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Rodrigo MJ, Subías M, Montolío A, Méndez-Martínez S, Martínez-Rincón T, Arias L, García-Herranz D, Bravo-Osuna I, Garcia-Feijoo J, Pablo L, Cegoñino J, Herrero-Vanrell R, Carretero A, Ruberte J, Garcia-Martin E, Pérez del Palomar A. Analysis of Parainflammation in Chronic Glaucoma Using Vitreous-OCT Imaging. Biomedicines 2021; 9:biomedicines9121792. [PMID: 34944608 PMCID: PMC8698891 DOI: 10.3390/biomedicines9121792] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/22/2021] [Accepted: 11/25/2021] [Indexed: 11/25/2022] Open
Abstract
Glaucoma causes blindness due to the progressive death of retinal ganglion cells. The immune response chronically and subclinically mediates a homeostatic role. In current clinical practice, it is impossible to analyse neuroinflammation non-invasively. However, analysis of vitreous images using optical coherence tomography detects the immune response as hyperreflective opacities. This study monitors vitreous parainflammation in two animal models of glaucoma, comparing both healthy controls and sexes over six months. Computational analysis characterizes in vivo the hyperreflective opacities, identified histologically as hyalocyte-like Iba-1+ (microglial marker) cells. Glaucomatous eyes showed greater intensity and number of vitreous opacities as well as dynamic fluctuations in the percentage of activated cells (50–250 microns2) vs. non-activated cells (10–50 microns2), isolated cells (10 microns2) and complexes (>250 microns2). Smaller opacities (isolated cells) showed the highest mean intensity (intracellular machinery), were the most rounded at earlier stages (recruitment) and showed the greatest change in orientation (motility). Study of vitreous parainflammation could be a biomarker of glaucoma onset and progression.
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Affiliation(s)
- María Jesús Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (M.S.); (S.M.-M.); (T.M.-R.); (L.A.); (L.P.); (E.G.-M.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain;
- Correspondence: ; Tel.: +34-976765558; Fax: +34-976566234
| | - Manuel Subías
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (M.S.); (S.M.-M.); (T.M.-R.); (L.A.); (L.P.); (E.G.-M.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
| | - Alberto Montolío
- Biomaterials Group, Aragon Engineering Research Institute (I3A), University of Zaragoza, 50018 Zaragoza, Spain; (A.M.); (J.C.); (A.P.d.P.)
- Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain
| | - Silvia Méndez-Martínez
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (M.S.); (S.M.-M.); (T.M.-R.); (L.A.); (L.P.); (E.G.-M.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
| | - Teresa Martínez-Rincón
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (M.S.); (S.M.-M.); (T.M.-R.); (L.A.); (L.P.); (E.G.-M.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
| | - Lorena Arias
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (M.S.); (S.M.-M.); (T.M.-R.); (L.A.); (L.P.); (E.G.-M.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
| | - David García-Herranz
- Innovation, Therapy and Pharmaceutical Development in Ophthalmology (InnOftal) Research Group, UCM 920415, Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University of Madrid (UCM), 28040 Madrid, Spain;
- Health Research Institute of the San Carlos Clinical Hospital (IdISSC), 28040 Madrid, Spain
- University Institute of Industrial Pharmacy (IUFI), School of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Irene Bravo-Osuna
- University Institute of Industrial Pharmacy (IUFI), School of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Julian Garcia-Feijoo
- Department of Ophthalmology, San Carlos Clinical Hospital, UCM, 28040 Madrid, Spain;
| | - Luis Pablo
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (M.S.); (S.M.-M.); (T.M.-R.); (L.A.); (L.P.); (E.G.-M.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain;
| | - José Cegoñino
- Biomaterials Group, Aragon Engineering Research Institute (I3A), University of Zaragoza, 50018 Zaragoza, Spain; (A.M.); (J.C.); (A.P.d.P.)
- Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain
| | - Rocio Herrero-Vanrell
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain;
- University Institute of Industrial Pharmacy (IUFI), School of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Ana Carretero
- Centre for Animal Biotechnology and Gene Therapy (CBATEG), Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain; (A.C.); (J.R.)
- CIBER for Diabetes and Associated Metabolic Diseases (CIBERDEM), 28029 Madrid, Spain
- Department of Animal Health and Anatomy, School of Veterinary Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Jesus Ruberte
- Centre for Animal Biotechnology and Gene Therapy (CBATEG), Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain; (A.C.); (J.R.)
- CIBER for Diabetes and Associated Metabolic Diseases (CIBERDEM), 28029 Madrid, Spain
- Department of Animal Health and Anatomy, School of Veterinary Medicine, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Elena Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, 50009 Zaragoza, Spain; (M.S.); (S.M.-M.); (T.M.-R.); (L.A.); (L.P.); (E.G.-M.)
- Miguel Servet Ophthalmology Research Group (GIMSO), Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
- National Ocular Pathology Network (OFTARED), Carlos III Health Institute, 28040 Madrid, Spain;
| | - Amaya Pérez del Palomar
- Biomaterials Group, Aragon Engineering Research Institute (I3A), University of Zaragoza, 50018 Zaragoza, Spain; (A.M.); (J.C.); (A.P.d.P.)
- Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain
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Hayashi A, Ito Y, Takatsudo Y, Hara N, Gehlbach PL, Mori K. Posterior Vitreous Detachment in Normal Healthy Subjects Younger Than Age Twenty. Invest Ophthalmol Vis Sci 2021; 62:19. [PMID: 34677570 PMCID: PMC8543394 DOI: 10.1167/iovs.62.13.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 09/27/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose To describe the initiation of posterior vitreous detachment (PVD) in the eyes of normal individuals, under 20 years of age, using wide-angle optical coherence tomography (OCT). Methods This is an observational cross-sectional study. Montaged images of horizontal and vertical OCT scans were obtained in 63 healthy eyes of 35 consecutive subjects ranging in age from 4 to 17 years. Results Forty-five eyes (71.4%) had obvious PVD, defined as a contiguous line of posterior cortical vitreous separated from the surface of the retina. Eighteen eyes (28.6%) had no PVD. The mean age of the individuals without PVD was significantly younger than those with PVD (P = 0.008). The spatial distribution of PVD initiation was highest in the superior quadrants, with the nasal, inferior, septum papillomaculae, and temporal quadrants following in descending order of frequency (P < 0.001). PVD was observed to begin anterior to the premacular liquefied lacuna, where the vitreous gel directly adheres to the vitreoretinal interface. In the majority of subjects (80.6%), PVD was initiated anterior to the vascular arcades. Conclusions PVD can be observed by OCT to begin in the first and second decade of life. It begins in the mid-peripheral vitreous, most frequently in the superior quadrants anterior to the vascular arcades. In this study, all PVDs originated outside of the macular liquefied lacunae, where the vitreous gel adheres directly to the retina.
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Affiliation(s)
- Ayumi Hayashi
- Department of Ophthalmology, International University of Health and Welfare, Nasushiobara-shi, Tochigi, Japan
| | - Yoko Ito
- Department of Ophthalmology, International University of Health and Welfare, Nasushiobara-shi, Tochigi, Japan
| | - Yuki Takatsudo
- Department of Ophthalmology, International University of Health and Welfare, Nasushiobara-shi, Tochigi, Japan
| | - Naoto Hara
- Department of Ophthalmology, International University of Health and Welfare, Nasushiobara-shi, Tochigi, Japan
| | - Peter L. Gehlbach
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Keisuke Mori
- Department of Ophthalmology, International University of Health and Welfare, Nasushiobara-shi, Tochigi, Japan
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Monitoring New Long-Lasting Intravitreal Formulation for Glaucoma with Vitreous Images Using Optical Coherence Tomography. Pharmaceutics 2021; 13:pharmaceutics13020217. [PMID: 33562488 PMCID: PMC7915309 DOI: 10.3390/pharmaceutics13020217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 01/07/2023] Open
Abstract
Intravitreal injection is the gold standard therapeutic option for posterior segment pathologies, and long-lasting release is necessary to avoid reinjections. There is no effective intravitreal treatment for glaucoma or other optic neuropathies in daily practice, nor is there a non-invasive method to monitor drug levels in the vitreous. Here we show that a glaucoma treatment combining a hypotensive and neuroprotective intravitreal formulation (IF) of brimonidine–Laponite (BRI/LAP) can be monitored non-invasively using vitreoretinal interface imaging captured with optical coherence tomography (OCT) over 24 weeks of follow-up. Qualitative and quantitative characterisation was achieved by analysing the changes in vitreous (VIT) signal intensity, expressed as a ratio of retinal pigment epithelium (RPE) intensity. Vitreous hyperreflective aggregates mixed in the vitreous and tended to settle on the retinal surface. Relative intensity and aggregate size progressively decreased over 24 weeks in treated rat eyes as the BRI/LAP IF degraded. VIT/RPE relative intensity and total aggregate area correlated with brimonidine levels measured in the eye. The OCT-derived VIT/RPE relative intensity may be a useful and objective marker for non-invasive monitoring of BRI/LAP IF.
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Microfluidic and Microscale Assays to Examine Regenerative Strategies in the Neuro Retina. MICROMACHINES 2020; 11:mi11121089. [PMID: 33316971 PMCID: PMC7763644 DOI: 10.3390/mi11121089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 12/15/2022]
Abstract
Bioengineering systems have transformed scientific knowledge of cellular behaviors in the nervous system (NS) and pioneered innovative, regenerative therapies to treat adult neural disorders. Microscale systems with characteristic lengths of single to hundreds of microns have examined the development and specialized behaviors of numerous neuromuscular and neurosensory components of the NS. The visual system is comprised of the eye sensory organ and its connecting pathways to the visual cortex. Significant vision loss arises from dysfunction in the retina, the photosensitive tissue at the eye posterior that achieves phototransduction of light to form images in the brain. Retinal regenerative medicine has embraced microfluidic technologies to manipulate stem-like cells for transplantation therapies, where de/differentiated cells are introduced within adult tissue to replace dysfunctional or damaged neurons. Microfluidic systems coupled with stem cell biology and biomaterials have produced exciting advances to restore vision. The current article reviews contemporary microfluidic technologies and microfluidics-enhanced bioassays, developed to interrogate cellular responses to adult retinal cues. The focus is on applications of microfluidics and microscale assays within mammalian sensory retina, or neuro retina, comprised of five types of retinal neurons (photoreceptors, horizontal, bipolar, amacrine, retinal ganglion) and one neuroglia (Müller), but excludes the non-sensory, retinal pigmented epithelium.
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Sebag J. Vitreous and Vision Degrading Myodesopsia. Prog Retin Eye Res 2020; 79:100847. [PMID: 32151758 DOI: 10.1016/j.preteyeres.2020.100847] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 03/01/2020] [Accepted: 03/03/2020] [Indexed: 12/16/2022]
Abstract
Macromolecules comprise only 2% of vitreous, yet are responsible for its gel state, transparency, and physiologic function(s) within the eye. Myopia and aging alter collagen and hyaluronan association causing concurrent gel liquefaction and fibrous degeneration. The resulting vitreous opacities and collapse of the vitreous body during posterior vitreous detachment are the most common causes for the visual phenomenon of vitreous floaters. Previously considered innocuous, the vitreous opacities that cause floaters sometimes impact vision by profoundly degrading contrast sensitivity function and impairing quality-of-life. While many people adapt to vitreous floaters, clinically significant cases can be diagnosed with Vision Degrading Myodesopsia based upon echographic assessment of vitreous structure and by measuring contrast sensitivity function. Perhaps due to the ubiquity of floaters, the medical profession has to date largely ignored the plight of those with Vision Degrading Myodesopsia. Improved diagnostics will enable better disease staging and more accurate identification of severe cases that merit therapy. YAG laser treatments may occasionally be slightly effective, but vitrectomy is currently the definitive cure. Future developments will usher in more informative diagnostic approaches as well as safer and more effective therapeutic strategies. Improved laser treatments, new pharmacotherapies, and possibly non-invasive optical corrections are exciting new approaches to pursue. Ultimately, enhanced understanding of the underlying pathogenesis of Vision Degrading Myodesopsia should result in prevention, the ultimate goal of modern Medicine.
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Affiliation(s)
- J Sebag
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA; Doheny Eye Institute, Pasadena, CA, USA; Department of Ophthalmology, Geffen School of Medicine, University of California, Los Angeles, CA, USA.
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Zhang X, Tian X, Zhang B, Guo L, Li X, Jia Y. Study on the effectiveness and safety of Foldable Capsular Vitreous Body implantation. BMC Ophthalmol 2019; 19:260. [PMID: 31852464 PMCID: PMC6921415 DOI: 10.1186/s12886-019-1268-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 12/06/2019] [Indexed: 12/13/2022] Open
Abstract
Background Foldable capsular vitreous body (FCVB) was designed to treat severe retinal detachment. The aim of this study was to evaluate the efficacy and safety of the implantation of foldable capsular vitreous body in 1-year follow-up. Methods A retrospective analysis was conducted for 20 patients with severe ocular trauma or silicone oil (SO) dependent eyes underwent vitrectomy and FCVB implantation in a 1-year follow-up. All treated eyes were peformed clinical examinations involved the visual acuity (VA) examination, Goldmann applanation tonometer, noncontact specular microscopy, fundus photography, B-Scan examination and optical coherence tomography (OCT). The groups were compared with t-test and the McNemar - Bowker test. Results In 1-year follow-up, 20 eyes were evaluated in the study. FCVB well supported the vitreous retina in all treated eyes, and 6 treated eyes achieved retinal reattachment 12 months after FCVB implantation. There were no significant differences in VA before and after FCVB implantation (P = 1.000). In addition, the postoperative IOP markedly elevated from the preoperative IOP of 12.90 ± 7.06 mmHg to 15.15 ± 3.36 mmHg (P = 0.000017). The intraocular pressure (IOP) of 10 eyes maintained at a normal level after surgeries. The other 10 eyes showed slightly lower IOP within the acceptable level. Though two patients developed keratopathy and ocular inflammation respectively, other treated eyes were symmetric with fellow eyes showing satisfactory appearance. Moreover, there was no SO emulsification or leakage happened in the observation. Conclusions FCVB implantation was an effective and safe treatment in the eyes with severe retinal detachment.
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Affiliation(s)
- Xiangyang Zhang
- Xinxiang Medical University, Xinxiang, 453003, Henan Province, China.,The People's Liberation Army 988th Hospital (formerly the People's Liberation Army 153rd Hospital), No. 602 Zhengshang Road, Zhengzhou, 450000, Henan Province, China
| | - Xuemin Tian
- The People's Liberation Army 988th Hospital (formerly the People's Liberation Army 153rd Hospital), No. 602 Zhengshang Road, Zhengzhou, 450000, Henan Province, China.
| | - Baike Zhang
- The People's Liberation Army 988th Hospital (formerly the People's Liberation Army 153rd Hospital), No. 602 Zhengshang Road, Zhengzhou, 450000, Henan Province, China
| | - Lisa Guo
- The People's Liberation Army 988th Hospital (formerly the People's Liberation Army 153rd Hospital), No. 602 Zhengshang Road, Zhengzhou, 450000, Henan Province, China
| | - Xiaodan Li
- The People's Liberation Army 988th Hospital (formerly the People's Liberation Army 153rd Hospital), No. 602 Zhengshang Road, Zhengzhou, 450000, Henan Province, China
| | - Yong Jia
- The People's Liberation Army 988th Hospital (formerly the People's Liberation Army 153rd Hospital), No. 602 Zhengshang Road, Zhengzhou, 450000, Henan Province, China
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Muraoka Y, Uji A, Ishikura M, Iida Y, Ooto S, Tsujikawa A. Segmentation of the Four-Layered Retinal Vasculature Using High-Resolution Optical Coherence Tomography Angiography Reveals the Microcirculation Unit. Invest Ophthalmol Vis Sci 2019; 59:5847-5853. [PMID: 30535425 DOI: 10.1167/iovs.18-25301] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To differentiate the four layers of the retinal vessel network in the human macula and examine their morphologic features using high-resolution optical coherence tomography angiography (HR-OCTA). Methods Macular areas measuring 464 × 464 pixels of 10 right eyes of 10 healthy subjects without ocular disease were scanned 10 times using a HR-OCTA device. Averaged OCTA images were created. Based on clear decorrelation signals, four vascular slabs were segmented, comprising one each in the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and top and bottom of the inner nuclear layer (INL). Qualitative features and quantitative measurements in each slab were compared with those in conventionally segmented slabs. Results HR-OCTA isolated four layers of vascular plexuses in the macula that followed the corresponding anatomic layers. Segmentations for the RNFL revealed that radial peripapillary capillaries (RPCs) extended to the central macular area. The RPCs followed relatively straight and long paths, with few apparent feed points and anastomoses. The GCL slab enhanced visualization of the capillary-free zones around the arteries and arterioles and helped to differentiate arterial and venous systems. The arterioles and venules were linked by capillaries that were arranged in a mesh-like fashion, with multiple arteriolar feed points and anastomoses. Vascular plexuses in the top and bottom of the INL consisted of capillaries in a vortex arrangement. The center of these vortex arrangements was consistent with the venules in the GCL. Conclusions HR-OCTA can differentiate the four layers of vascular plexuses in the human macula and elucidate their angiographic features.
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Affiliation(s)
- Yuki Muraoka
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akihito Uji
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masaharu Ishikura
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuto Iida
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Sotaro Ooto
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Tsukahara M, Mori K, Gehlbach PL, Mori K. Posterior Vitreous Detachment as Observed by Wide-Angle OCT Imaging. Ophthalmology 2018; 125:1372-1383. [DOI: 10.1016/j.ophtha.2018.02.039] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 02/12/2018] [Accepted: 02/20/2018] [Indexed: 10/17/2022] Open
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Mahendradas P, Madhu S, Kawali A, Roy AS, Vala R, Vinekar A, Shetty R. Enhanced Vitreous Imaging in Uveitis. Ocul Immunol Inflamm 2017; 27:148-154. [DOI: 10.1080/09273948.2017.1360501] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Grzybowski A. Microarchitecture of the Vitreous Body: A High-Resolution Optical Coherence Tomography Study. Am J Ophthalmol 2016; 170:243-244. [PMID: 27546103 DOI: 10.1016/j.ajo.2016.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 06/14/2016] [Accepted: 06/15/2016] [Indexed: 11/16/2022]
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Uji A, Yoshimura N. Reply. Am J Ophthalmol 2016; 170:244. [PMID: 27561423 DOI: 10.1016/j.ajo.2016.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
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