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Rossi T, Querzoli G, Cosimi P, Ripandelli G, Steel DH, Romano MR. TANGENTIAL RETINAL DISPLACEMENT INCREASES AFTER MACULAR PUCKER SURGERY: An Apparent Nonsense. Retina 2024; 44:610-617. [PMID: 37973044 DOI: 10.1097/iae.0000000000004001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
PURPOSE To measure the tangential retinal displacement and vision before and after macular pucker surgery and study if pars plana vitrectomy with epiretinal membrane peeling allows the reconstitution of previous anatomy or else it results in a different configuration. METHODS Retrospective series of patients undergoing pars plana vitrectomy for epiretinal membrane, with >6-month follow-up before and after surgery, complete with best-corrected visual acuity, optical coherence tomography, M-Charts, and infrared retinography. Tangential retinal displacement between earliest visit (T E ), time of surgery (T 0 ), and latest available visit (T L ) of the examined retina, concentric circles at 0.5, 1.5, and 4.5 mm radii, and the central horizontal and vertical meridians were measured. Tangential displacement was calculated as the optical flow of consecutive infrared photographs. RESULTS The study comprised 32 patients: 15 men and 17 women. Average preoperative and postoperative follow-up were 23.4 ± 27.9 months and 19.2 ± 11.8 months, respectively. Best-corrected visual acuity reduced before surgery (0.69 ± 0.16 Snellen to 0.46 ± 0.17; P < 0.001) and increased after (0.866 ± 0.16 Snellen; P < 0.001). Horizontal and vertical metamorphopsia increased between before surgery but only horizontal metamorphopsia significantly reduced after. Average tangential displacement before surgery was 35.6 ± 29.9 µ m versus 56.6 ± 41.3 µ m after ( P = 0.023). Preoperative and postoperative displacement within the fovea was less than over the entire area ( P < 0.001). CONCLUSION Retinal tangential displacement between diagnosis and surgery (T E - T 0 ) is less than the displacement occurring after surgery (T 0 - T L ). Postoperative displacement does not represent the restoration of the anatomy existing before the disease ensued but rather the resulting equilibrium of newly deployed forces.
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Affiliation(s)
| | - Giorgio Querzoli
- DICAAR Faculty of Engineering, University of Cagliari, Cagliari, Italy
| | | | | | - David H Steel
- Newcastle University, Newcastle, United Kingdom; and
| | - Mario R Romano
- Department of Biomedical Science, Humanitas University, Milan, Italy
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2
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D'Aloisio R, Ruggeri ML, Porreca A, Di Nicola M, Aharrh-Gnama A, Quarta A, Gironi M, Toto L, Mastropasqua R. Choroidal Vascularity Index Fluctuations in Epiretinal Membranes in Vitreoretinal Surgery: Comparison Between Idiopathic and Diabetic Ones. Transl Vis Sci Technol 2023; 12:9. [PMID: 38060233 PMCID: PMC10709804 DOI: 10.1167/tvst.12.12.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
Purpose The aim of the study was to analyze choroidal vascularity index (CVI) fluctuations in patients with epiretinal membrane after vitreoretinal surgery, comparing idiopathic and secondary diabetic ones. Methods Thirty eyes suffering from idiopathic ERMs (I-ERMS; n = 15) and diabetic ERMs (D-ERMS; n = 15) were analyzed in this observational prospective study. Anatomical (central macular thickness) and functional (best-corrected visual acuity) parameters were analyzed preoperatively and at 1 and 3 months after vitrectomy. Perfusion findings regarding CVI and luminal area were also calculated. Results At 1 month after surgery, the luminal area and CVI significantly decreased in the I-ERMS group, whereas they were increased in the D-ERMS group. At the 3-month follow-up, the CVI tended to return to baseline values in I-ERMS and to reduce in D-ERMS, but without any statistical differences. Conclusions The significant change in the CVI after surgery seems to imply that the choroidal layer is affected by vitreomacular disease and can become a novel potential biomarker of predictiveness in vitreoretinal surgery. Translational Relevance The aim of the study was to focus on the early choroidal changes to better understand initial predictive elements of long-term functional postoperative outcomes.
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Affiliation(s)
- Rossella D'Aloisio
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Maria Ludovica Ruggeri
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Annamaria Porreca
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Marta Di Nicola
- Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, University "G. d'Annunzio" Chieti-Pescara, Chieti, Italy
| | - Agbéanda Aharrh-Gnama
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Alberto Quarta
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Matteo Gironi
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Lisa Toto
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
| | - Rodolfo Mastropasqua
- Ophthalmology Clinic, Department of Medicine and Science of Ageing, University G. D'Annunzio Chieti- Pescara, Chieti, Italy
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Kiraly P, Downes SM, Fischer MD. Retinal Angiomatous Proliferation in a Patient with Retinitis Pigmentosa. Genes (Basel) 2023; 14:1438. [PMID: 37510342 PMCID: PMC10379935 DOI: 10.3390/genes14071438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/19/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Retinal angiomatous proliferation (RAP) and other types of choroidal neovascularization (CNV) are very rarely reported in patients with retinitis pigmentosa (RP). We present a case report of a 91-year-old patient with an obvious RP phenotype, who presented with a sudden onset of vision worsening and metamorphopsia in the left eye. Genetic testing on the UK inherited retinal disease panel did not identify a pathogenic variant. Multimodal imaging comprising optical coherence tomography (OCT), OCT angiography, and fluorescein and indocyanine green angiography showed a RAP lesion in the left macula. The patient received three treatments of monthly injections of aflibercept, with excellent morphological and functional outcomes. Taking into account the patient's age at presentation of the RAP lesion, it is not clear whether the RAP was associated or coincidental with RP. This case report highlights the importance of possessing an awareness that RAP lesions can occur in RP. Moreover, due to a good response and potential safety concerns with continuous anti-VEGF injections in RP patients, a pro re nata (PRN) regimen might be the safest option.
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Affiliation(s)
- Peter Kiraly
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford OX3 9DU, UK
| | - Susan M Downes
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford OX3 9DU, UK
| | - M Dominik Fischer
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
- Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford OX3 9DU, UK
- Centre for Ophthalmology, University Hospital Tübingen, 72076 Tübingen, Germany
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4
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Hsieh TC, Deng GH, Chang YC, Chang FL, He MS. A real-world study for timely assessing the diabetic macular edema refractory to intravitreal anti-VEGF treatment. Front Endocrinol (Lausanne) 2023; 14:1108097. [PMID: 37265702 PMCID: PMC10230025 DOI: 10.3389/fendo.2023.1108097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/08/2023] [Indexed: 06/03/2023] Open
Abstract
Background Early Identifying and characterizing patients with diabetic macular edema (DME) is essential for individualized treatment and outcome optimization. This study aimed to timely investigate optical coherence tomography (OCT) biomarkers of DME refractory to intravitreal anti-vascular endothelial growth factor (VEGF) therapy. Methods We retrospective reviewed 72 eyes from 44 treatment-naïve patients who were treated with intravitreal anti-VEGF for DME. OCT scans prior to anti-VEGF were evaluated for serous retinal detachment (SRD), size of outer nuclear layer cystoid changes, diffuse retinal thickening, integrity of the inner segment-outer segment (IS-OS) junction, quantity and location of hyperreflective foci, vitreomacular interface abnormalities, and epiretinal membrane (ERM). The Baseline best-corrected visual acuity (BCVA) and central macular thickness was recorded at baseline and 4 months after treatment with anti-VEGF. The main outcome measure was the correlation between spectral-domain OCT measurements and BCVA response at baseline and after anti-VEGF treatment (mean change from baseline; ≥ 10 Early Treatment Diabetic Retinopathy Study letters in BCVA). Results Partially continuous IS-OS layers (partially vs. completely continuous: β, -0.138; Wald chi-square, 16.392; P<0.001) was predictor of better response to anti-VEGF treatment. In contrast, ERM (present vs. absent ERM: β, 0.215; Wald chi-square, 5.921; P=0.015) and vitreomacular traction (vitreomacular traction vs. posterior vitreous detachment: β=0.259; Wald chi-square=5.938; P=0.015) were the predictors of poor response. The improvement of BCVA trended toward the OCT predictive value of central macular thickness reduction; however, this was not significant. Conclusion Partially continuous IS-OS layers is predictive of better response to anti-VEGF therapy in DME. Meanwhile, ERM is a significant predictor of poor response.
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Affiliation(s)
| | - Guang-Hong Deng
- Tzu Chi University Research Center for Big Data Teaching, Research and Statistic Consultation, Hualien, Taiwan
| | - Yung-Ching Chang
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Fang-Ling Chang
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Ming-Shan He
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien, Taiwan
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Lee EK, Kim HJ, Lee SY, Song SJ, Yu HG. Retinal vessel geometry in patients with idiopathic epiretinal membrane. Sci Rep 2023; 13:5108. [PMID: 36991036 PMCID: PMC10060414 DOI: 10.1038/s41598-023-32025-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 03/21/2023] [Indexed: 03/31/2023] Open
Abstract
We investigated the associations between retinal vascular geometric measurements and idiopathic epiretinal membrane (ERM). Whether changes in retinal vascular geometry are independent of systemic cardiovascular risk factors was also evaluated. This retrospective, cross sectional study included 98 patients with idiopathic ERM, and 99 healthy age-matched controls. Quantitative retinal vascular parameters were measured from digital retinal fundus photographs using a semi-automated computer-assisted program. Multivariate logistic regression analyses were performed to evaluate associations between retinal vascular geometric parameters and the presence of idiopathic ERM after adjusting for systemic cardiovascular risk factors. There was no significant difference in the baseline characteristics of the two groups, except that the ERM group had a higher proportion of females than the control group. In multivariate regression analyses, female sex (odds ratio [OR] 0.402; 95% CI 0.196-0.802; P = 0.011), wider retinal venular caliber (OR 16.852; 95% CI 5.384-58.997; P < 0.001) and decreased total fractal dimension (OR 0.156; 95% CI 0.052-0.440; P = 0.001) were associated with idiopathic ERM. Idiopathic ERM was associated with alterations in global retinal microvascular geometric parameters, wider retinal venules, and less complex vascular branching patterns, independent of cardiovascular risk factors.
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Affiliation(s)
- Eun Kyoung Lee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, #101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | - Hye Jee Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, #101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea
| | | | - Su Jeong Song
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyeong Gon Yu
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Hospital, #101, Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
- Retina Center, Sky Eye Institute, Seoul, Korea.
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Bianchi L, Altera A, Barone V, Bonente D, Bacci T, De Benedetto E, Bini L, Tosi GM, Galvagni F, Bertelli E. Untangling the Extracellular Matrix of Idiopathic Epiretinal Membrane: A Path Winding among Structure, Interactomics and Translational Medicine. Cells 2022; 11:cells11162531. [PMID: 36010606 PMCID: PMC9406781 DOI: 10.3390/cells11162531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 12/16/2022] Open
Abstract
Idiopathic epiretinal membranes (iERMs) are fibrocellular sheets of tissue that develop at the vitreoretinal interface. The iERMs consist of cells and an extracellular matrix (ECM) formed by a complex array of structural proteins and a large number of proteins that regulate cell–matrix interaction, matrix deposition and remodelling. Many components of the ECM tend to produce a layered pattern that can influence the tractional properties of the membranes. We applied a bioinformatics approach on a list of proteins previously identified with an MS-based proteomic analysis on samples of iERM to report the interactome of some key proteins. The performed pathway analysis highlights interactions occurring among ECM molecules, their cell receptors and intra- or extracellular proteins that may play a role in matrix biology in this special context. In particular, integrin β1, cathepsin B, epidermal growth factor receptor, protein-glutamine gamma-glutamyltransferase 2 and prolow-density lipoprotein receptor-related protein 1 are key hubs in the outlined protein–protein cross-talks. A section on the biomarkers that can be found in the vitreous humor of patients affected by iERM and that can modulate matrix deposition is also presented. Finally, translational medicine in iERM treatment has been summed up taking stock of the techniques that have been proposed for pharmacologic vitreolysis.
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Affiliation(s)
- Laura Bianchi
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
| | - Annalisa Altera
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Virginia Barone
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Denise Bonente
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Tommaso Bacci
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Elena De Benedetto
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Luca Bini
- Department of Life Sciences, University of Siena, 53100 Siena, Italy
| | - Gian Marco Tosi
- Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Federico Galvagni
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, 53100 Siena, Italy
| | - Eugenio Bertelli
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
- Correspondence:
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Hu Z, Mao X, Chen M, Wu X, Zhu T, Liu Y, Zhang Z, Fan W, Xie P, Yuan S, Liu Q. Single-Cell Transcriptomics Reveals Novel Role of Microglia in Fibrovascular Membrane of Proliferative Diabetic Retinopathy. Diabetes 2022; 71:762-773. [PMID: 35061025 DOI: 10.2337/db21-0551] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022]
Abstract
Vitreous fibrovascular membranes (FVMs), the hallmark of proliferative diabetic retinopathy (PDR), cause retinal hemorrhage, detachment, and eventually blindness. However, little is known about the pathophysiology of FVM. In this study, we used single-cell RNA sequencing on surgically harvested PDR-FVMs and generated a comprehensive cell atlas of FVM. Eight cellular compositions were identified, with microglia as the major cell population. We identified a GPNMB+ subpopulation of microglia, which presented both profibrotic and fibrogenic properties. Pseudotime analysis further revealed the profibrotic microglia was uniquely differentiated from retina-resident microglia and expanded in the PDR setting. Ligand-receptor interactions between the profibrotic microglia and cytokines upregulated in PDR vitreous implicated the involvement of several pathways, including CCR5, IFNGR1, and CD44 signaling, in the microglial activation within the PDR microenvironment. Collectively, our description of the novel microglia phenotypes in PDR-FVM may offer new insight into the cellular and molecular mechanism underlying the pathogenesis of DR, as well as potential signaling pathways amenable to disease-specific intervention.
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8
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Kim DI, Kim BH, Bae KW, Park UC. Comparison of surgical outcomes after removal of epiretinal membrane associated with retinal break and idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2022; 260:2121-2128. [PMID: 35029729 DOI: 10.1007/s00417-021-05550-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/14/2021] [Accepted: 12/31/2021] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To compare the surgical outcomes of epiretinal membranes (ERMs) associated with retinal break and idiopathic ERMs. METHODS This retrospective study included patients with an idiopathic ERM or an ERM associated with retinal break, who were followed up for ≥ 6 months after ERM removal. The postoperative functional and anatomical outcomes were compared between the groups. RESULTS A total of 160 and 38 eyes (198 patients) were in the idiopathic and retinal break groups, respectively. There was no significant difference in the baseline anatomical and functional parameters between the groups. At 6 months after surgery and at the final follow-up, best-corrected visual acuity, central foveal thickness, and ectopic inner foveal layer improved significantly in both groups, but there was no significant difference between the groups. In latter 49.0% of patients, tests for metamorphopsia and aniseikonia were performed. There was a significant improvement in the scores of metamorphopsia (0.40 ± 0.38 to 0.27 ± 0.28; p < 0.001) and aniseikonia (6.07 ± 4.46 to 4.11 ± 3.52; p < 0.001) in the idiopathic group at 6 months after surgery, but not in the retinal break group. The idiopathic group had significantly greater circularity of ERM extent compared to the retinal break group (p = 0.025). CONCLUSION Visual and anatomical improvements after removal of ERMs associated with retinal break and idiopathic ERMs were comparable. However, metamorphopsia and aniseikonia improved only after removal of idiopathic ERMs.
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Affiliation(s)
- Dong Ik Kim
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea
| | - Bo Hee Kim
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea
| | - Ki Woong Bae
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea
| | - Un Chul Park
- Department of Ophthalmology, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 110-799, Korea.
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Comparison between Vascular Endothelial Growth Factor and Platelet-Derived Growth Factor Levels in Rhegmatogenous Retinal Detachment. J Ophthalmol 2021; 2021:2688837. [PMID: 34912575 PMCID: PMC8668303 DOI: 10.1155/2021/2688837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/22/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction This study aimed to assess vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) levels within vitreous and blood serum samples of patients with rhegmatogenous retinal detachment (RRD) and their relationship to the development of proliferative vitreoretinopathy (PVR). Methods Seventeen eyes of patients with RRD were included in the RRD group and divided into three subgroups: RRD without PVR, RRD with PVR grades A and B, and RRD with PVR grade C. Five control eyes (nucleus and intraocular lens drop) were included in this study. Blood serum and vitreous samples were collected during vitrectomy. VEGF-A and PDGF-AA levels were determined by enzyme-linked immunosorbent assay. Results The mean vitreous VEGF-A level in the RRD group was 131.71 ± 58.25 pg/mL, and the mean vitreous PDGF-AA level was 174.62 ± 65.17 pg/mL. Both levels were significantly higher in the RRD group compared with the control group (p < 0.05). Vitreous VEGF-A and PDGF-AA levels were the highest in RRD with PVR grade C subgroup, with mean levels of 179.87 ± 21.02 pg/mL and 229.44 ± 14.09 pg/mL, respectively (p < 0.05). The vitreous VEGF-A/PDGF-AA ratios in the RRD subgroups were completely different. Conclusion Based on the tendency of VEGF-A and PDGF-AA levels, RRD surgery has to be performed as soon as possible prior to retinal cell death and membrane proliferative formation.
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MICROVASCULAR LEAKAGE IS A POOR PROGNOSTIC FACTOR FOR IDIOPATHIC EPIRETINAL MEMBRANE: A Fluorescein Angiography Study. Retina 2021; 41:2515-2522. [PMID: 34851884 DOI: 10.1097/iae.0000000000003223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate the angiographic findings assessed using fluorescein angiography and their prognostic values of idiopathic epiretinal membrane. METHODS Seventy-three eyes of idiopathic epiretinal membrane that had been followed up for 6 months after surgical treatment were included. Midphase fluorescein angiography images were obtained at baseline. Structural changes, including central subfield macular thickness, intraretinal cystic lesion, and ectopic inner retinal layer on the fovea, were assessed using optical coherence tomography. The main outcome measures were microvascular leakage (ML) and its association with optical coherence tomography findings and best-corrected visual acuity (BCVA). RESULTS Of a total of 73 eyes, 37 showed ML and had worse BCVA (P = 0.040), greater central subfield macular thickness (P = 0.028), and more ectopic inner retinal layer (P < 0.001) than those without ML at baseline. Also, ML was associated with worse postoperative BCVA (P < 0.001) and ectopic inner retinal layers (P < 0.001; P = 0.034) at baseline and 6 months. The baseline factors associated with postoperative BCVA of ≥20/25 were better BCVA (P = 0.027) and the absence of ML (P < 0.001). CONCLUSION Half of the idiopathic epiretinal membrane eyes showed that ML was associated with inner retinal deformity and poor visual recovery. Fluorescein angiography helped to predict visual prognosis after idiopathic epiretinal membrane surgery.
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Chen DY, Sun NH, Chen X, Gong JJ, Yuan ST, Hu ZZ, Lu NN, Körbelin J, Fukunaga K, Liu QH, Lu YM, Han F. Endothelium-derived semaphorin 3G attenuates ischemic retinopathy by coordinating β-catenin-dependent vascular remodeling. J Clin Invest 2021; 131:135296. [PMID: 33586674 DOI: 10.1172/jci135296] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 12/10/2020] [Indexed: 12/14/2022] Open
Abstract
Abnormal angiogenesis and regression of the diseased retinal vasculature are key processes associated with ischemic retinopathies, but the underlying mechanisms that regulate vascular remodeling remain poorly understood. Here, we confirmed the specific expression of semaphorin 3G (Sema3G) in retinal endothelial cells (ECs), which was required for vascular remodeling and the amelioration of ischemic retinopathy. We found that Sema3G was elevated in the vitreous fluid of patients with proliferative diabetic retinopathy (PDR) and in the neovascularization regression phase of oxygen-induced retinopathy (OIR). Endothelial-specific Sema3G knockout mice exhibited decreased vessel density and excessive matrix deposition in the retinal vasculature. Moreover, loss of Sema3G aggravated pathological angiogenesis in mice with OIR. Mechanistically, we demonstrated that HIF-2α directly regulated Sema3G transcription in ECs under hypoxia. Sema3G coordinated the functional interaction between β-catenin and VE-cadherin by increasing β-catenin stability in the endothelium through the neuropilin-2 (Nrp2)/PlexinD1 receptor. Furthermore, Sema3G supplementation enhanced healthy vascular network formation and promoted diseased vasculature regression during blood vessel remodeling. Overall, we deciphered the endothelium-derived Sema3G-dependent events involved in modulating physiological vascular remodeling and regression of pathological blood vessels for reparative vascular regeneration. Our findings shed light on the protective effect of Sema3G in ischemic retinopathies.
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Affiliation(s)
- Dan-Yang Chen
- Department of Physiology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, China.,Key Laboratory of Cardiovascular & Cerebrovascular Medicine, Drug Target and Drug Discovery Center, School of Pharmacy, Nanjing Medical University, Nanjing, China.,Institute of Pharmacology and Toxicology, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Ning-He Sun
- Department of Physiology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, China.,Key Laboratory of Cardiovascular & Cerebrovascular Medicine, Drug Target and Drug Discovery Center, School of Pharmacy, Nanjing Medical University, Nanjing, China.,Institute of Pharmacology and Toxicology, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Xiang Chen
- Key Laboratory of Cardiovascular & Cerebrovascular Medicine, Drug Target and Drug Discovery Center, School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Jun-Jie Gong
- Key Laboratory of Cardiovascular & Cerebrovascular Medicine, Drug Target and Drug Discovery Center, School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Song-Tao Yuan
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zi-Zhong Hu
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Nan-Nan Lu
- Institute of Pharmacology and Toxicology, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Jakob Körbelin
- Department of Oncology and Hematology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kohji Fukunaga
- Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan
| | - Qing-Huai Liu
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ying-Mei Lu
- Department of Physiology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing, China
| | - Feng Han
- Key Laboratory of Cardiovascular & Cerebrovascular Medicine, Drug Target and Drug Discovery Center, School of Pharmacy, Nanjing Medical University, Nanjing, China.,Institute of Brain Science, the Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
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12
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Ivastinovic D, Haas A, Weger M, Seidel G, Mayer-Xanthaki C, Lindner E, Guttmann A, Wedrich A. Vitrectomy for diabetic macular edema and the relevance of external limiting membrane. BMC Ophthalmol 2021; 21:334. [PMID: 34525998 PMCID: PMC8444500 DOI: 10.1186/s12886-021-02095-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/01/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To evaluate the relevance of external limiting membrane (ELM) on the visual and morphological results in eyes with diabetic macular edema (DME) that underwent pars plana vitrectomy (PPV) with epiretinal membrane (ERM) and internal limiting membrane (ILM) peeling. METHODS Medical records of patients with DME who underwent PPV at our unit between January 2017 and December 2019 were reviewed. We assessed preoperative and postoperative best-corrected visual acuity (BCVA), central macular thickness (CMT) using spectral domain OCT (optical coherence tomography). Exclusion criteria were previous PPV; incomplete data; concomitant diseases including retinal vein occlusion, age-related macular degeneration, uveitis; and a follow-up of less than 12 months. The surgeries were performed using 23- or 27-gauge vitrectomy. The ELM was graded depending on its configuration (grade 0 = intact, grade 1 to 3: disruption of varying extent). RESULTS Ninety-nine eyes were enrolled. The postoperative follow up averaged 23.7 months. The preoperative and final BCVA averaged 0.71 ± 0.28 and 0.52 ± 0.3 logMAR, respectively (p = 0.002). The CMT averaged 515.2 ± 209.1 μm preoperatively and 327 ± 66.1 μm postoperatively (p = 0.001). Eyes with intact ELM (n = 8) had a significantly better BCVA compared to those with ELM disruption (0.28 ± 0.14 vs. 0.7 ± 0.25 logMAR, p = 0.01). The final CMT was similar among the groups (intact ELM: 317 ± 54.6 μm; ELM disruption: 334 ± 75.2, p = 0.31). CONCLUSIONS PPV with ERM and ILM peeling is an effective treatment of DME. Eyes with intact ELM preoperatively had a significantly better final visual outcome. To maximize the benefit for patients with DME we recommend early PPV as long as ELM is intact.
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Affiliation(s)
- Domagoj Ivastinovic
- Department of Ophthalmology, Medical University Graz, Auenbruggerplatz 4, 8036, Graz, Austria.
| | - Anton Haas
- Department of Ophthalmology, Medical University Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Martin Weger
- Department of Ophthalmology, Medical University Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Gerald Seidel
- Department of Ophthalmology, Medical University Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | | | - Ewald Lindner
- Department of Ophthalmology, Medical University Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Andreas Guttmann
- Department of Ophthalmology, Medical University Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Andreas Wedrich
- Department of Ophthalmology, Medical University Graz, Auenbruggerplatz 4, 8036, Graz, Austria
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Adıyeke SK, Kutlu N, Özen K, Doran MA, Demirbaş K, Ture G, Talay E. Is pseudoexfoliation syndrome associated with vitreoretinal interface abnormalities? Graefes Arch Clin Exp Ophthalmol 2021; 260:431-437. [PMID: 34406503 DOI: 10.1007/s00417-021-05373-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 07/31/2021] [Accepted: 08/06/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND To evaluate vitreoretinal interface abnormalities in patients with pseudoexfoliation (PEX) syndrome. METHODS This case-control study was performed in 136 patients diagnosed with unilateral PEX (PEX group) and 139 age- and sex-matched healthy volunteers (Control group). Both the affected and contralateral eyes were evaluated in the PEX group and the right eye was evaluated in the Control group. Vitreoretinal interface abnormalities and posterior vitreous detachment (PVD) were evaluated on optical coherence tomography (OCT) examination. RESULTS The incidences of incomplete and complete PVD were significantly higher in the affected than contralateral eye in the PEX group and in the right eye in the Control group (P = 0.009, P = 0.012 and P = 0.004, P = 0.017, respectively). The rates of 'no PVD' were significantly higher in the contralateral eye in the PEX group and the Control group compared to the affected eye in the PEX group (P = 0.003 and P = 0.001, respectively). The odds ratio for incomplete PVD was 3.1 in PEX eyes compared to the contralateral eye in the PEX group and 3.9 compared to the Control group. The rate of epiretinal membranes (ERMs) in the affected eye was significantly different from the contralateral eye in the PEX and Control groups (P < 0.001 and P < 0.001, respectively). The odds ratio for ERM in PEX eyes was 3.51 compared to the contralateral eye in the PEX group and 4.23 compared to the Control group. In the presence of incomplete PVD, the odds ratio for ERM development was 3.81 in PEX eyes. CONCLUSIONS We detected high rates of ERMs and incomplete PVD in patients with PEX. It is important to evaluate and follow up PEX cases in terms of vitreoretinal interface abnormalities.
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Affiliation(s)
- Seda Karaca Adıyeke
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey.
| | - Neslisah Kutlu
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey
| | - Kıvanç Özen
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey
| | - Mehmet Ali Doran
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey
| | - Kemal Demirbaş
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey
| | - Gamze Ture
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey
| | - Ekrem Talay
- Tepecik Research and Training Hospital Ophthalmology Department, Izmir, Turkey
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Coppe AM, Lapucci G, Ripandelli G, Pesci FR, Buzzonetti L, Iarossi G. Inner Macular Changes in Fellow Eye of Patients With Unilateral Idiopathic Epiretinal Membrane. Invest Ophthalmol Vis Sci 2021; 62:29. [PMID: 34427622 PMCID: PMC8399621 DOI: 10.1167/iovs.62.10.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Purpose We evaluated a series of fellow eyes (FEs) in patients affected by unilateral idiopathic epiretinal membrane (IERM) with spectral-domain optical coherence tomography (SD-OCT) and OCT angiography (OCT-A) to determine if a previous defect in the inner retina is present before the mechanical damage to the inner limiting membrane (ILM) caused by posterior vitreous detachment. Methods In patients with IERM (N = 39), ganglion cell layer (GCL) thickness in FEs was assessed with SD-OCT; in a subgroup (N = 25) the vessel density (VD) at the superficial (SCP) and deep capillary plexus (DCP) was assessed with swept-source OCT-A (SS-OCT-A). These values were then compared with 30 age-matched healthy control eyes (CEs). The statistical analyses used SPSS software version 15.0 (SPSS, Inc., Chicago, IL, USA). Data collected underwent 1-way ANOVA. A level of P < 0.05 was accepted as statistically significant. Results The GCL thickness in the FEs was significantly lower than in CEs, with a significant thinning in all sectors except temporal ones (mean P < 0.001, superior P = 0.0002, superonasal P < 0.001, inferonasal P < 0.001, and inferior P = 0.002). The VD was significantly lower in the FEs in all sectors of SCP (mean P = 0.009, inner ring P = 0.028, and outer ring P = 0.007). Conclusions GCL and SCP are significantly reduced in the FEs. These data suggest that a vascular defect in the SCP could cause a cellular loss in the inner retina that may determine the cascade events leading to the IERM proliferation; the diagnosis in a preclinical phase could provide a treatment strategy to prevent the progression of the disease.
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Ikegami Y, Numaga J, Ue S, Sano T. Morphological alternation and influence of aqueous flare in idiopathic epiretinal membrane. Int J Retina Vitreous 2021; 7:40. [PMID: 34001276 PMCID: PMC8127242 DOI: 10.1186/s40942-021-00294-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/09/2021] [Indexed: 11/12/2022] Open
Abstract
Background Idiopathic epiretinal membrane (iERM) is a common retinal disease in the elderly population. The exact pathogenesis of iERM is unknown. The present study aimed to evaluate the relationship between aqueous flare and morphology of iERM using swept-source optical coherence tomography (OCT). Methods A consecutive series of 36 eyes of 33 patients with iERM and 109 control eyes of 109 patients were retrospectively examined. Aqueous flare measurements and OCT images were obtained on the same day. The average total retinal, inner retinal, outer retinal, and choroidal thicknesses were calculated using the thickness map mode with an Early Treatment Diabetic Retinopathy Study nine-zone grid that was divided into three zones. The maximum depth of the retinal folds in iERMs was manually measured. The correlation among flare value, maximum depth of folds, and retinal and choroidal thicknesses was evaluated. The morphological changes between the control eyes and the eyes with iERM in different stages were examined. Results The result demonstrated a significant positive correlation between the aqueous flare value and total and inner retinal thicknesses in the early stage of iERM. There was a significant positive correlation between the maximum depth of folds and total and inner retinal thicknesses in the early stage of iERM, and the maximum depth of folds significantly increased in the advanced stage. The total and inner retinal thicknesses and proportion of inner retinal thickness significantly increased as the stage of iERM progressed. Conclusions The aqueous flare value was associated with retinal thickness in the early stage of iERM, which supports the idea that inflammation or breakdown of blood–ocular barrier is involved in the process of iERM formation. The maximum retinal folds increased as the stage of iERM progressed and retinal thickness increased, which indicates that the tangential force increases as the iERM stage progresses.
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Affiliation(s)
- Yasuko Ikegami
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo, 173-0015, Japan. .,Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
| | - Jiro Numaga
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo, 173-0015, Japan
| | - Saori Ue
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo, 173-0015, Japan
| | - Tomohiro Sano
- Department of Ophthalmology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi district, Tokyo, 173-0015, Japan
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Sane SS, Ali MH, Kuppermann BD, Narayanan R. Comparative study of pars plana vitrectomy with or without intravitreal dexamethasone implant for idiopathic epiretinal membrane. Indian J Ophthalmol 2021; 68:1103-1107. [PMID: 32461441 PMCID: PMC7508104 DOI: 10.4103/ijo.ijo_1045_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Purpose: To investigate if use of adjunctive intravitreal dexamethasone implant during pars plana vitrectomy (PPV) leads to faster visual recovery and reduction of retinal thickness in idiopathic epiretinal membrane (ERM). Methods: In this non-randomized, comparative, interventional study 30 eyes (from 30 patients with idiopathic ERM) were enrolled. In the control group (n = 15), patients underwent 25-G pars plana vitrectomy (PPV) and ERM peeling. In the study group (n = 15), each patient underwent the same procedure as those in the control group, and also received an additional dexamethasone implant. Primary outcome after treatment was mean gain in best corrected visual acuity (BCVA), and secondary outcome was reduction in central retinal thickness (CRT). Data were analyzed using Fisher's exact test, Wilcoxon rank sum test, and two-sample t-test. Results: The mean gain in BCVA (logMAR) from baseline at 1-month follow-up was significantly higher in the study group (median = - 0.3, IQR = - 0.4, - 0.1) than in the control group (median = 0, IQR = - 0.1, 0.3; P < 0.008). However, no significant difference in mean gain in BCVA between the two groups was detectable at the 6-month follow-up (P < 0.55). At 1-month follow-up, one and seven patients in the control and study groups gained ≥15 letters of BCVA (P < 0.05), respectively. The mean reductions in CRT at the 1-month follow-up were significantly higher in the study group than in the control group (Mean = - 60 μm, SD = 92.1; P < 0.014; 95% CI = 19.75–156.54). The difference in mean reduction of CRT at 6 months was not significant (P < 0.24). Conclusion: Adjunctive dexamethasone implant can aid faster visual recovery after PPV in idiopathic ERM, although the implants do not affect long-term gains in visual acuity.
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Affiliation(s)
- Surabhi S Sane
- Kanuri Santhamma Vitreo-Retina Service, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Mohammad Hasnat Ali
- Department of Biostatistics; Suven Clinical Research Center, Hyderabad Eye Research Foundation, L.V. Prasad Eye Institute, Hyderabad, Telangana, India
| | | | - Raja Narayanan
- Kanuri Santhamma Vitreo-Retina Service; Suven Clinical Research Center, Hyderabad Eye Research Foundation, L.V. Prasad Eye Institute, Hyderabad, Telangana, India
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Ozturk M, Guven D, Kacar H, Karapapak M, Demir M. Functional and Morphological Results of Epiretinal Membrane Surgery in Idiopathic versus Diabetic Epiretinal Membranes. Semin Ophthalmol 2021; 36:366-372. [PMID: 33617394 DOI: 10.1080/08820538.2021.1890143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Idiopathic and diabetic epiretinal membranes (ERM) are different in terms of pathophysiology, etiology, and macular morphology, and thus might respond to surgical treatment differently. We aimed to compare the surgical results of two groups. METHODS Retrospective case series study of 71 eyes of 66 patients who underwent pars plana vitrectomy (PPV) due to idiopathic or diabetic ERM with at least 1-year follow-up. Examinations were performed before, and 1, 3, 6, and 12 months after surgery. The average macular thicknesses in nine sectors described by the Early Treatment Diabetic Retinopathy Study (ETDRS) were measured with spectral-domain optical coherence tomography (OCT), and BCVA was evaluated. ERM recurrence rates were investigated. RESULTS In both idiopathic and diabetic groups, retinal thickness (RT) changes occurred as long as 12 months after vitrectomy surgery for ERM. However, in the idiopathic group, significant changes were mainly seen in the first 6 months, while in the diabetic group changes slowed considerably between the third and sixth months, but again accelerated (becoming significant) during the last 6 months. CONCLUSIONS According to the findings of this study, as compared to those with idiopathic ERM, diabetic patients would likely see continuing benefits from ERM surgery 6 to 12 months post surgery. The BCVA changes of the two groups were similar. ILM peeling decreased ERM recurrence in the idiopathic group but not in the diabetic group.
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Affiliation(s)
- Mine Ozturk
- Haseki Training and Research Hospital, Clinic of Ophthalmology, University of Health Sciences, Istanbul, Turkey
| | - Dilek Guven
- Sisli Hamidiye Etfal Training and Research Hospital, Clinic of Ophthalmology, University of Health Sciences, Istanbul, Turkey
| | - Hakan Kacar
- Sisli Hamidiye Etfal Training and Research Hospital, Clinic of Ophthalmology, University of Health Sciences, Istanbul, Turkey
| | - Murat Karapapak
- Sisli Hamidiye Etfal Training and Research Hospital, Clinic of Ophthalmology, University of Health Sciences, Istanbul, Turkey
| | - Mehmet Demir
- Sisli Hamidiye Etfal Training and Research Hospital, Clinic of Ophthalmology, University of Health Sciences, Istanbul, Turkey
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Zou H, Shan C, Ma L, Liu J, Yang N, Zhao J. Polarity and epithelial-mesenchymal transition of retinal pigment epithelial cells in proliferative vitreoretinopathy. PeerJ 2020; 8:e10136. [PMID: 33150072 PMCID: PMC7583629 DOI: 10.7717/peerj.10136] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/18/2020] [Indexed: 12/11/2022] Open
Abstract
Under physiological conditions, retinal pigment epithelium (RPE) is a cellular monolayer composed of mitotically quiescent cells. Tight junctions and adherens junctions maintain the polarity of RPE cells, and are required for cellular functions. In proliferative vitreoretinopathy (PVR), upon retinal tear, RPE cells lose cell-cell contact, undergo epithelial-mesenchymal transition (EMT), and ultimately transform into myofibroblasts, leading to the formation of fibrocellular membranes on both surfaces of the detached retina and on the posterior hyaloids, which causes tractional retinal detachment. In PVR, RPE cells are crucial contributors, and multiple signaling pathways, including the SMAD-dependent pathway, Rho pathway, MAPK pathways, Jagged/Notch pathway, and the Wnt/β-catenin pathway are activated. These pathways mediate the EMT of RPE cells, which play a key role in the pathogenesis of PVR. This review summarizes the current body of knowledge on the polarized phenotype of RPE, the role of cell-cell contact, and the molecular mechanisms underlying the RPE EMT in PVR, emphasizing key insights into potential approaches to prevent PVR.
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Affiliation(s)
- Hui Zou
- Eye Center, The Second Hospital of Jilin University, Changchun, China
| | - Chenli Shan
- Eye Center, The Second Hospital of Jilin University, Changchun, China
| | - Linlin Ma
- Eye Center, The Second Hospital of Jilin University, Changchun, China
| | - Jia Liu
- Eye Center, The Second Hospital of Jilin University, Changchun, China
| | - Ning Yang
- Eye Center, The Second Hospital of Jilin University, Changchun, China
| | - Jinsong Zhao
- Eye Center, The Second Hospital of Jilin University, Changchun, China
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Juncal VR, Mak MY, Bamakrid M, Muni RH. Changes in Aqueous Cytokine Levels Following Intravitreal Aflibercept in Treatment-Naive Patients with Diabetic Macular Edema. J Ocul Pharmacol Ther 2020; 36:697-702. [DOI: 10.1089/jop.2020.0038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Verena R. Juncal
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
- Department of Ophthalmology, Unity Health Toronto, St. Michael's Hospital, Toronto, Canada
| | - Michael Y.K. Mak
- Department of Ophthalmology, University of Calgary, Calgary, Canada
| | - Motaz Bamakrid
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
- Department of Ophthalmology, Unity Health Toronto, St. Michael's Hospital, Toronto, Canada
| | - Rajeev H. Muni
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Canada
- Department of Ophthalmology, Unity Health Toronto, St. Michael's Hospital, Toronto, Canada
- Kensington Vision and Research Centre, Toronto, Canada
- Department of Ophthalmology, The Hospital for Sick Children, Toronto, Canada
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Eyeing the Extracellular Matrix in Vascular Development and Microvascular Diseases and Bridging the Divide between Vascular Mechanics and Function. Int J Mol Sci 2020; 21:ijms21103487. [PMID: 32429045 PMCID: PMC7278940 DOI: 10.3390/ijms21103487] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 12/20/2022] Open
Abstract
The extracellular matrix (ECM) is critical in all aspects of vascular development and health: supporting cell anchorage, providing structure, organization and mechanical stability, and serving as a sink for growth factors and sustained survival signals. Abnormal changes in ECM protein expression, organization, and/or properties, and the ensuing changes in vascular compliance affect vasodilator responses, microvascular pressure transmission, and collateral perfusion. The changes in microvascular compliance are independent factors initiating, driving, and/or exacerbating a plethora of microvascular diseases of the eye including diabetic retinopathy (DR) and vitreoretinopathy, retinopathy of prematurity (ROP), wet age-related macular degeneration (AMD), and neovascular glaucoma. Congruently, one of the major challenges with most vascular regenerative therapies utilizing localized growth factor, endothelial progenitor, or genetically engineered cell delivery, is the regeneration of blood vessels with physiological compliance properties. Interestingly, vascular cells sense physical forces, including the stiffness of their ECM, through mechanosensitive integrins, their associated proteins and the actomyosin cytoskeleton, which generates biochemical signals that culminate in a rapid expression of matricellular proteins such as cellular communication network 1 (CCN1) and CCN2 (aka connective tissue growth factor or CTGF). Loss or gain of function of these proteins alters genetic programs of cell growth, ECM biosynthesis, and intercellular signaling, that culminate in changes in cell behavior, polarization, and barrier function. In particular, the function of the matricellular protein CCN2/CTGF is critical during retinal vessel development and regeneration wherein new blood vessels form and invest a preformed avascular neural retina following putative gradients of matrix stiffness. These observations underscore the need for further in-depth characterization of the ECM-derived cues that dictate structural and functional properties of the microvasculature, along with the development of new therapeutic strategies addressing the ECM-dependent regulation of pathophysiological stiffening of blood vessels in ischemic retinopathies.
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Ishida Y, Iwama Y, Nakashima H, Ikeda T, Emi K. Risk Factors, Onset, and Progression of Epiretinal Membrane after 25-Gauge Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment. ACTA ACUST UNITED AC 2020; 4:284-288. [DOI: 10.1016/j.oret.2019.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 10/25/2022]
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Incidence and treatment outcomes of secondary epiretinal membrane following intravitreal injection for diabetic macular edema. Sci Rep 2020; 10:528. [PMID: 31953511 PMCID: PMC6969073 DOI: 10.1038/s41598-020-57509-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 01/02/2020] [Indexed: 12/14/2022] Open
Abstract
The purpose of this study was to investigate the incidence of secondary epiretinal membrane (ERM) after intravitreal injection and the effect of ERM on visual acuity and central macular thickness (CMT) in patients with diabetic macular edema (DME). We included 147 eyes of 95 patients over 18 years old who were diagnosed with DME from 2012 to 2016, treated with intravitreal injection, and followed-up more than 24 months. Mean CMT in the ERM group was significantly thicker than in the non-ERM group after 9, 12, 18, and 24 months. Secondary ERM developed in 9.5% of patients during follow-up. Compared to other agents, the incidence of secondary ERM was significantly higher after intravitreal injection of dexamethasone implant. Among patients in the ERM group, the mean decrease of CMT between pre-injection and 2 weeks post-injection was significantly less after secondary ERM formation than before ERM formation. Secondary ERM formation was significantly associated with the number of intravitreal injections and the use of dexamethasone implant. Therefore, secondary ERM develops more frequently as the number of intravitreal injections increases and after intravitreal dexamethasone implant injection. The therapeutic effects of intravitreal injections for DME patients decrease after secondary ERM formation.
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Transplantation Site Affects the Outcomes of Adipose-Derived Stem Cell-Based Therapy for Retinal Degeneration. Stem Cells Int 2020; 2020:9625798. [PMID: 32377204 PMCID: PMC7199575 DOI: 10.1155/2020/9625798] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/22/2019] [Accepted: 12/03/2019] [Indexed: 01/20/2023] Open
Abstract
Adipose-derived stem cells (ASCs) have shown a strong protective effect on retinal degenerative diseases (RDD) after being transplanted into the subretinal space in an animal model. Recently, several clinical trials have been conducted to treat RDD with intravitreal transplantation of stem cells, including ASCs. However, the outcomes of the clinical trials were not satisfactory. To investigate if the transplantation site alters the outcome of stem cell-based therapy for RDD, we isolated rat ASCs (rASCs) and labeled them with green fluorescent protein. Autologous rASCs were grafted into the vitreous chamber or subretinal space in a rat RDD model induced by sodium iodate (SI). The electric response was recorded by ERG. The anatomic structure of the retina was observed in cryosections of rat eyes at posttransplantation weeks 1, 2, and 4. Neural retina apoptosis and epiretinal membrane- (ERM-) like structure formation were investigated by immunostaining. The intravitreal transplantation of rASCs resulted in an extinguished electric response, although the rosette formation and apoptosis of neural retina were reduced. However, the rASCs that grafted in the subretinal space protected the retina from the damage caused by SI, including a partial recovering of the electric response and a reduction in rosette formation. Intravitreally grafted rASCs formed a membrane, resulting in retina folding at the injection site. Müller cells, retinal pigment epithelial cells, and microglial cells migrated from the retina to the rASC-formed membrane and subsequently formed an ERM-like structure. Furthermore, vitreous fluid promoted rASC migration, and rASC-conditioned medium enhanced Müller cell migration as indicated by in vitro studies. These data suggested that the vitreous chamber is not a good transplantation site for ASC-based therapy for RDD and that a deliberate decision should be made before transplantation of stem cells into the vitreous chamber to treat RDD in clinical trials.
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Analysis of Clinical and Functional Results of the Developed Technology of Combined Laser Treatment of Initial Stages of Idiopathic Epiretinal Membrane. ACTA BIOMEDICA SCIENTIFICA 2019. [DOI: 10.29413/abs.2019-4.4.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim. To analyze the clinical and functional results of the combined technology for laser treatment of patients with the initial stages of idiopathic epiretinal membrane.Methods. This study included 3 groups of patients: the main group (32 patients) after the combined laser technology (subthreshold “grid” laser photocoagulation (LP) and subthreshold micropulse LP); control group (30 patients) which did not receive any treatment; comparison group (30 patients) after subthreshold “grid” LP. The assessment uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), central retinal thickness (CRT) and central retinal sensitivity (CRS) was performed. The follow-up period was 5 years.Results. In the control group a slow decrease of UCVA, BCVA, CRS (p < 0.05) and an increasing CRT (p < 0.05) were observed. In the main group maximal UCVA, BCVA, CRS (p < 0.05) were marked from 3 to 6 months after laser treatment and there was a gradual decrease in the CRT indices. In the comparison group, a short-term positive effect was achieved up to 3 months with an increase of UCVA, BCVA, CRS (p < 0.05). 12 months post op there was an increase in CRT with a decrease of UCVA, BCVA, and CRS until the end of study.Conclusion. The technology of combined laser treatment showed high efficiency in control and comparison groups, with stabilization/increase of UCVA, BCVA, CRS and stabilization/improvement of the morphological parameters of the retina – the decrease of CRT with ERM involution.
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Takhchidi K, Zheltov GI, Kachalina GF, Kasmynina TA, Tebina EP. Combination laser therapy for epiretinal membrane: a physico-mathematical model. BULLETIN OF RUSSIAN STATE MEDICAL UNIVERSITY 2019. [DOI: 10.24075/brsmu.2019.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
An epiretinal membrane (ERM) is a product of abnormal cell proliferation on the inner surface of the retina and at the vitreomacular interface. Laser therapy is an interesting modality for treating pathologies of the vitreomacular interface. The wise choice of laser settings (wavelength, exposure time, power) minimizes damage to the retina and ensures a good therapeutic effect. This could be a serious impetus to the development and refinement of laser technologies for treating ERM. This work investigates the biophysical response of structural retinal components, including the dynamics of temperatures and acoustic oscillations, protein denaturation, and stimulation of tissue regeneration, to a quasi-cw laser beam and a subsequent series of laser micropulses. The manuscript also analyzes the mechanisms underlying the therapeutic effect of the proposed laser therapy in patients with ERM.
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Takhchidi K, Kachalina GF, Kasmynina TA, Tebina EP. Combined laser treatment of early idiopathic epiretinal membrane: clinical evaluation of the developed technique. BULLETIN OF RUSSIAN STATE MEDICAL UNIVERSITY 2019. [DOI: 10.24075/brsmu.2019.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Process of development of epiretinal membrane (ERM) on the retinal surface of macular area is one of the important problems associated with vitreoretinal pathologies. Up to the present day, there has not been developed an effective method to arrest fibrosis at the early stages of its development. This study aimed to evaluate efficacy and safety of the new combined laser technique designed to treat early idiopathic ERM (stages 0–1). Ninety-two patients aged 64.7 ± 9.6 years (mean) participated in the clinical research. They were divided into three groups: treatment group (n = 32), patients whose ERM was treated following the new combined laser technique; comparison group (n = 30), patients who underwent grid laser coagulation; control group (n = 30), no treatment, observation of the natural course. Based on the results of examination of the patients, we assessed uncorrected visual acuity, best corrected visual acuity, central retinal thickness, central retinal sensitivity. Assessed against the results registered in comparison and control groups, the developed combined laser treatment technique applied in the treatment group proved to be highly effective in maintaining/improving visual functional indicators and stabilizing/improving morphofunctional indicators throughout the entire period of observation. As pertains to the morphological and functional structures of sensory retina, the technique enabled retinal sensitivity improvement at different stages of observation, which reflects its safety and efficacy.
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Affiliation(s)
- KhP Takhchidi
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - GF Kachalina
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - TA Kasmynina
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - EP Tebina
- Pirogov Russian National Research Medical University, Moscow, Russia
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Nawaz IM, Rezzola S, Cancarini A, Russo A, Costagliola C, Semeraro F, Presta M. Human vitreous in proliferative diabetic retinopathy: Characterization and translational implications. Prog Retin Eye Res 2019; 72:100756. [PMID: 30951889 DOI: 10.1016/j.preteyeres.2019.03.002] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 03/26/2019] [Accepted: 03/28/2019] [Indexed: 02/07/2023]
Abstract
Diabetic retinopathy (DR) is one of the leading causes of visual impairment in the working-age population. DR is a progressive eye disease caused by long-term accumulation of hyperglycaemia-mediated pathological alterations in the retina of diabetic patients. DR begins with asymptomatic retinal abnormalities and may progress to advanced-stage proliferative diabetic retinopathy (PDR), characterized by neovascularization or preretinal/vitreous haemorrhages. The vitreous, a transparent gel that fills the posterior cavity of the eye, plays a vital role in maintaining ocular function. Structural and molecular alterations of the vitreous, observed during DR progression, are consequences of metabolic and functional modifications of the retinal tissue. Thus, vitreal alterations reflect the pathological events occurring at the vitreoretinal interface. These events are caused by hypoxic, oxidative, inflammatory, neurodegenerative, and leukostatic conditions that occur during diabetes. Conversely, PDR vitreous can exert pathological effects on the diabetic retina, resulting in activation of a vicious cycle that contributes to disease progression. In this review, we recapitulate the major pathological features of DR/PDR, and focus on the structural and molecular changes that characterize the vitreal structure and composition during DR and progression to PDR. In PDR, vitreous represents a reservoir of pathological signalling molecules. Therefore, in this review we discuss how studying the biological activity of the vitreous in different in vitro, ex vivo, and in vivo experimental models can provide insights into the pathogenesis of PDR. In addition, the vitreous from PDR patients can represent a novel tool to obtain preclinical experimental evidences for the development and characterization of new therapeutic drug candidates for PDR therapy.
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Affiliation(s)
- Imtiaz M Nawaz
- Department of Molecular and Translational Medicine, University of Brescia, Italy
| | - Sara Rezzola
- Department of Molecular and Translational Medicine, University of Brescia, Italy
| | - Anna Cancarini
- Department of Ophthalmology, University of Brescia, Italy
| | - Andrea Russo
- Department of Ophthalmology, University of Brescia, Italy
| | - Ciro Costagliola
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | | | - Marco Presta
- Department of Molecular and Translational Medicine, University of Brescia, Italy.
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CORRELATION BETWEEN OUTER RETINAL THICKENING AND RETINAL FUNCTION IMPAIRMENT IN PATIENTS WITH IDIOPATHIC EPIRETINAL MEMBRANES. Retina 2019; 39:331-338. [DOI: 10.1097/iae.0000000000001971] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Taghavi Y, Hassanshahi G, Kounis NG, Koniari I, Khorramdelazad H. Monocyte chemoattractant protein-1 (MCP-1/CCL2) in diabetic retinopathy: latest evidence and clinical considerations. J Cell Commun Signal 2019; 13:451-462. [PMID: 30607767 DOI: 10.1007/s12079-018-00500-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/07/2018] [Indexed: 10/27/2022] Open
Abstract
Diabetic retinopathy (DR) is considered as a diabetes-related complication that can render severe visual impairments and is also a risk factor for acquired blindness in both developed as well as developing countries. Through fibrovascular epiretinal membranes (ERMs), this condition can similarly lead to tractional retinal detachment. Laboratory efforts evaluating the DR pathogenesis can be provided by ocular vitreous fluid and ERMs resulting from vitrectomy. The clinical stages of DR are significantly associated with expression levels of certain chemokines, including monocyte chemotactic protein-1 (MCP-1) in the intraocular fluid. The MCP-1 is also a known potent chemotactic factor for monocytes and macrophages that can stimulate them to produce superoxide and other mediators. Following hyperglycemia, retinal pigmented epithelial (RPE) cells, endothelial cells, and Müller's glial cells are of utmost importance for MCP-1 production, and vitreous MCP-1 levels rise in patients with DR. Increased expression of the MCP-1 in the eyes can also play a significant role in the pathogenesis of DR. In this review, current clinical and laboratory progress achieved on the MCP-1 and the DR concerning neovascularization and inflammatory responses in vitreous and/or aqueous humor of DR patients was summarized. It was suggested that further exploration of the MCP-1/CCR2 axis association between clinical stages of DR and expression levels of inflammatory and angiogenic cytokines and chemokines, principally the MCP-1 might lead to potential therapies aiming at neutralizing antibodies and viral vectors.
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Affiliation(s)
- Yousof Taghavi
- Geriatric Care Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.,Department of Ophthalmology and Otorhinolaryngology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Gholamhossein Hassanshahi
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.,Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Nicholas G Kounis
- Department of Cardiology, University of Patras Medical School, Patras, Achaia, Greece
| | - Ioanna Koniari
- Department of Cardiology, Queen Elizabeth Hospital, Birmingham, England
| | - Hossein Khorramdelazad
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran. .,Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Song DH, Lee JE. Nonarteritic Anterior Ischemic Optic Neuropathy with an Atypical Visual Field Defect. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.12.1374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Dong Hun Song
- Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea
| | - Ji Eun Lee
- Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea
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Dexamethasone Intravitreal Implant (Ozurdex) for Long-Term Macular Edema after Epiretinal Membrane Peeling Surgery. J Ophthalmol 2018; 2018:5832186. [PMID: 30693103 PMCID: PMC6332950 DOI: 10.1155/2018/5832186] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 11/07/2018] [Accepted: 11/15/2018] [Indexed: 11/19/2022] Open
Abstract
Purpose To investigate the functional and anatomical outcome of the 0.7 mg dexamethasone (Ozurdex) intravitreal implant (IVD) in eyes with long-term macular edema after macular epiretinal membrane removal. Methods We enrolled 40 eyes with persistent macular edema at least 12 months after epiretinal membrane removal. Twenty eyes in the IVD group received IVD and the other 20 eyes were in the control group. The main outcome measures were change in best-corrected visual acuity (BCVA) and central foveal thickness (CFT). Results For eyes in the IVD group, the mean BCVA improved by 3.45 lines to 0.47 logMAR one month after IVD. However, the mean BCVA improved by only 0.14 lines to 0.74 logMAR at the same time in eyes in the control group. Six months later, the mean BCVA improved to 0.31 and 0.74 logMAR in the IVD and control groups, respectively. In the IVD group, the mean CFT decreased rapidly by 116.8 μm to 333.9 μm one month after IVD. Thereafter the CFT decreased at a slower pace. In the control group, the CFT remained static during the follow-up period. However, in the IVD group, 6 months after IVD, the CFT seemed to have a tendency to increase. Conclusions Single IVD could significantly decrease macular edema and improve visual outcome for eyes with persistent long-term macular edema after macular ERM removal and the effect can be sustained as long as 6 months after the initial injection. However, in order to maintain the visual and anatomical outcome, repeat IVD might be considered if macular edema recurs.
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Evaluation of TGF-Beta 2 and VEGF α Gene Expression Levels in Epiretinal Membranes and Internal Limiting Membranes in the Course of Retinal Detachments, Proliferative Diabetic Retinopathy, Macular Holes, and Idiopathic Epiretinal Membranes. J Ophthalmol 2018; 2018:8293452. [PMID: 29850215 PMCID: PMC5937441 DOI: 10.1155/2018/8293452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/01/2018] [Accepted: 02/28/2018] [Indexed: 11/28/2022] Open
Abstract
Purpose To evaluate the expression profiles of the VEGFα and TGFβ in the ERMs and ILMs in retinal disorders. Methods In this nonrandomized prospective study, 75 patients (34 females and 41 males) referred to pars plana vitrectomy (PPV) due to different retinal diseases were enrolled to the study. The samples of ERMs and ILMs collected during PPV were immediately put in TRIzol® Reagent (Life Technologies, USA) and stored at −70°C until RNA extraction. Gene expression analysis was done with TaqMan® Gene Expression Assays (Applied Biosystems, USA) following the manufacturer's instructions. Results The gene expression levels of VEGFα as well as of TGFβ2 were significantly higher in ERMs than in ILMs in all studied groups. The level of TGFβ2 expression exhibits a significantly lower values in iERMs as compared with the RRD group (p = 0.043). There were differences in TGFβ2 expression in ILM in groups studied: DR versus RRD, p = 0.003; DR versus iERM, p = 0,047; and iERM versus RRD, p = 0.004. Conclusions Our results revealed that factors associated with angiogenesis and wound healing processes in eyes with RRD, PDR, iERM, and MH were more upregulated in ERMs than in ILMs. This may indicate that ILM is not responsible for reproliferation and its peeling should be avoided in routine PPV.
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Xu J, Zhong H, Cui L, Lan Q, Chen L, He W, Wu Y, Jiang L, Huang H, Zhao X, Li L, Zeng S, Li M, Xu F. Expression of wild-type p53-induced phosphatase 1 in diabetic epiretinal membranes. Oncotarget 2018; 8:35532-35541. [PMID: 28402943 PMCID: PMC5482596 DOI: 10.18632/oncotarget.16683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/11/2017] [Indexed: 01/01/2023] Open
Abstract
Objective The aims of the present study were to investigate the expression and distribution of Wild-type p53-induced phosphatase 1 (Wip1) in diabetic patients with proliferative diabetic retinopathy (PDR) with epiretinal membranes (ERMs) meanwhile analyze the colocalization of Wip1 and nuclear factor kappa-B (NF-κB) p65 in ERMs. Methods ERMs samples were collected from patients with PDR (PDR group) or non-diabetic patients with idiopathic epiretinal membranes (iERMs) (control group) during pars plana vitrectomy. Real-Time PCR analysis was carried out to examine the mRNA expression of Wip1 in ERMs. Immunohistochemical analysis and Immunofluorescent analysis were performed to detect the protein expression of Wip1 in ERMs. Double immunofluorescent staining was performed to detect the colocalization of Wip1 and glial fibrillary acidic protein (GFAP) (retinal glial cells marker), also Wip1 and NF-κB. Results ERMs were obtained from 17 eyes of 17 patients with PDR (the PDR group) and 9 eyes of 9 nondiabetic patients (the control group) with iERMs. Our results showed high expression levels of Wip1 mRNAs in ERMs after PDR, but low in iERMs. In addition, both immunohistochemistry and immunofluorescence assay showed strong immunoreactivity for Wip1 in PDR ERMs. Furthermore, Wip1 and GFAP were coexpressed in PDR membranes. Finally, the expression of Wip1 was paralleled with NF-κB. Conclusion These data support the notion that Wip1 contributes to the formation of the ERMs in PDR membranes via NF-κB signaling.
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Affiliation(s)
- Jiping Xu
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Haibin Zhong
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Ling Cui
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Qianqian Lan
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Lifei Chen
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Wenjing He
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Yu Wu
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Li Jiang
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Hui Huang
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Xin Zhao
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Li Li
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Siming Zeng
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Min Li
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
| | - Fan Xu
- Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, People's Republic of China
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Kim SH, Song SJ, Bae JH. The Incidence and Risk Factors of Epiretinal Membrane in a Screened Korean Population. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.10.922] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Seong Ho Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Su Jeong Song
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Hun Bae
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Yoshida S, Nakama T, Ishikawa K, Nakao S, Sonoda KH, Ishibashi T. Periostin in vitreoretinal diseases. Cell Mol Life Sci 2017; 74:4329-4337. [PMID: 28913545 PMCID: PMC11107734 DOI: 10.1007/s00018-017-2651-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 09/04/2017] [Indexed: 12/19/2022]
Abstract
Proliferative vitreoretinal diseases such as diabetic retinopathy, proliferative vitreoretinopathy (PVR), and age-related macular degeneration are a leading cause of decreased vision and blindness in developed countries. In these diseases, retinal fibro(vascular) membrane (FVM) formation above and beneath the retina plays an important role. Gene expression profiling of human FVMs revealed significant upregulation of periostin. Subsequent analyses demonstrated increased periostin expression in the vitreous of patients with both proliferative diabetic retinopathy and PVR. Immunohistochemical analysis showed co-localization of periostin with α-SMA and M2 macrophage markers in FVMs. In vitro, periostin blockade inhibited migration and adhesion induced by PVR vitreous and transforming growth factor-β2 (TGF-β2). In vivo, a novel single-stranded RNAi agent targeting periostin showed the inhibitory effect on experimental retinal and choroidal FVM formation without affecting the viability of retinal cells. These results indicated that periostin is a pivotal molecule for FVM formation and a promising therapeutic target for these proliferative vitreoretinal diseases.
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Affiliation(s)
- Shigeo Yoshida
- Department of Ophthalmology, Kyushu University Graduate School of Medical Sciences, Fukuoka, 812-8582, Japan.
| | - Takahito Nakama
- Department of Ophthalmology, Kyushu University Graduate School of Medical Sciences, Fukuoka, 812-8582, Japan
| | - Keijiro Ishikawa
- Department of Ophthalmology, Kyushu University Graduate School of Medical Sciences, Fukuoka, 812-8582, Japan
| | - Shintaro Nakao
- Department of Ophthalmology, Kyushu University Graduate School of Medical Sciences, Fukuoka, 812-8582, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Kyushu University Graduate School of Medical Sciences, Fukuoka, 812-8582, Japan
| | - Tatsuro Ishibashi
- Department of Ophthalmology, Kyushu University Graduate School of Medical Sciences, Fukuoka, 812-8582, Japan
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Abstract
PDGFs and their receptors are critical regulators of numerous tissues and organs, including the eye. Extensive studies have shown that PDGFs and their receptors play critical roles in many ocular neovascular diseases, such as neovascular age-related macular degeneration, retinopathy of prematurity, and proliferative vitreoretinopathy. In addition, PDGFs and PDGFRs are also important players in ocular diseases involving the degeneration of retinal neuronal and vascular cells, such as glaucoma and retinitis pigmentosa. Due to their critical roles in the pathogenesis of many blinding ocular diseases, the PDGFs and PDGFRs have been considered as important target molecules for the treatment of eye diseases. PDGF-C and PDGF-D are relatively new members of the PDGF family and are potent angiogenic and survival factors. Recent studies have demonstrated their important roles in different types of eye diseases. Thus, modulating PDGF-C and PDGF-D activities may have therapeutic values for the treatment of ocular neovascular and degenerative diseases. This review mainly summarizes the recent advances on PDGF-C and PDGF-D biology in relationship to some major ocular diseases.
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Affiliation(s)
- Anil Kumar
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, Guangdong, PR China
| | - Xuri Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 South Xianlie Road, Guangzhou 510060, Guangdong, PR China.
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Xu K, Chin EK, Parke DW, Almeida DR. Epiretinal membrane and cystoid macular edema as predictive factors of recurrent proliferative vitreoretinopathy. Clin Ophthalmol 2017; 11:1819-1824. [PMID: 29066859 PMCID: PMC5644552 DOI: 10.2147/opth.s146681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Proliferative vitreoretinopathy (PVR) is the most common cause of recurrent retinal detachment (RD). We sought to determine the predictive factors of recurrent PVR formation and the need for additional vitreoretinal surgical intervention after uncomplicated primary RD repair. METHODS This is a retrospective single-center case-control study of consecutive patients with PVR formation after uncomplicated RD repair. Logistic regression was used to assess factors associated with recurrent PVR formation. RESULTS Thirty-seven eyes (37 patients) who had recurrent RD secondary to PVR formation were included. Among those, 27 eyes needed one additional surgery, whereas the remainder 10 eyes required two or more additional surgeries. In the univariate analysis, patients who had cystoid macular edema (CME) after the second surgery were 8.33 times (crude odds ratio [COR], 95% confidence interval [CI]: 1.23-56.67, p=0.0302) more likely to have recurrent PVR formation compared to those who did not have CME after the second surgery. Similarly, those who had epiretinal membrane (ERM) after the second surgery were 8.00 times (COR, 95% CI: 1.43-44.92, p=0.0182) more likely to have recurrent PVR formation compared to those who did not have ERM after the second surgery. In the multivariate analysis, patients who had ERM after the second surgery were 8.20 times (adjusted odds ratio [AOR], 95% CI: 1.08-62.40, p=0.0422) more likely to develop recurrent PVR compared to those who did not have ERM after the second surgery, when adjusted for age, sex, and CME after the second surgery. CONCLUSION ERM and CME are potential predictive factors for recurrent PVR formation after uncomplicated primary RD repair. Early recognition and treatment of ERM and CME may be critical to prevent subsequent PVR formation and improve visual outcomes.
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Affiliation(s)
- Kunyong Xu
- Department of Ophthalmology, Weill Cornell Medicine, Cornell University, New York, NY
| | - Eric K Chin
- Retina Consultants of Southern California, Redlands, CA
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Shah RS, Soetikno BT, Yi J, Liu W, Skondra D, Zhang HF, Fawzi AA. Visible-Light Optical Coherence Tomography Angiography for Monitoring Laser-Induced Choroidal Neovascularization in Mice. Invest Ophthalmol Vis Sci 2017; 57:OCT86-95. [PMID: 27409510 PMCID: PMC4968775 DOI: 10.1167/iovs.15-18891] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose This study sought to determine the earliest time-point at which evidence of choroidal neovascularization (CNV) could be detected with visible-light optical coherence tomography angiography (vis-OCTA) in a mouse model of laser-induced CNV. Methods Visible light-OCTA was used to study laser-induced CNV at different time-points after laser injury to monitor CNV development and measure CNV lesion size. Measurements obtained from vis-OCTA angiograms were compared with histopathologic measurements from isolectin-stained choroidal flatmounts. Results Choroidal neovascularization area measurements between the vis-OCTA system and isolectin-stained choroidal flatmounts were significantly different in area for days 2 to 4 postlaser injury, and were not significantly different in area for days 5, 7, and 14. Choroidal neovascularization area measurements taken from the stained flatmounts were larger than their vis-OCTA counterparts for all time-points. Both modalities showed a similar trend of CNV size increasing from the day of laser injury until a peak of day 7 postlaser injury and subsequently decreasing by day 14. Conclusions The earliest vis-OCTA can detect the presence of aberrant vessels in a mouse laser-induced CNV model is 5 days after laser injury. Visible light-OCTA was able to visualize the maximum of the CNV network 7 days postlaser injury, in accordance with choroidal flatmount immunostaining. Visible light-OCTA is a reliable tool in both detecting the presence of CNV development, as well as accurately determining the size of the lesion in a mouse laser-induced CNV model.
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Affiliation(s)
- Ronil S Shah
- Department of Ophthalmology Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
| | - Brian T Soetikno
- Department of Ophthalmology Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States 2Functional Optical Imaging Laboratory, Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, United States 3Med
| | - Ji Yi
- Functional Optical Imaging Laboratory, Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, United States
| | - Wenzhong Liu
- Functional Optical Imaging Laboratory, Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, United States
| | - Dimitra Skondra
- Department of Ophthalmology Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
| | - Hao F Zhang
- Department of Ophthalmology Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States 2Functional Optical Imaging Laboratory, Department of Biomedical Engineering, Northwestern University, Chicago, Illinois, United States
| | - Amani A Fawzi
- Department of Ophthalmology Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
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LONG-TERM RETROSPECTIVE ANALYSIS OF VISUAL ACUITY AND OPTICAL COHERENCE TOPOGRAPHIC CHANGES AFTER SINGLE VERSUS DOUBLE PEELING DURING VITRECTOMY FOR MACULAR EPIRETINAL MEMBRANES. Retina 2017; 36:2101-2109. [PMID: 27124883 DOI: 10.1097/iae.0000000000001055] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine the long-term effect of internal limiting membrane with associated epiretinal membrane (ERM) peeling versus single peeling alone in terms of best-corrected visual acuity and anatomical outcomes on spectral-domain optical coherence tomography. METHODS This retrospective comparative cohort study of patients who had follow-up of >1 year and underwent surgery for ERM by a single surgeon (S.C.) from January 1, 2008 to December 31, 2012 compared cases in which the internal limiting membrane was stained with brilliant blue G to facilitate double peeling (n = 42) and single peeling (n = 43) of the ERM alone for up to 3 years of follow-up. For continuous variables, an independent two-tailed t-test was performed. For binary variables, the Fisher's exact test was performed. Statistical significance was defined as P < 0.05. RESULTS Eighty-five of 142 patients fit the inclusion criteria. At the last follow-up, the single-peeling group were more likely to have ERM remaining in the central fovea postoperatively (P = 0.0020, becoming significant by postoperative Year 1, P = 0.022) and less likely to develop inner retinal dimpling (P = 0.000, becoming significant by postoperative Month 3, P = 0.015). At 3 years, central foveal thickness had decreased in the single-peeling group by -136.9 µm and by -84.1 μm in the double-peeling group, which was not significantly different (P = 0.08). Mean best-corrected visual acuity improved in both the groups at all time points. There was no statistically significant difference between the 2 groups at 3 years (P = 0.44; single-peeling group, 0.32 ± 0.42, Snellen 20/42; double-peeling group, 0.23 ± 0.27, Snellen 20/34). CONCLUSION Brilliant blue G-assisted internal limiting membrane peeling for ERM results in a more thorough removal of residual ERM around the paracentral fovea. However, there is no difference in long-term best-corrected visual acuity at 3 years and a greater likelihood of inner retinal dimpling.
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Pathologic Roles of Receptor-Associated Prorenin System in Idiopathic Epiretinal Membrane. Sci Rep 2017; 7:44266. [PMID: 28276504 PMCID: PMC5343583 DOI: 10.1038/srep44266] [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] [Received: 06/30/2016] [Accepted: 02/07/2017] [Indexed: 11/09/2022] Open
Abstract
Receptor-associated prorenin system (RAPS) refers to the pathogenic mechanism whereby prorenin binding to (pro)renin receptor [(P)RR] dually activates tissue renin-angiotensin system (RAS) and RAS-independent signaling via (P)RR. The aim of this study is to determine the association of RAPS with idiopathic epiretinal membrane (iERM). Reverse transcription-PCR indicated the expression of RAPS components, including (P)RR and Ang II type 1 receptor (AT1R), in iERM tissues and human Müller glial cell line. Double-labeling analyses demonstrated that (P)RR and AT1R were detected in cells positive for glial fibrillary acidic protein, a marker for glial cells, and co-localized with prorenin and angiotensinogen, respectively. Administration of prorenin to Müller glial cells enhanced mRNA expression of fibroblast growth factor 2, while Ang II application stimulated the expression of glial cell line-derived neurotrophic factor, nerve growth factor, and transforming growth factor-β1. These expression levels induced by prorenin or Ang II were reversed by (P)RR or AT1R blockade, respectively. Immunofluorescence revealed tissue co-localization of (P)RR and AT1R with the products of the upregulated genes in vitro. The present findings suggest the involvement of RAPS in the pathogenesis of iERM.
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Soluble form of LR11 is highly increased in the vitreous fluids of patients with idiopathic epiretinal membrane. Graefes Arch Clin Exp Ophthalmol 2017; 255:885-891. [DOI: 10.1007/s00417-017-3585-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 12/24/2016] [Accepted: 01/04/2017] [Indexed: 12/11/2022] Open
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Myojin S, Yoshimura T, Yoshida S, Takeda A, Murakami Y, Kawano Y, Oshima Y, Ishibashi T, Sonoda KH. Gene Expression Analysis of the Irrigation Solution Samples Collected during Vitrectomy for Idiopathic Epiretinal Membrane. PLoS One 2016; 11:e0164355. [PMID: 27736918 PMCID: PMC5063277 DOI: 10.1371/journal.pone.0164355] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 09/24/2016] [Indexed: 02/03/2023] Open
Abstract
Purpose The analysis of gene expression in idiopathic epiretinal membranes (iERMs) may help elucidate ERM formation and its pathology. Here, we conducted a case-control study, in order to determine the expression levels of cytokines and other genes in eyes with macular hole (MH) or iERM. Methods Twenty eyes, obtained from seven male and 13 female patients, were included in the study. The average age of the study subjects was 69.1 ± 7.67 years, and 15 eyes had iERM, while five eyes had MH. Irrigation solution samples were collected during vitrectomy, centrifuged, and the levels of cytokine and other mRNAs in the sediment were assessed using real-time PCR. The expression level of 11 cytokine genes, four transcription factor genes, two cytoskeletal genes, and genes encoding two extracellular matrix proteins in eyes with MH or iERM were determined and compared. Results The expression levels of interleukin 6 (IL6), tumor growth factor B2 (TGFB2), vascular endothelial growth factor A (VEGFA), chemokine C-X-C motif ligand 1 (CXCL1), v-rel avian reticuloendotheliosis viral oncogene homolog A (RELA), glial fibrillary acidic protein (GFAP), and tenascin C (TNC) were significantly higher in eyes with iERM than in eyes with MH. The expression of these genes was not associated with the preoperative visual acuity of the investigated patients. Conclusions The obtained results indicate that real-time PCR analysis of irrigation solution samples collected during vitrectomy can help assess the expression levels of several genes, and that iERM is associated with the expression of pro-inflammatory genes and the genes expressed during angiogenesis and wound healing process (IL6, TGFB2, VEGFA, CXCL1, RELA, GFAP, and TNC).
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Affiliation(s)
- Sayaka Myojin
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Takeru Yoshimura
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
- * E-mail:
| | - Shigeo Yoshida
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Atsunobu Takeda
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yusuke Murakami
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yoichi Kawano
- Section of Ophthalmology, Department of Medicine, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka 814-0193, Japan
| | - Yuji Oshima
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Tatsuro Ishibashi
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
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Ponomareva EN, Kazaryan AA. [Idiopathic epiretinal membranes: visual function impairment, morphological and functional features of retinal involvement]. Vestn Oftalmol 2016. [PMID: 28635827 DOI: 10.17116/oftalma2016132390-95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
By affecting different retinal layers, an idiopathic epiretinal membrane (iERM) produces changes in macular architectonics and functioning. Morphological and functional assessment of these patients using modern visualization methods and electroretinography contributes to a better understanding of pathogenetic mechanisms of iERM.
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Affiliation(s)
- E N Ponomareva
- Federal Research and Clinical Center, Federal Medical and Biological Agency of Russia, 28 Orehovyy bul'var, Moscow, Russian Federation, 115682
| | - A A Kazaryan
- Federal Research and Clinical Center, Federal Medical and Biological Agency of Russia, 28 Orehovyy bul'var, Moscow, Russian Federation, 115682
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Taney LS, Baumal CR, Duker JS. Sustained-release dexamethasone intravitreal implant for persistent macular edema after vitrectomy for epiretinal membrane. Ophthalmic Surg Lasers Imaging Retina 2015; 46:224-8. [PMID: 25707048 DOI: 10.3928/23258160-20150213-01] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 11/07/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Persistent macular edema (ME) after surgical removal of epiretinal membrane (ERM) may impair postoperative visual recovery. Sustained-release dexamethasone intravitreal implant (DEX) was used to treat recalcitrant ME after vitrectomy for ERM. PATIENTS AND METHODS Retrospective chart review of eyes treated with DEX for ME after ERM removal. Visual and anatomic outcomes were evaluated. RESULTS Five eyes with refractory ME on optical coherence tomography (OCT) after ERM surgery were treated with DEX. Four of five eyes demonstrated reduction in macular thickness on OCT (mean: 106 μm), with mean percentage reduction in central foveal thickness of 25%. Visual acuity improved by one or more Snellen lines in four of five eyes. DEX effect duration was 3 to 9 months. Two eyes with OCT and visual improvement after initial DEX received multiple DEX implants for maintenance therapy. CONCLUSION Inflammatory factors may contribute to persistent ME after vitrectomy for ERM. DEX may be a treatment option in such cases.
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Current Trends about Inner Limiting Membrane Peeling in Surgery for Epiretinal Membranes. J Ophthalmol 2015; 2015:671905. [PMID: 26425352 PMCID: PMC4573876 DOI: 10.1155/2015/671905] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 05/10/2015] [Indexed: 12/31/2022] Open
Abstract
The inner limiting membrane (ILM) is the basement membrane of the Müller cells and can act as a scaffold for cellular proliferation in the pathophysiology of disorders affecting the vitreomacular interface. The atraumatic removal of the macular ILM has been proposed for treating various forms of tractional maculopathy in particular for macular pucker. In the last decade, the removal of ILM has become a routine practice in the surgery of the epiretinal membranes (ERMs), with good anatomical results. However many recent studies showed that ILM peeling is a procedure that can cause immediate traumatic effects and progressive modification on the underlying inner retinal layers. Moreover, it is unclear whether ILM peeling is helpful to improve vision after surgery for ERM. In this review, we describe the current understanding about ILM peeling and highlight the beneficial and adverse effects associated with this surgical procedure.
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Zhou RM, Wang XQ, Yao J, Shen Y, Chen SN, Yang H, Jiang Q, Yan B. Identification and characterization of proliferative retinopathy-related long noncoding RNAs. Biochem Biophys Res Commun 2015; 465:324-30. [PMID: 26241674 DOI: 10.1016/j.bbrc.2015.07.120] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 07/24/2015] [Indexed: 11/26/2022]
Abstract
Proliferative vitreoretinopathy (PVR) is a serious complication of retinal detachment and vitreoretinal surgery, which can lead to severe vision reduction. Long non-coding RNAs (lncRNAs) play critical roles in many biological processes and disease development. We attempted to determine the role of lncRNAs in the setting of PVR. Microarray analysis revealed that 78 lncRNAs were abnormally expressed in the epiretinal membranes (ERMs) of PVR patients, including 48 up-regulated and 30 down-regulated lncRNA transcripts. We subsequently focus on one lncRNA, MALAT1, and investigated its expression pattern in the biofluid of PVR patients. MALAT1 was significantly up-regulated in the cellular and plasma fraction of peripheral blood in PVR patients. MALAT1 expression was obviously reduced after PVR operation. In vitro experiments revealed the role of MALAT1 in regulating RPE proliferation and migration, which is critical for ERMs formation. This study suggests that lncRNAs are the potential regulators of PVR pathology. MALAT1 is a potential prognostic indicator and a target for the diagnosis and gene therapy for PVR diseases.
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Affiliation(s)
- Rong-Mei Zhou
- Eye Hospital, Nanjing Medical University, Nanjing, China; The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Xiao-Qun Wang
- Eye Hospital, Nanjing Medical University, Nanjing, China; The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Jin Yao
- Eye Hospital, Nanjing Medical University, Nanjing, China; The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Yi Shen
- Eye Hospital, Nanjing Medical University, Nanjing, China
| | - Sai-Nan Chen
- Eye Hospital, Nanjing Medical University, Nanjing, China
| | - Hong Yang
- Eye Hospital, Nanjing Medical University, Nanjing, China; The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Qin Jiang
- Eye Hospital, Nanjing Medical University, Nanjing, China; The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China; Institute of Integrated Medicine, Nanjing Medical University, Nanjing, China.
| | - Biao Yan
- Eye Hospital, Nanjing Medical University, Nanjing, China; The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China; Institute of Integrated Medicine, Nanjing Medical University, Nanjing, China.
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Yüksel K, Karaküçük Y, Özkaya A, Pekel G, Baz Ö, Alagöz C, Yazıcı AT. Comparison of photoreceptor outer segment length in diabetic and idiopathic epiretinal membranes. Eye (Lond) 2015; 29:1446-52. [PMID: 26183287 DOI: 10.1038/eye.2015.133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 06/10/2015] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Idiopathic and diabetic epiretinal membranes (ERMs) differ significantly in terms of macular morphology. Our aim was to compare the photoreceptor outer segment (PROS) length in diabetic and idiopathic ERMs before and after surgery. METHODS Fifty-two eyes of 50 patients who underwent pars plana vitrectomy (PPV) due to idiopathic and diabetic ERMs were included in this retrospective case series. All of the patients underwent ERM and internal limiting membrane (ILM) removal. The patients had been followed up 6 months postoperatively. Spectral-domain optical coherence tomography (OCT) was used to measure the PROS length, overall PR length and central foveal thickness (CFT). RESULTS The PROS length, overall PR length, and CFT were statistically significantly lower at all the postoperative visits when compared to preoperative values in both the idiopathic and diabetic ERM groups (P<0.001). The amount of decrease in PROS and overall PR length were similar in both groups after surgery (P>0.05). There was no relation between amount of PROS length change and visual acuity gain in both groups (P>0.05). CONCLUSIONS Postoperative change of PROS length was similar in idiopathic and diabetic ERMs. PROS length change may not be an indicator of postoperative visual acuity.
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Affiliation(s)
- K Yüksel
- Ophthalmology Department, Beyoglu Eye Training and Research Hospital, Eye Clinic, Istanbul, Turkey
| | - Y Karaküçük
- Besni State Hospital, Eye Clinic, Adıyaman, Turkey
| | - A Özkaya
- Ophthalmology Department, Beyoglu Eye Training and Research Hospital, Eye Clinic, Istanbul, Turkey
| | - G Pekel
- Ophthalmology Department, Pamukkale University, Denizli, Turkey
| | - Ö Baz
- Ophthalmology Department, Beyoglu Eye Training and Research Hospital, Eye Clinic, Istanbul, Turkey
| | - C Alagöz
- Ophthalmology Department, Beyoglu Eye Training and Research Hospital, Eye Clinic, Istanbul, Turkey
| | - A T Yazıcı
- Ophthalmology Department, Beyoglu Eye Training and Research Hospital, Eye Clinic, Istanbul, Turkey
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Wen J, Jiang Y, Zheng X, Zhou Y. Six-month changes in cytokine levels after intravitreal bevacizumab injection for diabetic macular oedema and macular oedema due to central retinal vein occlusion. Br J Ophthalmol 2015; 99:1334-40. [DOI: 10.1136/bjophthalmol-2014-306341] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 03/12/2015] [Indexed: 02/04/2023]
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Widespread vitreoretinal traction simulating retinal vasculitis in a patient with uveitis. Retin Cases Brief Rep 2014; 6:379-82. [PMID: 25389935 DOI: 10.1097/icb.0b013e31823c4498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe a case of uveitis with widespread vitreoretinal traction simulating retinal vasculitis angiographically. METHODS Interventional case report. RESULTS A 62-year-old woman was examined for low vision in her left eye that persisted for ∼1 year. She had been treated for polymyalgia rheumatica for 1 year. Visual acuity was 20/20 in the right eye and 20/100 in the left eye. There were a few aged vitreous cells in both eyes. On fundus examination, there was mild epiretinal membrane in the left eye. Fluorescein angiography revealed diffuse fluorescein leakage in the late phase of angiography in the macular peripapillary and superior retinal hemisphere in the left eye, which appeared similar to retinal vasculitis. With optical coherence tomography, there was vitreomacular traction on the macular, peripapillary, and major branches of vessels in the left eye. Fundus examination was normal in the right eye. Pars plana vitrectomy was performed in the left eye uneventfully. Visual acuity was 40/100 at the postoperative 1-year follow-up. CONCLUSION Vitreoretinal traction can be widespread and can cause diffuse fluorescein leakage resembling vasculitis or other types of uveitis.
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Abstract
PURPOSE To evaluate the morphologic restoration of retinal anatomy after surgery for epiretinal membrane (ERM) peeling using spectral domain optical coherence tomography. Correlation of retinal structure with visual outcome. DESIGN Retrospective consecutive case series. METHODS Thirty-four consecutive eyes with ERM underwent surgery with 1 year follow-up examination. Spectral domain optical coherence tomography scans were analyzed preoperatively and 1, 3, 6, 9, and 12 months postoperative. Best-corrected visual acuity (BCVA) using Early Treatment Diabetic Retinopathy Study charts was measured at each visit. RESULTS All eyes showed a significant improvement of BCVA after ERM peeling (P = 0.002). The time point of BCVA and retinal restoration seen on spectral domain optical coherence tomography occurred simultaneously and varied between individuals (occurrence of BCVA: mean, 4.82 months; retinal restoration: mean, 4.24 months). At 3 months, the retinal anatomical restoration rate was 70% and 88% at 6 months. CONCLUSION Restoration of the retinal anatomical structure predominantly occurs within the first 3 months post-ERM peeling. An improvement of BCVA and anatomical retinal restoration after ERM removal varies in individuals. If retinal layers fully restore in their anatomical structure, BCVA improves at the same time point.
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