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Schulz A, Rickmann A, Julich‐Haertel H, Germann A, Briesen H, Januschowski K, Szurman P. Comparative cytotoxic and antiproliferative profile of methotrexate and fluorouracil on different ocular cells. Acta Ophthalmol 2021; 99:e1070-e1076. [PMID: 33381918 DOI: 10.1111/aos.14735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 10/30/2020] [Accepted: 11/30/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To analyse the cytotoxic and antiproliferative effect of methotrexate (MTX) and fluorouracil (5-FU) in vitro on fibroblasts, retinal pigment epithelial (RPE) and photoreceptor cells as an adjunct for reducing the incidence of proliferative vitreoretinopathy (PVR) after rhegmatogenous retinal detachment surgery. METHODS Methotrexate and 5-FU were dissolved separately in balanced salt solution (BSS) with concentrations ranging from 0-8000 µg/ml and 0-4000 µg/ml, respectively. All solutions were analysed in terms of pH and osmolarity and applied for 1 h to fibroblasts (BJ), RPE (ARPE-19) and photoreceptor (661W) cell lines adherently cultivated in 96-well cell culture plates (10 000 cells/well). 24 h after incubation, the proliferative (BrdU), metabolic (CellTiter-Glo) and apoptotic (Caspase 3/7) activity of the cells were examined in vitro. RESULTS 5-FU had an antiproliferative effect on BJ and ARPE-19 cells starting from low concentrations (2 µg/ml). However, the viability of 661W cells decreased and apoptosis was induced with increasing 5-FU concentration. In contrast, MTX up to a concentration of 266 µg/ml did neither result in a significant loss of viability nor in increased caspase 3/7 activity of BJ, ARPE-19 and 661W cells and inhibited the proliferation of ARPE-19 already at low concentrations starting from 8 µg/ml. CONCLUSIONS Methotrexate dissolved in BSS is biocompatible up to a concentration of 266 µg/ml and may act as an intraoperative rinse solution to inhibit RPE proliferation in PVR-diseased eyes. Contrary, the use of 5-FU within the posterior segment of the eye is limited by its cell-damaging effect on photoreceptor cells.
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Affiliation(s)
- André Schulz
- Eye Clinic Sulzbach Klaus Heimann Eye Research Institute Knappschaft Hospital Saar Sulzbach Germany
| | - Annekatrin Rickmann
- Eye Clinic Sulzbach Klaus Heimann Eye Research Institute Knappschaft Hospital Saar Sulzbach Germany
| | - Henrike Julich‐Haertel
- Eye Clinic Sulzbach Klaus Heimann Eye Research Institute Knappschaft Hospital Saar Sulzbach Germany
| | - Anja Germann
- Fraunhofer Institute for Biomedical Engineering Sulzbach Germany
| | - Hagen Briesen
- Fraunhofer Institute for Biomedical Engineering Sulzbach Germany
| | - Kai Januschowski
- Eye Clinic Sulzbach Klaus Heimann Eye Research Institute Knappschaft Hospital Saar Sulzbach Germany
- Centre for Ophthalmology University Eye Hospital Tuebingen Tuebingen Germany
| | - Peter Szurman
- Eye Clinic Sulzbach Klaus Heimann Eye Research Institute Knappschaft Hospital Saar Sulzbach Germany
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Doyle F, Keegan D. Anatomical and functional outcomes in combined rhegmatogenous retinal and choroidal detachment pre-treated with systemic corticosteroid: a case series. Ir J Med Sci 2021; 191:1937-1940. [PMID: 34487277 DOI: 10.1007/s11845-021-02750-9] [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: 03/16/2021] [Accepted: 08/15/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Combined rhegmatogenous retinal and choroidal detachment (CRRCD) is a rare phenomenon. It is important that CRRCD is recognised preoperatively so that corticosteroids may be administered as this may make repair surgery easier to do. AIMS We here report on the anatomical and visual outcomes of 3 patients treated for CRRCD. METHODS Retrospective review of 3 eyes of 3 patients with CRRCD which underwent scleral buckle, vitrectomy, and silicone oil insertion. Data including visual acuity, intraocular pressure, ocular inflammatory status, the presence of subretinal fluid, the presence of retinal breaks, the presence of proliferative vitreoretinopathy, demographic information, medical and ophthalmic history, administration of perioperative corticosteroids, surgical techniques, and complications was collected. RESULTS Patients were aged 60, 66, and 62 years old at the time of surgery. There was a minimum follow-up time of 20 months. Initial visual acuity was 4/60. Initial intraocular pressure was 3 mmHg, 7 mmHg, and 7 mmHg. All eyes had deep, inflamed anterior chambers at the time of presentation. All eyes underwent 20-gauge vitrectomy, scleral buckle, and silicone oil insertion. All patients received a perioperative course of oral corticosteroids. Final visual acuity was 6/12, 6/7.5, and 6/18. CONCLUSION These 3 patients had good anatomical and functional results following surgery for CRRCD. All patients had visual acuity of 6/18 or better at last review.
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Affiliation(s)
- Fergus Doyle
- Department of Ophthalmology, Mater Retina Research Group, Dublin, Ireland.
| | - David Keegan
- Department of Ophthalmology, Mater Retina Research Group, Dublin, Ireland
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Zhang ZY, Sun YJ, Song JY, Fan B, Li GY. Experimental models and examination methods of retinal detachment. Brain Res Bull 2021; 169:51-62. [PMID: 33434623 DOI: 10.1016/j.brainresbull.2021.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 12/11/2020] [Accepted: 01/04/2021] [Indexed: 12/19/2022]
Abstract
Retinal detachment refers to the separation of the retinal neuroepithelium and pigment epithelium, usually involving the death of photoreceptor cells. Severe detachment may lead to permanent visual impairment if not treated properly and promptly. According to the underlying causes, retinal detachment falls into one of three categories: exudative retinal detachment, traction detachment, and rhegmatogenous retinal detachment. Like many other diseases, it is difficult to study the pathophysiology of retinal detachment directly in humans, because the human retinal tissues are precious, scarce and non-regenerative; thus, establishing experimental models that better mimic the disease is necessary. In this review, we summarize the existing models of the three categories of retinal detachment both in vivo and in vitro, along with an overview of their examination methods and the major strengths and weaknesses of each model.
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Affiliation(s)
- Zi-Yuan Zhang
- Second Hosp Jilin Univ, Dept Ophthalmol, 218 Zi Qiang St, Changchun, 130041, PR China.
| | - Ying-Jian Sun
- Second Hosp Jilin Univ, Dept Ophthalmol, 218 Zi Qiang St, Changchun, 130041, PR China.
| | - Jing-Yao Song
- Second Hosp Shandong Univ, Dept Ophthalmol, 247 Bei Yuan St, Jinan, 250031, PR China.
| | - Bin Fan
- Second Hosp Jilin Univ, Dept Ophthalmol, 218 Zi Qiang St, Changchun, 130041, PR China.
| | - Guang-Yu Li
- Second Hosp Jilin Univ, Dept Ophthalmol, 218 Zi Qiang St, Changchun, 130041, PR China.
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Delgado-Tirado S, Amarnani D, Zhao G, Rossin EJ, Eliott D, Miller JB, Greene WA, Ramos L, Arevalo-Alquichire S, Leyton-Cifuentes D, Gonzalez-Buendia L, Isaacs-Bernal D, Whitmore HAB, Chmielewska N, Duffy BV, Kim E, Wang HC, Ruiz-Moreno JM, Kim LA, Arboleda-Velasquez JF. Topical delivery of a small molecule RUNX1 transcription factor inhibitor for the treatment of proliferative vitreoretinopathy. Sci Rep 2020; 10:20554. [PMID: 33257736 PMCID: PMC7705016 DOI: 10.1038/s41598-020-77254-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 11/09/2020] [Indexed: 12/21/2022] Open
Abstract
Proliferative vitreoretinopathy (PVR) is the leading cause of retinal detachment surgery failure. Despite significant advances in vitreoretinal surgery, it still remains without an effective prophylactic or therapeutic medical treatment. After ocular injury or retinal detachment, misplaced retinal cells undergo epithelial to mesenchymal transition (EMT) to form contractile membranes within the eye. We identified Runt-related transcription factor 1 (RUNX1) as a gene highly expressed in surgically-removed human PVR specimens. RUNX1 upregulation was a hallmark of EMT in primary cultures derived from human PVR membranes (C-PVR). The inhibition of RUNX1 reduced proliferation of human C-PVR cells in vitro, and curbed growth of freshly isolated human PVR membranes in an explant assay. We formulated Ro5-3335, a lipophilic small molecule RUNX1 inhibitor, into a nanoemulsion that when administered topically curbed the progression of disease in a novel rabbit model of mild PVR developed using C-PVR cells. Mass spectrometry analysis detected 2.67 ng/mL of Ro5-3335 within the vitreous cavity after treatment. This work shows a critical role for RUNX1 in PVR and supports the feasibility of targeting RUNX1 within the eye for the treatment of an EMT-mediated condition using a topical ophthalmic agent.
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Affiliation(s)
- Santiago Delgado-Tirado
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
| | - Dhanesh Amarnani
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
| | - Guannan Zhao
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
| | - Elizabeth J Rossin
- Retina Service, Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
| | - Dean Eliott
- Retina Service, Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
| | - John B Miller
- Retina Service, Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
| | - Whitney A Greene
- Sensory Trauma Task Area, United States Army Institute of Surgical Research, Fort Sam Houston, San Antonio, USA
| | - Leslie Ramos
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
| | - Said Arevalo-Alquichire
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
- Energy, Materials and Environment Group, Faculty of Engineering, Universidad de La Sabana, Chia, Colombia
| | - David Leyton-Cifuentes
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
- Universidad EIA, Envigado, Colombia
| | - Lucia Gonzalez-Buendia
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
| | - Daniela Isaacs-Bernal
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
- Energy, Materials and Environment Group, Faculty of Engineering, Universidad de La Sabana, Chia, Colombia
| | - Hannah A B Whitmore
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
| | - Natalia Chmielewska
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
- Boston College, Boston, USA
| | - Brandon V Duffy
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
- Harvard College, Cambridge, USA
| | - Eric Kim
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA
| | - Heuy-Ching Wang
- Sensory Trauma Task Area, United States Army Institute of Surgical Research, Fort Sam Houston, San Antonio, USA
| | - Jose M Ruiz-Moreno
- Department of Ophthalmology, Castilla La Mancha University, Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain
- Vissum Corporation, Alicante, Spain
| | - Leo A Kim
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA.
- Retina Service, Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA.
| | - Joseph F Arboleda-Velasquez
- Schepens Eye Research Institute of Massachusetts Eye and Ear and the Department of Ophthalmology at Harvard Medical School, Boston, USA.
- Universidad EIA, Envigado, Colombia.
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PREDICTIVE FACTORS FOR PROLIFERATIVE VITREORETINOPATHY FORMATION AFTER UNCOMPLICATED PRIMARY RETINAL DETACHMENT REPAIR. Retina 2020; 39:1488-1495. [PMID: 29787465 DOI: 10.1097/iae.0000000000002184] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE To determine predictive factors of proliferative vitreoretinopathy (PVR) formation after uncomplicated primary retinal detachment repair. METHODS Retrospective, single-center, case-control study of 74 consecutive patients with (37 eyes) and without (37 eyes) PVR formation after undergoing uncomplicated primary surgery for retinal detachment repair. Logistic regression was used to assess factors associated with PVR formation. RESULTS Retinal detachment involving the macula was 4.2 times (adjusted odds ratio; 95% confidence interval, 1.4-12.9; P = 0.0119) more likely to have PVR formation compared with those without. Patients who were current or former smokers were 3.6 times (adjusted odds ratio; 95% confidence interval, 1.1-11.7; P = 0.0352) more likely to have PVR formation compared with nonsmokers. Compared with 25-gauge (g) vitrectomy, larger gauge vitrectomy (20 g or 23 g) was 3.6 times (adjusted odds ratio; 95% confidence interval, 1.2-11.3; P = 0.0276) more likely to have PVR formation. Duration of retinal detachment symptoms, high myopia, lens status, lattice degeneration, location of retinal break, number of retinal breaks, and surgical technique (e.g., scleral buckle with or without vitrectomy versus vitrectomy alone) were not found to be predictive of PVR formation. CONCLUSION Cigarette smoking and macular involvement are significant risk factors predictive of PVR formation after uncomplicated primary retinal detachment repair.
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ULTRA-WIDEFIELD OPTICAL COHERENCE TOMOGRAPHY FOR RETINAL DETACHMENT WITH PROLIFERATIVE VITREORETINOPATHY. Retin Cases Brief Rep 2020; 16:355-359. [PMID: 32032288 DOI: 10.1097/icb.0000000000000980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the efficacy of using preoperative and postoperative ultra-widefield optical coherence tomography) images in the treatment of proliferative vitreoretinopathy. METHODS The preoperative and postoperative images of a 62-year-old man with proliferative vitreoretinopathy accompanied by a rhegmatogenous retinal detachment were analyzed. PATIENT At the initial examination, the vision was 20/400. It was difficult to obtain clear images of the fundus by color fundus photography because of synechia iridis posterior and mild vitreal opacities. Three-dimensional ultra-widefield optical coherence tomography images showed that the posterior hyaloid membrane was adherent to the retinal surface at a region superior to the macula. A space was present between the hyaloid membrane and retina in the images. During surgery, the hyaloid membrane was pierced over this space without injuring the retina, and the membrane was successfully removed. After surgery, the retina was reattached and a remnant of the proliferative tissue was detected in the ultra-widefield optical coherence tomography images. Four months after the surgery, the vision improved to 20/40. CONCLUSION Ultra-widefield optical coherence tomography can be used to examine the spatial relationship between a proliferative membrane and the retina in eyes with proliferative vitreoretinopathy even when the preoperative fundus images obtained by conventional methods are not clear.
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Kuhn F, Halda T, Witherspoon CD, Morris R, Mester V. Intraocular Foreign Bodies: Myths and Truths. Eur J Ophthalmol 2018; 6:464-71. [PMID: 8997594 DOI: 10.1177/112067219600600422] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Over the centuries, the management of eyes with intraocular foreign bodies (IOFB) has posed a special challenge to the physician, and the anxiety created by such injuries has never abated. During the past few decades, several new diagnostic tests, IOFB removal techniques, and methods to treat the complications of the injury have been introduced. Nevertheless, old habits die hard: many of the management options that used to be standard are not appropriate any more but have proved difficult to change. This article reviews over forty of these die-hard myths and confronts them with factual statements published in the peer-review international literature.
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Affiliation(s)
- F Kuhn
- United States Eye Injury Registry, Birmingham, AL, USA
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8
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Park GB, Kim D. Cigarette smoke-induced EGFR activation promotes epithelial mesenchymal migration of human retinal pigment epithelial cells through regulation of the FAK-mediated Syk/Src pathway. Mol Med Rep 2018; 17:3563-3574. [PMID: 29286114 PMCID: PMC5802154 DOI: 10.3892/mmr.2017.8355] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 11/08/2017] [Indexed: 01/14/2023] Open
Abstract
Epithelial-mesenchymal transition (EMT) of retinal pigment epithelial (RPE) cells is inevitable change of age‑related macular degeneration (AMD). Smoking is a major risk factor for the development of EMT in several diseases, including lung cancer. Cigarette smoke‑induced stress promotes the production of epidermal growth factor (EGF) in RPE cells. However, the underlying signaling pathways induced by aberrant EGF receptor (EGFR) expression in cigarette smoke-exposed RPE cells remain largely unknown. In the present study, the morphological transformation and production of EMT-associated cytokines were investigated to analyze the effect of smoking on the retina. Furthermore, EGF‑treated or cigarette smoke‑exposed RPE cells, as well as the downstream targets of EGFR, were investigated to identify the key molecules involved in EMT of cigarette smoke‑stimulated RPE cells via immunoblotting. Exposure of RPE cells to cigarette smoke extract (CSE) induced secretion of VEGF and TGF‑β1, and increased the expression of EMT markers. CSE‑mediated focal adhesion kinase (FAK) activation resulted in the phosphorylation and activation of spleen associated tyrosine kinase (Syk)/Src proto‑oncogene, non‑receptor tyrosine kinase (Src), leading to migration and invasion of RPE cells. Knockdown of FAK or pharmacological inhibition of Syk/Src abrogated CSE‑mediated VEGF and TGF‑β1 production and blocked the phosphorylation of Smad2/3 in CSE‑stimulated RPE cells. Erlotinib (an EGFR inhibitor) suppressed EGF and CSE‑mediated switch from an epithelial to mesenchymal phenotype. Baicalein, an inhi-bitor of 12/15‑lipooxygenase, also efficiently suppressed CSE‑induced EMT processes by inhibiting EGFR‑associated downstream signaling transduction. The results identified a novel signaling pathway mediated by EGFR in CSE‑activated RPE cells, and suggest baicalein as a potential new therapeutic drug for CSE‑associated retinopathy.
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Affiliation(s)
- Ga Bin Park
- Department of Biochemistry, Kosin University College of Medicine, Busan 49267, Republic of Korea
| | - Daejin Kim
- Department of Anatomy, Inje University College of Medicine, Busan 47392, Republic of Korea
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Abu El-Asrar A, Al-Kwikbi H, Kangave D. Prognostic Factors after Primary Vitrectomy and Perfluorocarbon Liquids for Bullous Rhegmatogenous Retinal Detachment. Eur J Ophthalmol 2018; 19:107-17. [DOI: 10.1177/112067210901900116] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose To identify prognostic factors for visual acuity and anatomic outcomes associated with bullous rhegmatogenous retinal detachment (RRD) management using primary pars plana vitrectomy, intraoperative perfluorocarbon liquids (PFCLs), and internal gas tamponade. Methods The authors studied a consecutive series of 115 eyes (115 patients) with a bullous RRD not complicated by proliferative vitreoretinopathy (PVR) associated with large, multiple, and/or posterior breaks in 58 (50.4%) eyes. All eyes underwent vitrectomy, injection of PFCL, and gas tamponade as the primary procedure. Encircling scleral bands were placed in all cases. The follow-up period ranged from 3 to 60 months (mean 16.6±14.1 months). Results Retinal reattachment was achieved in 92.2% of eyes (106/115) with one operation and in all eyes after a second procedure. PVR was observed in 1 (0.87%) eye and pre-retinal membranes in 3 (2.6%) eyes. Progression of pre-existing cataract and development of new cataract occurred in 45 (58.4%) of the 77 phakic eyes. The presence of inferior retinal breaks was significantly associated with redetachment after the first procedure (p=0.0156). On univariate analysis, better preoperative visual acuity (p<0.001), macular sparing retinal detachment (p<0.001), and fewer quadrants involved by the detachment (p=0.0015) were significant positive prognostic factors for final visual acuity. Logistic regression analysis highlighted that macular sparing retinal detachment and absence of trauma were associated with better final visual acuity. Conclusions Redetachment was associated with the presence of inferior retinal breaks. Visual recovery was dependent on preoperative visual acuity, macular involvement, extent of retinal detachment, and trauma.
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Affiliation(s)
- A.M. Abu El-Asrar
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh - Saudi Arabia
| | - H.F. Al-Kwikbi
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh - Saudi Arabia
| | - D. Kangave
- Research Center, College of Medicine, King Saud University, Riyadh - Saudi Arabia
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Kuo HK, Chen YH, Kuo YH, Ke MC, Tseng YC, Wu PC. Evaluation of the Effect of Everolimus on Retinal Pigment Epithelial Cells and Experimental Proliferative Vitreoretinopathy. Curr Eye Res 2017; 43:333-339. [PMID: 29182404 DOI: 10.1080/02713683.2017.1396618] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE Failure of retinal detachment surgery is most commonly due to the development of proliferative vitreoretinopathy (PVR). Everolimus is an inhibitor of mammalian target of rapamycin (mTOR), and is available as oral tablets. In this study, we investigated the effect of everolimus on retinal pigment epithelial cells and modification of the severity of experimental PVR. METHODS In our in vitro studies, primary culture of retinal pigment epithelium (RPE) cells was obtained from pigmented Rex rabbits. Cell proliferation was assayed with the tetrazolium dye cytotoxicity test, and cell migration assay was performed in 24-well transwell units with 8-μm filters. In the in vivo study, pigmented Rex rabbits weighing between 2 and 2.5 kg were used. Each rabbit eye underwent gas compression; one week later, 5 × 104 RPE cells were injected into the vitreous cavity to induce PVR, and each eye was graded with indirect ophthalmoscopy on days 1, 3, 7, 14, 21, and 28. The rabbits were administered everolimus (0.5 mg/day orally) from the day of PVR induction. Total proteins extracted from RPE cells and dissected retinal samples were processed for Western blotting analysis of mTOR and ribosomal protein S6 (RPS6). RESULTS The in vitro studies showed that everolimus significantly inhibited the proliferation of RPE cells at 0.1 μg/ml; additionally, at 10 μg/ml, it suppressed the migration of RPE cells and significantly suppressed the expression of mTOR and RPS6 in RPE cells. The in vivo study did not show any benefit of oral everolimus (0.5 mg/day) in suppressing experimental PVR. Thus, everolimus significantly suppressed the expression of mTOR and RPS6 in PVR. CONCLUSIONS Everolimus suppressed the proliferation and migration of RPE cells in vitro. Oral everolimus (0.5 mg/day) suppressed the expression of mTOR and RPS6 in the retina, but showed no effect in suppressing experimental PVR.
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Affiliation(s)
- Hsi-Kung Kuo
- a Department of Ophthalmology , Kaohsiung Chang-Gung Memorial Hospital , Kaohsiung , Taiwan.,b Chang-Gung University College of Medicine , Kaohsiung , Taiwan
| | - Yi-Hao Chen
- a Department of Ophthalmology , Kaohsiung Chang-Gung Memorial Hospital , Kaohsiung , Taiwan.,b Chang-Gung University College of Medicine , Kaohsiung , Taiwan
| | - Yu-Hsia Kuo
- a Department of Ophthalmology , Kaohsiung Chang-Gung Memorial Hospital , Kaohsiung , Taiwan
| | - Mu-Chan Ke
- a Department of Ophthalmology , Kaohsiung Chang-Gung Memorial Hospital , Kaohsiung , Taiwan
| | - Ya-Chi Tseng
- a Department of Ophthalmology , Kaohsiung Chang-Gung Memorial Hospital , Kaohsiung , Taiwan
| | - Pei-Chang Wu
- a Department of Ophthalmology , Kaohsiung Chang-Gung Memorial Hospital , Kaohsiung , Taiwan.,b Chang-Gung University College of Medicine , Kaohsiung , Taiwan
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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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12
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Amarnani D, Machuca-Parra AI, Wong LL, Marko CK, Stefater JA, Stryjewski TP, Eliott D, Arboleda-Velasquez JF, Kim LA. Effect of Methotrexate on an In Vitro Patient-Derived Model of Proliferative Vitreoretinopathy. Invest Ophthalmol Vis Sci 2017; 58:3940-3949. [PMID: 28777835 PMCID: PMC5544356 DOI: 10.1167/iovs.16-20912] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose The purpose of this study was to develop a method for isolating, culturing, and characterizing cells from patient-derived membranes in proliferative vitreoretinopathy (PVR) to be used for drug testing. Methods PVR membranes were obtained from six patients with grade C PVR. Membrane fragments were analyzed by gross evaluation, fixed for immunohistologic studies to establish cell identity, or digested with collagenase II to obtain single cell suspensions for culture. PVR-derived primary cultures were used to examine the effects of methotrexate (MTX) on proliferation, migration, and cell death. Results Gross analysis of PVR membranes showed presence of pigmented cells, indicative of retinal pigment epithelial cells. Immunohistochemistry identified cells expressing α-smooth muscle actin, glial fibrillary acidic protein, Bestrophin-1, and F4/80, suggesting the presence of multiple cell types in PVR. Robust PVR primary cultures (C-PVR) were successfully obtained from human membranes, and these cells retained the expression of cell identity markers in culture. C-PVR cultures formed membranes and band-like structures in culture reminiscent of the human condition. MTX significantly reduced the proliferation and band formation of C-PVR, whereas it had no significant effect on cell migration. MTX also induced regulated cell death within C-PVR as assessed by increased expression of caspase-3/7. Conclusions PVR cells obtained from human membranes can be successfully isolated, cultured, and profiled in vitro. Using these primary cultures, we identified MTX as capable of significantly reducing growth and inducing cell death of PVR cells in vitro.
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Affiliation(s)
- Dhanesh Amarnani
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Boston, Massachusetts, United States
| | | | - Lindsay L Wong
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Boston, Massachusetts, United States
| | - Christina K Marko
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Boston, Massachusetts, United States
| | - James A Stefater
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | - Tomasz P Stryjewski
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | - Dean Eliott
- Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | | | - Leo A Kim
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Boston, Massachusetts, United States.,Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
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Histopathological and ophthalmoscopic evaluation of apocynin on experimental proliferative vitreoretinopathy in rabbit eyes. Int Ophthalmol 2016; 37:599-605. [PMID: 27495951 DOI: 10.1007/s10792-016-0318-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
Abstract
The aim of the current study was to evaluate the effect of apocynin (APO) on the development of proliferative vitreoretinopathy (PVR). New Zealand-type male rabbits were randomly grouped into three as follows: (1) Sham group rabbits which were applied intraperitoneal (i.p.) vehicle without PVR; (2) PVR group rabbits where PVR was created and an i.p. vehicle was administered for 21 successive days; (3) PVR + APO group rabbits where PVR was created and i.p. APO was administered for 21 successive days. Fundus examination was conducted with an indirect ophthalmoscope before starting the experiments and at each visit afterwards. At the end of the work, the rabbits were sacrificed under high-dose anesthesia and then eye tissues were taken for histopathological analyses. In the PVR + APO group, histopathologic and ophthalmoscopic examination revealed significant decrease in PVR formation. As the result, it has been observed that APO at least partially inhibits PVR formation.
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He S, Barron E, Ishikawa K, Nazari Khanamiri H, Spee C, Zhou P, Kase S, Wang Z, Dustin LD, Hinton DR. Inhibition of DNA Methylation and Methyl-CpG-Binding Protein 2 Suppresses RPE Transdifferentiation: Relevance to Proliferative Vitreoretinopathy. Invest Ophthalmol Vis Sci 2015; 56:5579-89. [PMID: 26305530 DOI: 10.1167/iovs.14-16258] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate expression of methyl-CpG-binding protein 2 (MeCP2) in epiretinal membranes from patients with proliferative vitreoretinopathy (PVR) and to investigate effects of inhibition of MeCP2 and DNA methylation on transforming growth factor (TGF)-β-induced retinal pigment epithelial (RPE) cell transdifferentiation. METHODS Expression of MeCP2 and its colocalization with cytokeratin and α-smooth muscle actin (α-SMA) in surgically excised PVR membranes was studied using immunohistochemistry. The effects of 5-AZA-2'-deoxycytidine (5-AZA-dC) on human RPE cell migration and viability were evaluated using a modified Boyden chamber assay and the colorimetric 3-(4,5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay. Expression of RASAL1 mRNA and its promoter region methylation were evaluated by real-time PCR and methylation-specific PCR. Effects of 5-AZA-dC on expression of α-SMA, fibronectin (FN), and TGF-β receptor 2 (TGF-β R2) and Smad2/3 phosphorylation were analyzed by Western blotting. Effect of short interfering RNA (siRNA) knock-down of MeCP2 on expression of α-SMA and FN induced by TGFβ was determined. RESULTS MeCP2 was abundantly expressed in cells within PVR membranes where it was double labeled with cells positive for cytokeratin and α-SMA. 5-AZA-dC inhibited expression of MeCP2 and suppressed RASAL1 gene methylation while increasing expression of the RASAL1 gene. Treatment with 5-AZA-dC significantly suppressed the expression of α-SMA, FN, TGF-β R2 and phosphorylation of Smad2/3 and inhibited RPE cell migration. TGF-β induced expression of α-SMA, and FN was suppressed by knock-down of MeCP2. CONCLUSIONS MeCP2 and DNA methylation regulate RPE transdifferentiation and may be involved in the pathogenesis of PVR.
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Affiliation(s)
- Shikun He
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States 2Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California, Unit
| | - Ernesto Barron
- Doheny Eye Institute, Los Angeles, California, United States
| | | | - Hossein Nazari Khanamiri
- Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States
| | - Chris Spee
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States
| | - Peng Zhou
- Doheny Eye Institute, Los Angeles, California, United States
| | - Satoru Kase
- Doheny Eye Institute, Los Angeles, California, United States
| | - Zhuoshi Wang
- Doheny Eye Institute, Los Angeles, California, United States
| | - Laurie Diane Dustin
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States
| | - David R Hinton
- Department of Pathology, Keck School of Medicine of the University of Southern California, Los Angeles, California, United States 2Department of Ophthalmology, Keck School of Medicine of the University of Southern California, Los Angeles, California, Unit
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Aqueous and alcoholic extracts of Triphala and their active compounds chebulagic acid and chebulinic acid prevented epithelial to mesenchymal transition in retinal pigment epithelial cells, by inhibiting SMAD-3 phosphorylation. PLoS One 2015; 10:e0120512. [PMID: 25793924 PMCID: PMC4368423 DOI: 10.1371/journal.pone.0120512] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 02/06/2015] [Indexed: 11/24/2022] Open
Abstract
Epithelial to Mesenchymal Transition (EMT) of the retinal pigment epithelium is involved in the pathogenesis of proliferative vitreoretinopathy (PVR) that often leads to retinal detachment. In this study, Triphala, an ayurvedic formulation and two of its active ingredients, namely chebulagic acid and chebulinic acid were evaluated for anti-EMT properties based on in vitro experiments in human retinal pigment epithelial cell line (ARPE-19) under TGFβ1 induced conditions. ARPE-19 cells were treated with TGFβ1 alone or co-treated with various concentrations of aqueous extract (AqE) (30 - 300 μg/ml); alcoholic extract (AlE) (50 - 500 μg/ml) of triphala and the active principles chebulagic acid (CA) and chebulinic acid (CI) (CA,CI: 50 - 200 μM). The expression of EMT markers namely MMP-2, αSMA, vimentin and the tight junction protein ZO-1 were evaluated by qPCR, western blot and immunofluorescence. The functional implications of EMT, namely migration and proliferation of cells were assessed by proliferation assay, scratch assay and transwell migration assay. AqE, AlE, CA and CI reduced the expression and activity of MMP-2 at an ED50 value of 100 μg/ml, 50 μg/ml, 100 μM and 100 μM, respectively. At these concentrations, a significant down-regulation of the expression of αSMA, vimentin and up-regulation of the expression of ZO-1 altered by TGFβ1 were observed. These concentrations also inhibited proliferation and migration of ARPE-19 cells induced by TGFβ1. EMT was found to be induced in ARPE-19 cells, through SMAD-3 phosphorylation and it was inhibited by AqE, AlE, CA and CI. Further studies in experimental animals are required to attribute therapeutic potential of these extracts and their active compounds, as an adjuvant therapy in the disease management of PVR.
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16
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In vitro vitamin K3 effect on conjunctival fibroblast migration and proliferation. ScientificWorldJournal 2014; 2014:916713. [PMID: 24523654 PMCID: PMC3910386 DOI: 10.1155/2014/916713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 10/14/2013] [Indexed: 11/30/2022] Open
Abstract
Purpose. To evaluate the dose effect of vitamin K3 on wound healing mechanisms. Methods. Conjunctival fibroblasts were incubated for 24 hours. An artificial wound was made and the cells were incubated with fresh medium plus doses of vitamin K3 to be tested. Wound repair was monitored at 0, 18, 24, and 48 hours. Proliferation was measured in actively dividing cells by [3H]thymidine uptake. Six different groups were tested: group 1/no drugs added, group 2/ethanol 0.1%, group 3/vitamin K3 1 mg/L, group 4/vitamin K3 2 mg/L, group 5/vitamin K3 4 mg/L, and group 6/vitamin K3 6 mg/L. Each experiment was carried out in triplicate and 4 times. Results. There were no differences among groups at the initial time. In vitro wound repair was slower in groups 4, 5, and 6. There were no differences between control and ethanol groups and between control and vitamin K3 1 mg/L groups. Fibroblast mitogenic activity was statistically decreased in all vitamin K groups; statistical differences were found among vitamin K3 1 mg/mL and higher doses too. In groups 5 and 6, cellular toxicity was presented. Conclusions. Vitamin K3 is able to inhibit fibroblast proliferation. Vitamin K3 2 mg/L or higher doses inhibit wound healing repair, exhibiting cellular toxicity at 4 and 6 mg/L.
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Brunner S, Binder S. Surgery for Proliferative Diabetic Retinopathy. Retina 2013. [DOI: 10.1016/b978-1-4557-0737-9.00111-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chen YJ, Tsai RK, Wu WC, He MS, Kao YH, Wu WS. Enhanced PKCδ and ERK signaling mediate cell migration of retinal pigment epithelial cells synergistically induced by HGF and EGF. PLoS One 2012; 7:e44937. [PMID: 23028692 PMCID: PMC3447816 DOI: 10.1371/journal.pone.0044937] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 08/10/2012] [Indexed: 12/04/2022] Open
Abstract
Proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy (PDR) are characterized by the development of epi-retinal membranes which may exert a tractional force on retina. A lot of inflammatory growth factors may disturb the local ocular cells such as retinal pigment epithelial (RPE) cells, causing them to migrate and proliferate in the vitreous cavity and ultimately forming the PVR membrane. In this study, the signal pathways mediating cell migration of RPE induced by growth factors were investigated. Hepatocyte growth factor (HGF), epidermal growth factor (EGF) or heparin-binding epidermal growth factor (HB-EGF) induced a greater extent of migration of RPE50 and ARPE19 cells, compared with other growth factors. According to inhibitor studies, migration of RPE cells induced by each growth factor was mediated by protein kinase C (PKC) and ERK (MAPK). Moreover, HGF coupled with EGF or HB-EGF had synergistic effects on cell migration and enhanced activation of PKC and ERK, which were attributed to cross activation of growth factor receptors by heterogeneous ligands. Furthermore, using the shRNA technique, PKCδ was found to be the most important PKC isozyme involved. Finally, vitreous fluids from PVR and PDR patients with high concentration of HGF may induce RPE cell migration in PKCδ- and ERK- dependent manner. In conclusion, migration of RPE cells can be synergistically induced by HGF coupled with HB-EGF or EGF, which were mediated by enhanced PKCδ activation and ERK phosphorylation.
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Affiliation(s)
- Yu Jung Chen
- Department of Laboratory Medicine and Biotechnology, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Rong Kung Tsai
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien, Taiwan
| | - Wen Chen Wu
- Department of Ophthalmology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming Shan He
- Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien, Taiwan
| | - Ying-Hsien Kao
- Department of Medical Research, E-DA Hospital, I-Shou University College, Kaohsiung, Taiwan
| | - Wen Sheng Wu
- Department of Laboratory Medicine and Biotechnology, College of Medicine, Tzu Chi University, Hualien, Taiwan
- * E-mail:
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Vascular endothelial growth factor A competitively inhibits platelet-derived growth factor (PDGF)-dependent activation of PDGF receptor and subsequent signaling events and cellular responses. Mol Cell Biol 2012; 32:1955-66. [PMID: 22431518 DOI: 10.1128/mcb.06668-11] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Certain platelet-derived growth factor (PDGF) isoforms are associated with proliferative vitreoretinopathy (PVR), a sight-threatening complication that develops in a subset of patients recovering from retinal reattachment surgery. Although these PDGF isoforms are abundant in the vitreous of patients and experimental animals with PVR, they make only a minor contribution to activating PDGF receptor α (PDGFRα) and driving experimental PVR. Rather, growth factors outside of the PDGF family are the primary (and indirect) agonists of PDGFRα. These observations beg the question of why vitreal PDGFs fail to activate PDGFRα. We report here that vitreous contains an inhibitor of PDGF-dependent activation of PDGFRα and that a major portion of this inhibitory activity is due to vascular endothelial cell growth factor A (VEGF-A). Furthermore, recombinant VEGF-A competitively blocks PDGF-dependent binding and activation of PDGFR, signaling events, and cellular responses. These findings unveil a previously unappreciated relationship between distant members of the PDGF/VEGF family that may contribute to pathogenesis of a blinding eye disease.
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Pennock S, Rheaume MA, Mukai S, Kazlauskas A. A novel strategy to develop therapeutic approaches to prevent proliferative vitreoretinopathy. THE AMERICAN JOURNAL OF PATHOLOGY 2011; 179:2931-40. [PMID: 22035642 DOI: 10.1016/j.ajpath.2011.08.043] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Revised: 08/03/2011] [Accepted: 08/09/2011] [Indexed: 11/26/2022]
Abstract
Proliferative vitreoretinopathy (PVR) thwarts the repair of rhegmatogenous retinal detachments. Currently, there is no effective prevention for PVR. Platelet-derived growth factor receptor α (PDGFRα) is associated with PVR in humans and strongly promotes experimental PVR driven by multiple vitreal growth factors outside the PDGF family. We sought to identify vitreal factors required for experimental PVR and to establish a potential approach to prevent PVR. Vitreous was obtained from normal rabbits or those in which PVR was either developing or stabilized. Normal vitreous contained substantial levels of growth factors and cytokines, which changed quantitatively and/or qualitatively as PVR progressed and stabilized. Neutralizing a subset of these agents in rabbit vitreous eliminated their ability to induce PVR-relevant signaling and cellular responses. A single intravitreal injection of neutralizing reagents for this subset prevented experimental PVR. To identify growth factors and cytokines likely driving PVR in humans, we subjected vitreous from patients with or without PVR to a similar series of analyses. This analysis accurately identified those agents required for vitreous-induced contraction of cells from a patient PVR membrane. We conclude that combination therapy encompassing a subset of vitreal growth factors and cytokines is a potential approach to prevent PVR.
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Affiliation(s)
- Steven Pennock
- Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts 02114, USA
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21
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Lei H, Rhéaume MA, Velez G, Mukai S, Kazlauskas A. Expression of PDGFRα is a determinant of the PVR potential of ARPE19 cells. Invest Ophthalmol Vis Sci 2011; 52:5016-21. [PMID: 21642621 PMCID: PMC3176061 DOI: 10.1167/iovs.11-7442] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 04/11/2011] [Accepted: 05/17/2011] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Previous studies indicate that the expression of platelet-derived growth factor (PDGF) receptor α (PDGFRα) dramatically increases the ability of fibroblasts to induce experimental proliferative vitreoretinopathy (PVR). The purpose of this study was to determine whether PDGFRα contributed to the PVR potential of retinal pigment epithelial (RPE) cells, one of the most abundant cell types in PVR membranes. METHODS PDGFRα expression in human ARPE19 cells was increased or decreased by stably expressing the PDGFRα cDNA or short hairpin (sh) RNA directed at PDGFRα, respectively. The level of PDGFRα expression in the resulting panel of cell lines was either barely detectable (KD), standard (similar to the level of primary RPE cells), or overexpressed approximately 80-fold. Western blot analysis was used to assess the level of p53 and the activation state of PDGFRα and Akt. The following cellular responses were monitored: proliferation, apoptosis, and contraction. The PVR potential of cells was tested in a rabbit model of PVR in which cells were coinjected with platelet-rich plasma into the vitreous. RESULTS Comparison of KD and overexpressing cells indicated that high-level expression of PDGFRα dramatically augmented signaling events, cellular responses, and the PVR potential of ARPE19 cells. However, all these outcomes were also significantly increased, albeit not as robustly, by PDGFRα expression to the level typically present in RPE cells. CONCLUSIONS Even though RPE cells express substantially less PDGFRα than fibroblasts, it significantly boosts PVR-related signaling events, cellular responses, and the PVR potential of ARPE19 cells. These studies suggest that inhibiting activation, signaling, or both by PDGFRα has the potential to prevent the development of PVR.
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Affiliation(s)
- Hetian Lei
- From the The Schepens Eye Research Institute and
| | - Marc-André Rhéaume
- the Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Gisela Velez
- From the The Schepens Eye Research Institute and
| | - Shizuo Mukai
- the Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
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Lei H, Velez G, Cui J, Samad A, Maberley D, Matsubara J, Kazlauskas A. N-acetylcysteine suppresses retinal detachment in an experimental model of proliferative vitreoretinopathy. THE AMERICAN JOURNAL OF PATHOLOGY 2010; 177:132-40. [PMID: 20489144 DOI: 10.2353/ajpath.2010.090604] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Proliferative vitreoretinopathy (PVR) is a complication that develops in 5% to 10% of patients who undergo surgery to correct a detached retina. The only treatment option for PVR is surgical intervention, which has a limited success rate that diminishes in patients with recurring PVR. Our recent studies revealed that antioxidants prevented intracellular signaling events that were essential for experimental PVR. The purpose of this study was to test whether N-acetyl-cysteine (NAC), an antioxidant used in a variety of clinical settings, was capable of protecting rabbits from PVR. Vitreous-driven activation of PDGFRalpha and cellular responses intrinsic to PVR (contraction of collagen gels and cell proliferation) were blocked by concentrations of NAC that were well below the maximum tolerated dose. Furthermore, intravitreal injection of NAC effectively protected rabbits from developing retinal detachment, which is the sight-robbing phase of PVR. Finally, these observations with an animal model appear relevant to clinical PVR because NAC prevented human PVR vitreous-induced contraction of primary RPE cells derived from a human PVR membrane. Our observations demonstrate that antioxidants significantly inhibited experimental PVR, and suggest that antioxidants have the potential to function as a PVR prophylactic in patients undergoing retinal surgery to repair a detached retina.
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Affiliation(s)
- Hetian Lei
- Department of Ophthalmology, Schepens Eye Research Institute, Harvard Medical School, 20 Staniford St, Boston, MA 02114, USA
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Lei H, Velez G, Hovland P, Hirose T, Gilbertson D, Kazlauskas A. Growth factors outside the PDGF family drive experimental PVR. Invest Ophthalmol Vis Sci 2009; 50:3394-403. [PMID: 19324843 DOI: 10.1167/iovs.08-3042] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Proliferative vitreoretinopathy (PVR) is a recurring and problematic disease for which there is no pharmacologic treatment. Platelet-derived growth factor (PDGF) in the vitreous is associated with experimental and clinical PVR. Furthermore, PDGF receptors (PDGFRs) are present and activated in epiretinal membranes of patient donors, and they are essential for experimental PVR. These observations suggest that PVR arises at least in part from PDGF/PDGFR-driven events. The goal of this study was to determine whether PDGFs were a potential therapeutic target for PVR. METHODS Experimental PVR was induced in rabbits by injecting fibroblasts. Vitreous specimens were collected from experimental rabbits or from patients undergoing vitrectomy to repair retinal detachment. A neutralizing PDGF antibody and a PDGF Trap were tested for their ability to prevent experimental PVR. Activation of PDGFR was monitored by antiphosphotyrosine Western blot analysis of immunoprecipitated PDGFRs. Contraction of collagen gels was monitored in vitro. RESULTS Neutralizing vitreal PDGFs did not effectively attenuate PVR, even though the reagents used potently blocked PDGF-dependent activation of the PDGF alpha receptor (PDGFRalpha). Vitreal growth factors outside the PDGF family modestly activated PDGFRalpha and appeared to do so without engaging the ligand-binding domain of PDGFRalpha. This indirect route to activate PDGFRalpha had profound functional consequences. It promoted the contraction of collagen gels and appeared sufficient to drive experimental PVR. CONCLUSIONS Although PDGF appears to be a poor therapeutic target, PDGFRalpha is particularly attractive because it can be activated by a much larger spectrum of vitreal growth factors than previously appreciated.
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Affiliation(s)
- Hetian Lei
- Department of Ophthalmology, Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts 02114, USA
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Lei H, Kazlauskas A. Growth factors outside of the platelet-derived growth factor (PDGF) family employ reactive oxygen species/Src family kinases to activate PDGF receptor alpha and thereby promote proliferation and survival of cells. J Biol Chem 2009; 284:6329-36. [PMID: 19126548 PMCID: PMC2649107 DOI: 10.1074/jbc.m808426200] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 01/06/2009] [Indexed: 11/06/2022] Open
Abstract
The vitreous contains a plethora of growth factors that are strongly implicated in the formation of fibroproliferative diseases such as proliferative vitreoretinopathy. Although platelet-derived growth factors (PDGFs) are present in the vitreous, vitreal growth factors outside of the PDGF family activated the PDGF alpha receptor (PDGFRalpha) and promoted disease progression in a rabbit model of proliferative vitreoretinopathy (H. Lei, G. Velez, P. Hovland, T. Hirose, D. Gilbertson, and A. Kazlauskas (2008) submitted for publication.) In this report we investigated the mechanism by which non-PDGFs activated PDGFRalpha. We found that non-PDGFs increased the cellular level of reactive oxygen species (ROS) and that this event was necessary and sufficient for phosphorylation of PDGFRalpha. We speculated that the underlying mechanism was ROS-mediated inhibition of phosphotyrosine phosphatases, which antagonize receptor auto-phosphorylation. However, this did not appear to be the case. Non-PDGFs promoted tyrosine phosphorylation of catalytically inactive PDGFRalpha, and thereby indicated that at least one additional tyrosine kinase was involved. Indeed, preventing expression or blocking the kinase activity of Src family kinases suppressed non-PDGF-dependent tyrosine phosphorylation of PDGFRalpha. Thus non-PDGFs increased the level of ROS, which activated Src family kinases and resulted in phosphorylation of PDGFRalpha. Finally, although non-PDGFs induced only modest phosphorylation of PDGFRalpha, proliferation and survival of cells in response to non-PDGFs was significantly enhanced by expression of PDGFRalpha. These studies reveal a novel mechanism for activation of PDGFRalpha that appears capable of enhancing the responsiveness of cells to growth factors outside of the PDGF family.
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Affiliation(s)
- Hetian Lei
- Schepens Eye Research Institute, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts 02114, USA
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Cui J, Lei H, Samad A, Basavanthappa S, Maberley D, Matsubara J, Kazlauskas A. PDGF receptors are activated in human epiretinal membranes. Exp Eye Res 2008; 88:438-44. [PMID: 19032953 DOI: 10.1016/j.exer.2008.10.020] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Revised: 10/15/2008] [Accepted: 10/17/2008] [Indexed: 11/30/2022]
Abstract
Previous investigators reported that epiretinal membranes isolated from patients with proliferative vitreoretinopathy (PVR) express various platelet-derived growth factor (PDGF) family members and PDGF receptors (PDGFRs) (Cui, J.Z., Chiu, A., Maberley, D., Ma, P., Samad, A., Matsubara, J.A., 2007. Stage specificity of novel growth factor expression during development of proliferative vitreoretinopathy. Eye 21, 200-208; Robbins, S.G., Mixon, R.N., Wilson, D.J., Hart, C.E., Robertson, J.E., Westra, I., Planck, S.R., Rosenbaum, J.T., 1994. Platelet-derived growth factor ligands and receptors immunolocalized in proliferative retinal diseases. Invest. Ophthalmol. Vis. Sci. 35(10), 3649-3663). Co-expression of ligand and receptor raises the possibility of an autocrine loop, which could be of importance in the pathogenesis of PVR. To begin to address this issue we determined whether the PDGFRs in epiretinal membranes isolated from PVR patient donors were activated. Indeed, immunohistochemical staining (using pan- and phospho-PDGFR antibodies) revealed that both PDGFR subunits were activated. Quantification of these data demonstrated that a greater percentage of cells expressed the PDGFR alpha subunit as compared with the beta subunit (44 +/- 13% versus 32 +/- 6.5%). Staining with phospho-PDGFR antibodies indicated that 36 +/- 10% of the PDGFR alpha subunits were activated, whereas only 16 +/- 5.5% of the PDGFR beta subunits were activated. Thus, a 2.25 fold greater percentage of the PDGFR alpha subunits was activated. Co-staining with diagnostic cell-type antibodies indicated that both retinal pigment epithelial and glial cells expressed activated PDGFR alpha subunits. These findings support the recent discovery that PDGF-C is the major vitreal isoform because PDGF-C is 3 times more likely to activate a PDGFR alpha subunit as compared with a PDGFR beta subunit. We conclude that PDGFRs are activated in epiretinal membranes of patients with PVR, and that the profile of active PDGFR subunits functionally supports the idea that PDGF-C is the predominant PDGF isoform present in the vitreous of patients with PVR. These findings identify PDGF-A, -AB and C as the best therapeutic targets within the PDGF family.
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Affiliation(s)
- Jing Cui
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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Lei H, Velez G, Hovland P, Hirose T, Kazlauskas A. Plasmin is the major protease responsible for processing PDGF-C in the vitreous of patients with proliferative vitreoretinopathy. Invest Ophthalmol Vis Sci 2008; 49:42-8. [PMID: 18172073 DOI: 10.1167/iovs.07-0776] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Proliferative vitreoretinopathy (PVR) is the primary cause of failure of retinal reattachment surgery. Growth factors such as platelet-derived growth factor (PDGF) are strongly associated with PVR. Of the five PDGF family members, PDGF-C predominates in the vitreous of experimental and clinical PVR. PDGF-C is secreted as a latent protein that requires proteolytic processing for activation. Although tissue plasminogen activator (tPA) is primarily responsible for processing PDGF-C in cultured cells, it constitutes a minority of the processing activity in the vitreous of experimental animals and in patients with PVR. Identifying the major PDGF-C processing protease was the purpose of this study. METHODS The presence of serum proteins in the vitreous was detected by Coomassie blue staining and Western blotting. PDGF-C processing activity was detected in an in vitro processing assay using either native or recombinant PDGF-C as the substrate. Plasmin activity was blocked using alpha(2)-plasmin inhibitor. Phosphorylation of the PDGF receptor (PDGFR) was monitored by antiphosphotyrosine Western blotting. Vitreous specimens were collected from experimental rabbits or from patients undergoing vitrectomy to repair retinal detachment or for other reasons. RESULTS A number of prominent serum proteins (albumin and IgG) were detected in the vitreous of all patients undergoing retinal surgery. The level of these proteins markedly increased in the vitreous of rabbits as they developed PVR. These observations suggested that serum-borne proteases are also likely to be present in the vitreous. Indeed, plasmin (a protease capable of processing PDGF-C) was present in the vitreous from PVR rabbits and retinal surgery patients. Plasmin was dramatically more effective than tPA in processing PDGF-C in an in vitro assay. Blocking plasmin activity eliminated most of the processing activity in the vitreous of patients and rabbits with PVR. CONCLUSIONS Plasmin was the major PDGF-C processing protease in the vitreous of PVR rabbits and patients undergoing retinal surgery. Blocking plasmin prevented the generation of active PDGF-C, which is the major PDGF isoform relevant for PVR. These observations are the first report of an in vivo protease responsible for processing PDGF-C. In addition, plasmin was identified as a novel therapeutic target for patients with PVR.
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Affiliation(s)
- Hetian Lei
- Department of Ophthalmology, Schepens Eye Research Institute, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, USA
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Affiliation(s)
- Harry M Engel
- Department of Ophthalmology, Montefiore Medical Center, Bronx, New York 10467, USA.
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Canataroglu H, Varinli I, Ozcan AA, Canataroglu A, Doran F, Varinli S. Interleukin (IL)-6, interleukin (IL)-8 levels and cellular composition of the vitreous humor in proliferative diabetic retinopathy, proliferative vitreoretinopathy, and traumatic proliferative vitreoretinopathy. Ocul Immunol Inflamm 2006; 13:375-81. [PMID: 16422002 DOI: 10.1080/09273940490518900] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate the interleukin (IL)-6 levels, IL-8 levels, and cellular composition of the vitreous humor in patients with proliferative diabetic retinopathy (PDR), proliferative vitreoretinopathy (PVR), and traumatic PVR. METHODS Vitreous samples from 14 patients with PDR, 10 patients with PVR, and 10 patients with traumatic PVR were analyzed. Fifteen cadaver eyes were used as controls. Cytokine levels were measured by ELISA. RESULTS Elevated IL-6 levels were detected in the vitreous of 12 (85.7%) of the PDR patients, eight (80%) of the PVR patients, and all (100%) of the traumatic PVR patients. None of the control IL-6 results were elevated. Vitreous IL-8 levels were elevated in 12 (85.7%) of the PDR patients, six (60%) of the PVR patients, all (100%) of the traumatic PVR patients, and one (6.7%) of the control eyes. Cytological examination of the vitreous specimens revealed a predominance of macrophages (50%) in the PDR samples and a predominance of retinal pigment epithelial (RPE) cells (60%) in the PVR samples. In contrast, neutrophils predominated (88%) in the traumatic PVR samples. CONCLUSION The findings suggest that IL-6 and IL-8 may be involved in the pathogenesis of PDR, PVR, and traumatic PVR. High proportions of RPE cells and macrophages are associated with elevated IL-6 and IL-8 levels in the vitreous of PDR and PVR patients; however, the fact that these cells are not predominant in traumatic PVR suggests that different immune response mechanisms may be active in the pathogenesis of these disorders.
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Affiliation(s)
- Hatice Canataroglu
- Department of Ophthalmology, Cukurova University Faculty of Medicine, 01330 Balcali, Adana, Turkey
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Ryan SJ, Yoon YH. Posterior Segment Trauma: Open Globe. Retina 2006. [DOI: 10.1016/b978-0-323-02598-0.50144-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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El-Bradey MH, Cheng L, Bartsch DU, Niessman M, El-Musharaf A, Freeman WR. The effect of prinomastat (AG3340), a potent inhibitor of matrix metalloproteinase, on a new animal model of epiretinal membrane. Retina 2004; 24:783-9. [PMID: 15492635 DOI: 10.1097/00006982-200410000-00016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To develop a simple epiretinal membrane (ERM) animal model and evaluate the efficacy of prinomastat (AG3340), a synthetic inhibitor of matrix metalloproteinase. METHODS This experiment was carried out on 18 eyes of nine Brown Norway rats. Preretinal hemorrhage was induced bilaterally using diode laser focused deeply on choroidal blood vessels. One day later, AG3340 was injected intravitreally in the right eyes while the left eyes received equal amounts of vehicle. The developed epiretinal membrane was measured in disk areas and compared between groups. RESULTS Clinically, preretinal hemorrhage showed a slow clearance persisting for 8 to 10 weeks. ERM was well established around 12 weeks. Histologically, ERMs consist of fibroblast and glial cells embedded in collagen-rich extracellular matrix infiltrated by macrophages. Seventy-five percent of the hemorrhagic laser burns in the control group developed ERM, whereas only 25% of the hemorrhagic laser burns in treated group developed ERM (P = 0.01). The total surface area of developed ERM was 3.66 DD in treated eyes versus 25.45 DD in control eyes (P = 0.049). The mean surface area of ERM per eye was 0.52 disk areas +/- 1.05 in treated eyes versus 3.18 +/- 3.07 in control eyes. CONCLUSION We demonstrated that ERM can be induced on rat retina by simple hemorrhagic retinal laser coagulation. This new animal model could be used for future evaluation of different medical treatment modalities for proliferating ERM. Furthermore, AG3340 demonstrated an inhibitory effect on ERM formation in this new rat model.
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Affiliation(s)
- Mohamed H El-Bradey
- Jacobs Retina Center, Department of Ophthalmology, University of California, Shiley Eye Center, San Diego, California, USA
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Proulx S, Landreville S, Guérin SL, Salesse C. Integrin α5 expression by the ARPE-19 cell line: comparison with primary RPE cultures and effect of growth medium on the α5 gene promoter strength. Exp Eye Res 2004; 79:157-65. [PMID: 15325562 DOI: 10.1016/j.exer.2004.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2003] [Accepted: 03/08/2004] [Indexed: 11/22/2022]
Abstract
Primary cultures of human retinal pigment epithelium (RPE) requires young human donors with short post-mortem time and no known retinal diseases. The use of an established human RPE cell line, like ARPE-19, would be a welcomed alternative to primary cultures. This cell line retains many of the characteristics of RPE cells, including cell morphology, functional tight junctions and expression of CRALBP and RPE65. This study was conducted in order to investigate integrin alpha5 expression at both the gene and protein level in the ARPE-19 cell line and compare the results with those obtained with primary cultures of RPE cells. The potential use of this cell line as a substitute for primary cultures of RPE cells was also considered. Integrin alpha5 protein was detected on RPE and ARPE-19 cultures at different confluencies by immunofluorescence and immunoprecipitation analyses. Semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to study alpha5 mRNA levels. Transient transfections were performed in order to compare alpha5 promoter strength in both types of cells. Immunofluorescence studies showed that both primary RPE and ARPE-19 cells yielded similar alpha5 staining patterns at all cell confluencies. Both immunoprecipitation and RT-PCR analyses provided evidence that sub-confluent and confluent RPE and ARPE-19 cells have similar cell surface alpha5 protein and mRNA levels whereas post-confluent cells had a marked decrease in both protein and transcript levels. ARPE-19 cells show a large increase in promoter strength compared to primary cultures. When compared to primary cultures, the cell line exhibited major differences in the way the alpha5 promoter is regulated, even if both cell types are cultured under identical conditions. This study demonstrates that primary cultures of human RPE and ARPE-19 cells show reductions in both the alpha5 protein and the mRNA when cells reach post-confluency. However, major differences have been observed in the strength of the alpha5 promoter between both cell types. We also show that culturing ARPE-19 cells in a different growth medium alters the transcriptional activity directed by the alpha5 promoter.
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Affiliation(s)
- Stéphanie Proulx
- Unité de Recherche en Ophtalmologie, Centre de Recherche du CHUQ, Pavillon CHUL, Faculté de médecine, Université Laval, Salle S-5, 2705 Boul. Laurier, Ste-Foy, Que., Canada G1V 4G2
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La Heij EC, van de Waarenburg MPH, Blaauwgeers HGT, Kessels AGH, Liem ATA, Theunissen C, Steinbusch H, Hendrikse F. Basic fibroblast growth factor, glutamine synthetase, and interleukin-6 in vitreous fluid from eyes with retinal detachment complicated by proliferative vitreoretinopathy. Am J Ophthalmol 2002; 134:367-75. [PMID: 12208248 DOI: 10.1016/s0002-9394(02)01536-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To investigate the presence of basic fibroblast growth factor (bFGF), glutamine synthetase (GS), and interleukin-6 (IL-6) in vitreous fluid from eyes with retinal detachment complicated by proliferative vitreoretinopathy (PVR). DESIGN Comparative case series; experimental study. METHODS In a prospective study, we measured bFGF, GS, IL-6, and total protein in vitreous fluid samples from 53 eyes from 53 consecutive patients with PVR operated on in our hospital. As controls, vitreous fluid samples from eyes with a macular hole (n = 9) or pucker (n = 11) were used. MAIN OUTCOME MEASURES Laboratory data of the patient group were compared with the control group and correlated with various clinical data, especially with visual recovery and redetachment. RESULTS For IL-6, bFGF, and total protein we found significantly higher levels in PVR patients' eyes than in control eyes (P =.03, P =.046, and P <.0001, respectively). Within the PVR group, no significant correlation was found for IL-6, bFGF, GS, or total protein with the various tested clinical variables. CONCLUSIONS We found increased levels of IL-6, bFGF, and total protein in vitreous fluid from patients' eyes with PVR. Whether the increased levels of IL-6, bFGF, and total protein are the result of an injury-induced upregulation of these proteins as part of a self-protective mechanism of the retina to minimize photoreceptor damage after the mechanical injury induced by retinal detachment is, at present, not known.
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Affiliation(s)
- Ellen C La Heij
- Department of Ophthalmology, University Hospital Maastricht, The Netherlands
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Wang YS, Hui YN, Wiedemann P. Role of apoptosis in the cytotoxic effect mediated by daunorubicin in cultured human retinal pigment epithelial cells. J Ocul Pharmacol Ther 2002; 18:377-87. [PMID: 12222768 DOI: 10.1089/10807680260218542] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
To investigate whether apoptosis is involved in the therapeutic effect of daunorubicin on proliferative vitreoretinopathy (PVR), cultured human retinal pigment epithelial cells (RPE) were exposed to a cytotoxic dose of 180 microg/l daunorubicin. After 12-hour treatment with the drug and 24-hour prolonged post-incubation in the drug-free medium, progressive condensation, shrinkage of cytoplasm and nucleus, and fragmented nuclei were identified by light and electron microscopy. TUNEL assay showed the characteristic apoptotic patterns of circumscribed clumps and sometimes even dark masses in nuclei. The expression of bax protein was enhanced, and the integral optical density values for immunocytochemical expression of bax protein increased by 22.0% in the drug-treated group (P < 0.05). The results demonstrated the pivotal role of apoptotic mechanism in the cytotoxic effect mediated by daunorubicin, and confirmed the relationship between the drug-induced apoptosis and overexpression of bax protein. It suggested that the upregulation of bax mediated by daunorubicin could lead to the onset of apoptosis, and therefore contribute to its therapeutic mechanisms for the treatment of PVR.
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Affiliation(s)
- Yu-Sheng Wang
- Department of Ophthalmology, Xijing Hospital, Fourth Military Medical University, Xi'an, People's Republic of China.
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Lorenzo J, Capeans C, Suarez A, Pacheco P, Sánchez-Salorio M. Posterior vitreous findings in cases of spontaneous retinal reattachment. Ophthalmology 2002; 109:1251-5. [PMID: 12093646 DOI: 10.1016/s0161-6420(02)01085-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To describe the posterior vitreous findings in two patients with retinal detachment who experienced spontaneous retinal reattachment. DESIGN Two observational case reports. TESTING Biomicroscopic and high-resolution echographic evaluation of the vitreoretinal relationships. MAIN OUTCOME MEASURES Retinal reattachment and echographic vitreoretinal relationships. RESULTS Two patients, one with a rhegmatogenous retinal detachment and one with a tractional retinal detachment, were noted to have a partial posterior vitreous detachment with vitreoretinal adherence at the time of presentation. Spontaneous retinal reattachment occurred in both cases, with echography showing complete vitreous separation from the retina. CONCLUSIONS Complete posterior vitreous detachment may release tractional components in retinal detachment and contribute to spontaneous retinal reattachment.
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Affiliation(s)
- José Lorenzo
- Department of Ophthalmology, Hospital Clínico Universitario, Santiago de Compostela, Spain.
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Pastor JC, de la Rúa ER, Martín F. Proliferative vitreoretinopathy: risk factors and pathobiology. Prog Retin Eye Res 2002; 21:127-44. [PMID: 11906814 DOI: 10.1016/s1350-9462(01)00023-4] [Citation(s) in RCA: 254] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Proliferative vitreoretinopathy (PVR) is still a major cause of failure of retinal detachment surgery. Despite a dramatic increase in our pathobiologic knowledge of PVR during the last 10 years, little of this information has been used to modify the surgical management of the disease, and, thus, the anatomic and functional results are still unsatisfactory. Collaborative research involving clinicians and basic researchers must be encouraged. PVR must be considered a multifactorial disease caused by interaction of several cells and intra- and extraocular factors. Therefore, therapeutic options based on the inhibition of one factor or phenomenon may be regarded with scepticism. To prevent PVR, it is necessary to determine the factors involved in its development, and because of its relatively small prevalence, large, prospective, multicenter studies seem necessary. In addition, clinical research must not be underestimated. PVR affects both sides of the retina and the retina itself, a point to which little attention has been paid and that is critical for surgical results. Therefore, a new classification that provides information about clinical relevance, such as the evolutionary stages of the disease (biologic activity) and the degree of surgical difficulty (location of the fibrotic process), seems necessary.
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Affiliation(s)
- J Carlos Pastor
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Retina Group, Ramon y Cajal, 7, 47005, Spain.
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Mittra RA, Mieler WF. Controversies in the management of open-globe injuries involving the posterior segment. Surv Ophthalmol 1999; 44:215-25. [PMID: 10588440 DOI: 10.1016/s0039-6257(99)00104-6] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There are numerous unresolved issues and controversies regarding the management of open-globe injuries involving the posterior segment. These areas include, but are not limited to, the following issues. Although vitrectomy has been shown to improve visual outcomes and allow retention of the eye in many cases, the extent of visual improvement is often limited because of the nature of the injury. Timing of vitrectomy surgery has been and will continue to be debated by proponents of early versus delayed intervention. The multiple features of acute ocular injury make it very difficult to interpret retrospective data regarding the most appropriate timing for surgical intervention. The use of prophylactic cryotherapy, in the setting of a scleral laceration with possible retinal damage, is not as controversial at present, as there is now sufficient data indicating that cryotherapy may actually exacerbate intraocular proliferation and worsen the situation. The role and benefit of a prophylactic scleral buckle is very widely contested, and it is not known if it truly decreases the risk of subsequent retinal detachment. Another area of debate centers on the use of antibiotics. When there is a known clinical infection, intravitreal antibiotics are the mainstays of therapy. However, in the absence of clinical infection, the use of prophylactic antibiotics and their routes of administration are quite controversial. Although there are significant data regarding the use of antibiotics in the postoperative setting, this information cannot be extrapolated into the setting of open-globe injuries, as organisms and virulence factors differ. Similarly, the use of vitrectomy versus vitreous tap in the setting of traumatic endophthalmitis is not fully resolved, although vitrectomy is used in most cases to repair concurrent damage from the injury itself. Finally, the placement of intraocular lenses in the acute trauma setting is controversial, as the risk of complications is quite high. Prospective, controlled clinical studies have not been done. This article reviews pertinent data regarding these management issues and controversies, and provides recommendations for treatment based on the available published data and the authors' personal experience.
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Affiliation(s)
- R A Mittra
- Retina Associates of Cleveland, Ohio, USA
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Barile GR, Chang SS, Park LS, Reppucci VS, Schiff WM, Schmidt AM. Soluble cellular adhesion molecules in proliferative vitreoretinopathy and proliferative diabetic retinopathy. Curr Eye Res 1999; 19:219-27. [PMID: 10487959 DOI: 10.1076/ceyr.19.3.219.5314] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To measure vitreous levels of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cellular adhesion molecule-1 (sVCAM-1) in the eyes of patients with retinal detachment (RD) due to proliferative diabetic retinopathy (PDR) or proliferative vitreoretinopathy (PVR) and to determine whether the levels of these mediators correlated with clinical parameters of disease. METHODS Undiluted vitreous specimens were collected from 50 eyes of 48 patients undergoing vitrectomy for traction RD due to PDR (21 specimens) and recurrent RD due to PVR (19 specimens). Control vitreous specimens were obtained from patients undergoing macular hole repair (10 specimens). The levels of sICAM-1 and sVCAM-1 were measured in each sample by specific enzyme-linked immunoadsorbent assays. RESULTS Vitreous levels of sICAM-1 were significantly increased in vitreous specimens from both PVR (median +/- SD; 12.0 +/- 76.3 ng/ml; P < 0.01) and PDR (8.4 +/- 24.0 ng/ml; P < 0.01) when compared to vitreous from eyes with macular holes (0. 3 +/- 4.2 ng/ml). Vitreous levels of sVCAM-1 were significantly increased in both PVR (36.5 +/- 255.2 ng/ml; P < 0.001) and PDR (26. 2 +/- 93.5 ng/ml; P < 0.01) when compared to control vitreous (17.7 +/- 7.8 ng/ml). The vitreous levels of sICAM-1 were higher in cases of PDR which developed recurrent proliferative disease (P < 0.01) and recurrent RD (P = 0.01), whereas the levels of sICAM-1 in PVR and sVCAM-1 in PDR and PVR did not significantly correlate with these clinical parameters. CONCLUSIONS Soluble forms of ICAM-1 and VCAM-1 are increased in the vitreous cavity of patients with RD due to PDR or PVR, reflecting the inflammatory nature of these conditions and suggesting a possible role for these mediators in the pathogenesis of proliferative retinal disease. The vitreous levels of these sCAMs at the time of surgery may serve as a marker of inflammation, but their specific levels do not predict the likelihood of recurrent proliferation or surgical anatomic success in most cases of PVR and PDR.
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Affiliation(s)
- G R Barile
- The Edward S Harkness Eye Institute St Luke's-Roosevelt Hospital Center Columbia University College of Physicians & Surgeons Department of Ophthalmology NY, 10032, USA.
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Limb GA, Chignell AH. Vitreous levels of intercellular adhesion molecule 1 (ICAM-1) as a risk indicator of proliferative vitreoretinopathy. Br J Ophthalmol 1999; 83:953-6. [PMID: 10413701 PMCID: PMC1723143 DOI: 10.1136/bjo.83.8.953] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To investigate whether high vitreous levels of the soluble intercellular adhesion molecule 1 (sICAM-1) may be related to clinical risk factors of proliferative vitreoretinopathy (PVR) and whether their measurement may serve as an additional risk indicator of this complication in eyes with rhegmatogenous retinal detachment (RRD). METHODS Levels of sICAM-1 were measured by enzyme linked immunosorbent assays (ELISA) in vitreous from 36 eyes with RRD clinically considered to be at high risk of developing PVR (large retinal breaks, vitreous haemorrhage, long standing RRD, and previous vitreoretinal surgery). Levels of sICAM-1 in this group were compared with those in vitreous from 31 eyes with RRD without clinical risk factors for PVR, 32 eyes with established PVR and 10 eyes with macular holes. RESULTS Vitreous from eyes with RRD at high risk of developing PVR contained significantly higher levels of sICAM-1 (range 6.1-97.7 ng/ml; Mann-Whitney test, p=0.0002) than those from eyes with RRD at low risk of developing this complication (range 4.8-17.7 ng/ml). Vitreous sICAM-1 levels in eyes with RRD at high risk of developing PVR were significantly lower than in eyes with established PVR (p=0.037), but higher than in eyes with macular holes (p <0.0001). Levels of sICAM-1 >/=15 ng/ml (3 x median of the levels present in control eyes) provide a useful cut off point for a highly specific test (96.7%) with high positive (91.6%) and negative (96.7%) predictive values, despite a relatively low sensitivity (30. 5%). CONCLUSIONS The present findings suggest that laboratory measurement of sICAM-1 levels in vitreous from eyes with RRD may constitute an additional factor for identifying patients at high risk of PVR. Hence, determination of sICAM-1 levels may aid in the monitoring of patients likely to develop this complication and in the identification of patients who may benefit from adjuvant anti-inflammatory therapy.
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Affiliation(s)
- G A Limb
- Department of Pathology, Moorfields Eye Hospital and Institute of Ophthalmology, London
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Sharma T, Gopal L, Badrinath SS. Primary vitrectomy for rhegmatogenous retinal detachment associated with choroidal detachment. Ophthalmology 1998; 105:2282-5. [PMID: 9855161 DOI: 10.1016/s0161-6420(98)91230-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE This study aimed to report the success rate of primary vitrectomy, scleral buckling, and oral steroids in eyes with combined rhegmatogenous retinal detachment (RRD) and choroidal detachment (CD) and to compare these results with those reported in the literature for similar cases managed by scleral buckling alone. DESIGN Consecutive case series. PARTICIPANTS Twenty-one eyes of 21 consecutive patients with primary RRD associated with CD were examined. INTERVENTION All patients were treated with systemic corticosteroids before surgery. Pars plana vitrectomy with scleral buckling or encircling or both were performed. MAIN OUTCOME MEASURES Retinal reattachment rate and resolution of choroidal detachment were measured. RESULTS At mean follow-up of 11.4 months, retinal reattachment was attained in 19 eyes (90.5%) compared to less than 53% reported in the literature for scleral buckling alone. With preoperative oral steroids, choroidal detachment regressed completely in 13 eyes (61.9%). In the remaining eyes with persistent choroidal detachment, suprachoroidal fluid was drained during vitrectomy. CONCLUSION Aggressive treatment with oral steroids followed by pars plana vitrectomy and scleral buckling or encircling is recommended instead of scleral buckling alone in the management of combined primary rhegmatogenous retinal detachment and choroidal detachment.
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Affiliation(s)
- T Sharma
- The Vitreoretinal Service, Sankara Nethralaya, Vision Research Foundation, Chennai, India
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Abstract
Proliferative vitreoretinopathy (PVR) is still the most common cause of failure of surgery for rhegmatogenous retinal detachment, despite the substantial effort that has been devoted to better understanding and managing this condition during the past 25 years. Basic research has indicated that PVR represents scarring, the end stage of the wound-healing process that occurs after retinal detachment surgery. Medical treatment has been directed toward preventing inflammation, the first phase of the wound healing process, and inhibiting cell proliferation, the second phase. The 1983 Retina Society classification was modified in 1989 by the Silicone Study Group, whose classification differentiates between posterior and anterior forms of PVR and recognizes three patterns of proliferation: diffuse, focal, and subretinal. The anterior form has a worse prognosis than the posterior form, and its treatment requires more complex surgical procedures. In this review, risk factors and pathobiology of PVR are discussed, and management of PVR of various degrees of severity are considered.
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Affiliation(s)
- J C Pastor
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), University of Valladolid, Spain.
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Abstract
Proliferative vitreoretinopathy (PVR) is one of the major causes of failure in retinal detachment surgery. To prevent PVR, it is necessary to determine factors predisposing its development. In primary PVR, large retinal tears, long duration of retinal detachment, vitreous hemorrhages, aphakia and choroidal detachment were demonstrated as clinical risk factors for PVR. In postoperative PVR, it was revealed that large breaks, pre- and postoperative choroidal detachment, minor intra- or postoperative hemorrhages, signs of uveitis, extensive retinal detachment, vitrectomy, cryopexy, air injection and preoperative PVR were risk factors for PVR by multivariate analysis. Almost all risk factors for PVR are associated with intravitreal dispersion of retinal pigment epithelial (RPE) cells or breakdown of the blood-ocular barrier which are prerequisite to development of PVR.
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Affiliation(s)
- H Nagasaki
- Department of Ophthalmology, Kurume University School of Medicine, Japan
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Niesman MR, Peyman GA, Miceli MV. Liposome uptake by human retinal pigment epithelial cells in culture. Curr Eye Res 1997; 16:1073-80. [PMID: 9395765 DOI: 10.1076/ceyr.16.11.1073.5105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To examine the internalization of liposomes containing various phospholipids by human retinal pigment epithelial (RPE) cells in culture. The internalization was compared to that exhibited by macrophages and fibroblast cells. METHODS The uptake into cells was monitored by using a non-degradable, radioactive cholesterol-hexadecyl ether derivative and a pH-sensitive, water-soluble fluorescent dye. Variables tested to determine their effect on uptake included time, phospholipid concentration, the presence or absence of serum in medium and the presence or absence of cholesterol in the liposome bilayer. The most avidly ingested liposome was tested to determine its ability to deliver a liposome-dependent drug. RESULTS Liposome uptake was time and concentration dependent. Uptake for RPE was maximal in serum-free media, while the opposite was true for the other cells tested. Cell survival following exposure to fluoroorotic acid-containing liposomes correlated with the radioactive cholesterol-hexadecyl ether and fluorescent dye uptake data. CONCLUSIONS No single liposome carrier or set of conditions tested appeared to be optimum for the delivery of a cytotoxic agent to these three cell types. This bears consideration when designing strategies for the prevention and treatment of intraocular proliferative diseases such as proliferative vitreoretinopathy (PVR).
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Affiliation(s)
- M R Niesman
- Arkansas Center for Eye Research, Little Rock, USA.
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Schneeberger SA, Hjelmeland LM, Tucker RP, Morse LS. Vascular endothelial growth factor and fibroblast growth factor 5 are colocalized in vascular and avascular epiretinal membranes. Am J Ophthalmol 1997; 124:447-54. [PMID: 9323936 DOI: 10.1016/s0002-9394(14)70861-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To determine by immunocytochemical analysis of epiretinal membranes whether vascular endothelial growth factor and the fibroblast growth factor FGF-5 are present in patients with proliferative diabetic retinopathy or proliferative vitreoretinopathy. METHODS Human surgical specimens of epiretinal membranes were obtained from 11 eyes with proliferative diabetic retinopathy and five eyes with proliferative vitreoretinopathy. Sections were immunostained with an affinity-purified antibody against an internal sequence of human FGF-5 and with a commercially available affinity-purified antibody corresponding to the first 20 residues of human vascular endothelial growth factor. Slides were visualized using avidin-biotin-peroxidase complex. Control studies were performed with nonimmune immunoglobulin G and preabsorbed vascular endothelial growth factor and FGF-5 antibody, respectively. RESULTS Immunoreactive FGF-5 is present in most cells, including endothelial cells of vascular and avascular epiretinal membranes, but seems to be absent from the extracellular matrix. A similar staining pattern was observed for vascular endothelial growth factor. CONCLUSIONS Vascular endothelial growth factor and FGF-5 are remarkably colocalized in both vascular and avascular epiretinal membranes arising from proliferative diabetic retinopathy and proliferative vitreoretinopathy, respectively. This result questions the concept that the presence of a single angiogenic factor determines the vascular status of an epiretinal proliferation.
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Affiliation(s)
- S A Schneeberger
- Department of Ophthalmology, University of California, Davis, Sacramento 95816, USA
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Limb GA, Chignell AH, Woon H, Green W, Cole CJ, Dumonde DC. Evidence of chronic inflammation in retina excised after relaxing retinotomy for anterior proliferative vitreoretinopathy. Graefes Arch Clin Exp Ophthalmol 1996; 234:213-20. [PMID: 8964525 DOI: 10.1007/bf00430412] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Epiretinal membranes from eyes with proliferative vitreoretinopathy (PVR) frequently express molecules associated with chronic inflammation. To investigate the extent to which inflammation may compromise the detached retina, we determined the expression of inflammatory molecules in anterior retina removed after relaxing retinotomy for retinal detachment complicated by anterior PVR. METHODS Surgical retinal specimens were studied immunohistochemically for the distribution of the vascular cell adhesion molecules VCAM, E-selectin, P-selectin, ICAM and PECAM and for the presence of the cytokine TNF alpha and of T lymphocytes (CD3-positive cells), macrophages (CD68-positive cells) and HLA-DR molecules. The findings were compared with those in control cadaveric retina. RESULTS Aberrant expression of ICAM-1 was observed in four of nine retinal specimens from eyes with PVR, whereas its expression in control retinas was confined to the external limiting membrane and ganglion cell layers. PECAM was observed in seven of nine surgical retinal specimens and in four of five controls. E-selectin and P-selectin were expressed within the luminal aspects of four of nine retinal specimens from eyes with PVR, and VCAM was present in three of nine surgical specimens investigated. All cadaveric control retinas were negative for E-selectin and VCAM, whilst one was positive for P-selectin. Staining for TNF alpha was observed within luminal aspects and walls of retinal vessels from eight of nine surgical specimens, but was not seen in any of the cadaveric controls. T lymphocytes and cells expressing the macrophage marker CD68 were identified in two and seven of nine diseased retinas respectively, but not in any of the controls. Cells staining for HLA-DR were observed in eight of nine surgical retinal specimens and in three of five controls. CONCLUSION The present findings indicate that retina from eyes with advanced PVR may itself be subject to inflammatory changes, and indicate that the PVR process is not limited to retinal membranes, but involves a more widespread distribution of inflammation than is generally appreciated.
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Affiliation(s)
- G A Limb
- Immunology Research Unit, Rayne Institute, St Thomas' Hospital, London, UK
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Bodanowitz S, Hesse L, Weinand F, Kroll P. Vitrectomy in diabetic patients with a blind fellow eye. ACTA OPHTHALMOLOGICA SCANDINAVICA 1996; 74:84-8. [PMID: 8689491 DOI: 10.1111/j.1600-0420.1996.tb00690.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Results of pars plana vitrectomy for complications of proliferative diabetic retinopathy were analysed in 32 consecutive patients with a blind fellow eye due to diabetic eye disease. The mean follow-up period was 22.3 months. Only 16% of all eyes examined had received full scatter photocoagulation prior to referral for vitrectomy. Out of 9 eyes with vitreous haemorrhage, 8 improved to a visual acuity of > or = 0.2 postoperatively. Amid 23 eyes which were vitrectomized for advanced traction retinal detachment, only 4 eyes improved to a postoperative visual acuity of > or = 0.02. In this group 12 eyes deteriorated after vitrectomy, 3 eyes progressing to no light perception. The postoperative visual outcome after vitrectomy for traction retinal detachment in this group of diabetics with a blind fellow eye (mean postoperative visual acuity 0.03 +/- 0.05) was significantly worse (p < 0.000) compared to a group of 196 patients with a seeing fellow eye who were vitrectomized for traction retinal detachment at our clinic (mean postoperative visual acuity 0.09 +/- 0.11). Therefore we conclude that traction retinal detachment in this subgroup of patients is a particularly severe presentation of diabetic retinopathy with a guarded functional prognosis after vitrectomy. Our results demonstrate the importance of timely full scatter photocoagulation and early vitrectomy in eyes with progressive fibrovascular proliferation not responding to panretinal photocoagulation. We conclude that especially diabetic patients with a blind fellow eye must be followed closely and assigned to vitrectomy at an earlier stage of their disease in order to improve functional prognosis.
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Affiliation(s)
- S Bodanowitz
- Department of Ophthalmology, Philipps University, Marburg, Germany
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Abstract
Orbital sonography with color-flow Doppler imaging is a relatively new technology with significant application in the pediatric patient. This review stresses the primary indications for pediatric ophthalmic ultrasound and also discusses those instances where the use of ultrasound supplements other imaging studies.
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Affiliation(s)
- F G Ramji
- Department of Pediatric Imaging, Children's Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI 48201-2196, USA
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Soheilian M, Peyman GA, Wafapoor H, Navarro GC, Thompson H. Surgical management of traumatic retinal detachment with perfluorocarbon liquid. The Vitreon Study Group. Int Ophthalmol 1996; 20:241-9. [PMID: 9112194 DOI: 10.1007/bf00131918] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND To evaluate the effect of perfluoroperhydrophenanthrene on the outcome of traumatic retinal detachment with proliferative vitreoretinopathy, a retrospective study of 111 patients was performed at 35 tertiary care centers, both private practice and institutional. We believed that perfluoroperhydrophenanthrene would assist in manipulating the retina during surgery, removing intraocular foreign bodies, draining suprachoroidal hemorrhage, and reattaching the retina because of the perfluorocarbon's high specific gravity. METHODS Of the 700 patients in the Vitreo study group, 111 with a history of trauma (109 had retinal detachment, 50 had proliferative vitreoretinopathy) were chosen for this study. Perfluoroperhydrophenanthrene was used intraoperatively to manipulate the retina hydrokinetically, remove intraocular foreign bodies, drain suprachoroidal hemorrhage, and to reattach the retina in the case of giant tears. RESULTS Logistic multiple regression analysis was used to identify factors as being predictive of poor visual outcome. Factors predictive of poor visual outcome were: type of trauma (p = 0.0065) (ruptured globe); presence of giant retinal tear (p = 0.0253); and low preoperative visual acuity (p = 0.044). At the last follow-up examination, the reattachment rate was 75.6% (i.e., 84 eyes). Of those 84 eyes, 55 (49.5%) had achieved a visual acuity of > or = 5/200 and 34 (30.6%) had a visual acuity of > or = 20/200. In cases complicated by proliferative vitreoretinopathy, the final reattachment rate was 66%, with 40% of the eyes studied obtaining a visual acuity of > or = 5/200. CONCLUSIONS Perfluoroperhydrophenanthrene has been used intraoperatively in the management of traumatic retinal detachments without any apparent ill effects.
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Affiliation(s)
- M Soheilian
- LSU Eye Center, Louisiana State University Medical Center School of Medicine, New Orleans, USA
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Yang CH, Huang TF, Liu KR, Chen MS, Hung PT. Inhibition of cell-induced vitreous contraction by synthetic peptide derived from the collagen receptor binding sequence. J Ocul Pharmacol Ther 1996; 12:353-61. [PMID: 8875342 DOI: 10.1089/jop.1996.12.353] [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: 02/02/2023] Open
Abstract
Cell-mediated tractional retinal detachment (TRD) is the end result of various intraocular proliferative disorders. Interactions between cells and extracellular matrix via cellular surface receptors, integrins, play an important role. Anti-adhesion therapy has been suggested as a promising way to treat the integrin-dependent pathological events. We tested three synthetic peptides, Gly-Arg-Gly-Asp-Ser (GRGDS), derived from the fibronectin receptor binding domain; Try-Ile-Gly-Ser-Arg (YIGSR), from the laminin receptor binding domain, and Ala-Asp-Gly-Glu-Ala (ADGEA), from the collagen receptor binding domain, to evaluate their inhibitory effect on cell-mediated matrix attachment and vitreous contraction in vitro, and on cell-induced TRD in rabbit eyes in vivo. Indirect immunofluorescent stain demonstrated both bovine retinal pigment epithelial (RPE) cells and rabbit dermal fibroblasts expressed the alpha 2 beta 1, alpha 5 beta 1 and alpha 6 beta 1 integrins, the collagen, fibronectin, and laminin receptors, respectively. GRGDS exhibited a broad spectrum of inhibitory activity on RPE cell attachment to extracellular matrices. YIGSR specifically inhibited RPE cell attachment to laminin, whereas ADGEA inhibited RPE cell attachment to collagen type I and IV. ADGEA inhibited RPE cell-induced vitreous contraction in a dose-dependent manner, whereas GRGDS and YIGSR had no effect. ADGEA (1250 micrograms/mL) delayed the development of TRD but did not prevent it. ADGEA was nontoxic to cells and retina, as demonstrated by cytotoxicity tests and histological examination. The synthetic peptide, ADGEA, and its analogs may be potential candidates for the treatment of cell-mediated collagenous contraction in the ocular tissues.
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Affiliation(s)
- C H Yang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Republic of China
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