicus Biosciences, 2528 Qume Drive, Unit 1, San José, California 95131, USA
| | - Steven Nusinowitz
- Jules Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California 90095, USA
| | - Jean-Pierre Hubschman
- Jules Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California 90095, USA
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Li Q, Lai KL, Chan PS, Leung SC, Li HY, Fang Y, To KKW, Choi CHJ, Gao QY, Lee TWY. Micellar delivery of dasatinib for the inhibition of pathologic cellular processes of the retinal pigment epithelium. Colloids Surf B Biointerfaces 2016; 140:278-286. [PMID: 26764115 DOI: 10.1016/j.colsurfb.2015.12.053] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 12/10/2015] [Accepted: 12/23/2015] [Indexed: 12/12/2022]
Abstract
The objective of this study was to fabricate dasatinib-loaded nanoparticles and evaluate their efficacy in inhibiting cellular processes of the retinal pigment epithelium (RPE) related to proliferative vitreoretinopathy (PVR), for which there are no approved pharmacological approaches. We successfully encapsulated dasatinib, a poorly soluble multi-targeted tyrosine kinase inhibitor which has great potential for the treatment of PVR, into nanoparticles prepared from micellation of PEG-b-PCL. The size of the nanomicelles was approximately 55nm with a narrow distribution. They increased the solubility of dasatinib by 475× and provided a sustained drug release. ARPE-19, an immortal RPE cell line, was used to assess the in vitro efficacy of micellar dasatinib because the RPE is believed to play a key role in the pathogenesis of PVR. Three cell-based assays, namely, proliferation, adhesion and migration, which represent three important PVR-related cellular changes of the RPE, were conducted and the cytotoxicity of micelles was also evaluated. Both blank and dasatinib-loaded micelles were non-cytotoxic towards ARPE-19 cells. Micellar dasatinib significantly inhibited cell proliferation, adhesion and migration compared to the free drug; this might be attributable to enhanced solubility. PEG-b-PCL micelles were taken up into the ARPE-19 cells by an energy-dependent clatharin and caveolae-mediated endocytosis. Our results indicated that cellular uptake and the anti-proliferation effect of drugloaded micelles were linearly correlated. Drug loading appears to be a critical parameter for cellular uptake which in turn impacts the in vitro bioactivities of polymeric micelles. Our results clearly demonstrated that dasatinib-encapsulated micelles offer considerable promise in the management of PVR.
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Affiliation(s)
- Qingqing Li
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Ka Lun Lai
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Pui Shan Chan
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Sui Chu Leung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Ho Yin Li
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Yuan Fang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Kenneth K W To
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Chung Hang J Choi
- Division of Biomedical Engineering, Department of Electronic Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Qian Ying Gao
- State Key Laboratory of Ophthalmology, ZhongShan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Thomas W Y Lee
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China.
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Hsu J, Khan MA, Shieh WS, Chiang A, Maguire JI, Park CH, Garg SJ, Ho AC, Kaiser RS. Effect of Serial Intrasilicone Oil Bevacizumab Injections in Eyes With Recurrent Proliferative Vitreoretinopathy Retinal Detachment. Am J Ophthalmol 2016; 161:65-70.e1-2. [PMID: 26432568 DOI: 10.1016/j.ajo.2015.09.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 09/23/2015] [Accepted: 09/23/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the effect of serial intrasilicone oil bevacizumab injections (1.25 mg/0.05 mL) on visual acuity (VA) and anatomic outcomes in eyes undergoing proliferative vitreoretinopathy (PVR)-related retinal detachment (RD) repair. DESIGN Prospective, nonrandomized, historical-control pilot study. METHODS setting: Tertiary care center. STUDY POPULATION Nondiabetic eyes undergoing pars plana vitrectomy (PPV) and silicone oil tamponade with or without scleral buckling procedure (SBP) for recurrent RD due to PVR. INTERVENTION Intrasilicone oil injection of 1.25 mg bevacizumab was performed intraoperatively and at postoperative months 1, 2, and 3. OUTCOMES Retinal reattachment rate, final VA, and rate of epiretinal membrane (ERM) formation at month 6. RESULTS Twenty eyes of 20 patients were enrolled and compared to a historical control group composed of 35 age- and sex-matched controls. In the study group, logMAR VA improved from mean 1.78 ± 0.43 (Snellen 20/1205) to 1.43 ± 0.70 (Snellen 20/538, P = .04), retinal reattachment was achieved in 14 of 20 eyes (70%), and ERM formation was observed in 7 of 20 eyes (35%) at 6 months. In the control group, logMAR VA improved from mean 1.50 ± 0.74 (Snellen 20/632) to 1.43 ± 0.58 (Snellen 20/538, P = .64), retinal reattachment was achieved in 25 of 35 eyes (71%), and ERM formation was observed in 7 of 35 eyes (20%) at 6 months. No significant difference in final VA (P = .96), retinal reattachment rate (P = .75), or ERM formation (P = .33) was observed between groups. No intrasilicone oil injection-related adverse events occurred. CONCLUSIONS Serial intrasilicone oil injections of bevacizumab did not improve retinal reattachment rate, improve final VA, or reduce ERM formation in patients undergoing PVR-related RD surgery.
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CLINICAL PRESENTATIONS AND OUTCOMES OF RHEGMATOGENOUS RETINAL DETACHMENT IN RETINITIS PIGMENTOSA. Retina 2015; 36:1345-8. [PMID: 26655616 DOI: 10.1097/iae.0000000000000910] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To describe the clinical presentations and outcomes of rhegmatogenous retinal detachments (RRD) in eyes with retinitis pigmentosa. METHODS A retrospective review of all patients of retinitis pigmentosa with RRD from January 1990 to December 2013 at a tertiary eye care institute. RESULTS Of total 28,622 patients of retinitis pigmentosa over a 23-year period, 17 eyes of 17 patients had RRD. Mean age at presentation was 34.53 ± 16.42 years (median 32 years). Median duration of decreased vision attributed to RRD was 6 months. Ten eyes (59%) had cataract and 3 eyes (18%) had history of cataract surgery. Thirteen eyes (76%) had inferior retinal detachment; 9 eyes (53%) had lattice with retinal holes; and 8 eyes (47%) had atrophic retinal holes. There were no horse-shoe tears, giant retinal tears, dialysis, and macular holes related RRD. Majority (82%) of retinal breaks were in the inferotemporal quadrant. Only 3 eyes (18%) had proliferative vitreoretinopathy at presentation. Twelve eyes at presentation had best-corrected visual acuity <20/200 and 6 eyes had only light perception. The macula was involved by the detachment in all cases. Mean preoperative visual acuity was 1.4 ± 0.88 logarithm of the minimum angle of resolution (median 1.3, range 3-0.1; 20/502). Surgery was not advised in 6 eyes (35% patients); 5 eyes (30%) underwent scleral buckling and 6 eyes (35%) underwent vitrectomy. Median follow-up was 5 months. Reattachment rate at last follow-up was 91% (15 eyes). Mean postoperative best-corrected visual acuity recorded was 1.06 ± 0.8 (median 1, range 3-0.1; 20/229) (P = 0.15). Eight eyes at last visit had best-corrected visual acuity <20/200. Of the 11 eyes operated, 4 improved in vision and 7 retained the preoperative vision. CONCLUSION The incidence of RRD in retinitis pigmentosa is very low. Presentation, although delayed, is at a younger age. Horse-shoe tears and proliferative vitreoretinopathy are uncommon; cataract is a common coexisting pathology. Surgical reattachment rates appear high and recurrent RRD is uncommon. However, visual gain is limited by the underlying retinal degenerative condition.
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Pastor-Idoate S, Rodríguez-Hernández I, Rojas J, Fernández I, García-Gutierrez MT, Ruiz-Moreno JM, Rocha-Sousa A, Ramkissoon YD, Harsum S, MacLaren RE, Charteris DG, Van Meurs JC, González-Sarmiento R, Pastor JC. BAX and BCL-2 polymorphisms, as predictors of proliferative vitreoretinopathy development in patients suffering retinal detachment: the Retina 4 project. Acta Ophthalmol 2015; 93:e541-9. [PMID: 25991504 DOI: 10.1111/aos.12718] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 02/18/2015] [Indexed: 12/31/2022]
Abstract
PURPOSE To compare the distribution of BCL-2 -938C>A (rs2279115) and BAX -248G>A (rs4645878) genotypes among European subjects undergoing rhegmatogenous retinal detachment (RRD) surgery in relation to the further development of proliferative vitreoretinopathy (PVR). METHODS A case-control gene association study, as a part of Retina 4 project, was designed. rs2279115 and rs4645878 polymorphisms were analysed in 555 samples from patients with RRD (134 with PVR secondary to surgery). Proportions of genotypes and AA homozygous groups of BCL-2 and BAX polymorphisms between subsamples were analysed in two phases. Genotypic and allelic frequencies were compared in global sample and in subsamples. RESULTS BAX: Differences were observed in the genotype frequencies and in AA carriers between controls and cases in the global series. The odds ratio (OR) of A carriers in the global sample was 1.7 (95% CI: 1.23-2.51). Proportions of genotypes in Spain + Portugal were significant different. The OR of A carriers from Spain and Portugal was 1.8 (95% CI: 1.11-2.95). BCL-2: No significant differences were observed in genotype frequencies. However, proportions of genotypes in Spain + Portugal were significant. A protective effect (OR: 0.6 95% CI: 0.43-0.96) was found in A carriers from Spain and Portugal. CONCLUSIONS Results suggest that A allele of rs4645878 could be a biomarker of high risk of developing PVR in patients undergoing RD surgery. The possible role of BCL-2 (inhibitor of necroptosis pathway) as a possible new target in PVR prophylaxis should be investigated.
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Affiliation(s)
- Salvador Pastor-Idoate
- Instituto de Oftalmobiología Aplicada (IOBA-Retina Group); University of Valladolid; Valladolid Spain
- Unidad de Medicina Molecular; Departamento de Medicina; University of Salamanca; Salamanca Spain
| | - Irene Rodríguez-Hernández
- Unidad de Medicina Molecular; Departamento de Medicina; University of Salamanca; Salamanca Spain
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC); Consejo Superior de Investigaciones Científicas (CSIC); Instituto de Investigación Biomédica de Salamanca (IBSAL); University of Salamanca; Salamanca Spain
| | - Jimena Rojas
- Instituto de Oftalmobiología Aplicada (IOBA-Retina Group); University of Valladolid; Valladolid Spain
| | - Itziar Fernández
- Instituto de Oftalmobiología Aplicada (IOBA-Retina Group); University of Valladolid; Valladolid Spain
| | | | | | - Amandio Rocha-Sousa
- Department of Sense Organs; Medical School; Hospital SanJoão; University of Porto; Porto Portugal
| | - Yashin D. Ramkissoon
- Moorfields Eye Hospital; National Institute of Health Research (NIHR); Biomedical Research Centre; London UK
- Royal Hallamshire Hospital; University of Sheffield; Sheffield UK
| | - Steven Harsum
- Moorfields Eye Hospital; National Institute of Health Research (NIHR); Biomedical Research Centre; London UK
| | - Robert E. MacLaren
- Moorfields Eye Hospital; National Institute of Health Research (NIHR); Biomedical Research Centre; London UK
- Nuffield Laboratory of Ophthalmology; John Radcliffe Hospital; University of Oxford; Oxford UK
| | - David G. Charteris
- Moorfields Eye Hospital; National Institute of Health Research (NIHR); Biomedical Research Centre; London UK
| | - Jan C. Van Meurs
- Rotterdam Eye Hospital; Erasmus Medical Center; University of Rotterdam; Rotterdam The Netherlands
| | - Rogelio González-Sarmiento
- Unidad de Medicina Molecular; Departamento de Medicina; University of Salamanca; Salamanca Spain
- Instituto de Biología Molecular y Celular del Cáncer (IBMCC); Consejo Superior de Investigaciones Científicas (CSIC); Instituto de Investigación Biomédica de Salamanca (IBSAL); University of Salamanca; Salamanca Spain
| | - Jose C. Pastor
- Instituto de Oftalmobiología Aplicada (IOBA-Retina Group); University of Valladolid; Valladolid Spain
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He S, Barron E, Ishikawa K, Nazari Khanamiri H, Spee C, Zhou P, Kase S, Wang Z, Dustin LD, Hinton DR. Inhibition of DNA Methylation and Methyl-CpG-Binding Protein 2 Suppresses RPE Transdifferentiation: Relevance to Proliferative Vitreoretinopathy. Invest Ophthalmol Vis Sci 2015; 56:5579-89. [PMID: 26305530 DOI: 10.1167/iovs.14-16258] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate expression of methyl-CpG-binding protein 2 (MeCP2) in epiretinal membranes from patients with proliferative vitreoretinopathy (PVR) and to investigate effects of inhibition of MeCP2 and DNA methylation on transforming growth factor (TGF)-β-induced retinal pigment epithelial (RPE) cell transdifferentiation. METHODS Expression of MeCP2 and its colocalization with cytokeratin and α-smooth muscle actin (α-SMA) in surgically excised PVR membranes was studied using immunohistochemistry. The effects of 5-AZA-2'-deoxycytidine (5-AZA-dC) on human RPE cell migration and viability were evaluated using a modified Boyden chamber assay and the colorimetric 3-(4,5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay. Expression of RASAL1 mRNA and its promoter region methylation were evaluated by real-time PCR and methylation-specific PCR. Effects of 5-AZA-dC on expression of α-SMA, fibronectin (FN), and TGF-β receptor 2 (TGF-β R2) and Smad2/3 phosphorylation were analyzed by Western blotting. Effect of short interfering RNA (siRNA) knock-down of MeCP2 on expression of α-SMA and FN induced by TGFβ was determined. RESULTS MeCP2 was abundantly expressed in cells within PVR membranes where it was double labeled with cells positive for cytokeratin and α-SMA. 5-AZA-dC inhibited expression of MeCP2 and suppressed RASAL1 gene methylation while increasing expression of the RASAL1 gene. Treatment with 5-AZA-dC significantly suppressed the expression of α-SMA, FN, TGF-β R2 and phosphorylation of Smad2/3 and inhibited RPE cell migration. TGF-β induced expression of α-SMA, and FN was suppressed by knock-down of MeCP2. CONCLUSIONS MeCP2 and DNA methylation regulate RPE transdifferentiation and may be involved in the pathogenesis of PVR.
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Affiliation(s)
- Shikun He
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States 2Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California, Unit
| | - Ernesto Barron
- Doheny Eye Institute, Los Angeles, California, United States
| | | | - Hossein Nazari Khanamiri
- Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States
| | - Chris Spee
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States
| | - Peng Zhou
- Doheny Eye Institute, Los Angeles, California, United States
| | - Satoru Kase
- Doheny Eye Institute, Los Angeles, California, United States
| | - Zhuoshi Wang
- Doheny Eye Institute, Los Angeles, California, United States
| | - Laurie Diane Dustin
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States
| | - David R Hinton
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States 2Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California, Unit
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Du ZD, Hu LT, Zhao GQ, Wang Q, Xu Q, Jiang N, Lin J. Protein tyrosine phosphatase 1B regulates migration of ARPE-19 cells through EGFR/ERK signaling pathway. Int J Ophthalmol 2015; 8:891-7. [PMID: 26558197 DOI: 10.3980/j.issn.2222-3959.2015.05.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 03/03/2015] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate whether protein tyrosine phosphatase 1B (PTP1B) contributed to initiate human retinal pigment epithelium cells (A)-19 migration and investigate the signaling pathways involved in this process. METHODS ARPE-19 cells were cultured and treated with the siRNA-PTP1B. Expression of PTP1B was confirmed by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). AG1478 [a selective inhibitor of epidermal growth factor receptor (EGFR)] and PD98059 (a specific inhibitor of the activation of mitogen-activated protein kinase) were used to help to determine the PTP1B signaling mechanism. Western blot analysis verified expression of EGFR and extracellular signal-regulated kinase (ERK) in ARPE-19 cells. The effect of siRNA-PTP1B on cell differentiation was confirmed by immunostaining for α-smooth muscle actin (α-SMA) and qRT-PCR. Cell migration ability was analyzed by transwell chamber assay. RESULTS The mRNA levels of PTP1B were reduced by siRNA-PTP1B as determined by qRT-PCR assay. SiRNA-PTP1B activated EGFR and ERK phosphorylation. α-SMA staining and qRT-PCR assay demonstrated that siRNA-PTP1B induced retinal pigment epithelium (RPE) cells to differentiate toward better contractility and motility. Transwell chamber assay proved that PTP1B inhibition improved migration activity of RPE cells. Treatment with AG1478 and PD98059 abolished siRNA-PTP1B-induced activation of EGFR and ERK, α-SMA expression and cell migration. CONCLUSION PTP1B inhibition promoted myofibroblast differentiation and migration of ARPE-19 cells, and EGFR/ERK signaling pathway played important role in migration process.
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Affiliation(s)
- Zhao-Dong Du
- Department of Ophthalmology, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Li-Ting Hu
- Department of Ophthalmology, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Gui-Qiu Zhao
- Department of Ophthalmology, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Qian Wang
- Department of Ophthalmology, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Qiang Xu
- Department of Ophthalmology, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Nan Jiang
- Department of Ophthalmology, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Jing Lin
- Department of Ophthalmology, Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
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Symeonidis C, Androudi S, Georgalas I, Tzamalis A, Chalvatzis N, Rotsos T, Souliou E, Diza E, Dimitrakos SA. Chemokine CXCL-1: activity in the vitreous during proliferative vitreoretinopathy. Clin Exp Immunol 2015; 181:338-42. [PMID: 25766782 DOI: 10.1111/cei.12627] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 03/01/2015] [Accepted: 03/10/2015] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to investigate CXCL-1 chemokine levels in the vitreous during rhegmatogenous retinal detachment (RRD) with and without proliferative vitreoretinopathy (PVR) and identify possible correlations with clinical parameters (extent and duration or RRD and PVR grade). Vitreous samples from patients with primary RRD with or without PVR were collected and assayed using a double antibody enzyme-linked immunosorbent assay (ELISA). Eleven vitreous samples from organ donors were employed as a control group. CXCL-1 levels were measured in 35 vitreous samples from 35 RRD patients. Mean CXCL-1 levels (64·82 ± 6·47 pg/ml) were significantly higher (P = 0·048) compared to controls. There was a significant positive correlation between CXCL-1 levels and the extent of the detachment (r = 0·794, P = 0·006). Peak CXCL-1 levels coincided with 3+ quadrant RRD, an interim of 29-60 days' duration and PVR grade B. Increased CXCL-1 levels may be indicative of mild inflammation in the detached retina and the adjacent vitreous. The results of the present study may provide novel insight into the complex interactions taking place during the early and late stages of RRD complicated by PVR.
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Affiliation(s)
- C Symeonidis
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 'Papageorgiou' General Hospital, Thessaloniki, Macedonia
| | - S Androudi
- Department of Ophthalmology, University of Thessaly, University Hospital, Larissa, Thessaly
| | - I Georgalas
- Department of Ophthalmology, School of Medicine, University of Athens, 'G. Gennimatas' Hospital, Athens
| | - A Tzamalis
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 'Papageorgiou' General Hospital, Thessaloniki, Macedonia
| | - N Chalvatzis
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 'Papageorgiou' General Hospital, Thessaloniki, Macedonia
| | - T Rotsos
- Department of Ophthalmology, School of Medicine, University of Athens, 'G. Gennimatas' Hospital, Athens
| | - E Souliou
- Department of Microbiology, School of Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - E Diza
- Department of Microbiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - S A Dimitrakos
- Department of Ophthalmology, School of Medicine, Aristotle University of Thessaloniki, 'Papageorgiou' General Hospital, Thessaloniki, Macedonia
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Su X, Tan MJ, Li Z, Wong M, Rajamani L, Lingam G, Loh XJ. Recent Progress in Using Biomaterials as Vitreous Substitutes. Biomacromolecules 2015; 16:3093-102. [PMID: 26366887 DOI: 10.1021/acs.biomac.5b01091] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Vitreous substitutes are crucial adjuncts during vitreo-retinal surgery for retinal diseases such as complicated retinal detachment, macular holes, complications of diabetic retinopathy, and ocular trauma involving posterior segment. In retinal detachment surgery, an internal tamponade agent is required to provide internal pressure for reattachment of the detached neurosensory retina. Current available options serve only as a temporary surgical adduct or short-term solution and are associated with inherent problems. Despite many years of intensive research, an ideal vitreous substitute remains elusive. Indeed, the development of an ideal vitreous substitute requires the concerted efforts of synthetic chemists and biomaterial engineers, as well as ophthalmic surgeons. In this review, we propose that polymeric hydrogels present the future of artificial vitreous substitutes due to its high water composition, optical transparency, and rheological properties that closely mimic the natural vitreous. In particular, thermosensitive smart hydrogels, with reversible sol to gel change, have emerged as the material class with the most potential to succeed as ideal vitreous substitutes, facilitating easy implementation during surgery. Importantly, these smart hydrogels also display potential as efficacious drug delivery systems.
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Affiliation(s)
- Xinyi Su
- Department of Ophthalmology, National University Hospital , 1E Kent Ridge Road, NUHS Tower Block, Level 7, Singapore 119228, Singapore.,Singapore Eye Research Institute , 11 Third Hospital Avenue, Singapore 168751, Singapore
| | - Mein Jin Tan
- Institute of Materials Research and Engineering (IMRE), A*STAR , 3 Research Link, Singapore 117602, Singapore
| | - Zibiao Li
- Institute of Materials Research and Engineering (IMRE), A*STAR , 3 Research Link, Singapore 117602, Singapore
| | - Meihua Wong
- Department of Ophthalmology, National University Hospital , 1E Kent Ridge Road, NUHS Tower Block, Level 7, Singapore 119228, Singapore
| | | | - Gopal Lingam
- Department of Ophthalmology, National University Hospital , 1E Kent Ridge Road, NUHS Tower Block, Level 7, Singapore 119228, Singapore
| | - Xian Jun Loh
- Institute of Materials Research and Engineering (IMRE), A*STAR , 3 Research Link, Singapore 117602, Singapore.,Department of Materials Science and Engineering, National University of Singapore , 9 Engineering Drive 1, Singapore 117576, Singapore.,Singapore Eye Research Institute , 11 Third Hospital Avenue, Singapore 168751, Singapore
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Pastor JC, Rojas J, Pastor-Idoate S, Di Lauro S, Gonzalez-Buendia L, Delgado-Tirado S. Proliferative vitreoretinopathy: A new concept of disease pathogenesis and practical consequences. Prog Retin Eye Res 2015. [PMID: 26209346 DOI: 10.1016/j.preteyeres.2015.07.005] [Citation(s) in RCA: 217] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
During the last four decades, proliferative vitreoretinopathy (PVR) has defied the efforts of many researchers to prevent its occurrence or development. Thus, PVR is still the major complication following retinal detachment (RD) surgery and a bottle-neck for advances in cell therapy that require intraocular surgery. In this review we tried to combine basic and clinical knowledge, as an example of translational research, providing new and practical information for clinicians. PVR was defined as the proliferation of cells after RD. This idea was used for classifying PVR and also for designing experimental models used for testing many drugs, none of which were successful in humans. We summarize current information regarding the pathogenic events that follow any RD because this information may be the key for understanding and treating the earliest stages of PVR. A major focus is made on the intraretinal changes derived mainly from retinal glial cell reactivity. These responses can lead to intraretinal PVR, an entity that has not been clearly recognized. Inflammation is one of the major components of PVR, and we describe new genetic biomarkers that have the potential to predict its development. New treatment approaches are analyzed, especially those directed towards neuroprotection, which can also be useful for preventing visual loss after any RD. We also summarize the results of different surgical techniques and clinical information that is oriented toward the identification of high risk patients. Finally, we provide some recommendations for future classification of PVR and for designing comparable protocols for testing new drugs or techniques.
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Affiliation(s)
- J Carlos Pastor
- Retina Group, IOBA (Eye Institute), University of Valladolid, Valladolid, Spain; Department of Ophthalmology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain.
| | - Jimena Rojas
- Retina Group, IOBA (Eye Institute), University of Valladolid, Valladolid, Spain; Department of Ophthalmology, Hospital Universitario Austral, Universidad Austral, Buenos Aires, Argentina
| | - Salvador Pastor-Idoate
- Retina Group, IOBA (Eye Institute), University of Valladolid, Valladolid, Spain; Manchester Royal Eye Hospital, Manchester Vision Regeneration (MVR) Lab at NIHR/Wellcome Trust, Manchester, United Kingdom
| | - Salvatore Di Lauro
- Retina Group, IOBA (Eye Institute), University of Valladolid, Valladolid, Spain; Department of Ophthalmology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | - Lucia Gonzalez-Buendia
- Retina Group, IOBA (Eye Institute), University of Valladolid, Valladolid, Spain; Department of Ophthalmology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | - Santiago Delgado-Tirado
- Retina Group, IOBA (Eye Institute), University of Valladolid, Valladolid, Spain; Department of Ophthalmology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain
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131
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Abstract
BACKGROUND Proliferative vitreoretinopathy (PVR) remains the most significant obstacle to successful retinal reattachment surgery. Preclinical studies continue to add insights into the complex molecular events leading to PVR development, helping to identify new targets for potential prophylactic or therapeutic agents. This article reviews the recent evidence supporting surgical and medical treatments for PVR. METHODS PUBMED was used for literature search. Clinical studies regarding surgical management of PVR from January 1, 2000 to August 1, 2014 were included. Clinical studies regarding medical management of PVR from January 1, 2000 to August 1, 2014 were included if the design of study was a randomized controlled trial. RESULTS Many recent studies have evaluated surgical and medical strategies for the treatment and prevention of PVR. Newer vitreoretinal surgery technology (23- and 25-gauge vitrectomy) and tamponade agents (heavy silicone oils) have been studied. Medical therapies evaluated include antiinflammatory agents, low molecular weight heparin, 5-fluorouracil, 13-cis-retinoic acid, and daunorubicin, amongst others. CONCLUSION Surgical management with pars plana vitrectomy, with or without scleral buckle or inferior retinectomy, remains an effective treatment for PVR-related detachments. Consensus regarding a preferred surgical strategy remains controversial. Many medical therapies have been studied but fail to demonstrate a statistically significant benefit in clinical trials. Further studies to clarify the efficacy of available and novel treatment options are warranted.
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132
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Khoroshilova-Maslova IP, Leparskaya NL, Nabieva MM, Andreeva LD. Experimental Modeling of Proliferative Vitreoretinopathy. An Experimental Morphological Study. Bull Exp Biol Med 2015; 159:100-2. [PMID: 26033599 DOI: 10.1007/s10517-015-2900-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Indexed: 11/30/2022]
Abstract
A model of proliferative vitreoretinopathy induced by simultaneous intravitreal injection of recombinant IL-1β and platelet concentrate is created and its main morphological manifestations are studied on Chinchilla rabbits. The model reflects pathogenesis of proliferative vitreoretinopathy: epiretinal membrane with the formation of retinal plication, traction detachment of the retina; moderate inflammatory reaction in the uveal tract, in the optic nerve infundibulum, in the vitreous body; intact structural elements of the retina, dissociation of the retinal pigmented epithelium cells with their subsequent migration. The model is adequate to the clinical picture of proliferative vitreoretinopathy in humans, which recommends it for experimental studies of the efficiency of drug therapy and prevention of this disease.
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Affiliation(s)
- I P Khoroshilova-Maslova
- Helmholtz Moscow Research Institute of Ocular Diseases, Ministry of Health of the Russian Federation, Moscow, Russia
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133
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Aqueous and alcoholic extracts of Triphala and their active compounds chebulagic acid and chebulinic acid prevented epithelial to mesenchymal transition in retinal pigment epithelial cells, by inhibiting SMAD-3 phosphorylation. PLoS One 2015; 10:e0120512. [PMID: 25793924 PMCID: PMC4368423 DOI: 10.1371/journal.pone.0120512] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 02/06/2015] [Indexed: 11/24/2022] Open
Abstract
Epithelial to Mesenchymal Transition (EMT) of the retinal pigment epithelium is involved in the pathogenesis of proliferative vitreoretinopathy (PVR) that often leads to retinal detachment. In this study, Triphala, an ayurvedic formulation and two of its active ingredients, namely chebulagic acid and chebulinic acid were evaluated for anti-EMT properties based on in vitro experiments in human retinal pigment epithelial cell line (ARPE-19) under TGFβ1 induced conditions. ARPE-19 cells were treated with TGFβ1 alone or co-treated with various concentrations of aqueous extract (AqE) (30 - 300 μg/ml); alcoholic extract (AlE) (50 - 500 μg/ml) of triphala and the active principles chebulagic acid (CA) and chebulinic acid (CI) (CA,CI: 50 - 200 μM). The expression of EMT markers namely MMP-2, αSMA, vimentin and the tight junction protein ZO-1 were evaluated by qPCR, western blot and immunofluorescence. The functional implications of EMT, namely migration and proliferation of cells were assessed by proliferation assay, scratch assay and transwell migration assay. AqE, AlE, CA and CI reduced the expression and activity of MMP-2 at an ED50 value of 100 μg/ml, 50 μg/ml, 100 μM and 100 μM, respectively. At these concentrations, a significant down-regulation of the expression of αSMA, vimentin and up-regulation of the expression of ZO-1 altered by TGFβ1 were observed. These concentrations also inhibited proliferation and migration of ARPE-19 cells induced by TGFβ1. EMT was found to be induced in ARPE-19 cells, through SMAD-3 phosphorylation and it was inhibited by AqE, AlE, CA and CI. Further studies in experimental animals are required to attribute therapeutic potential of these extracts and their active compounds, as an adjuvant therapy in the disease management of PVR.
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134
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Choi AY, Yeo Y, Kim YC. Phacovitrectomy versus Phacoemulsification after Vitrectomy for Rhegmatogenous Retinal Detachment Repair. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2015. [DOI: 10.3341/jkos.2015.56.3.357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- A Young Choi
- Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Youngdo Yeo
- Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Yu Cheol Kim
- Department of Ophthalmology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
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135
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Yasin MN, Svirskis D, Seyfoddin A, Rupenthal ID. Implants for drug delivery to the posterior segment of the eye: A focus on stimuli-responsive and tunable release systems. J Control Release 2014; 196:208-21. [DOI: 10.1016/j.jconrel.2014.09.030] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2014] [Revised: 09/28/2014] [Accepted: 09/30/2014] [Indexed: 12/21/2022]
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136
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Tuuminen R, Haukka J, Loukovaara S. Statins in rhegmatogenous retinal detachment are associated with low intravitreal angiopoietin-2, VEGF and MMP-2 levels, and improved visual acuity gain in vitrectomized patients. Graefes Arch Clin Exp Ophthalmol 2014; 253:1685-93. [PMID: 25432094 DOI: 10.1007/s00417-014-2873-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/22/2014] [Accepted: 11/19/2014] [Indexed: 01/08/2023] Open
Abstract
PURPOSE In rhegmatogenous retinal detachment (RRD), intravitreal growth factors and cytokines may compromise post-vitrectomy outcomes. Here, we analysed perioperative intravitreal protein levels of potent vasoactive, pro-inflammatory, and extracellular matrix-remodelling factors in RRD eyes of patients treated with statins and evaluated post-vitrectomy outcome in the same study eyes. METHODS Institutional, retrospective, observational study of 14 patients operated on for RRD while on statins compared to patients without statin medication (n = 82). Vitreous samples were subjected to protein measurements of angiopoietin (ANGPT)-1 and -2, transforming growth factor-β1, and vascular endothelial growth factor (VEGF) by ELISA, and of matrix metalloproteinase (MMP)-2 and -9 by gelatin zymography. A 1-month best-corrected visual acuity (BCVA) gain was modelled by Student's T-test and multivariate linear regression with concomitant perioperative medication. Cumulative 12-month revitrectomy frequency was modelled by Kaplan-Meier log-rank test. RESULTS Intravitreal levels of ANGPT-2 (49.2 ± 33.1 vs. 112.8 ± 134.1 pg/ml, mean ± SD, p < 0.001), VEGF (2.3 ± 2.4 vs. 17.7 ± 57.8 pg/ml, p = 0.021), and MMP-2 (1107.1 ± 884.6 vs 1976.4 ± 970.1 AU/ml, p = 0.005) in RRD eyes of patients treated with statins were lower than in non-statin-treated controls. Patients on statins had better 1-month BCVA improvement than did those not on statins (p = 0.022), with no difference in 1-year re-vitrectomy rates. CONCLUSIONS Intravitreal levels of ANGPT-2, VEGF, factors involved in vascular permeability and inflammation, and activity of MMP-2, the factor connected with breakdown of basement membrane and fibroproliferation, were lower in RRD eyes of patients with statin treatment. At 1-month, postoperative BCVA gain was improved in statin-treated RRD eyes, suggesting that statin administration may be effective in preventing inflammation-related PVR formation.
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Affiliation(s)
- Raimo Tuuminen
- Department of Ophthalmology, Helsinki University Central Hospital, Haartmaninkatu 4 C, FI-00290, Helsinki, Finland
| | - Jari Haukka
- Hjelt Institute, Faculty of Medicine, University of Helsinki, Haartmaninkatu 4 C, FI-00290, Helsinki, Finland
| | - Sirpa Loukovaara
- Unit of Vitreoretinal Surgery, Department of Ophthalmology, Helsinki University Central Hospital, Haartmaninkatu 4 C, FI-00290, Helsinki, Finland.
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Chiquet C, Rouberol F. Prolifération vitréo-rétinienne : traitement préventif. J Fr Ophtalmol 2014; 37:737-43. [DOI: 10.1016/j.jfo.2014.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 10/25/2022]
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138
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Prolifération vitréo-rétinienne : traitement curatif. J Fr Ophtalmol 2014; 37:653-9. [DOI: 10.1016/j.jfo.2014.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 04/23/2014] [Accepted: 04/23/2014] [Indexed: 11/19/2022]
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139
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Tosi GM, Marigliani D, Romeo N, Toti P. Disease pathways in proliferative vitreoretinopathy: an ongoing challenge. J Cell Physiol 2014; 229:1577-83. [PMID: 24604697 DOI: 10.1002/jcp.24606] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 01/16/2014] [Indexed: 11/08/2022]
Abstract
Despite remarkable advances in vitreoretinal surgery, proliferative vitreoretinopathy (PVR) remains a common cause of severe visual loss or blindness. One of the critical reasons for PVR-induced blindness is tractional retinal detachment due to the formation of contractile preretinal fibrous membranes. This membrane formation is characterized by the proliferation and migration of cells and the excessive synthesis and deposition of extracellular matrix proteins. Herein we present the disease pathways of PVR, reviewing the role of both systemic and intraocular cells as well as molecular mediators. A chronological sequence of events leading to PVR is also hypothesized. Better understanding of the pathogenesis of PVR is needed in order to improve disease management. Efforts should be oriented towards greater cooperation between basic researchers and clinicians, aimed at matching the different clinical scenarios with the biological markers of the disease.
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Affiliation(s)
- Gian Marco Tosi
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
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140
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Su CC, Chan CM, Chen HM, Wu CC, Hsiao CY, Lee PL, Lin VCH, Hung CF. Lutein inhibits the migration of retinal pigment epithelial cells via cytosolic and mitochondrial Akt pathways (lutein inhibits RPE cells migration). Int J Mol Sci 2014; 15:13755-67. [PMID: 25110866 PMCID: PMC4159823 DOI: 10.3390/ijms150813755] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 07/16/2014] [Accepted: 07/25/2014] [Indexed: 11/17/2022] Open
Abstract
During the course of proliferative vitreoretinopathy (PVR), the retinal pigment epithelium (RPE) cells will de-differentiate, proliferate, and migrate onto the surfaces of the sensory retina. Several studies have shown that platelet-derived growth factor (PDGF) can induce migration of RPE cells via an Akt-related pathway. In this study, the effect of lutein on PDGF-BB-induced RPE cells migration was examined using transwell migration assays and Western blot analyses. We found that both phosphorylation of Akt and mitochondrial translocation of Akt in RPE cells induced by PDGF-BB stimulation were suppressed by lutein. Furthermore, the increased migration observed in RPE cells with overexpressed mitochondrial Akt could also be suppressed by lutein. Our results demonstrate that lutein can inhibit PDGF-BB induced RPE cells migration through the inhibition of both cytoplasmic and mitochondrial Akt activation.
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Affiliation(s)
- Ching-Chieh Su
- Graduate Institute of Applied Science and Engineering, Fu Jen Catholic University,New Taipei City 24205, Taiwan.
| | - Chi-Ming Chan
- School of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan.
| | - Han-Min Chen
- Graduate Institute of Applied Science and Engineering, Fu Jen Catholic University,New Taipei City 24205, Taiwan.
| | - Chia-Chun Wu
- Department of Life Sciences, Fu Jen Catholic University, New Taipei City 24205, Taiwan.
| | - Chien-Yu Hsiao
- Department of Nutrition and Health Science, Chang Guang University of Science and Technology,Taoyuan 33303, Taiwan.
| | - Pei-Lan Lee
- Slone Epidemiology Center, Boston University, Boston, Massachusetts, United States of America,Boston, MA 02215, USA.
| | - Victor Chia-Hsiang Lin
- Graduate Institute of Applied Science and Engineering, Fu Jen Catholic University,New Taipei City 24205, Taiwan.
| | - Chi-Feng Hung
- School of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan.
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141
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Nan K, Ma F, Hou H, Freeman WR, Sailor MJ, Cheng L. Porous silicon oxide-PLGA composite microspheres for sustained ocular delivery of daunorubicin. Acta Biomater 2014; 10:3505-12. [PMID: 24793657 DOI: 10.1016/j.actbio.2014.04.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 03/23/2014] [Accepted: 04/22/2014] [Indexed: 01/09/2023]
Abstract
A water-soluble anthracycline antibiotic drug (daunorubicin, DNR) was loaded into oxidized porous silicon (pSiO2) microparticles and then encapsulated with a layer of polymer (poly lactide-co-glycolide, PLGA) to investigate their synergistic effects in control of DNR release. Similarly fabricated PLGA-DNR microspheres without pSiO2, and pSiO2 microparticles without PLGA were used as control particles. The composite microparticles synthesized by a solid-in-oil-in-water emulsion method have mean diameters of 52.33±16.37μm for PLGA-pSiO2_21/40-DNR and the mean diameter of 49.31±8.87μm for PLGA-pSiO2_6/20-DNR. The mean size, 26.00±8μm, of PLGA-DNR was significantly smaller, compared with the other two (P<0.0001). Optical microscopy revealed that PLGA-pSiO2-DNR microspheres contained multiple pSiO2 particles. In vitro release experiments determined that control PLGA-DNR microspheres completely released DNR within 38days and control pSiO2-DNR microparticles (with no PLGA coating) released DNR within 14days, while the PLGA-pSiO2-DNR microspheres released DNR for 74days. Temporal release profiles of DNR from PLGA-pSiO2 composite particles indicated that both PLGA and pSiO2 contribute to the sustained release of the payload. The PLGA-pSiO2 composite displayed a more constant rate of DNR release than the pSiO2 control formulation, and displayed a significantly slower release of DNR than either the PLGA or pSiO2 formulations. We conclude that this system may be useful in managing unwanted ocular proliferation when formulated with antiproliferation compounds such as DNR.
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142
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Rojas J, Fernandez I, Pastor JC, MacLaren RE, Ramkissoon Y, Harsum S, Charteris DG, Van Meurs JC, Amarakoon S, Garcia-Arumi J, Ruiz-Moreno JM, Rocha-Sousa A, Brion M, Carracedo A. Predicting proliferative vitreoretinopathy: temporal and external validation of models based on genetic and clinical variables. Br J Ophthalmol 2014; 99:41-8. [DOI: 10.1136/bjophthalmol-2014-305263] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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143
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Rouberol F, Chiquet C. [Proliferative vitreoretinopathy: pathophysiology and clinical diagnosis]. J Fr Ophtalmol 2014; 37:557-65. [PMID: 24997864 DOI: 10.1016/j.jfo.2014.04.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 12/24/2022]
Abstract
Proliferative vitreoretinopathy (PVR) remains one of the most common causes of failed retinal detachment (RD) surgery. Many histological and clinical studies have highlighted the chain of events leading to PVR: cellular migration into the vitreous cavity, cellular differentiation, myofibroblast proliferation and activation, synthesis of extracellular matrix proteins, then contraction of preretinal tissues. The development of PVR can be explained schematically by cellular exposure to growth factors and cytokines (particularly retinal pigment epithelial cells and glial cells), in the context of break-down of the blood-retinal barrier (inflammation, choroidal detachment, iatrogenic effect of cryotherapy and surgery) and of cellular contact with the vitreous. Although the pathophysiology of PVR is now better understood, its severity remains an issue. A systematic search for preoperative PVR risk factors allows the most suitable therapeutic option to be chosen.
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Affiliation(s)
- F Rouberol
- Centre d'ophtalmologie Kléber, 50, cours Franklin-Roosevelt, 69006 Lyon, France
| | - C Chiquet
- Clinique universitaire d'ophtalmologie, université J.-Fourier, CHU de Grenoble, CS 2017, 38043 Grenoble cedex 09, France.
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144
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Silicone oil: different physical proprieties and clinical applications. BIOMED RESEARCH INTERNATIONAL 2014; 2014:502143. [PMID: 25013785 PMCID: PMC4071776 DOI: 10.1155/2014/502143] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 05/18/2014] [Indexed: 01/31/2023]
Abstract
Silicone oils are important tools in vitreoretinal surgery because they have the ability to displace aqueous humor from the retinal surface, maintaining the adhesion between retina and retinal pigment epithelium. To understand this capability, it is important to know the silicone oil characteristics. Herein, we report first on the main chemical-physical proprieties and then we review the clinical applications of the current silicone oil which is lighter than water with particular reference to their indications with small gauge vitrectomy. Finally, we describe the surgical techniques to inject and remove this type of silicone oil. In the summary of this paper, we explain why silicone oils are today increasingly used and why their introduction has improved the prognosis of several retinal diseases. In fact, having different types of silicone oils allows us to choose the appropriate endotamponade for every single case.
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145
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Chiba C. The retinal pigment epithelium: An important player of retinal disorders and regeneration. Exp Eye Res 2014; 123:107-14. [DOI: 10.1016/j.exer.2013.07.009] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 07/06/2013] [Accepted: 07/08/2013] [Indexed: 12/28/2022]
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146
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Donati S, Caprani SM, Airaghi G, Vinciguerra R, Bartalena L, Testa F, Mariotti C, Porta G, Simonelli F, Azzolini C. Vitreous substitutes: the present and the future. BIOMED RESEARCH INTERNATIONAL 2014; 2014:351804. [PMID: 24877085 PMCID: PMC4024399 DOI: 10.1155/2014/351804] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/15/2014] [Accepted: 04/16/2014] [Indexed: 02/05/2023]
Abstract
Vitreoretinal surgery has advanced in numerous directions during recent years. The removal of the vitreous body is one of the main characteristics of this surgical procedure. Several molecules have been tested in the past to fill the vitreous cavity and to mimic its functions. We here review the currently available vitreous substitutes, focusing on their molecular properties and functions, together with their adverse effects. Afterwards we describe the characteristics of the ideal vitreous substitute. The challenges facing every ophthalmology researcher are to reach a long-term intraocular permanence of vitreous substitute with total inertness of the molecule injected and the control of inflammatory reactions. We report new polymers with gelification characteristics and smart hydrogels representing the future of vitreoretinal surgery. Finally, we describe the current studies on vitreous regeneration and cell cultures to create new intraocular gels with optimal biocompatibility and rheological properties.
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Affiliation(s)
- Simone Donati
- Department of Surgical and Morphological Sciences, Section of Ophthalmology, School of Medicine, University of Insubria, Via Guicciardini 9, 21100 Varese, Italy
| | - Simona Maria Caprani
- Department of Surgical and Morphological Sciences, Section of Ophthalmology, School of Medicine, University of Insubria, Via Guicciardini 9, 21100 Varese, Italy
| | - Giulia Airaghi
- Department of Surgical and Morphological Sciences, Section of Ophthalmology, School of Medicine, University of Insubria, Via Guicciardini 9, 21100 Varese, Italy
| | - Riccardo Vinciguerra
- Department of Surgical and Morphological Sciences, Section of Ophthalmology, School of Medicine, University of Insubria, Via Guicciardini 9, 21100 Varese, Italy
| | - Luigi Bartalena
- Endocrine Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Insubria, 21100 Varese, Italy
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Second University of Naples, 80121 Naples, Italy
| | - Cesare Mariotti
- Department of Ophthalmology, Polytechnic University of Ancona, 60121 Ancona, Italy
| | - Giovanni Porta
- Genetic Laboratory, Department of Surgical and Morphological Sciences, School of Medicine, University of Insubria, 21100 Varese, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, Second University of Naples, 80121 Naples, Italy
| | - Claudio Azzolini
- Department of Surgical and Morphological Sciences, Section of Ophthalmology, School of Medicine, University of Insubria, Via Guicciardini 9, 21100 Varese, Italy
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147
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Kim B, Abdel-Rahman MH, Wang T, Pouly S, Mahmoud AM, Cebulla CM. Retinal MMP-12, MMP-13, TIMP-1, and TIMP-2 expression in murine experimental retinal detachment. Invest Ophthalmol Vis Sci 2014; 55:2031-40. [PMID: 24526442 DOI: 10.1167/iovs.13-13374] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
PURPOSE Matrix metalloproteinases (MMPs) and their inhibitors play a role in the pathobiology of retinal detachment (RD) and proliferative vitreoretinopathy (PVR). Proliferative vitreoretinopathy is facilitated by chronic retinal detachment and involves excessive deposition of extracellular matrix (ECM) proteins. Matrix metalloproteinase-2 and -13 are important modulators of the ECM which have not been evaluated in RD. The purpose of this study was to investigate the retinal expression of select MMPs, including MMP-12, MMP-13, and associated inhibitors in a murine model of retinal detachment. METHODS Transient or chronic retinal detachments (RDs) were induced by subretinal injection of either saline (SA) or hyaluronic acid (HA) in C57BL/6 mice. To confirm that the HA-RD model has features consistent with PVR-like changes, glial activation and subretinal fibrosis were evaluated with immunofluorescence, dilated fundus examination, and spectral-domain optical coherence tomography (SD-OCT). Gene expression was quantified by qRT-PCR. Proteins were assayed by immunoblot and immunohistochemistry. RESULTS Hyaluronic acid RD eyes developed gliosis and subretinal fibrosis on dilated exam, SD-OCT, and immunofluorescence analysis. Gene expression of Mmp-12 and Mmp-13, and Timp-1 was strongly upregulated at all time points in RD compared with controls. Timp-2, Mmp-2, and Mmp-9 expression was modest. Hyaluronic acid RDs exhibited more MMP and TIMP expression than SA-RDs. MMP-12, -13, and TIMP-1 proteins were elevated in RDs compared with controls. Immunohistochemistry revealed moderate to strong MMP-13 levels in subretinal space macrophages. CONCLUSIONS Fibrosis can develop in the HA-RD model. There is an upregulation of select MMPs that may modulate the wound healing process following RD.
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Affiliation(s)
- Bongsu Kim
- Havener Eye Institute, Department of Ophthalmology and Visual Science, The Ohio State University, Columbus, Ohio, United States
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148
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Ghasemi Falavarjani K, Hashemi M, Modarres M, Hadavand Khani A. Intrasilicone oil injection of bevacizumab at the end of retinal reattachment surgery for severe proliferative vitreoretinopathy. Eye (Lond) 2014; 28:576-80. [PMID: 24556886 DOI: 10.1038/eye.2014.21] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 12/30/2013] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate the role of bevacizumab injected into the silicone oil at the end of retinal reattachment surgery for rhegmatogenous retinal detachment (RRD) associated with severe proliferative vitreoretinopathy (PVR) for prevention of postoperative PVR and compare the results with those without intrasilicone injection. METHODS In this prospective comparative interventional study, eyes with RRD with grade C PVR were included. Standard 20 gauge pars plana vitrectomy, and retinal reattachment was performed. In case group, 1.25 mg bevacizumab was injected into the silicone oil at the end of surgery. The rate of retinal redetachment associated with PVR was assessed. RESULTS In all 38 eyes of 38 patients (19 cases and 19 controls) with a mean age of 46.6 ± 18.3 years were studied. The two groups were matched for age, sex, preoperative visual acuity, presence of anterior and posterior PVR, extent of PVR, and history of previous retinal detachment surgery. Retinal redetachment with PVR occurred in nine (47.3%) and seven (36.8%) eyes in case and control groups, respectively (P=0.5). Extensive subretinal fibrous proliferations in addition to preretinal membranes occurred more in the case group (55.5 vs 14.3%). At final visit, visual acuity was similar between the two groups (1.6 ± 0.8 and 1.6 ± 0.6, respectively, P=0.9). CONCLUSION Intrasilicone injection of bevacizumab at the end of vitrectomy for RRD with severe PVR does not eliminate the risk of postoperative PVR.
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Affiliation(s)
- K Ghasemi Falavarjani
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M Hashemi
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - M Modarres
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - A Hadavand Khani
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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149
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External validation of existing formulas to predict the risk of developing proliferative vitreoretinopathy: the Retina 1 Project; report 5. Retina 2014; 33:1519-27. [PMID: 23594721 DOI: 10.1097/iae.0b013e31828991ea] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To externally validate the accuracy of previously published formulas for predicting proliferative vitreoretinopathy development after retinal detachment surgery. METHODS Clinical variables from consecutive retinal detachment patients (n = 1,047) were collected from the Retina 1 Project conducted in 17 Spanish and Portuguese centers. These data were used for external validation of four previously published formulas, F1 to F4. Receiver-operating characteristic curves were used to validate the quality of formulas, and measures of discrimination, precision, and calibration were calculated for each. Concordance among the formulas was determined by Cohen kappa index. RESULTS The areas under the receiver-operating characteristic curves were as follows: F1, 0.5809; F2, 0.5398; F3, 0.5964; and F4, 0.4617. F1 had the highest accuracy, 74.21%. Almost 19% of proliferative vitreoretinopathy cases were correctly classified by F1 compared with 13%, 15%, and 10% for F2, F3, and F4, respectively. There was moderate concordance between F2 and F3 but little between the other formulas. CONCLUSION After external validation, none of the formulas were accurate enough for routine clinical use. To increase its usefulness, other factors besides the clinical ones considered here should be incorporated into future formulas for predicting risk of developing proliferative vitreoretinopathy.
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150
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Feltgen N, Walter P. Rhegmatogenous retinal detachment--an ophthalmologic emergency. DEUTSCHES ARZTEBLATT INTERNATIONAL 2014; 111:12-21; quiz 22. [PMID: 24565273 PMCID: PMC3948016 DOI: 10.3238/arztebl.2014.0012] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/09/2013] [Accepted: 09/09/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND Rhegmatogenous retinal detachment is the most common retinological emergency threatening vision, with an incidence of 1 in 10 000 persons per year, corresponding to about 8000 new cases in Germany annually. Without treatment, blindness in the affected eye may result. METHOD Selective review of the literature. RESULTS Rhegmatogenous retinal detachment typically presents with the perception of light flashes, floaters, or a "dark curtain." In most cases, the retinal tear is a consequence of degeneration of the vitreous body. Epidemiologic studies have identified myopia and prior cataract surgery as the main risk factors. Persons in the sixth and seventh decades of life are most commonly affected. Rhegmatogenous retinal detachment is an emergency, and all patients should be seen by an ophthalmologist on the same day that symptoms arise. The treatment consists of scleral buckle, removal of the vitreous body (vitrectomy), or a combination of the two. Anatomical success rates are in the range of 85% to 90%. Vitrectomy is followed by lens opacification in more than 70% of cases. The earlier the patient is seen by an ophthalmologist, the greater the chance that the macula is still attached, so that visual acuity can be preserved. CONCLUSION Rhegmatogenous retinal detachment is among the main emergency indications in ophthalmology. In all such cases, an ophthalmologist must be consulted at once.
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