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Lanca C, Foo LL, Ang M, Tan CS, Kathrani B, Htoon HM, Tan D, Hoang QV, Brennan N, Saw SM, Sabanayagam C. Rapid Myopic Progression in Childhood Is Associated With Teenage High Myopia. Invest Ophthalmol Vis Sci 2021; 62:17. [PMID: 33851974 PMCID: PMC8054625 DOI: 10.1167/iovs.62.4.17] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Purpose The purpose of this study was to evaluate the association of childhood progression of spherical equivalent (SE) with high myopia (HM) in teenagers in the Singapore Cohort of Risk factors for Myopia (SCORM). Methods We included 928 SCORM children followed over a mean follow-up of 6.9 ± 1.0 years from baseline (6–11 years old) until their teenage years (12–19 years old). Cycloplegic autorefraction and axial length (AL) measurements were performed yearly. The outcomes in teenagers were HM (SE ≤ −5 diopter [D)], AL ≥ 25 mm, SE and AL. Three-year SE and AL progression in childhood and baseline SE and AL with outcomes were evaluated using multivariable logistic or linear regression models, with predictive performance of risk factors assessed using the area under the curve (AUC). Results At the last visit, 9.8% of teenagers developed HM and 22.7% developed AL ≥ 25 mm. In multivariate regression analyses, every −0.3 D/year increase in 3-year SE progression and every 0.2 mm/year increase in 3-year AL progression were associated with a −1.14 D greater teenage SE and 0.52 mm greater teenage AL (P values < 0.001). The AUC (95% confidence interval [CI]) of a combination of 3-year SE progression and baseline SE for teenage HM was 0.97 (95% CI = 0.95 – 0.98). The AUC of 3-year AL progression and baseline AL for teenage AL ≥ 25 mm was 0.91 (95% CI = 0.89 – 0.94). Conclusions Three-year myopia progression in childhood combined with baseline SE or AL were good predictors of teenage HM. Clinicians may use this combination of factors to guide timing of interventions, potentially reducing the risk of HM later in life.
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Affiliation(s)
| | - Li-Lian Foo
- Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore.,Singapore National Eye Centre, Singapore
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore.,Singapore National Eye Centre, Singapore
| | - Chuen-Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Biten Kathrani
- Johnson & Johnson Vision, Johnson & Johnson Vision Care, Singapore
| | - Hla Myint Htoon
- Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Donald Tan
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore.,Singapore National Eye Centre, Singapore
| | - Quan V Hoang
- Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore.,Singapore National Eye Centre, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Noel Brennan
- Johnson & Johnson Vision, Johnson & Johnson Vision Care, Jacksonville, FL, United States
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore.,Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
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Hudson N, Celkova L, Hopkins A, Greene C, Storti F, Ozaki E, Fahey E, Theodoropoulou S, Kenna PF, Humphries MM, Curtis AM, Demmons E, Browne A, Liddie S, Lawrence MS, Grimm C, Cahill MT, Humphries P, Doyle SL, Campbell M. Dysregulated claudin-5 cycling in the inner retina causes retinal pigment epithelial cell atrophy. JCI Insight 2019; 4:130273. [PMID: 31391341 PMCID: PMC6693834 DOI: 10.1172/jci.insight.130273] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 06/27/2019] [Indexed: 11/17/2022] Open
Abstract
Age-related macular degeneration (AMD) is the leading cause of central retinal vision loss worldwide, with an estimated 1 in 10 people over the age of 55 showing early signs of the condition. There are currently no forms of therapy available for the end stage of dry AMD, geographic atrophy (GA). Here, we show that the inner blood-retina barrier (iBRB) is highly dynamic and may play a contributory role in GA development. We have discovered that the gene CLDN5, which encodes claudin-5, a tight junction protein abundantly expressed at the iBRB, is regulated by BMAL1 and the circadian clock. Persistent suppression of claudin-5 expression in mice exposed to a cholesterol-enriched diet induced striking retinal pigment epithelium (RPE) cell atrophy, and persistent targeted suppression of claudin-5 in the macular region of nonhuman primates induced RPE cell atrophy. Moreover, fundus fluorescein angiography in human and nonhuman primate subjects showed increased retinal vascular permeability in the evening compared with the morning. These findings implicate an inner retina-derived component in the early pathophysiological changes observed in AMD, and we suggest that restoring the integrity of the iBRB may represent a novel therapeutic target for the prevention and treatment of GA secondary to dry AMD.
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Affiliation(s)
- Natalie Hudson
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Lucia Celkova
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Alan Hopkins
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Chris Greene
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Federica Storti
- Lab for Retinal Cell Biology, Department of Ophthalmology, University of Zürich, Zürich, Switzerland
| | - Ema Ozaki
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Erin Fahey
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Sofia Theodoropoulou
- Academic Unit of Ophthalmology, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
| | - Paul F. Kenna
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | | | - Annie M. Curtis
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | | | | | | | - Christian Grimm
- Lab for Retinal Cell Biology, Department of Ophthalmology, University of Zürich, Zürich, Switzerland
| | - Mark T. Cahill
- The Research Foundation, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Pete Humphries
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
| | - Sarah L. Doyle
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Matthew Campbell
- Smurfit Institute of Genetics, Trinity College Dublin, Dublin, Ireland
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Bobba S, Di Girolamo N, Munsie M, Chen F, Pébay A, Harkin D, Hewitt AW, O'Connor M, McLenachan S, Shadforth AMA, Watson SL. The current state of stem cell therapy for ocular disease. Exp Eye Res 2018; 177:65-75. [PMID: 30029023 DOI: 10.1016/j.exer.2018.07.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/16/2018] [Accepted: 07/16/2018] [Indexed: 12/13/2022]
Abstract
Herein, we review the safety, efficacy, regulatory standards and ethical implications of the use of stem cells in ocular disease. A literature review was conducted, registered clinical trials reviewed, and expert opinions sought. Guidelines and codes of conduct from international societies and professional bodies were also reviewed. Collated data is presented on current progress in the field of ocular regenerative medicine, future challenges, the clinical trial process and ethical considerations in stem cell therapy. A greater understanding of the function and location of ocular stem cells has led to rapid advances in possible therapeutic applications. However, in the context of significant technical challenges and potential long-term complications, it is imperative that stem cell practices operate within formal clinical trial frameworks. While there remains broad scope for innovation, ongoing evidence-based review of potential interventions and the development of standardized protocols are necessary to ensure patient safety and best practice in ophthalmic care.
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Affiliation(s)
- Samantha Bobba
- Prince of Wales Hospital Clinical School, High Street, Randwick, Sydney, New South Wales, 2031, Australia.
| | - Nick Di Girolamo
- School of Medical Sciences, University of New South Wales, Kensington, Sydney, New South Wales, 2052, Australia
| | - Megan Munsie
- Centre for Stem Cell Systems, School of Biomedical Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia
| | - Fred Chen
- Lions Eye Institute, 2 Verdun Street, Nedlands, Western Australia, 6009, Australia
| | - Alice Pébay
- Centre for Stem Cell Systems, School of Biomedical Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia; Centre for Eye Research Australia, Level 7/32 Gisborne Street, East Melbourne, Victoria, 3002, Australia
| | - Damien Harkin
- School of Biomedical Sciences, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4000, Australia
| | - Alex W Hewitt
- Centre for Eye Research Australia, Level 7/32 Gisborne Street, East Melbourne, Victoria, 3002, Australia; School of Medicine, University of Tasmania, Churchill Avenue, Hobart, Tasmania, 7005, Australia
| | - Michael O'Connor
- School of Medicine, Western Sydney University, Victoria Road Parramatta, New South Wales, Parramatta, 2150, Australia
| | - Samuel McLenachan
- Centre for Ophthalmology and Visual Science, University of Western Australia, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia
| | - Audra M A Shadforth
- School of Biomedical Sciences, Queensland University of Technology, 2 George Street, Brisbane, Queensland, 4000, Australia
| | - Stephanie L Watson
- Prince of Wales Hospital Clinical School, High Street, Randwick, Sydney, New South Wales, 2031, Australia; Save Sight Institute, University of Sydney, 8 Macquarie Street, Sydney, New South Wales, 2000, Australia; Sydney Eye Hospital, 8 Macquarie Street, Sydney, New South Wales, 2000, Australia.
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Stem cells in regenerative medicine - from laboratory to clinical application - the eye. Cent Eur J Immunol 2017; 42:173-180. [PMID: 28860936 PMCID: PMC5573891 DOI: 10.5114/ceji.2017.69360] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 11/25/2016] [Indexed: 12/18/2022] Open
Abstract
Stem cells are currently one of the most researched and explored subject in science. They consstitue a very promising part of regenerative medicine and have many potential clinical applications. Harnessing their ability to replicate and differentiate into many cell types can enable successful treatment of diseases that were incurable until now. There are numerous types of stem cells (e.g. ESCs, FSCs, ASCs, iPSCs) and many different methods of deriving and cultivating them in order to obtain viable material. The eye is one of the most interesting targets for stem cell therapies. In this article we summarise different aspects of stem cells, discussing their characteristics, sources and methods of culture. We also demonstrate the most recent clinical applications in ophthalmology based on an extensive current literature review. Tissue engineering techniques developed for corneal limbal stem cell deficiency, age-related macular degeneration (AMD) and glaucoma are among those presented. Both laboratory and clinical aspects of stem cells are discussed.
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Oshima H, Iwase T, Ishikawa K, Yamamoto K, Terasaki H. Long-term results after limited macular translocation surgery for wet age-related macular degeneration. PLoS One 2017; 12:e0177241. [PMID: 28542257 PMCID: PMC5441587 DOI: 10.1371/journal.pone.0177241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/24/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the long-term results of limited macular translocation (LMT) surgery with radial chorioscleral outfolding in patients with wet age-related macular degeneration (AMD) and subfoveal choroidal neovascularization (CNV). In addition, to identify the factors associated with the final best-corrected visual acuity (BCVA). Methods The medical records of 20 eyes of 20 consecutive patients (65.2±9.8 years) who had undergone LMT for the treatment of wet AMD and were followed for at least 5 years, were reviewed. The surgical outcomes including the BCVA, degree of foveal displacement, and complications were recorded. Results The mean foveal displacement was 1332 ± 393 μm after the LMT. The CNV was removed in 16 eyes and photocoagulated in 4 eyes. The mean preoperative VA was 0.83 ± 0.33 logMAR units which significantly improved to 0.59 ± 0.37 logMAR units at 1 year after the surgery (P = 0.015). This BCVA was maintained at 0.59 ± 0.41 logMAR units on the final examination. The final BCVA was significantly correlated with that at 1 year after the surgery (r = 0.83, P<0.001). Multiple linear regression analysis showed that the final BCVA was significantly correlated with the BCVA at 1 year after the surgery (P<0.001), a recurrence of a CNV (P = 0.001), and the age (P = 0.022). Conclusions LMT improves the BCVA significantly at 1 year, and the improved BCVA lasted for at least 5 years. These results indicate that the impaired function of the sensory retina at the fovea can recover on the new RPE after the displacement for at least 5 years. The ability to maintain good retinal function on the new RPE for a long period is important for future treatments of CNVs such as the transplantation of RPE cells and stem cells.
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Affiliation(s)
- Hisaaki Oshima
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takeshi Iwase
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- * E-mail:
| | - Kohei Ishikawa
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Kentaro Yamamoto
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Zhu Y, Zhang T, Xu G, Peng L. Anti-vascular endothelial growth factor for choroidal neovascularisation in people with pathological myopia. Cochrane Database Syst Rev 2016; 12:CD011160. [PMID: 27977064 PMCID: PMC6464015 DOI: 10.1002/14651858.cd011160.pub2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Choroidal neovascularisation (CNV) is a common complication of pathological myopia. Once developed, most eyes with myopic CNV (mCNV) experience a progression to macular atrophy, which leads to irreversible vision loss. Anti-vascular endothelial growth factor (anti-VEGF) therapy is used to treat diseases characterised by neovascularisation and is increasingly used to treat mCNV. OBJECTIVES To assess the effects of anti-vascular endothelial growth factor (anti-VEGF) therapy for choroidal neovascularisation (CNV), compared with other treatments, sham treatment or no treatment, in people with pathological myopia. SEARCH METHODS We searched a number of electronic databases including CENTRAL and Ovid MEDLINE, ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform ICTRP). We did not use any date or language restrictions in the electronic searches for trials. Electronic databases were last searched on 16 June 2016. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs comparing anti-VEGF therapy with another treatment (e.g. photodynamic therapy (PDT) with verteporfin, laser photocoagulation, macular surgery, another anti-VEGF), sham treatment or no treatment in participants with mCNV. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. Two authors independently screened records, extracted data, and assessed risk of bias. We contacted trial authors for additional data. We analysed outcomes as risk ratios (RRs) or mean differences (MDs). We graded the certainty of the evidence using GRADE. MAIN RESULTS The present review included six studies which provided data on the comparison between anti-VEGF with PDT, laser, sham treatment and another anti-VEGF treatment, with 594 participants with mCNV. Three trials compared bevacizumab or ranibizumab with PDT, one trial compared bevacizumab with laser, one trial compared aflibercept with sham treatment, and two trials compared bevacizumab with ranibizumab. Pharmaceutical companies conducted two trials. The trials were conducted at multiple clinical centres across three continents (Europe, Asia and North America). In all these six trials, one eye for each participant was included in the study.When compared with PDT, people treated with anti-VEGF agents (ranibizumab (one RCT), bevacizumab (two RCTs)), were more likely to regain vision. At one year of follow-up, the mean visual acuity (VA) in participants treated with anti-VEGFs was -0.14 logMAR better, equivalent of seven Early Treatment Diabetic Retinopathy Study (ETDRS) letters, compared with people treated with PDT (95% confidence interval (CI) -0.20 to -0.08, 3 RCTs, 263 people, low-certainty evidence). The RR for proportion of participants gaining 3+ lines of VA was 1.86 (95% CI 1.27 to 2.73, 2 RCTs, 226 people, moderate-certainty evidence). At two years, the mean VA in people treated with anti-VEGFs was -0.26 logMAR better, equivalent of 13 ETDRS letters, compared with people treated with PDT (95% CI -0.38 to -0.14, 2 RCTs, 92 people, low-certainty evidence). The RR for proportion of people gaining 3+ lines of VA at two years was 3.43 (95% CI 1.37 to 8.56, 2 RCTs, 92 people, low-certainty evidence). People treated with anti-VEGFs showed no obvious reduction (improvement) in central retinal thickness at one year compared with people treated with PDT (MD -17.84 μm, 95% CI -41.98 to 6.30, 2 RCTs, 226 people, moderate-certainty evidence). There was low-certainty evidence that people treated with anti-VEGF were more likely to have CNV angiographic closure at 1 year (RR 1.24, 95% CI 0.99 to 1.54, 2 RCTs, 208 people). One study allowed ranibizumab treatment as of month 3 in participants randomised to PDT, which may have led to an underestimate of the benefits of anti-VEGF treatment.When compared with laser photocoagulation, there was more improvement in VA among bevacizumab-treated people than among laser-treated people after one year (MD -0.22 logMAR, equivalent of 11 ETDRS letters, 95% CI -0.43 to -0.01, 1 RCT, 36 people, low-certainty evidence) and after two years (MD -0.29 logMAR, equivalent of 14 ETDRS letters, 95% CI -0.50 to -0.08, 1 RCT, 36 people, low-certainty evidence).When compared with sham treatment, people treated with aflibercept had better vision at one year (MD -0.19 logMAR, equivalent of 9 ETDRS letters, 95% CI -0.27 to -0.12, 1 RCT, 121 people, moderate-certainty evidence). The fact that this study allowed for aflibercept treatment at 6 months in the control group might cause an underestimation of the benefit with anti-VEGF.People treated with ranibizumab had similar improvement in VA recovery compared with people treated with bevacizumab after one year (MD -0.02 logMAR, equivalent of 1 ETDRS letter, 95% CI -0.11 to 0.06, 2 RCTs, 80 people, moderate-certainty evidence).Of the included six studies, two studies reported no adverse events in either group and two industry-sponsored studies reported both systemic and ocular adverse events. In the control group, there were no systemic or ocular adverse events reported in 149 participants. Fifteen people reported systemic serious adverse events among 359 people treated with anti-VEGF agents (15/359, 4.2%). Five people reported ocular adverse events among 359 people treated with anti-VEGF agents (5/359, 1.4%). The number of adverse events was low, and the estimate of RR was uncertain regarding systemic serious adverse events (4 RCTs, 15 events in 508 people, RR 4.50, 95% CI 0.60 to 33.99, very low-certainty evidence) and serious ocular adverse events (4 RCTs, 5 events in 508 people, RR 1.82, 95% CI 0.23 to 14.71, very low-certainty evidence). There were no reports of mortality or cases of endophthalmitis or retinal detachment.There was sparse reporting of data for vision-related quality of life (in favour of anti-VEGF) in only one trial at one year of follow-up. The studies did not report data for other outcomes, such as percentage of participants with newly developed chorioretinal atrophy. AUTHORS' CONCLUSIONS There is low to moderate-certainty evidence from RCTs for the efficacy of anti-VEGF agents to treat mCNV at one year and two years. Moderate-certainty evidence suggests ranibizumab and bevacizumab are equivalent in terms of efficacy. Adverse effects occurred rarely and the trials included here were underpowered to assess these. Future research should be focused on the efficacy and safety of different drugs and treatment regimens, the efficacy on different location of mCNV, as well as the effects on practice in the real world.
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Affiliation(s)
- Ying Zhu
- Xiangya Hospital, Central South UniversityDepartment of OphthalmologyNo. 87, Xiangya RoadChangshaHunanChina410008
| | - Ting Zhang
- Eye and Ear Nose Throat Hospital, Shanghai Medical School, Fudan UniversityDepartment of OphthalmologyNo. 83, Fenyang RoadShanghaiChina200032
| | - Gezhi Xu
- Eye and Ear Nose Throat Hospital, Shanghai Medical School, Fudan UniversityDepartment of OphthalmologyNo. 83, Fenyang RoadShanghaiChina200032
| | - Lijun Peng
- Linyi People's Hospital affiliated to Shandong UniversityDepartment of Gastroenterology27 Jie Fang RoadLinyiShandongChina276000
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Ozkaya A, Alagoz C, Garip R, Alkin Z, Perente I, Yazici AT, Taskapili M. The role of indocyanine green angiography imaging in further differential diagnosis of patients with nAMD who are morphologically poor responders to ranibizumab in a real-life setting. Eye (Lond) 2016; 30:958-65. [PMID: 27080484 DOI: 10.1038/eye.2016.71] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 02/15/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo evaluate the neovascular age-related macular degeneration (nAMD) in patients who were morphologically poor responders to intravitreal ranibizumab (IVR) treatment using indocyanine green angiography (ICGA) for further investigation.MethodsThis was a cross-sectional, retrospective study. The patients with an initial diagnosis of nAMD who made through the clinical examination, optical coherence tomography, and fluorescein angiography imaging, and were treated with at least three monthly IVR injections that resulted with a morphological poor response, were included. ICGA was obtained from the patients and evaluated in regard to differential diagnosis of other macular diseases, which might mimic nAMD.ResultsThe study included 132 eyes of 117 patients. The mean age was 67.4±9.4 years. After ICGA imaging, 13 eyes (9.8%) were diagnosed as true nAMD, 74 eyes (56.1%) as polypoidal choroidal vasculopathy (PCV), 35 eyes (26.5%) as chronic central serous chorioretinopathy (CSC), 3 eyes (2.3%) as retinal angiomatous proliferation (RAP), 3 eyes (2.3%) as choroidal neovascularization secondary to CSC, 2 eyes (1.5%) as adult-onset vitelliform macular dystrophy, and 2 eyes (1.5%) as drusenoid pigment epithelial detachment with vitelliform material, respectively. The duration between the initial diagnosis and the revised diagnosis was 15.6±10.5 months in the non-AMD group, and the mean injection number of these patients was 6.6±4.4.ConclusionsMost of the nAMD patients who were thought to be morphologically poor responders to IVR were diagnosed as having non-AMD diseases via ICGA. A detailed differential diagnostic work-up is needed before considering these patients as poor responders.
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Affiliation(s)
- A Ozkaya
- Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - C Alagoz
- Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - R Garip
- Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - Z Alkin
- Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - I Perente
- Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - A T Yazici
- Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
| | - M Taskapili
- Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
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Usui Y, Westenskow PD, Murinello S, Dorrell MI, Scheppke L, Bucher F, Sakimoto S, Paris LP, Aguilar E, Friedlander M. Angiogenesis and Eye Disease. Annu Rev Vis Sci 2015; 1:155-184. [DOI: 10.1146/annurev-vision-082114-035439] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yoshihiko Usui
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California 92037; , , , , , , , , ,
| | - Peter D. Westenskow
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California 92037; , , , , , , , , ,
- The Lowy Medical Research Institute, La Jolla, California 92037
| | - Salome Murinello
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California 92037; , , , , , , , , ,
| | - Michael I. Dorrell
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California 92037; , , , , , , , , ,
- The Lowy Medical Research Institute, La Jolla, California 92037
- Department of Biology, Point Loma Nazarene University, San Diego, California 92106
| | - Lea Scheppke
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California 92037; , , , , , , , , ,
| | - Felicitas Bucher
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California 92037; , , , , , , , , ,
| | - Susumu Sakimoto
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California 92037; , , , , , , , , ,
| | - Liliana P. Paris
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California 92037; , , , , , , , , ,
| | - Edith Aguilar
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California 92037; , , , , , , , , ,
| | - Martin Friedlander
- Department of Cell and Molecular Biology, The Scripps Research Institute, La Jolla, California 92037; , , , , , , , , ,
- The Lowy Medical Research Institute, La Jolla, California 92037
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Alvarez Palomo AB, McLenachan S, Chen FK, Da Cruz L, Dilley RJ, Requena J, Lucas M, Lucas A, Drukker M, Edel MJ. Prospects for clinical use of reprogrammed cells for autologous treatment of macular degeneration. FIBROGENESIS & TISSUE REPAIR 2015; 8:9. [PMID: 25984235 PMCID: PMC4432516 DOI: 10.1186/s13069-015-0026-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 04/24/2015] [Indexed: 12/12/2022]
Abstract
Since the discovery of induced pluripotent stem cells (iPSC) in 2006, the symptoms of many human diseases have been reversed in animal models with iPSC therapy, setting the stage for future clinical development. From the animal data it is clear that iPSC are rapidly becoming the lead cell type for cell replacement therapy and for the newly developing field of iPSC-derived body organ transplantation. The first human pathology that might be treated in the near future with iPSC is age-related macular degeneration (AMD), which has recently passed the criteria set down by regulators for phase I clinical trials with allogeneic human embryonic stem cell-derived cell transplantation in humans. Given that iPSC are currently in clinical trial in Japan (RIKEN) to treat AMD, the establishment of a set of international criteria to make clinical-grade iPSC and their differentiated progeny is the next step in order to prepare for future autologous cell therapy clinical trials. Armed with clinical-grade iPSC, we can then specifically test for their threat of cancer, for proper and efficient differentiation to the correct cell type to treat human disease and then to determine their immunogenicity. Such a rigorous approach sets a far more relevant paradigm for their intended future use than non-clinical-grade iPSC. This review focuses on the latest developments regarding the first possible use of iPSC-derived retinal pigment epithelial cells in treating human disease, covers data gathered on animal models to date and methods to make clinical-grade iPSC, suggests techniques to ensure quality control and discusses possible clinical immune responses.
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Affiliation(s)
- Ana Belen Alvarez Palomo
- Control of Pluripotency Laboratory, Department of Physiological Sciences I, Faculty of Medicine, University of Barcelona, Hospital Clinic, Casanova 143, 08036 Barcelona, Spain
| | - Samuel McLenachan
- Centre for Ophthalmology and Visual Science (Lions Eye Institute), University of Western Australia, 2 Verdun Street, Nedlands, WA 6009 Australia
| | - Fred K Chen
- Centre for Ophthalmology and Visual Science (Lions Eye Institute), University of Western Australia, 2 Verdun Street, Nedlands, WA 6009 Australia
| | - Lyndon Da Cruz
- Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD England
| | - Rodney J Dilley
- Ear Sciences Centre, 1 Salvado Rd, Subiaco, WA 6008 Australia ; School of Surgery, University of Western Australia, 35 Stirling Highway, Nedlands, WA 6009 Australia
| | - Jordi Requena
- Control of Pluripotency Laboratory, Department of Physiological Sciences I, Faculty of Medicine, University of Barcelona, Hospital Clinic, Casanova 143, 08036 Barcelona, Spain
| | - Michaela Lucas
- School of Medicine and Pharmacology, University of Western Australia, 35 Stirling Highway, Nedlands, WA 6009 Australia ; PathWest, SCGH Laboratories Hospital Ave, Nedlands, WA 6009 Australia
| | - Andrew Lucas
- Institute for Immunology and Infectious Diseases, Murdoch University, Building 390, Discovery Way, Murdoch, Perth, WA 6150 Australia
| | - Micha Drukker
- Helmholtz Zentrum München, German Research Centre for Environmental Health (GmbH), Institute of Stem Cell Research, Ingolstädter Landstraße 1, D-85764 Neuherberg, Germany
| | - Michael J Edel
- Control of Pluripotency Laboratory, Department of Physiological Sciences I, Faculty of Medicine, University of Barcelona, Hospital Clinic, Casanova 143, 08036 Barcelona, Spain ; Division of Pediatrics and Child Health, Westmead Children's Hospital, Corner Hawkesbury Road and Hainsworth Street, Westmead, Sydney, NSW 2145 Australia ; School of Anatomy, Physiology & Human Biology and Centre for Cell Therapy and Regenerative Medicine (CCTRM), University of Western Australia, 35 Stirling Highway, Nedlands, WA 6009 Australia
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van Romunde SHM, Polito A, Bertazzi L, Guerriero M, Pertile G. Long-Term Results of Full Macular Translocation for Choroidal Neovascularization in Age-Related Macular Degeneration. Ophthalmology 2015; 122:1366-74. [PMID: 25881514 DOI: 10.1016/j.ophtha.2015.03.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 03/05/2015] [Accepted: 03/06/2015] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To investigate the long-term outcome of full macular translocation (FMT) for neovascular age-related macular degeneration (AMD) and to identify predictive factors. DESIGN Retrospective, uncontrolled case series. PARTICIPANTS Patients were considered for FMT if they had low vision in the fellow eye and choroidal neovascularization (CNV) along with (1) no response to vascular endothelial growth factor (VEGF) inhibitors, (2) retinal pigment epithelium (RPE) tear, (3) subretinal hemorrhage, (4) foveal scar tissue of recent onset, or (5) CNV before the availability of VEGF inhibitors. From 2004 through 2012, a total of 255 patients underwent FMT. Exclusion criteria were patients younger than 60 years, FMT for disease other than AMD, and a follow-up of less than 12 months. METHODS Preoperative, annual, and last distance best-corrected visual acuity (BCVA) were obtained retrospectively from patient files. Complications were recorded using funduscopy, optical coherence tomography, autofluorescence, and angiography. MAIN OUTCOME MEASURES Distance BCVA at 1 year and 5 years after surgery and at last visit compared with preoperative BCVA. RESULTS One hundred fifty-eight patients (mean follow-up, 45 months) were included. Median BCVA improved from 0.90 logarithm of the minimum angle of resolution (logMAR) before surgery to 0.70 logMAR 1 year after FMT (2 lines gained; P = 0.000). In a subgroup of 56 patients followed up for 5 years or more, median BCVA improved from 0.95 logMAR before surgery to 0.70 logMAR 1 year after surgery, and remained improved 5 years after FMT with a median BCVA of 0.80 logMAR (1.5 lines gained compared with preoperative BCVA; P = 0.000). The main complications were foveal RPE atrophy (n = 73; 47%) and CNV recurrence (n = 47; 30%). Foveal RPE atrophy (odds ratio [OR], 7.0), CNV recurrence (OR, 2.6), and proliferative vitreoretinopathy (PVR; OR, 17.6) were statistically significant predictors (P < 0.05) for losing 1 line or more at last visit. CONCLUSIONS In this study, BCVA was improved up to 5 years after FMT. Foveal RPE atrophy, CNV recurrence, and PVR carried a worse prognosis. In patients who are unlikely to benefit from VEGF inhibitors, FMT can be considered for second eyes with neovascular AMD.
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Affiliation(s)
- Saskia H M van Romunde
- Department of Ophthalmology, Sacro Cuore - Don Calabria hospital, Negrar, Verona, Italy.
| | - Antonio Polito
- Department of Ophthalmology, Sacro Cuore - Don Calabria hospital, Negrar, Verona, Italy
| | - Laura Bertazzi
- Department of Ophthalmology, Sacro Cuore - Don Calabria hospital, Negrar, Verona, Italy
| | | | - Grazia Pertile
- Department of Ophthalmology, Sacro Cuore - Don Calabria hospital, Negrar, Verona, Italy
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11
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Dang Y, Zhang C, Zhu Y. Stem cell therapies for age-related macular degeneration: the past, present, and future. Clin Interv Aging 2015; 10:255-64. [PMID: 25609937 PMCID: PMC4298283 DOI: 10.2147/cia.s73705] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
In the developed world, age-related macular degeneration (AMD) is one of the major causes of irreversible blindness in the elderly. Although management of neovascular AMD (wet AMD) has dramatically progressed, there is still no effective treatment for nonneovascular AMD (dry AMD), which is characterized by retinal pigment epithelial (RPE) cell death (or dysfunction) and microenvironmental disruption in the retina. Therefore, RPE replacement and microenvironmental regulation represent viable treatments for dry AMD. Recent advances in cell biology have demonstrated that RPE cells can be easily generated from several cell types (pluripotent stem cells, multipotent stem cells, or even somatic cells) by spontaneous differentiation, coculturing, defined factors or cell reprogramming, respectively. Additionally, in vivo studies also showed that the restoration of visual function could be obtained by transplanting functional RPE cells into the subretinal space of recipient. More importantly, clinical trials approved by the US government have shown promising prospects in RPE transplantation. However, key issues such as implantation techniques, immune rejection, and xeno-free techniques are still needed to be further investigated. This review will summarize recent advances in cell transplantation for dry AMD. The obstacles and prospects in this field will also be discussed.
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Affiliation(s)
- Yalong Dang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, People's Republic of China ; Clinical Stem Cell Research Center, Peking University Third Hospital, Beijing, People's Republic of China ; Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Chun Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, People's Republic of China ; Clinical Stem Cell Research Center, Peking University Third Hospital, Beijing, People's Republic of China
| | - Yu Zhu
- Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China
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12
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Tamponade or filling effect: changes of forces in myopic eyes. BIOMED RESEARCH INTERNATIONAL 2014; 2014:618382. [PMID: 25101290 PMCID: PMC4101978 DOI: 10.1155/2014/618382] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 06/22/2014] [Indexed: 02/05/2023]
Abstract
Myopia is the most common ocular abnormality. Its high and growing prevalence has contributed to a recent surge in surgical interest in the disorder, since retinal detachment in eyes with high myopia differs from that in emmetropic eyes or eyes with low myopia. The myopic eye, because of its specific anatomy, poses special challenges that need to be overcome to ensure the appropriate use of vitreous substitutes. However, intraocular tamponades have shown great potential for revolutionizing retinal detachment surgery and vitreomacular surgery in general in myopic eyes. We provide an updated review of the clinical use of vitreous substitutes in the myopic eye, paying particular attention to analyzing the ideal function of endotamponade agents and comparing the effects of these agents on the physical and biological properties of the eye.
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13
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Sakimoto S, Sakaguchi H, Ohji M, Gomi F, Ikuno Y, Fujikado T, Kamei M, Nishida K. Consecutive case series with long-term follow-up of full macular translocation for myopic choroidal neovascularisation. Br J Ophthalmol 2014; 98:1221-5. [PMID: 24692747 DOI: 10.1136/bjophthalmol-2013-304189] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To examine the long-term outcomes of full macular translocation (FMT) for myopic choroidal neovascularisation (mCNV). METHODS We evaluated a consecutive case series of 60 eyes with mCNV that underwent FMT. We assessed the best-corrected visual acuity (BCVA), fundus photographs and fluorescein angiography images, and evaluated the anatomic and visual outcomes. RESULTS The mean follow-up period was 76.3 months. The macula was relocated successfully in all eyes. The mean distance of macular translocation was 2842 μm. The baseline BCVA was 0.78 logarithm of the minimum angle of resolution (logMAR) unit; the logMAR BCVA values at 1, 3 and 5 years postoperatively significantly (p<0.001) improved to 0.54 at 1 year and then remained stable. The new fovea was associated with enlargement of the myopic chorioretinal atrophy in 19 (31.7%) eyes. Subfoveal or juxtafoveal CNV at the translocated new fovea developed in five (8.3%) eyes. CONCLUSIONS FMT for mCNV maintained the improvement in VA for more than 5 years. However, postoperative complications and progression of chorioretinal atrophy due to myopia still seem to limit the visual improvement after FMT for mCNV.
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Affiliation(s)
- Susumu Sakimoto
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hirokazu Sakaguchi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masahito Ohji
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Fumi Gomi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yasushi Ikuno
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takashi Fujikado
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Motohiro Kamei
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Japan
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15
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Displacement of foveal area toward optic disc after macular hole surgery with internal limiting membrane peeling. Eye (Lond) 2013; 27:871-7. [PMID: 23703632 DOI: 10.1038/eye.2013.99] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 04/23/2013] [Indexed: 02/01/2023] Open
Abstract
PURPOSE To determine whether there is a displacement of the fovea toward the optic disc after successful macular hole (MH) surgery with internal limiting membrane (ILM) peeling. METHODS The medical records of 54 eyes of 53 patients that had undergone pars plana vitrectomy with ILM peeling and gas or air tamponade for an idiopathic MH were evaluated. Spectral-domain optical coherence tomography (OCT) had been performed before and >6 months after the surgery. The preoperative distances between the center of the MH and the optic disc (MH-OD), center of the MH and the bifurcation or crossing of retinal vessels (MH-RV) were measured in the OCT images. In addition, the postoperative distance between the center of the fovea and optic disc (F-OD) and the center of the fovea and the same bifurcation or crossing of retinal vessels (F-RV) were measured in the OCT images. RESULTS The F-OD was 2.67±0.33 disc diameters (DD), which was significantly shorter than that of the MH-OD of 2.77±0.33 DD (P<0.001). The F-RV was also significantly shorter than the MH-RV on the inner nasal area (from 0.85±0.16DD to 0.79±0.15DD; P<0.001), the inner temporal area (from 0.82±0.15DD to 0.77±0.14DD; P<0.001), and outer nasal area (from 1.70±0.31DD to 1.65±0.32DD; P<0.001), but it was significantly longer than the MH-RV in the outer temporal area (from 1.65±0.29DD to 1.68±0.29DD; P<0.001). CONCLUSION Our results showed that successful closure of a MH by vitrectomy with ILM peeling and gas tamponade leads to a displacement of the center of the macula toward the optic disc.
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Carr AJF, Smart MJK, Ramsden CM, Powner MB, da Cruz L, Coffey PJ. Development of human embryonic stem cell therapies for age-related macular degeneration. Trends Neurosci 2013; 36:385-95. [PMID: 23601133 DOI: 10.1016/j.tins.2013.03.006] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 02/11/2013] [Accepted: 03/18/2013] [Indexed: 12/16/2022]
Abstract
Age-related macular degeneration (AMD) is the leading cause of vision loss in older adults and ultimately leads to the death of photoreceptor cells in the macular area of the neural retina. Currently, treatments are only available for patients with the wet form of AMD. In this review, we describe recent approaches to develop cell-based therapies for the treatment of AMD. Recent research has focused on replacing the retinal pigment epithelium (RPE), a monolayer of cells vital to photoreceptor cell health. We discuss the various methods used to differentiate and purify RPE from human embryonic stem cells (HESC), and describe the surgical approaches being used to transplant these cells in existing and forthcoming clinical trials.
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Affiliation(s)
- Amanda-Jayne F Carr
- The London Project to Cure Blindness, Division of ORBIT, Institute of Ophthalmology, University College London, 11-43 Bath Street, London, EC1V 9EL, UK.
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