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Channa R, Wolf RM, Simo R, Brigell M, Fort P, Curcio C, Lynch S, Verbraak F, Abramoff MD. A New Approach to Staging Diabetic Eye Disease: Staging of Diabetic Retinal Neurodegeneration and Diabetic Macular Edema. OPHTHALMOLOGY SCIENCE 2024; 4:100420. [PMID: 38284099 PMCID: PMC10818256 DOI: 10.1016/j.xops.2023.100420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/29/2023] [Accepted: 10/23/2023] [Indexed: 01/30/2024]
Abstract
Topic The goal of this review was to summarize the current level of evidence on biomarkers to quantify diabetic retinal neurodegeneration (DRN) and diabetic macular edema (DME). Clinical relevance With advances in retinal diagnostics, we have more data on patients with diabetes than ever before. However, the staging system for diabetic retinal disease is still based only on color fundus photographs and we do not have clear guidelines on how to incorporate data from the relatively newer modalities into clinical practice. Methods In this review, we use a Delphi process with experts to identify the most promising modalities to identify DRN and DME. These included microperimetry, full-field flash electroretinogram, spectral-domain OCT, adaptive optics, and OCT angiography. We then used a previously published method of determining the evidence level to complete detailed evidence grids for each modality. Results Our results showed that among the modalities evaluated, the level of evidence to quantify DRN and DME was highest for OCT (level 1) and lowest for adaptive optics (level 4). Conclusion For most of the modalities evaluated, prospective studies are needed to elucidate their role in the management and outcomes of diabetic retinal diseases. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Roomasa Channa
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
| | - Risa M. Wolf
- Department of Pediatric Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Rafael Simo
- Division of Endocrinology, Vall d’Hebron University Hospital, CIBERDEM, Barcelona, Spain
| | | | - Patrice Fort
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan
| | - Christine Curcio
- Department of Ophthalmology, University of Alabama, Birmingham, Alabama
| | | | - Frank Verbraak
- Department of Ophthalmology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Michael D. Abramoff
- Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, Iowa
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Günter A, Belhadj S, Seeliger MW, Mühlfriedel R. The Mongolian gerbil as an advanced model to study cone system physiology. Front Cell Neurosci 2024; 18:1339282. [PMID: 38333056 PMCID: PMC10850313 DOI: 10.3389/fncel.2024.1339282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/02/2024] [Indexed: 02/10/2024] Open
Abstract
In this work, we introduce a diurnal rodent, the Mongolian gerbil (Meriones unguiculatus) (MG) as an alternative to study retinal cone system physiology and pathophysiology in mice. The cone system is of particular importance, as it provides high-acuity and color vision and its impairment in retinal disorders is thus especially disabling. Despite their nocturnal lifestyle, mice are currently the most popular animals to study cone-related diseases due to the high availability of genetically modified models. However, the potential for successful translation of any cone-related results is limited due to the substantial differences in retinal organization between mice and humans. Alternatively, there are diurnal rodents such as the MG with a higher retinal proportion of cones and a macula-like specialized region for improved visual resolution, the visual streak. The focus of this work was the evaluation of the MG's cone system functionality using full-field electroretinography (ERG), together with a morphological assessment of its retinal/visual streak organization via angiography, optical coherence tomography (OCT), and photoreceptor immunohistochemistry. We found that rod system responses in MGs were comparable or slightly inferior to mice, while in contrast, cone system responses were much larger, more sensitive, and also faster than those in the murine counterparts, and in addition, it was possible to record sizeable ON and OFF ERG components. Morphologically, MG cone photoreceptor opsins were evenly distributed throughout the retina, while mice show a dorsoventral M- and S-opsin gradient. Additionally, each cone expressed a single opsin, in contrast to the typical co-expression of opsins in mice. Particular attention was given to the visual streak region, featuring a higher density of cones, elongated cone and rod outer segments (OSs), and an increased thickness of the inner and outer retinal layers in comparison to peripheral regions. In summary, our data render the MG a supreme model to investigate cone system physiology, pathophysiology, and to validate potential therapeutic strategies in that context.
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Affiliation(s)
- Alexander Günter
- Division of Ocular Neurodegeneration, Centre for Ophthalmology, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany
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Dellaa A, Mbarek S, Kahloun R, Dogui M, Khairallah M, Hammoum I, Rayana-Chekir NB, Charfeddine R, Lachapelle P, Chaouacha-Chekir RB. Functional alterations of retinal neurons and vascular involvement progress simultaneously in the Psammomys obesus model of diabetic retinopathy. J Comp Neurol 2021; 529:2620-2635. [PMID: 33474721 DOI: 10.1002/cne.25114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 01/05/2021] [Accepted: 01/08/2021] [Indexed: 11/11/2022]
Abstract
To investigate the progression of diabetic retinopathy (DR) in a new diurnal animal model, we monitored clinically the DR in Psammomys obesus (P. obesus) during 7 months using electroretinography (ERG) and imaging techniques. After the onset of DR, all ERG components decreased progressively. In scotopic conditions, by 3-months of disease progression, the diabetic P. obesus displayed a significant decrease in amplitude of b-max, b-wave responses, and mixed b-waves. While mixed a-wave decreased between 4 and 7 months. Significant differences of OP2 appeared following 1 month of disease. In photopic conditions, we noticed a decrease in the a-wave at 2 months, while it took more than 5 months in b-wave amplitude. The photopic negative response (PhNR) and the i-wave amplitudes decreased following 4 and 5 months. OP1 and OP2 were the first to be altered and a significant decrease in the amplitude started after 3 months. Finally, 30 Hz-flicker and photopic S-cone were impaired after 2 and 3 months, respectively. The assessment of the eye fundus of the retina revealed an abnormal vascular architecture appeared at Months 6 and 7. In addition, we noticed exudates in the superior periphery of the retina at the same stage. The retina thickness showed a significant reduction at Month 7. Our results indicate that the clinical correlates of human DR are present in diabetic P. obesus. The depressed of ERGs, disruption of retinal architecture, and the appearance of exudates may reflect vascular and neuronal damage throughout the retina as are seen in the advanced stages of human DR.
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Affiliation(s)
- Ahmed Dellaa
- Laboratory of Physiopathology, Food and Biomolecules, Higher Institute of Biotechnology of Sidi Thabet, BiotechPole Sidi Thabet, University of Manouba, Tunisia
| | - Sihem Mbarek
- Laboratory of Physiopathology, Food and Biomolecules, Higher Institute of Biotechnology of Sidi Thabet, BiotechPole Sidi Thabet, University of Manouba, Tunisia
| | - Rim Kahloun
- Department of Ophthalmology, Hospital of Fattouma Bourguiba, Monastir, Tunisia
| | - Mohamed Dogui
- Department of Functional Explorations of the Nervous System, Hospital of Sahloul, Sousse, Tunisia
| | - Moncef Khairallah
- Department of Ophthalmology, Hospital of Fattouma Bourguiba, Monastir, Tunisia
| | - Imane Hammoum
- Laboratory of Physiopathology, Food and Biomolecules, Higher Institute of Biotechnology of Sidi Thabet, BiotechPole Sidi Thabet, University of Manouba, Tunisia
| | - Narjess Ben Rayana-Chekir
- Les Ophtalmologistes Associés de Sousse, Résidence Médicale Essalem, Place du Maghreb Arabe-Sousse, Tunisia
| | | | - Pierre Lachapelle
- Department of Ophthalmology, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Rafika Ben Chaouacha-Chekir
- Laboratory of Physiopathology, Food and Biomolecules, Higher Institute of Biotechnology of Sidi Thabet, BiotechPole Sidi Thabet, University of Manouba, Tunisia
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Kim K, Kim ES, Kim DG, Yu SY. Progressive retinal neurodegeneration and microvascular change in diabetic retinopathy: longitudinal study using OCT angiography. Acta Diabetol 2019; 56:1275-1282. [PMID: 31401734 DOI: 10.1007/s00592-019-01395-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 07/29/2019] [Indexed: 01/08/2023]
Abstract
AIMS To investigate the association between progressive macular ganglion cell/inner plexiform layer (mGCIPL) thinning and change of optical coherence tomography angiography (OCTA)-derived microvascular parameters in early-stage diabetic retinopathy (DR). METHODS A retrospective cohort study involved 40 eyes presenting with no DR or mild non-proliferative DR at baseline, and 30 healthy controls were included. All participants underwent spectral-domain OCT and OCTA at baseline and at 6, 12, 18, and 24 months. Change of mGCIPL thickness and OCTA metrics including foveal avascular zone (FAZ) area and FAZ circularity, vessel density (VD), and perfusion index (PI) was measured. Correlations between mGCIPL thickness and OCTA metrics were explored using regression models. RESULTS Average progressive mGCIPL loss was 0.45 µm per year. Three microvascular parameters were significantly impaired at 24 months compared to baseline (FAZ area: 0.34-0.36 mm2, VD: 18.9-18.5/mm, PI: 0.35-0.34). A strong positive correlation was found between loss of mGCIPL and VD from baseline to 24 months (r = 0.817, p < 0.001). Multivariable regression analysis showed that thinner baseline mGCIPL and greater loss of mGCIPL thickness (B = 0.658, p < 0.001) were significantly associated with change of VD. CONCLUSIONS In the early stage of DR, progressive structural retinal neurodegeneration and parafoveal microvascular change seem to be highly linked. Advanced mGCIPL thinning might precede microvascular impairment in early DR.
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Affiliation(s)
- Kiyoung Kim
- Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University, Seoul, Republic of Korea
| | - Eung Suk Kim
- Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University, Seoul, Republic of Korea
| | - Do Gyun Kim
- Department of Ophthalmology, Hanyang University College of Medicine Myongji Hospital, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Seung-Young Yu
- Department of Ophthalmology, Kyung Hee University Medical Center, Kyung Hee University, Seoul, Republic of Korea.
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Verra DM, Sajdak BS, Merriman DK, Hicks D. Diurnal rodents as pertinent animal models of human retinal physiology and pathology. Prog Retin Eye Res 2019; 74:100776. [PMID: 31499165 DOI: 10.1016/j.preteyeres.2019.100776] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/27/2019] [Accepted: 08/31/2019] [Indexed: 12/12/2022]
Abstract
This presentation will survey the retinal architecture, advantages, and limitations of several lesser-known rodent species that provide a useful diurnal complement to rats and mice. These diurnal rodents also possess unusually cone-rich photoreceptor mosaics that facilitate the study of cone cells and pathways. Species to be presented include principally the Sudanian Unstriped Grass Rat and Nile Rat (Arvicanthis spp.), the Fat Sand Rat (Psammomys obesus), the degu (Octodon degus) and the 13-lined ground squirrel (Ictidomys tridecemlineatus). The retina and optic nerve in several of these species demonstrate unusual resilience in the face of neuronal injury, itself an interesting phenomenon with potential translational value.
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Affiliation(s)
- Daniela M Verra
- Department of Neurobiology of Rhythms, Institut des Neurosciences Cellulaires et Intégratives (INCI), CNRS UPR 3212, Strasbourg, France
| | | | - Dana K Merriman
- Department of Biology, University of Wisconsin Oshkosh, Oshkosh, WI, USA
| | - David Hicks
- Department of Neurobiology of Rhythms, Institut des Neurosciences Cellulaires et Intégratives (INCI), CNRS UPR 3212, Strasbourg, France.
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