Vitrectomy With Membrane Peeling for Vasocentric Idiopathic Epiretinal Membranes

Current Treatment Modalities of JIA-associated Uveitis and its Complications: Literature Review

Uveitis is a common and serious complication of juvenile idiopathic arthritis. Up to 75% of all cases of anterior uveitis in childhood are associated with juvenile idiopathic arthritis. Despite the remarkable progress in early detection and treatment of inflammation, vision-threatening complications of uveitis still occur in almost 60% of patients. Structural complications include band keratopathy, maculopathy (macular edema, macular cysts, and epiretinal membrane), glaucomatous optic neuropathy, and cataracts. The management of complications in juvenile idiopathic arthritis is usually complex and requires early surgical intervention. In this paper, we review the general concepts of common ocular complications seen in patients with JIA-associated uveitis, with special attention to the recent diagnostic and preferred treatment approaches at the Massachusetts Eye Research and Surgery Institution. Received 9 March 2015; revised 30 September 2015; accepted 30 October 2015; published online 14 January 2016.

[Recurrence of an idiopathic vasocentric epiretinal membrane: clinical and surgical particularities]

The vasocentric epiretinal membranes (ERM) are idiopathic ERM centered on retinal blood vessels, described mainly in young patients. We report a case of a 70-year-old patient who presented with a decrease in visual acuity secondary to a vasocentric epiretinal membrane. A successful vitrectomy and ERM removal were performed. Four years after surgery, a contractile ERM centered on the superior temporal blood vessel occurred and was associated with retinal distortions at the posterior pole. The second surgery combined removal of the recurrent ERM, which was adherent to the temporal vessels, and peeling of the internal limiting membrane in the macular area. Although there was visual recovery, the patient is still suffering from metamorphopsia 2 years after surgery. The vasocentric ERM have a poor visual outcome and a high risk of recurrence in comparison with other ERM disorders. This case report describes the main clinical and surgical characteristics of this type of membrane.

Periostin, discovered by nano-flow liquid chromatography and mass spectrometry, is a novel marker of diabetic retinopathy

Diabetes can lead to serious microvascular complications including proliferative diabetic retinopathy (PDR), the leading cause of blindness in adults. Recent studies using gene array technology have attempted to apply a hypothesis-generating approach to elucidate the pathogenesis of PDR, but these studies rely on mRNA differences, which may or may not be related to significant biological processes. To better understand the basic mechanisms of PDR and to identify potential new biomarkers, we performed shotgun liquid chromatography (LC)/tandem mass spectrometry (MS/MS) analysis on pooled protein extracts from neovascular membranes obtained from PDR specimens and compared the results with those from non-vascular epiretinal membrane (ERM) specimens. We detected 226 distinct proteins in neovascular membranes and 154 in ERM. Among these proteins, 102 were specific to neovascular membranes and 30 were specific to ERM. We identified a candidate marker, periostin, as well as several known PDR markers such as pigment epithelium-derived factor (PEDF). We then performed RT-PCR using these markers. The expression of periostin was significantly up-regulated in proliferative membrane specimens. Periostin induces cell attachment and spreading and plays a role in cell adhesion. Proteomic analysis by LC/MS/MS, which permits accurate quantitative comparison, was useful in identifying new candidates such as periostin potentially involved in the pathogenesis of PDR.