[Bilateral retinal detachment and high myopia: report of nine cases]

SWATH Based Quantitative Proteomics Reveals Significant Lipid Metabolism in Early Myopic Guinea Pig Retina

Most of the previous myopic animal studies employed a single-candidate approach and lower resolution proteomics approaches that were difficult to detect minor changes, and generated limited systems-wide biological information. Hence, a complete picture of molecular events in the retina involving myopic development is lacking. Here, to investigate comprehensive retinal protein alternations and underlying molecular events in the early myopic stage, we performed a data-independent Sequential Window Acquisition of all Theoretical Mass Spectra (SWATH) based proteomic analysis coupled with different bioinformatics tools in pigmented guinea pigs after 4-day lens-induced myopia (LIM). Myopic eyes compared to untreated contralateral control eyes caused significant changes in refractive error and choroid thickness (p < 0.05, n = 5). Relative elongation of axial length and the vitreous chamber depth were also observed. Using pooled samples from all individuals (n = 10) to build a species-specific retinal ion library for SWATH analysis, 3202 non-redundant proteins (with 24,616 peptides) were identified at 1% global FDR. For quantitative analysis, the 10 individual retinal samples (5 pairs) were analyzed using a high resolution Triple-TOF 6600 mass spectrometry (MS) with technical replicates. In total, 37 up-regulated and 21 down-regulated proteins were found significantly changed after LIM treatment (log2 ratio (T/C) > 0.26 or < -0.26; p ≤ 0.05). Data are accepted via ProteomeXchange with identifier PXD025003. Through Ingenuity Pathways Analysis (IPA), "lipid metabolism" was found as the top function associated with the differentially expressed proteins. Based on the protein abundance and peptide sequences, expression patterns of two regulated proteins (SLC6A6 and PTGES2) identified in this pathway were further successfully validated with high confidence (p < 0.05) using a novel Multiple Reaction Monitoring (MRM) assay on a QTRAP 6500+ MS. In summary, through an integrated discovery and targeted proteomic approach, this study serves as the first report to detect and confirm novel retinal protein changes and significant biological functions in the early LIM mammalian guinea pigs. The study provides new workflow and insights for further research to myopia control.

Immediate Sequential Bilateral Vitreoretinal Surgery: Descriptive Case Series and Literature Review

BACKGROUND AND OBJECTIVE

Bilateral vision-threatening disease necessitating urgent surgery in both eyes is challenging in vitreoretinal disorders, where surgeries are often longer and higher risk than in other ocular disorders. The authors present a case series of patients undergoing immediate sequential bilateral vitreoretinal surgery (ISBVS) on the same day.

PATIENTS AND METHODS

Retrospective case series and literature review. Main outcome measures were surgical indications, systemic diseases, presenting and final visual acuity, and adverse events or complications during or after surgery.

RESULTS

During the time period searched, 14 patients underwent ISBVS, without significant adverse events, infections, or complications. Illustrative cases are presented.

CONCLUSION

The authors recommend considering ISBVS under certain conditions, such as in patients who are unable to undergo local anesthesia surgery, and in those who definitely require urgent or semi-urgent bilateral vitreoretinal surgery requiring a second general anesthesia in the near future if performed separately, especially in cases where the anesthesia is considered high risk. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:494-498.].

BILATERAL SIMULTANEOUS RHEGMATOGENOUS RETINAL DETACHMENT: Clinical Characteristics and Surgical Outcome

PURPOSE

To elucidate the clinical characteristics and surgical outcome of consecutive patients with bilateral simultaneous retinal detachment who reported to a tertiary eye care institution over a period of 10 years.

METHODS

Retrospective interventional consecutive study of 168 eyes of 84 patients with bilateral simultaneous retinal detachment, observed by indirect ophthalmoscopy at the initial examination was performed. Demographic and clinical characteristics were collected before and after surgery. Patients with attached retina at final follow-up were considered to have anatomical success and those with two or more lines improvement in visual acuity were considered to have functional success.

RESULTS

Most cases (90% in the better eye and 82.1% in the worse eye) were managed by scleral buckling procedure. With scleral buckle, anatomical success was seen in 99% and functional success was seen in 87% of the cases. Pars plana vitrectomy was performed in remaining cases with anatomical success in 83% and functional success in 78% of cases. Eyes with partial retinal detachment, without macular involvement, and eyes in which additional surgeries were not performed had significantly better anatomical and functional results.

CONCLUSION

Early sequential surgery gives good anatomical and functional outcomes. Surgical outcomes were better with scleral buckling than pars plana vitrectomy.

Characteristics and Outcomes of Simultaneous Bilateral Rhegmatogenous Retinal Detachments

BACKGROUND AND OBJECTIVE

To better understand the clinical course and outcomes of simultaneous bilateral retinal detachments managed by modern vitreoretinal surgical techniques.

PATIENTS AND METHODS

A retrospective review of 21 patients (42 eyes) presenting between April 2000 and June 2015 with simultaneous bilateral rhegmatogenous retinal detachments.

RESULTS

Mean visual acuity (VA) improved from 20/100 at presentation to 20/40 at last follow-up (P = .01). The mean final VA for patients undergoing scleral buckle (SB) alone was 20/30 (log MAR 0.17), pars plana vitrectomy (PPV) alone was 20/40 (logMAR 0.33), and combined PPV/SB was 20/80 (logMAR 0.59) (P = .019). Primary reattachment rate in this series was 98%.

CONCLUSION

In contrast to prior studies, which investigated the management of simultaneous bilateral retinal detachments primarily by SB alone, multiple treatment modalities were utilized in this study, including vitrectomy alone, and overall success of retinal detachment repair was high regardless of treatment modality chosen. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:840-845.].