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Thylefors J, Sheikh R, Jakobsson G. The effect of axial length on pseudophakic retinal detachment. Acta Ophthalmol 2024. [PMID: 38587993 DOI: 10.1111/aos.16691] [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: 12/17/2023] [Accepted: 03/29/2024] [Indexed: 04/10/2024]
Abstract
PURPOSE The purpose of the study was to analyse the surgical management and outcome regarding axial length in the population affected by pseudophakic retinal detachment (PRD) 2015-2020. METHOD The patients included were from an observational cohort study of patients undergoing cataract surgery in the region of Skåne during 2015-2017. Data were retrieved from the Swedish National Cataract Register and cross-referenced with cases of PRD in the same region from 2015 to 2020. The surgical method used and findings at follow-up were recorded. The patients were stratified according to axial length (AL) to <25 mm, 25 ≤ n < 26.5 mm and ≥26.5 mm. The main outcome was primary success with one surgery apart from silicone oil removal. The secondary outcome was postoperative visual acuity. RESULTS In the whole study group of 58 624 cases, complete follow-up data were available for 288 eyes. The median follow-up time was 324 days, and primary operation was successful in 82.9% of these cases. The median visual acuity was 0.31 (LogMAR). In the stratification those with AL < 25 mm had a primary success of 75.8%, AL 25 ≤ n < 26.5 mm of 87.9% and ≥26.5 mm of 95.8%. CONCLUSIONS The primary anatomical success was 82.9% in the whole group of PRD but with stratification they had an increasing number of primary success with longer AL.
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Affiliation(s)
- Joakim Thylefors
- Department of Clinical Sciences Lund, Ophthalmology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Rafi Sheikh
- Department of Clinical Sciences Lund, Ophthalmology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Gunnar Jakobsson
- Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Region Västra Götaland, Sweden
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Govers BM, van Huet RAC, Roosing S, Keijser S, Los LI, den Hollander AI, Klevering BJ. The genetics and disease mechanisms of rhegmatogenous retinal detachment. Prog Retin Eye Res 2023; 97:101158. [PMID: 36621380 DOI: 10.1016/j.preteyeres.2022.101158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/20/2022] [Accepted: 12/23/2022] [Indexed: 01/07/2023]
Abstract
Rhegmatogenous retinal detachment (RRD) is a sight threatening condition that warrants immediate surgical intervention. To date, 29 genes have been associated with monogenic disorders involving RRD. In addition, RRD can occur as a multifactorial disease through a combined effect of multiple genetic variants and non-genetic risk factors. In this review, we provide a comprehensive overview of the spectrum of hereditary disorders involving RRD. We discuss genotype-phenotype correlations of these monogenic disorders, and describe genetic variants associated with RRD through multifactorial inheritance. Furthermore, we evaluate our current understanding of the molecular disease mechanisms of RRD-associated genetic variants on collagen proteins, proteoglycan versican, and the TGF-β pathway. Finally, we review the role of genetics in patient management and prevention of RRD. We provide recommendations for genetic testing and prophylaxis of at-risk patients, and hypothesize on novel therapeutic approaches beyond surgical intervention.
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Affiliation(s)
- Birgit M Govers
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Ramon A C van Huet
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Susanne Roosing
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sander Keijser
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Leonoor I Los
- Department of Ophthalmology, University Medical Center Groningen, Groningen, the Netherlands
| | - Anneke I den Hollander
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands; AbbVie, Genomics Research Center, Cambridge, MA, USA
| | - B Jeroen Klevering
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands.
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Strzalkowski P, Schuster AK, Strzalkowska A, Steinberg JS, Dithmar S. Semi-automated quantification of vitreal hyperreflective foci in SD-OCT and their relevance in patients with peripheral retinal breaks. BMC Ophthalmol 2023; 23:324. [PMID: 37460946 DOI: 10.1186/s12886-023-03060-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/25/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Retinal breaks (RB) are emergencies that require treatment to prevent progression of rhegmatogenous retinal detachment. Vitreal hyperreflective foci (VHF) representing migration of RPE cell clusters or interphotoreceptor matrix from the RB are potential biomarkers. The aim of this study is to investigate VHF in RB-patients using SD-OCT. METHODS The retrospective cross-sectional study included RB patients from our Department of Ophthalmology, HSK Wiesbaden who underwent macular SD-OCT (SPECTRALIS®, Heidelberg Engineering, Germany) on both eyes. VHF, defined and quantified as foci that differ markedly in size and reflectivity from the background speckle pattern, were assessed for presence and frequency. The RB-affected eyes were the study group (G1), the partner eyes the control group (G2). RESULTS 160 consecutive patients with RB were included. Age was 60 ± 10.2 years (52% female). 89.4% of G1 and 87.5% of G2 were phakic (p = 0.73). 94.4% (n = 151) were symptomatic. Symptom duration was 8.0 ± 10.1 days in G1, 94.4% (n = 151) showed VHF versus 5.6% (p < 0.0001) in G2, of which 75% (n = 6) showed asymptomatic lattice degenerations. Detectable VHF showed a strong association of OR = 320 (95% CI, 110-788, p < 0.0001)) with respect to symptomatic RB. Sensitivity and specificity were 94.7% and 94.7%, respectively. CONCLUSIONS Most eyes with symptomatic RB show vitreal VHF in SD-OCT. Detected VHF are strongly associated with RB, and our semi-automated greyscale reflectivity analysis indicates that VHF likely originate from photoreceptor complexes torn out of the RB area that migrate into the vitreous cavity. The presence of VHF may indicate RB and should lead to a thorough fundus examination in both symptomatic and asymptomatic cases.
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Affiliation(s)
- P Strzalkowski
- Department of Ophthalmology, Helios HSK Wiesbaden, Wiesbaden, Germany.
- Department of Ophthalmology, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany.
| | - A K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg, University of Mainz, Mainz, Germany
| | - A Strzalkowska
- Department of Ophthalmology, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg, University of Mainz, Mainz, Germany
| | - J S Steinberg
- Department of Ophthalmology, Helios HSK Wiesbaden, Wiesbaden, Germany
| | - S Dithmar
- Department of Ophthalmology, Helios HSK Wiesbaden, Wiesbaden, Germany
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Zhang C, Lan Y, Guo H, Gao Z, Song J, Chen W. The adhesion behavior of the retina. Exp Eye Res 2023:109541. [PMID: 37321365 DOI: 10.1016/j.exer.2023.109541] [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: 12/26/2022] [Revised: 05/29/2023] [Accepted: 06/12/2023] [Indexed: 06/17/2023]
Abstract
Ocular diseases and treatment related to rhegmatogenous retinal detachment (RRD) are highly correlated with retinal adhesion behavior. Therefore, this paper proposes to study the adhesion behavior of the intact retina. This can provide theoretical guidance for the treatment and research of retinal detachment (RD) related diseases. To systematically analyze this aspect, two experiments were performed on the porcine retina. The pull-off test combined with the modified JKR theory was used to study the adhesion behavior of the vitreoretinal interface, while the peeling test was used to study the adhesion behavior of the chorioretinal interface. In addition, the adhesion phase involved in the pull-off test was simulated and analyzed by building the corresponding finite element method (FEM). The experimental results of adhesion force on the vitreoretinal interface were obtained by pull-off test with five sizes of rigid punch. The experimental value of the pull-off force FPO tends to increase gradually with increasing punch radius in the range of 0.5-4 mm. A comparison of the experimental results with the simulation results shows that they are in a well agreement. And there is no statistical difference between the experimental and theoretical values of the pull-off force FPO. In addition, the values of retinal adhesion work were also obtained by pull-off test. Interestingly, there is a significant scale effect of the retinal work of adhesion. Finally, the peeling test gave a maximum peeling strength TMax of about 13 mN/mm and a stable peeling strength TD of about 11 mN/mm between the retina and the choroid. The pull-off test well shows the process of retinal traction by the diseased vitreous at the beginning of RRD. A comparison of the experimental results with the finite element results verifies the accuracy of the simulation. The peeling test well investigated the adhesion behavior between the retina and the choroid and obtained key biomechanical data (peeling strength, etc.). The combination of the two experiments allows a more systematic study of the whole retina. This research can provide more complete material parameters for finite element modeling of retina-related diseases, and it also can provide the theoretical guidance for individualized design of retinal repair surgery.
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Affiliation(s)
- Chenxi Zhang
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China
| | - Yunfei Lan
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China
| | - Hongmei Guo
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China; Third Hospital of Shanxi Medical University (Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital), Taiyuan, 030032, China.
| | - Zhipeng Gao
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China
| | - Jie Song
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China
| | - Weiyi Chen
- College of Biomedical Engineering, Taiyuan University of Technology, Taiyuan, 030024, China
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Li C, Zhang B, Tan X, Jia Y, Guo L, Wang C, Xing Y, Li Q, Tian X. A pilot clinical study of complex rhegmatogenous retinal detachment treatment via foldable capsular buckle scleral buckling. BMC Ophthalmol 2023; 23:196. [PMID: 37142972 PMCID: PMC10158219 DOI: 10.1186/s12886-023-02913-5] [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: 11/30/2022] [Accepted: 04/08/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND To evaluate the feasibility of and identify problems in treating complex rhegmatogenous retinal detachment using foldable capsular buckle scleral buckling. METHODS This prospective clinical study enrolled five patients with complex rhegmatogenous retinal detachment treated with foldable capsular buckle scleral buckling at the 988th Hospital of People's Liberation Army Joint Logistic Force, China. During the 24-week follow-up period, the patients underwent measurements of their best-corrected visual acuity, slit-lamp examination, indirect ophthalmoscopy, and visual field testing. Additionally, B-ultrasound and fundus photography of the patients' retinal reattachments helped evaluate the treatment's post-surgery efficacy. We determined the safety of foldable capsular buckle scleral buckling based on infection, eye pain, diplopia, elevated intraocular pressure, and other postoperative severe complications. RESULTS All five patients' complex rhegmatogenous retinal detachments were successfully treated and evaluated via B-ultrasound and fundus photography after surgery. Visual acuity was enhanced in four patients 24 weeks after surgery, while the remaining patients developed diplopia after surgery. No other complications were observed. CONCLUSION This pilot study preliminarily determined that foldable capsular buckle scleral buckling is feasible for efficient and safe treatment of complex rhegmatogenous retinal detachment. These results support this surgery as a potential and novel alternative to current extraocular procedures for treating complex rhegmatogenous retinal detachment. TRIAL REGISTRATION The prospective observational clinical study protocol was approved by the Institutional Review Board and Ethics Committee and registered at the clinical research center in the 988th Hospital of People's Liberation Army Joint Logistic Force, China (9,882,019,000).
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Affiliation(s)
- Cheng Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China
| | - Baike Zhang
- The 988th Hospital of People's Liberation Army Joint Logistic Force, Zhengzhou, 450000, China
| | - Xiao Tan
- Shenzhen Aier Eye Hospital Affiliated to Jinan University, Shenzhen, 518000, China
| | - Yong Jia
- The 988th Hospital of People's Liberation Army Joint Logistic Force, Zhengzhou, 450000, China
| | - Lisha Guo
- The 988th Hospital of People's Liberation Army Joint Logistic Force, Zhengzhou, 450000, China
| | - Chunlei Wang
- The 988th Hospital of People's Liberation Army Joint Logistic Force, Zhengzhou, 450000, China
| | - Yaofan Xing
- Xinxiang Medical University, Xinxiang, 453000, China
| | - Qiaoyun Li
- The 988th Hospital of People's Liberation Army Joint Logistic Force, Zhengzhou, 450000, China
| | - Xuemin Tian
- The 988th Hospital of People's Liberation Army Joint Logistic Force, Zhengzhou, 450000, China.
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Features of a well-timed macular hole closure related retinal regmatogenous detachment complicated by macular hole. OPHTHALMOLOGY JOURNAL 2023. [DOI: 10.17816/ov109976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
The literature review deals with the analysis of the timing and surgical techniques of macular hole closure in patients with retinal detachment complicated by macular hole. Modern concepts of treatment tactics for this disease, its efficacy are analyzed. Benefits and drawbacks of each of the discussed surgical treatment methods are specified.
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Moledina M, Charteris DG, Chandra A. The Genetic Architecture of Non-Syndromic Rhegmatogenous Retinal Detachment. Genes (Basel) 2022; 13:genes13091675. [PMID: 36140841 PMCID: PMC9498391 DOI: 10.3390/genes13091675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/14/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
Rhegmatogenous retinal detachment (RRD) is the most common form of retinal detachment (RD), affecting 1 in 10,000 patients per year. The condition has significant ocular morbidity, with a sizeable proportion of patients obtaining poor visual outcomes. Despite this, the genetics underpinning Idiopathic Retinal Detachment (IRD) remain poorly understood; this is likely due to small sample sizes in relevant studies. The majority of research pertains to the well-characterised Mende lian syndromes, such as Sticklers and Wagners, associated with RRD. Nevertheless, in recent years, there has been an increasing body of literature identifying the common genetic mutations and mechanisms associated with IRD. Several recent Genomic Wide Association Studies (GWAS) studies have identified a number of genetic loci related to the development of IRD. Our review aims to provide an up-to-date summary of the significant genetic mechanisms and associations of Idiopathic RRD.
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Affiliation(s)
- Malik Moledina
- Department of Ophthalmology, Southend University Hospital, Mid & South Essex NHS Foundation Trust, Southend-on-Sea SS0 0RY, UK
| | - David G. Charteris
- Institute of Ophthalmology, University College, London EC1V 9EL, UK
- Vitreoretinal Unit, Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
| | - Aman Chandra
- Department of Ophthalmology, Southend University Hospital, Mid & South Essex NHS Foundation Trust, Southend-on-Sea SS0 0RY, UK
- School of Medicine, Anglia Ruskin University, Chelmsford CM1 1SQ, UK
- Correspondence: ; Tel.: +44-7914-817445
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Evaluation of Lymphocyte-to-Monocyte Ratio and Mean Platelet Volume-to-Platelet Ratio in Rhegmatogenous Retinal Detachment. J Ophthalmol 2022; 2022:9127745. [PMID: 36157678 PMCID: PMC9507743 DOI: 10.1155/2022/9127745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/07/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To assess the predictive value of inflammatory blood biomarkers in rhegmatogenous retinal detachment (RRD) patients and its correlation with proliferative retinopathy (PVR) grade. Methods 82 RRD patients and 1 : 1 age- and gender-randomly matched cataract patients as the control group were included. The clinical features and laboratory parameters of all participants were collected and recorded, and the comprehensive index of inflammatory blood and its correlation with PVR were calculated. Results Monocytes and monocyte-to-high-density lipoprotein ratio (MHR) were significantly lower (P=0.005, P=0.044), while mean platelet volume (MPV), lymphocyte-to-monocyte ratio (LMR), and MPV-to-platelet ratio (MPR) were significantly higher in RRD patients as compared with the control group (P=0.013, P=0.019, P=0.037). LMR and MPR might be the predictors of RRD. The receiver operating characteristics analysis showed that the values of MPV, LMR, and MPR in RRD patients were 0.612, 0.606, and 0.594, respectively. PVR grade was not associated with inflammatory blood biomarkers. Conclusion The increase in MPV, LMR, and MPR were associated with increased odds of RRD. LMR and MPR may be useful as inexpensive and effortless biomarkers for assessing the occurrence of RRD.
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Song J, Chen T, Zuo W, Chen W, Lei M, Ai M. Changes of retinal ganglion cell complex after vitrectomy in rhegmatogenous retinal detachment patients and its correlation with inflammatory blood biomarkers. BMC Ophthalmol 2022; 22:290. [PMID: 35780091 PMCID: PMC9250177 DOI: 10.1186/s12886-022-02512-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 06/28/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose To compare retinal ganglion cell complex (GCC) parameters between rhegmatogenous retinal detachment (RRD) eyes and normal contralateral eyes after vitrectomy and to evaluate their correlation with inflammatory blood markers. Methods We investigated 25 eyes that underwent vitrectomy due to RRD. Venous blood samples were collected from all participants before 08:00 a.m. on the second day of admission after a 12-hour fast for blood counts. The differences of retinal structure between RRD and contralateral eyes were compared 1 week postoperatively. Results Focal loss volume (FLV) (2.009 ± 1.286)% was significantly increased compared with the contralateral eyes (p < 0.001). Monocyte-to-high-density lipoprotein was significantly positively correlated with GCC thickness parameters, and negatively correlated with FLV and global loss volume (GLV). Postoperative best-corrected visual acuity was negatively correlated with GLV (p = 0.039, R2 = 0.172). Conclusion Retinal ganglion cells (RGCs) loss might present early postoperatively in RRD eyes, and was associated with systemic inflammation. RGCs loss might affect postoperative vision.
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Affiliation(s)
- Jiayi Song
- Department of Ophthalmology, Renmin Hospital of Wuhan University, No. 9 ZhangZhiDong Street, Wuchang District, Wuhan, 430060, Hubei, China
| | - Ting Chen
- Department of Ophthalmology, Renmin Hospital of Wuhan University, No. 9 ZhangZhiDong Street, Wuchang District, Wuhan, 430060, Hubei, China
| | - Wen Zuo
- Department of Ophthalmology, Renmin Hospital of Wuhan University, No. 9 ZhangZhiDong Street, Wuchang District, Wuhan, 430060, Hubei, China
| | - Wenyu Chen
- Department of Ophthalmology, Renmin Hospital of Wuhan University, No. 9 ZhangZhiDong Street, Wuchang District, Wuhan, 430060, Hubei, China
| | - Min Lei
- Department of Ophthalmology, Renmin Hospital of Wuhan University, No. 9 ZhangZhiDong Street, Wuchang District, Wuhan, 430060, Hubei, China
| | - Ming Ai
- Department of Ophthalmology, Renmin Hospital of Wuhan University, No. 9 ZhangZhiDong Street, Wuchang District, Wuhan, 430060, Hubei, China.
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Fonteh CN, Patnaik JL, Grove NC, Lynch AM, Christopher KL. Predictors of Pseudophakic Retinal Tears at a Tertiary Care Academic Medical Center. Ophthalmol Retina 2022; 6:450-456. [PMID: 35093584 DOI: 10.1016/j.oret.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To describe the incidence and identify risk factors for retinal tears (RT) among patients who underwent cataract phacoemulsification surgery, as well as to describe the timing and features of the RTs. DESIGN Retrospective case-control study SUBJECTS: Patients who underwent cataract phacoemulsification surgery between January 2014 and December 2019 at an academic eye center in Colorado. METHODS Information was extracted from medical chart review into a cataract outcomes database. Measures of association and p-values were determined from logistic regression models with generalized estimating equations to account for some patients having two eyes included in the database. MAIN OUTCOME MEASURES RT diagnosis within one year following cataract surgery. Incidence of RTs were analyzed by demographics, comorbid medical history, ocular characteristics, surgical characteristics, and intra-operative complications. RESULTS In total 13,007 cataract surgeries were included in the analysis, and 79 (0.6%) of those eyes developed RTs within one year following cataract surgery. Males and patients <65 years old had higher incidences of RTs (0.8% vs 0.5% for females, p=0.0175 and 1.0% vs 0.2% for age, <65 years vs >75, p=0.0001). The mean preoperative best-corrected visual acuity was better for the RT group (logMAR 0.252 vs 0.366, p=0.0073) and axial myopia (>26mm) was more common (31.2% vs 10.9%, p<0.0001). Patients with intra-operative complications had a higher incidence of RTs (4.2%, p<0.0001). Mean time from cataract surgery to RT was 128 (SD=110) days. Most RTs were symptomatic (57.0%), located in the superior hemisphere (83.5%), and 40.5% were diagnosed concurrently with a retinal detachment. The multivariable model resulted in intra-operative complications, axial length, and preoperative visual acuity having the strongest association with RT. CONCLUSION Patients with better preoperative visual acuity, eyes with longer axial length, and those with intra-operative complications were at an increased risk for RT following cataract surgery. Careful counseling is important and post-operative follow-up is advised for patients identified pre-operatively as being at an elevated risk for RT given the large rate of asymptomatic RTs and high rate of progression to retinal detachment.
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Affiliation(s)
- Cheryl N Fonteh
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO.
| | - Jennifer L Patnaik
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO
| | - Nathan C Grove
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO
| | - Anne M Lynch
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO
| | - Karen L Christopher
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO
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11
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A PILOT CLINICAL STUDY OF TREATING RHEGMATOGENOUS RETINAL DETACHMENT BY SILICONE RUBBER BALLOON SCLERAL BUCKLING. Retina 2021; 40:1918-1928. [PMID: 31725525 PMCID: PMC7505152 DOI: 10.1097/iae.0000000000002685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the efficacy and primary safety of treating rhegmatogenous retinal detachment (RRD) using foldable capsular vitreous body scleral buckling. METHODS Five patients with simple RRD were treated with foldable capsular vitreous body scleral buckling. B-ultrasound and fundus photography examining of retina reattachment were used to evaluate the postsurgery efficacy. The safety of the treatment was evaluated based on the occurrence of infection, eye pain, diplopia, elevated intraocular pressure, and other serious postoperative complications after surgery. The observation time after the operation was at least 12 weeks. RESULTS The simple RRD of all five patients was successfully reattached before being evaluating by B-ultrasound and fundus photography after surgery. Visual acuity was enhanced in two patients who were macularly affected. One patient had temporary diplopia and eye movement limitation after surgery. No other complications were recorded. CONCLUSION This pilot study determined that foldable capsular vitreous body scleral buckling can be efficacious and safe for simple RRD. The results indicate that this surgery may be a novel alternative to the current extraocular procedures for simple RRD.
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12
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Kaupke N, Spitzer MS, Kromer R. [Treatment of retinal detachment during the COVID-19 pandemic : Did patients with retinal detachment seek treatment later during the COVID-19 pandemic? Results from a German university eye hospital]. Ophthalmologe 2021; 118:670-674. [PMID: 33037895 PMCID: PMC7547549 DOI: 10.1007/s00347-020-01248-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/06/2020] [Accepted: 09/21/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Retinal detachment is an ophthalmological emergency. Delayed diagnostics and treatment increase the risk of permanent loss of vision. Current media reports have suggested that patients with medical emergencies delay seeking treatment out of fear of being infected with the corona virus SARS-CoV‑2. This study analyzed data from a German university hospital to determine if the coronavirus pandemic had an impact on treatment and visual outcomes of patients with retinal detachment. METHODS In this study 60 patients treated for rhegmatogenous retinal detachment in the eye hospital of the University Hospital Hamburg-Eppendorf between 15 March and 5 May 2020 were retrospectively analyzed. Patients from the corresponding period of the previous year acted as a control group. Significant differences between the groups were investigated by hypothesis testing. RESULTS When compared to the period in the previous year there were no significant differences for sex, age, eye, length of symptoms, previous visit to doctor, visual acuity, macula status, degree of retinal detachment, proliferative vitreoretinopathy and type or length of procedure during the coronavirus pandemic. Of the patients with retinal detachment 29% had general health concerns due to the coronavirus pandemic. CONCLUSION Medical treatment for retinal detachment was not influenced by the coronavirus pandemic. In contrast to other medical emergencies the morbidity of retinal detachment did not increase and admitted cases did not decrease during the pandemic when compared to the same period in the previous year.
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Affiliation(s)
- N Kaupke
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland.
| | - M S Spitzer
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
| | - R Kromer
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Deutschland
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Soekamto C, Chu ER, Johnson DA, Sohn JH, Bahadorani S. Protective Role of 360° Laser Retinopexy in Patients with Rhegmatogenous Retinal Detachment: a Systematic Review and Meta-analysis. KOREAN JOURNAL OF OPHTHALMOLOGY 2021; 35:215-222. [PMID: 34120420 PMCID: PMC8200595 DOI: 10.3341/kjo.2021.0013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/21/2021] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Visual impairment from retinal re-detachment could be debilitating. The aim of this review is to evaluate the role of 360° laser retinopexy on success rate of rhegmatogenous retinal detachment (RRD) repair by a meta-analysis study. METHODS The PubMed, Scopus, and the Cochrane Library databases were searched comprehensively from the date of database inception to January 2021, evaluating the role of 360° laser retinopexy in visual and anatomical success rate of RRD repair. This review was conducted based on the preferred reporting items for systematic review and meta-analysis (PRISMA) protocols. RESULTS Among 202 articles screened for eligibility, six studies were found to be eligible for inclusion in our final analysis. Our meta-analysis demonstrates that prophylactic treatment with circumferential laser photocoagulation has no significant effect on the initial rate of retinal re-detachment or final best-corrected visual acuity following pars plana vitrectomy repair of RRD. Subgroup analysis of studies (n = 3) with 23-gauge pars plana vitrectomy, however, favors attachment rate in patients undergoing 360° prophylactic laser treatment. CONCLUSIONS Three hundred and sixty degree laser retinopexy appears to have favorable outcomes in patients undergoing 23-gauge retinal detachment repair. This protective effect, however, is not apparent with inclusion of 20-gauge vitrectomy studies.
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Affiliation(s)
- Christa Soekamto
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Edward R Chu
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Daniel A Johnson
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Jeong-Hyeon Sohn
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Sepehr Bahadorani
- Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX, USA
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Dong N, Cai Q, Li Z, Xu L, Wu H, Lin Z, Qiu B, Li C, Lin Z. Convenient hyaluronidase biosensors based on the target-trigger enhancing of the permeability of a membrane using an electronic balance as a readout. Analyst 2021; 146:3299-3304. [PMID: 33999089 DOI: 10.1039/d1an00257k] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The change in hyaluronidase (HAase) is related to specific changes in the structure of vitreous, and it is necessary to develop simple but sensitive methods for HAase detection. In this work, a thin film fabricated from a hyaluronic acid (HA)-polyethyleneimine (PEI) hydrogel has been covered on a mixed cellulose microporous membrane (MCEM) to form a HA-PEI-MCEM firstly and it was then applied in a filtration system. The permeability of the filter membrane greatly affects the amount of water passing through within a certain time and the water can be collected and quantitatively measured with a simple electronic balance easily. The low permeability of the HA-PEI-MCEM allows a small amount of water to be drained. But after the addition of HAase, which can hydrolyze HA in the hydrogel, the permeability of the membrane increased. Therefore, the amount of water passing through the HA-PEI-MCEM composite membrane increased accordingly. The composite of the membrane, and the reaction conditions after the addition of HAase were optimized. Under the optimized conditions, the amount of water collected within 5 min showed a linear relationship with the HAase concentration in a range of 1.0-36 U mL-1 with a limit of detection of 0.35 U mL-1.The proposed method has been applied to detect HAase in vitreous samples with satisfactory results.
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Affiliation(s)
- Nuo Dong
- Eye Institute & Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China. and Department of Ophthalmology, Affiliated People's Hospital & Zhenjiang Kangfu Eye Hospital, Jiangsu University, Zhenjiang, Jiangsu, China and Fujian Provincial Key Laboratory of Ocular Surface and Corneal Disease, Xiamen, Fujian, China
| | - Qing Cai
- Eye Institute & Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China.
| | - Zhixin Li
- Ministry of Education Key Laboratory for Analytical Science of Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection for Food Safety, College of Chemistry, Fuzhou University, Fuzhou, Fujian, China.
| | - Liangzhen Xu
- Eye Institute & Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China.
| | - Huping Wu
- Eye Institute & Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China. and Fujian Provincial Key Laboratory of Ocular Surface and Corneal Disease, Xiamen, Fujian, China
| | - Zhirong Lin
- Eye Institute & Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China. and Fujian Provincial Key Laboratory of Ocular Surface and Corneal Disease, Xiamen, Fujian, China
| | - Bin Qiu
- Ministry of Education Key Laboratory for Analytical Science of Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection for Food Safety, College of Chemistry, Fuzhou University, Fuzhou, Fujian, China.
| | - Cheng Li
- Eye Institute & Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China.
| | - Zhenyu Lin
- Ministry of Education Key Laboratory for Analytical Science of Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection for Food Safety, College of Chemistry, Fuzhou University, Fuzhou, Fujian, China.
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Association of retinal detachment with age 50 years or younger at onset in patients with acute retinal necrosis. Graefes Arch Clin Exp Ophthalmol 2021; 259:2905-2911. [PMID: 33846837 DOI: 10.1007/s00417-021-05166-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Due to the guarded prognosis of acute retinal necrosis (ARN), it is relevant to develop a strategy to early categorize those patients in a higher risk of worse outcomes. The purpose of this study is to describe clinical features and predictive factors for retinal detachment (RD) in patients with ARN. METHODS Retrospective observational case series of 34 adult patients (38 eyes) with ARN examined between January 2005 and July 2015 in the National Eye Institute (Bethesda, USA), the Department of Ophthalmology, University of Chile (Santiago, Chile), and APEC (CDMX, Mexico). RESULTS A total of 16 males and 18 females with a mean age at presentation of 44.5 ± 16.8 years were included. Twenty-seven patients (79.4%) received intravenous acyclovir as first-line treatment, and 7 patients received either oral antiviral (4 patients) or oral plus intravitreal antiviral (3 patients). All subjects were treated with prednisone, with a mean initial dose of 57.7 ± 16.3 mg per day. Seventeen patients (50.0%) developed retinal detachment. An association of retinal detachment with age at onset was observed (p = 0.04), with patients younger than 50 years presenting a higher risk (OR = 14.86, p = 0.0009). Additionally, patients in this higher risk group had more inflammation in both anterior chamber and vitreous (p = 0.04 and 0.03, respectively). No other predictive factor for retinal detachment was found in the present study. CONCLUSIONS RD represents an important complication in patients with ARN. Younger patients may be at higher risk of this complication, possibly secondary to the presence of a higher level of inflammation.
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Pouw AE, Greiner MA, Coussa RG, Jiao C, Han IC, Skeie JM, Fingert JH, Mullins RF, Sohn EH. Cell-Matrix Interactions in the Eye: From Cornea to Choroid. Cells 2021; 10:687. [PMID: 33804633 PMCID: PMC8003714 DOI: 10.3390/cells10030687] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/03/2021] [Accepted: 03/16/2021] [Indexed: 02/07/2023] Open
Abstract
The extracellular matrix (ECM) plays a crucial role in all parts of the eye, from maintaining clarity and hydration of the cornea and vitreous to regulating angiogenesis, intraocular pressure maintenance, and vascular signaling. This review focuses on the interactions of the ECM for homeostasis of normal physiologic functions of the cornea, vitreous, retina, retinal pigment epithelium, Bruch's membrane, and choroid as well as trabecular meshwork, optic nerve, conjunctiva and tenon's layer as it relates to glaucoma. A variety of pathways and key factors related to ECM in the eye are discussed, including but not limited to those related to transforming growth factor-β, vascular endothelial growth factor, basic-fibroblastic growth factor, connective tissue growth factor, matrix metalloproteinases (including MMP-2 and MMP-9, and MMP-14), collagen IV, fibronectin, elastin, canonical signaling, integrins, and endothelial morphogenesis consistent of cellular activation-tubulogenesis and cellular differentiation-stabilization. Alterations contributing to disease states such as wound healing, diabetes-related complications, Fuchs endothelial corneal dystrophy, angiogenesis, fibrosis, age-related macular degeneration, retinal detachment, and posteriorly inserted vitreous base are also reviewed.
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Affiliation(s)
- Andrew E. Pouw
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals & Clinics, Iowa City, IA 52242, USA; (A.E.P.); (M.A.G.); (R.G.C.); (C.J.); (I.C.H.); (J.M.S.); (J.H.F.); (R.F.M.)
- Institute for Vision Research, University of Iowa, Iowa City, IA 52242, USA
| | - Mark A. Greiner
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals & Clinics, Iowa City, IA 52242, USA; (A.E.P.); (M.A.G.); (R.G.C.); (C.J.); (I.C.H.); (J.M.S.); (J.H.F.); (R.F.M.)
- Institute for Vision Research, University of Iowa, Iowa City, IA 52242, USA
| | - Razek G. Coussa
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals & Clinics, Iowa City, IA 52242, USA; (A.E.P.); (M.A.G.); (R.G.C.); (C.J.); (I.C.H.); (J.M.S.); (J.H.F.); (R.F.M.)
- Institute for Vision Research, University of Iowa, Iowa City, IA 52242, USA
| | - Chunhua Jiao
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals & Clinics, Iowa City, IA 52242, USA; (A.E.P.); (M.A.G.); (R.G.C.); (C.J.); (I.C.H.); (J.M.S.); (J.H.F.); (R.F.M.)
- Institute for Vision Research, University of Iowa, Iowa City, IA 52242, USA
| | - Ian C. Han
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals & Clinics, Iowa City, IA 52242, USA; (A.E.P.); (M.A.G.); (R.G.C.); (C.J.); (I.C.H.); (J.M.S.); (J.H.F.); (R.F.M.)
- Institute for Vision Research, University of Iowa, Iowa City, IA 52242, USA
| | - Jessica M. Skeie
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals & Clinics, Iowa City, IA 52242, USA; (A.E.P.); (M.A.G.); (R.G.C.); (C.J.); (I.C.H.); (J.M.S.); (J.H.F.); (R.F.M.)
| | - John H. Fingert
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals & Clinics, Iowa City, IA 52242, USA; (A.E.P.); (M.A.G.); (R.G.C.); (C.J.); (I.C.H.); (J.M.S.); (J.H.F.); (R.F.M.)
- Institute for Vision Research, University of Iowa, Iowa City, IA 52242, USA
| | - Robert F. Mullins
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals & Clinics, Iowa City, IA 52242, USA; (A.E.P.); (M.A.G.); (R.G.C.); (C.J.); (I.C.H.); (J.M.S.); (J.H.F.); (R.F.M.)
- Institute for Vision Research, University of Iowa, Iowa City, IA 52242, USA
| | - Elliott H. Sohn
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals & Clinics, Iowa City, IA 52242, USA; (A.E.P.); (M.A.G.); (R.G.C.); (C.J.); (I.C.H.); (J.M.S.); (J.H.F.); (R.F.M.)
- Institute for Vision Research, University of Iowa, Iowa City, IA 52242, USA
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Lee CS, Shaver K, Yun SH, Kim D, Wen S, Ghorayeb G. Comparison of the visual outcome between macula-on and macula-off rhegmatogenous retinal detachment based on the duration of macular detachment. BMJ Open Ophthalmol 2021; 6:e000615. [PMID: 33782654 PMCID: PMC7957123 DOI: 10.1136/bmjophth-2020-000615] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 01/21/2021] [Accepted: 02/22/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To compare the visual outcomes between macula-on and macula-off primary rhegmatogenous retinal detachment (RRD) based on the duration of macular detachment (DMD). Methods and Analysis Retrospective study including 96 eyes with RRD (34 macula-on and 62 macula-off) repaired between June 2012 and March 2020. The final visual acuity (VA) was compared after the patients were divided by the status of the macula and their DMD. Results The mean final VA of patients with macula-on RRD (group A) was logarithm of the minimum angle of resolution (logMAR) 0.04±0.07, which was not statistically different from that of individuals with macula-off RRD with DMD ≤3 days (group B; logMAR 0.05±0.06) (p=0.79). There were statistically significant differences in the final VA between group A and patients with macula-off RRD with DMD of 4–7 days (group C; logMAR 0.15±0.15) (p=0.017) as well as between group A and those with macula-off RRD with DMD ≥8 days (group D; logMAR 0.36±0.29) (p<0.001). There was no significant difference in the final VA between group B and C (p=0.33). Conclusion The mean final VA of patients with macula-on RRD was comparable to that of the macula-off patients with DMD ≤3 days. Our findings suggest that if macula-on RRD could not be immediately repaired, a repair within 72 hours may result in similar outcomes, even if the macula detaches within that time frame. However, once the macula detaches, we do not observe statistically significant differences in outcome for repairs done within 7 days.
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Affiliation(s)
- Chang Sup Lee
- Ophthalmology, West Virginia University, Morgantown, West Virginia, USA
| | - Karl Shaver
- Joan C Edwards School of Medicine at Marshall University, Huntington, West Virginia, USA
| | - Samuel Huisok Yun
- Ophthalmology, West Virginia University, Morgantown, West Virginia, USA
| | - Daniel Kim
- Ophthalmology, West Virginia University, Morgantown, West Virginia, USA
| | - Sijin Wen
- Biostatistics, West Virginia University School of Public Health, Morgantown, West Virginia, USA
| | - Ghassan Ghorayeb
- Ophthalmology, West Virginia University, Morgantown, West Virginia, USA
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EROL MK, KALAYCI M, CETINKAYA E, SUREN E, YIGIT K. Quality assessment of YouTube videos intended to inform patients about retinal detachment surgery. HEALTH POLICY AND TECHNOLOGY 2021. [DOI: 10.1016/j.hlpt.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Öhman T, Gawriyski L, Miettinen S, Varjosalo M, Loukovaara S. Molecular pathogenesis of rhegmatogenous retinal detachment. Sci Rep 2021; 11:966. [PMID: 33441730 PMCID: PMC7806834 DOI: 10.1038/s41598-020-80005-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/16/2020] [Indexed: 02/08/2023] Open
Abstract
Rhegmatogenous retinal detachment (RRD) is an ophthalmic emergency, which usually requires prompt surgery to prevent further detachment and restore sensory function. Although several individual factors have been suggested, a systems level understanding of molecular pathomechanisms underlying this severe eye disorder is lacking. To address this gap in knowledge we performed the molecular level systems pathology analysis of the vitreous from 127 patients with RRD using state-of-the art quantitative mass spectrometry to identify the individual key proteins, as well as the biochemical pathways contributing to the development of the disease. RRD patients have specific vitreous proteome profiles compared to other diseases such as macular hole, pucker, or proliferative diabetic retinopathy eyes. Our data indicate that various mechanisms, including glycolysis, photoreceptor death, and Wnt and MAPK signaling, are activated during or after the RRD to promote retinal cell survival. In addition, platelet-mediated wound healing processes, cell adhesion molecules reorganization and apoptotic processes were detected during RRD progression or proliferative vitreoretinopathy formation. These findings improve the understanding of RRD pathogenesis, identify novel targets for treatment of this ophthalmic disease, and possibly affect the prognosis of eyes treated or operated upon due to RRD.
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Affiliation(s)
- Tiina Öhman
- Institute of Biotechnology and Helsinki Institute of Life Science, University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014, Helsinki, Finland
| | - Lisa Gawriyski
- Institute of Biotechnology and Helsinki Institute of Life Science, University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014, Helsinki, Finland
| | - Sini Miettinen
- Institute of Biotechnology and Helsinki Institute of Life Science, University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014, Helsinki, Finland
| | - Markku Varjosalo
- Institute of Biotechnology and Helsinki Institute of Life Science, University of Helsinki, Viikinkaari 1, P.O. Box 65, 00014, Helsinki, Finland.
| | - Sirpa Loukovaara
- Department of Ophthalmology, Unit of Vitreoretinal Surgery, Helsinki University Hospital, Haartmaninkatu 4 C, 00290, Helsinki, Finland. .,Individualized Drug Therapy Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
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Toklu E, Altinisik M, Elbay A, Koytak A. Comparison of postoperative anterior segment changes associated with pars plana vitrectomy with and without vitreous base shaving. Int J Ophthalmol 2020; 13:1745-1752. [PMID: 33215005 DOI: 10.18240/ijo.2020.11.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/12/2020] [Indexed: 12/15/2022] Open
Abstract
AIM To compare changes in anterior segment topography and axial length (AL) evaluated with Pentacam and IOL Master after pars plana vitrectomy (PPV) performed with and without vitreous base shaving. METHODS This prospective study included patients who underwent PPV or phacoemulsification+PPV (Phaco+PPV) for various indications. Patients who underwent total posterior hyaloid detachment and excessive vitreous base shaving with scleral indentation were referred to as complete PPV (c-PPV). The patients whom posterior hyaloid was separated as far as the posterior arcades and vitreous base shaving with scleral depression was not performed were classified as the partial PPV (p-PPV) group. All patients underwent detailed ophthalmologic examinations preoperatively and 1wk, 1, and 3mo postoperatively. Changes in the anterior chamber depth (ACD), anterior chamber volume (ACV), iridocorneal angle (ICA), central corneal thickness (CCT), and keratometric measurements (K1 and K2) were evaluated with Pentacam HR. Changes in the AL measurements were analyzed with IOL Master. RESULTS A significant increase in ACD was observed in c-PPV cases (P=0.02), but this increase was not significant in the p-PPV group (P=0.053). In contrast, ICA increased significantly in the c-PPV group (P=0.02) but decreased in the p-PPV group (P=0.09). BCVA was significantly improved in the c-PPV group from week 1 (P<0.001) while the increase in the p-PPV group reached significance at 3mo (P=0.035). CCT increased in the first week and later returned to baseline in both groups. No significant differences in the other parameters were observed between the groups, and there were no significant changes in intraocular pressure, ACV, AL, K1 or K2 values (P>0.05 for all). CONCLUSION Incomplete posterior hyaloid excision and not removing the vitreous base in PPV surgeries may create a more stable anterior chamber, thus preventing the downward movement of the lens-iris diaphragm, and may cause ciliary body retraction, thereby reducing ICA. Awareness of these effects can provide some amount of guidance to physicians in selecting the appropriate PPV procedure and preempting surgical complications.
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Affiliation(s)
- Enes Toklu
- Departmentof Ophthalmology, Kemalpasa State Hospital, İzmir 35730, Turkey
| | - Muhammed Altinisik
- Department of Ophthalmology, Faculty of Medicine, Manisa Celal Bayar University, Manisa 45040, Turkey
| | - Ahmet Elbay
- Department of Ophthalmology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey
| | - Arif Koytak
- Department of Ophthalmology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey
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Di Michele F, Tatone A, Romano MR, Repetto R. A mechanical model of posterior vitreous detachment and generation of vitreoretinal tractions. Biomech Model Mechanobiol 2020; 19:2627-2641. [DOI: 10.1007/s10237-020-01360-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/19/2020] [Indexed: 01/21/2023]
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Propst SL, Kirschner JM, Strachan CC, Roumpf SK, Menard LM, Sarmiento EJ, Hunter BR. Ocular Point-of-Care Ultrasonography to Diagnose Posterior Chamber Abnormalities: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e1921460. [PMID: 32074291 DOI: 10.1001/jamanetworkopen.2019.21460] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
IMPORTANCE Diagnosing posterior chamber ocular abnormalities typically requires specialist assessment. Point-of-care ultrasonography (POCUS) performed by nonspecialists, if accurate, could negate the need for urgent ophthalmologist evaluation. OBJECTIVE This meta-analysis sought to define the diagnostic test characteristics of emergency practitioner-performed ocular POCUS to diagnose multiple posterior chamber abnormalities in adults. DATA SOURCES PubMed (OVID), MEDLINE, EMBASE, Cochrane, CINAHL, and SCOPUS were searched from inception through June 2019 without restrictions. Conference abstracts and trial registries were also searched. Bibliographies of included studies and relevant reviews were manually searched, and experts in the field were queried. STUDY SELECTION Included studies compared ocular POCUS performed by emergency practitioners with a reference standard of ophthalmologist evaluation. Pediatric studies were excluded. All 116 studies identified during abstract screening as potentially relevant underwent full-text review by multiple authors, and 9 studies were included. DATA EXTRACTION AND SYNTHESIS In accordance with PRISMA guidelines, multiple authors extracted data from included studies. Results were meta-analyzed for each diagnosis using a bivariate random-effects model. Data analysis was performed in July 2019. MAIN OUTCOMES AND MEASURES The outcomes of interest were diagnostic test characteristics of ocular POCUS for the following diagnoses: retinal detachment, vitreous hemorrhage, vitreous detachment, intraocular foreign body, globe rupture, and lens dislocation. RESULTS Nine studies (1189 eyes) were included. All studies evaluated retinal detachment, but up to 5 studies assessed each of the other diagnoses of interest. For retinal detachment, sensitivity was 0.94 (95% CI, 0.88-0.97) and specificity was 0.94 (95% CI, 0.85-0.98). Sensitivity and specificity were 0.90 (95% CI, 0.65-0.98) and 0.92 (95% CI, 0.75-0.98), respectively, for vitreous hemorrhage and were 0.67 (95% CI, 0.51-0.81) and 0.89 (95% CI, 0.53-0.98), respectively, for vitreous detachment. Sensitivity and specificity were high for lens dislocation (0.97 [95% CI, 0.83-0.99] and 0.99 [95% CI, 0.97-1.00]), intraocular foreign body (1.00 [95% CI, 0.81-1.00] and 0.99 [95% CI, 0.99-1.00]), and globe rupture (1.00 [95% CI, 0.63-1.00] and 0.99 [95% CI, 0.99-1.00]). Results were generally unchanged in sensitivity analyses of studies with low risk of bias. CONCLUSIONS AND RELEVANCE This study suggests that emergency practitioner-performed ocular POCUS is an accurate test to assess for retinal detachment in adults. Its utility in diagnosing other posterior chamber abnormalities is promising but needs further study.
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Affiliation(s)
- Steven L Propst
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis
- Department of Emergency Medicine, CoxHealth, Springfield, Missouri
| | - Jonathan M Kirschner
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis
| | - Christian C Strachan
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis
| | - Steven K Roumpf
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis
| | - Laura M Menard
- Ruth Lilly Medical Library, Indiana University School of Medicine, Indianapolis
| | - Elisa J Sarmiento
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis
| | - Benton R Hunter
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis
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Geiger M, Smith JM, Lynch A, Patnaik JL, Oliver SCN, Dixon JA, Mandava N, Palestine AG. Predictors for recovery of macular function after surgery for primary macula-off rhegmatogenous retinal detachment. Int Ophthalmol 2019; 40:609-616. [DOI: 10.1007/s10792-019-01219-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 11/02/2019] [Indexed: 11/29/2022]
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Different Mechanistic Association of Myopia with Rhegmatogenous Retinal Detachment between Young and Elderly Patients. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5357241. [PMID: 31485442 PMCID: PMC6702806 DOI: 10.1155/2019/5357241] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 07/25/2019] [Indexed: 12/14/2022]
Abstract
Objectives To investigate the mechanism of rhegmatogenous retinal detachment (RRD) in young and elderly Korean patients based on the results of axial length distribution. Subjects/Methods We retrospectively reviewed the medical records of 1599 patients with RRD who had bilateral axial length data examined at one center between 2003 and 2018. Axial lengths were measured using ultrasound or IOLMaster500. The frequency of RRD and axial length distribution according to age groups were investigated. Results Patients with RRD displayed a bimodal distribution across ages with two age groups showing the highest peak at 55–59 years and a second peak at 25–29 years of age. The mean axial length was significantly longer in patients younger than 50 years old than that in patients ≥ 50 years old (26.18 ± 1.86 mm vs. 24.55 ± 1.67 mm, respectively, p < 0.001). The percentage of patients with high myopia (axial length ≥ 26 mm) in patients < 50 years old was higher than that in those ≥ 50 years old (51.9% vs. 15.0%, respectively, p < 0.001; odds ratio, 6.11; 95% confidence interval, 4.83 to 7.74). Conclusions We found a difference in the prevalence of myopia between young and elderly patients with RRD, which corresponds to a bimodal distribution of RRD incidence in East Asian countries. Our data indicate that myopia or high myopia-induced early vitreous detachment appears to be a major mechanism of occurrence of RRD in young East Asian patients, while senile vitreous liquefaction and detachment is the main mechanism of RRD in elderly patients.
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Chen DZ, Koh V, Tan M, Tan CS, Nah G, Shen L, Bhargava M, Cheng CY, Zhao P, Wong TY, Saw SM. Peripheral retinal changes in highly myopic young Asian eyes. Acta Ophthalmol 2018; 96:e846-e851. [PMID: 29575821 DOI: 10.1111/aos.13752] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 02/08/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the type and prevalence of peripheral retinal changes and its relationship with axial length (AL) in a population of young Asian adult males. METHODS This was a cross-sectional study of male subjects aged between 19 and 25 years old. High myopes [spherical equivalent refraction, (SER) < -6.00 D] were recruited and underwent further ocular investigations including dilated retinal photography and binocular indirect ophthalmoscopy by two trained ophthalmologists. The frequency of peripheral retinal changes within high myopes was correlated with axial length and also compared with a group of emmetropes (SER between -0.50 D and +1.00 D). RESULTS A total of 593 high myopes and 156 emmetropes were recruited. White without pressure (WWOP; n = 458, 46.5%) and lattice degeneration (LD; n = 109, 14.6%) were the commonest findings, and their prevalence was significantly higher among high myopes (LD, 16.9% versus 5.8%; WWOP, 57.2% versus 5.8%; both p < 0.001). Among high myopes, temporal LD was more common (71%) and 35% had more than one area in the same eye. Increasing AL was associated with LD (odds ratio 1.28, p = 0.01) and retinal holes (odd's ratio 1.44, p = 0.02) on multivariate analysis. CONCLUSION White without pressure (WWOP) and LD were the commonest peripheral retinal changes. One-third of high myopes with LD had more than one area in the same eye. Increasing AL was associated with LD and retinal holes. Studies in older adults should be conducted to develop clinical guidelines for the management of high myopes.
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Affiliation(s)
- David Z. Chen
- Vision Performance Centre; Military Medicine Institute; Singapore Singapore
- Department of Ophthalmology; National University Health System; Singapore Singapore
| | - Victor Koh
- Vision Performance Centre; Military Medicine Institute; Singapore Singapore
- Department of Ophthalmology; National University Health System; Singapore Singapore
| | - Marcus Tan
- Vision Performance Centre; Military Medicine Institute; Singapore Singapore
| | - Colin S. Tan
- National Healthcare Group Eye Institute; Tan Tock Seng Hospital; Singapore Singapore
- Fundus Image Reading Center; National Healthcare Group Eye Institute; Singapore Singapore
| | - Gerard Nah
- Vision Performance Centre; Military Medicine Institute; Singapore Singapore
| | - Liang Shen
- Biostatistics Unit; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - Mayuri Bhargava
- Vision Performance Centre; Military Medicine Institute; Singapore Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute; Singapore National Eye Centre; Singapore Singapore
| | - Paul Zhao
- Vision Performance Centre; Military Medicine Institute; Singapore Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute; Singapore National Eye Centre; Singapore Singapore
- Department of Ophthalmology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - Seang-Mei Saw
- Singapore Eye Research Institute; Singapore National Eye Centre; Singapore Singapore
- Department of Ophthalmology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
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Öhman T, Tamene F, Göös H, Loukovaara S, Varjosalo M. Systems pathology analysis identifies neurodegenerative nature of age-related vitreoretinal interface diseases. Aging Cell 2018; 17:e12809. [PMID: 29963742 PMCID: PMC6156470 DOI: 10.1111/acel.12809] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/11/2018] [Accepted: 06/01/2018] [Indexed: 12/14/2022] Open
Abstract
Aging is a phenomenon that is associated with profound medical implications. Idiopathic epiretinal membrane (iEMR) and macular hole (MH) are the major vision-threatening vitreoretinal diseases affecting millions of aging people globally, making these conditions an important public health issue. iERM is characterized by fibrous tissue developing on the surface of the macula, which leads to biomechanical and biochemical macular damage. MH is a small breakage in the macula and is associated with many ocular conditions. Although several individual factors and pathways are suggested, a systems pathology level understanding of the molecular mechanisms underlying these disorders is lacking. Therefore, we performed mass spectrometry-based label-free quantitative proteomics analysis of the vitreous proteomes from patients with iERM and MH to identify the key proteins, as well as the multiple interconnected biochemical pathways, contributing to the development of these diseases. We identified a total of 1,014 unique proteins, many of which are linked to inflammation and the complement cascade, revealing the inflammation processes in retinal diseases. Additionally, we detected a profound difference in the proteomes of iEMR and MH compared to those of diabetic retinopathy with macular edema and rhegmatogenous retinal detachment. A large number of neuronal proteins were present at higher levels in the iERM and MH vitreous, including neuronal adhesion molecules, nervous system development proteins, and signaling molecules, pointing toward the important role of neurodegenerative component in the pathogenesis of age-related vitreoretinal diseases. Despite them having marked similarities, several unique vitreous proteins were identified in both iERM and MH, from which candidate targets for new diagnostic and therapeutic approaches can be provided.
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Affiliation(s)
- Tiina Öhman
- Institute of Biotechnology and Helsinki Institute of Life Science; University of Helsinki; Helsinki Finland
| | - Fitsum Tamene
- Institute of Biotechnology and Helsinki Institute of Life Science; University of Helsinki; Helsinki Finland
| | - Helka Göös
- Institute of Biotechnology and Helsinki Institute of Life Science; University of Helsinki; Helsinki Finland
| | - Sirpa Loukovaara
- Unit of Vitreoretinal Surgery, Department of Ophthalmology; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Markku Varjosalo
- Institute of Biotechnology and Helsinki Institute of Life Science; University of Helsinki; Helsinki Finland
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Park SW, Lee JJ, Lee JE. Scleral buckling in the management of rhegmatogenous retinal detachment: patient selection and perspectives. Clin Ophthalmol 2018; 12:1605-1615. [PMID: 30214145 PMCID: PMC6124476 DOI: 10.2147/opth.s153717] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Although the technique of pars plana vitrectomy (PPV) develops rapidly, scleral buckling (SB) has several advantages over PPV for rhegmatogenous retinal detachment (RRD), including early visual rehabilitation and prevention of cataract progression. It is recommended to select the primary procedure for RRD by considering the advantages and disadvantages of each procedure based on the patient status. The vitreous body status affects the features of RRD. Vitreous liquefaction is an age-dependent process, resulting in the development of posterior vitreous detachment (PVD). RRD is usually associated with PVD, typically presenting with a retinal tear, strong vitreoretinal traction, and bullous detachment. In contrast, RRD may develop without PVD, and typically presents with a small atrophic hole, shallow detachment, and slow progression. RRD with less liquefied vitreous and no PVD can be managed successfully with SB alone even in the presence of subretinal strand as less liquefied vitreous acts as bio-tamponade blocking fluid passage. The strong traction induced by PVD and bullous detachment in an eye with extensively liquefied vitreous reduces the success rate of SB. PPV is gaining popularity as the primary procedure for RRD, especially in eyes with retinal tears, PVD, or pseudophakia. Nevertheless, SB remains the preferred procedure in young phakic patients without PVD.
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Affiliation(s)
- Sung Who Park
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea, .,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea,
| | - Jae Jung Lee
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea, .,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea,
| | - Ji Eun Lee
- Department of Ophthalmology, School of Medicine, Pusan National University, Yangsan, South Korea, .,Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea,
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Santos FM, Gaspar LM, Ciordia S, Rocha AS, Castro E Sousa JP, Paradela A, Passarinha LA, Tomaz CT. iTRAQ Quantitative Proteomic Analysis of Vitreous from Patients with Retinal Detachment. Int J Mol Sci 2018; 19:ijms19041157. [PMID: 29641463 PMCID: PMC5979392 DOI: 10.3390/ijms19041157] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/07/2018] [Accepted: 04/08/2018] [Indexed: 12/15/2022] Open
Abstract
Rhegmatogenous retinal detachment (RRD) is a potentially blinding condition characterized by a physical separation between neurosensory retina and retinal pigment epithelium. Quantitative proteomics can help to understand the changes that occur at the cellular level during RRD, providing additional information about the molecular mechanisms underlying its pathogenesis. In the present study, iTRAQ labeling was combined with two-dimensional LC-ESI-MS/MS to find expression changes in the proteome of vitreous from patients with RRD when compared to control samples. A total of 150 proteins were found differentially expressed in the vitreous of patients with RRD, including 96 overexpressed and 54 underexpressed. Several overexpressed proteins, several such as glycolytic enzymes (fructose-bisphosphate aldolase A, gamma-enolase, and phosphoglycerate kinase 1), glucose transporters (GLUT-1), growth factors (metalloproteinase inhibitor 1), and serine protease inhibitors (plasminogen activator inhibitor 1) are regulated by HIF-1, which suggests that HIF-1 signaling pathway can be triggered in response to RRD. Also, the accumulation of photoreceptor proteins, including phosducin, rhodopsin, and s-arrestin, and vimentin in vitreous may indicate that photoreceptor degeneration occurs in RRD. Also, the accumulation of photoreceptor proteins, including phosducin, rhodopsin, and s-arrestin, and vimentin in vitreous may indicate that photoreceptor degeneration occurs in RRD. Nevertheless, the differentially expressed proteins found in this study suggest that different mechanisms are activated after RRD to promote the survival of retinal cells through complex cellular responses.
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Affiliation(s)
- Fátima Milhano Santos
- CICS-UBI-Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal.
- Chemistry Department, Faculty of Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal.
- Laboratory of Pharmacology and Toxicology-UBIMedical, University of Beira Interior, 6200-284 Covilhã, Portugal.
| | - Leonor Mesquita Gaspar
- CICS-UBI-Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal.
- Chemistry Department, Faculty of Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal.
| | - Sergio Ciordia
- Unidad de Proteomica, Centro Nacional de Biotecnología, CSIC, Calle Darwin 3, Campus de Cantoblanco, 28049 Madrid, Spain.
| | - Ana Sílvia Rocha
- CICS-UBI-Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal.
- Chemistry Department, Faculty of Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal.
| | - João Paulo Castro E Sousa
- CICS-UBI-Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal.
- Hospital Center Leiria-Pombal, 3100-462 Pombal, Portugal.
| | - Alberto Paradela
- Unidad de Proteomica, Centro Nacional de Biotecnología, CSIC, Calle Darwin 3, Campus de Cantoblanco, 28049 Madrid, Spain.
| | - Luís António Passarinha
- CICS-UBI-Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal.
- Laboratory of Pharmacology and Toxicology-UBIMedical, University of Beira Interior, 6200-284 Covilhã, Portugal.
| | - Cândida Teixeira Tomaz
- CICS-UBI-Health Sciences Research Centre, University of Beira Interior, 6201-506 Covilhã, Portugal.
- Chemistry Department, Faculty of Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal.
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FACTORS ASSOCIATED WITH VISUAL OUTCOME AFTER MACULA-OFF RHEGMATOGENOUS RETINAL DETACHMENT SURGERY. Retina 2018; 38:137-147. [DOI: 10.1097/iae.0000000000001512] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gu YH, Ke GJ, Wang L, Gu QH, Zhou EL, Pan HB, Wang SY. Risk factors of rhegmatogenous retinal detachment associated with choroidal detachment in Chinese patients. Int J Ophthalmol 2016; 9:989-93. [PMID: 27500106 DOI: 10.18240/ijo.2016.07.09] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 01/06/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To comprehensively analyze the risk factors of rhegmatogenous retinal detachment (RRD) associated with choroidal detachment (CD). METHODS A total of 265 eyes of 265 consecutive cases of RRD were retrospectively analyzed. All patients had systemic and ophthalmologic examination. CD was diagnosed by indirect ophthalmoscopy, B-scan ultrasonography, and ultrasound biomicroscope (UBM). Each parameter was compared between patients of RRD and rhegmatogenous retinal detachment associated with choroidal detachment (RRDCD). Logistic regression analysis was used to determine the independent risk factors of CD. RESULTS There were 52 eyes (19.62%) with CD. Pseudophakia was more commonly seen in RRDCD (21.15% vs 6.10%, P=0.002). Intraocular pressure (IOP) was lower (8.60±3.62 vs 12.96±3.55, P<0.001), best-corrected visual acuity was worse [3.00 (2.00 to 3.00) vs 1.92 (1.22 to 3.00), P=0.001], and refractive error was more myopic [-4 (-9 to -2) vs -2 (-6 to 0), P=0.007] in RRDCD. Eyes with RRDCD had larger extent of retinal detachment (P=0.007). In RRDCD, 34.62% of eyes presented with multiple holes (P=0.044) and 25.00% with macular holes (P=0.012), compared with 20.66% and 14.08% in RRD. High myopia (P=0.039), low IOP (P=0.017), and larger extent of retinal detachment (P<0.001) were significant and independent risk factors for developing CD. CONCLUSION For CD in RRD, related factors include BCVA, IOP, lens status, refractive error, extent of retinal detachment, number of holes, and macular hole. Larger extent of retinal detachment, high myopia, and low IOP are significant and independent risk factors.
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Affiliation(s)
- Yong-Hao Gu
- Department of Ophthalmology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Gen-Jie Ke
- Department of Ophthalmology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Lin Wang
- Department of Ophthalmology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Qi-Hong Gu
- Department of Ophthalmology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei 230001, Anhui Province, China
| | - En-Liang Zhou
- Department of Ophthalmology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Hong-Biao Pan
- Department of Ophthalmology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei 230001, Anhui Province, China
| | - Shi-Ying Wang
- Department of Ophthalmology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei 230001, Anhui Province, China
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Decreased hyaluronan concentration during primary rhegmatogenous retinal detachment. Eur J Ophthalmol 2016; 26:633-638. [PMID: 27198637 DOI: 10.5301/ejo.5000802] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the concentration and molecular weight of hyaluronan (HA) polysaccharides as well as hyaluronidase activity in patients with rhegmatogenous retinal detachment (RRD). METHODS Twenty vitreous samples from 20 patients with RRD and 19 samples from 19 patients with idiopathic epiretinal membrane, macular hole, or vitreomacular traction syndrome were collected during surgical management with pars plana vitrectomy. The molecular weight of various HA fragments was assessed using agarose gel electrophoresis. Enzyme-linked immunosorbent assay was employed for the measurement of HA (in μg/mL). Hyaluronidase activity was evaluated using substrate (HA) sodium dodecyl sulfate polyacrylamide gel electrophoresis. RESULTS Agarose gel electrophoresis showed that the vitreous of the control group contained HA of high molecular mass, in contrast with the patient group. Mean HA concentration in the patient group was 50.96 μg/mL and differed significantly from that of the control group, which was 271.81 μg/mL (p<0.0005). Hyaluronidase activity was significantly higher in the vitreous of patients with RRD (p = 0.037). CONCLUSIONS The vitreous of patients with RRD is characterized by decreased HA concentration compared to controls of the same age and sex and shows higher hyaluronidase catalytic activity. Hyaluronan degradation could be associated with specific vitreous alterations that potentially contribute to retinal break formation and consequently detachment.
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Johnston T, Chandra A, Hewitt AW. Current Understanding of the Genetic Architecture of Rhegmatogenous Retinal Detachment. Ophthalmic Genet 2016; 37:121-9. [PMID: 26757352 DOI: 10.3109/13816810.2015.1033557] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Rhegmatogenous retinal detachment (RRD) is a common and potentially blinding surgical retinal disease. While the precise molecular mechanisms leading to RRD are poorly understood, there is an increasing body of literature supporting the role of heritable factors in the pathogenesis of the condition. Much work has been undertaken investigating genes important in syndromic forms of RRD (e.g., Stickler, Wagner Syndrome, etc.) and research pertaining to genetic investigations of idiopathic or non-syndromic RRD has also recently been reported. To date, at least 12 genetic loci have been implicated in the development of syndromes of which RRD is a feature. A recent GWAS identified five loci implicated in the development of idiopathic RRD.This article provides an overview of the genetic mechanisms of both syndromic and idiopathic RRD. The genetics of predisposing conditions, such as myopia and lattice degeneration, are also discussed.
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Affiliation(s)
- Timothy Johnston
- a Centre for Eye Research Australia, University of Melbourne, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital , Melbourne , Victoria , Australia and
| | - Aman Chandra
- a Centre for Eye Research Australia, University of Melbourne, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital , Melbourne , Victoria , Australia and
| | - Alex W Hewitt
- a Centre for Eye Research Australia, University of Melbourne, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital , Melbourne , Victoria , Australia and.,b School of Medicine, Menzies Research Institute Tasmania, University of Tasmania , Hobart , Tasmania , Australia
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Abstract
PURPOSE To investigate the risk of rhegmatogenous retinal detachment (RRD) after central serous chorioretinopathy (CSCR). METHODS The study included 2,830 patients with CSCR and 16,980 control patients matched using a propensity score for age, sex, and comorbidities including status after cataract operation, blunt trauma, myopia, diabetes mellitus, hypertension, and hyperlipidemia from January 2001 through December 2010 from the Taiwan Longitudinal Health Insurance Database 2000. Information of each patient was collected until December 2011. Cox proportional hazard regression analysis was used to obtain the adjusted hazard ratio for RRD. The RRD-free survival rate was calculated using Kaplan-Meier analysis. RESULTS Thirty-five patients with CSCR (1.24%) and 27 controls (0.16%) had RRD (P < 0.0001) during follow-up, resulting in a significantly higher risk of RRD in the patients with CSCR (incidence rate ratio = 7.83, 95% confidence interval = 4.74-12.93). After adjustment for potential confounders, the adjusted hazard ratio for developing RRD was increased 7.85 times in the cohort of total sample (adjusted hazard ratio = 7.85, 95% confidence interval = 4.75-12.97). CONCLUSION It was found that CSCR increased the risk of RRD even after adjustment for age, sex, and comorbidities including status after cataract operation, blunt trauma, myopia, diabetes mellitus, hypertension, and hyperlipidemia.
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Matsumoto H, Murakami Y, Kataoka K, Notomi S, Mantopoulos D, Trichonas G, Miller JW, Gregory MS, Ksander BR, Marshak-Rothstein A, Vavvas DG. Membrane-bound and soluble Fas ligands have opposite functions in photoreceptor cell death following separation from the retinal pigment epithelium. Cell Death Dis 2015; 6:e1986. [PMID: 26583327 PMCID: PMC4670938 DOI: 10.1038/cddis.2015.334] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 10/09/2015] [Accepted: 10/12/2015] [Indexed: 01/30/2023]
Abstract
Fas ligand (FasL) triggers apoptosis of Fas-positive cells, and previous reports described FasL-induced cell death of Fas-positive photoreceptors following a retinal detachment. However, as FasL exists in membrane-bound (mFasL) and soluble (sFasL) forms, and is expressed on resident microglia and infiltrating monocyte/macrophages, the current study examined the relative contribution of mFasL and sFasL to photoreceptor cell death after induction of experimental retinal detachment in wild-type, knockout (FasL-/-), and mFasL-only knock-in (ΔCS) mice. Retinal detachment in FasL-/- mice resulted in a significant reduction of photoreceptor cell death. In contrast, ΔCS mice displayed significantly more apoptotic photoreceptor cell death. Photoreceptor loss in ΔCS mice was inhibited by a subretinal injection of recombinant sFasL. Thus, Fas/FasL-triggered cell death accounts for a significant amount of photoreceptor cell loss following the retinal detachment. The function of FasL was dependent upon the form of FasL expressed: mFasL triggered photoreceptor cell death, whereas sFasL protected the retina, indicating that enzyme-mediated cleavage of FasL determines, in part, the extent of vision loss following the retinal detachment. Moreover, it also indicates that treatment with sFasL could significantly reduce photoreceptor cell loss in patients with retinal detachment.
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Affiliation(s)
- H Matsumoto
- Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - Y Murakami
- Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - K Kataoka
- Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - S Notomi
- Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - D Mantopoulos
- Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - G Trichonas
- Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - J W Miller
- Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - M S Gregory
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Schepens Eye Research Institute, Boston, MA, USA
| | - B R Ksander
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Schepens Eye Research Institute, Boston, MA, USA
| | - A Marshak-Rothstein
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - D G Vavvas
- Angiogenesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
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Proteomic Analysis of the Vitreous following Experimental Retinal Detachment in Rabbits. J Ophthalmol 2015; 2015:583040. [PMID: 26664739 PMCID: PMC4667062 DOI: 10.1155/2015/583040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Revised: 10/17/2015] [Accepted: 10/19/2015] [Indexed: 01/04/2023] Open
Abstract
Purpose. The pathogenesis of rhegmatogenous retinal detachment (RRD) remains incompletely understood, with no clinically effective treatment for potentially severe complications such as photoreceptor cell death and proliferative vitreoretinopathy. Here we investigate the protein profile of the vitreous following experimental retinal detachment using a comparative proteomic based approach. Materials and Methods. Retinal detachment was created in the right eyes of six New Zealand red pigmented rabbits. Sham surgery was undertaken in five other rabbits that were used as controls. After seven days the eyes were enucleated and the vitreous was removed. The vitreous samples were evaluated with two-dimensional polyacrylamide gel electrophoresis and the differentially expressed proteins were identified with tandem mass spectrometry. Results. Ten protein spots were found to be at least twofold differentially expressed when comparing the vitreous samples of the sham and retinal detachment surgery groups. Protein spots that were upregulated in the vitreous following retinal detachment were identified as albumin fragments, and those downregulated were found to be peroxiredoxin 2, collagen-Iα1 fragment, and α-1-antiproteinase F. Conclusions. Proteomic investigation of the rabbit vitreous has identified a set of proteins that help further our understanding of the pathogenesis of rhegmatogenous retinal detachment and its complications.
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Abstract
BACKGROUND Idiopathic epiretinal membrane (iERM) is a fibrocellular membrane that proliferates on the inner surface of the retina at the macular area. Membrane contraction is an important sight-threatening event and is due to fibrotic remodeling. METHODS Analysis of the current literature regarding the epidemiology, clinical features, and pathogenesis of iERM and fibrotic tissue contraction. RESULTS Epidemiologic studies report a relationship between iERM prevalence, increasing age, and posterior vitreous detachment. Clinically, iERM progresses through different stages characterized by an increased thickness and wrinkling of the membrane. Pathophysiologically, iERM formation is a fibrotic process in which myofibroblast formation and the deposition of newly formed collagens play key roles. Anomalous posterior vitreous detachment may be a key event initiating the formation of iERM. The age-related accumulation of advanced glycation end products may contribute to anomalous posterior vitreous detachment formation and may also influence the mechanical properties of the iERM. CONCLUSION Remodeling of the extracellular matrix at the vitreoretinal interface by aging and fibrotic changes, plays a significant role in the pathogenesis of iERM. A better understanding of molecular mechanisms underlying this process may eventually lead to the development of effective and nonsurgical approaches to treat and prevent vitreoretinal fibrotic diseases.
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Elevated hydrogen sulfide levels in vitreous body and plasma in patients with proliferative diabetic retinopathy. Retina 2015; 34:2003-9. [PMID: 24743641 DOI: 10.1097/iae.0000000000000184] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Hydrogen sulfide (H2S), a colorless gas, has been confirmed to be a gaseous messenger molecule and an endogenous stimulus for angiogenesis recently. This study was performed to investigate the role of H2S in diabetic retinopathy. METHODS Blood samples were collected from normal controls and patients with diabetes. Vitreous samples were collected from patients with proliferative diabetic retinopathy (PDR) and patients with rhegmatogenous retinal detachment. Patients were grouped into diabetic patients without diabetic retinopathy (non-DR), with nonproliferative DR, and with PDR. Concentrations of H2S and vascular endothelial growth factor in the plasma and vitreous body were detected using a spectrophotometer. RESULTS A decreased H2S level in the plasma was observed in non-DR group (41.89 ± 8.52 μM, P < 0.05), and an increased H2S level in the plasma was observed in PDR group (60.49 ± 11.14 μM, P < 0.001), when compared with that in normal controls (49.67 ± 9.72 μM). There was no difference in plasma H2S level between patients with nonproliferative DR (54.13 ± 8.61 μM) and normal controls. In the vitreous body, H2S levels in PDR group were significantly higher (76.80 ± 24.08 μM, P < 0.001) than that in rhegmatogenous retinal detachment group (24.37 ± 11.25 μM). Levels of vascular endothelial growth factor in plasma from patients with diabetes were significantly lower (P < 0.001) than that in normal controls. Vascular endothelial growth factor levels in the vitreous body from diabetic patients with PDR were significantly higher (885.61 ± 190.41 pg/mL, P < 0.001) than that from patients with rhegmatogenous retinal detachment (89.98 ± 19.56 pg/mL). Seven days after an intravitreal injection of ranibizumab, a significantly decreased H2S level (55.58 ± 7.20 μM, P < 0.05) was observed in the vitreous body in patients with PDR when compared with that (75.07 ± 12.95 μM) in the vitreous body collected just before intravitreal injection. CONCLUSION These results indicated that anti-vascular endothelial growth factor may downregulate the H2S level in the vitreous body, and H2S may play a role in the development of DR. Hydrogen sulfide may be a novel target for the therapy of DR.
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Lv Z, Li Y, Wu Y, Qu Y. Surgical complications of primary rhegmatogenous retinal detachment: a meta-analysis. PLoS One 2015; 10:e0116493. [PMID: 25734450 PMCID: PMC4348461 DOI: 10.1371/journal.pone.0116493] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 12/10/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To investigate the surgical complications of scleral buckling (SB) and pars plana vitrectomy (PPV) performed on primary rhegmatogenous retinal detachment (RRD) and to discover which surgical procedures bring fewer complications. METHODS An electronic literature search using the PubMed database, ISI Web of Knowledge and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials and observational studies comparing SB with PPV on primary RRD. Outcome measures included intra-operative complications and early and late post-operative complications. RESULTS During the operation, significantly less subretinal hemorrhage occurred in the PPV group than in the SB group (OR = 4.71; 95%CI, 1.33-16.64; p = 0.02) and the hypotony incidence was significantly higher in the SB group (OR = 18.24; 95%CI, 2.37-140.44; p = 0.005); however, the occurrence of iatrogenic breaks was significantly lower in the SB group (OR = 0.05; 95%CI, 0.01-0.21; p<0.0001). In the early stage of post-operation, significantly higher incidence of choroidal detachment was identified in the SB group than in the PPV group (OR = 10.19; 95%CI, 2.36-44.09; p = 0.002); patients undergoing SB had significantly higher odds of residual subretinal fluid (OR = 14.71; 95%CI, 1.84-117.32; p = 0.01); the occurrence of high intraocular pressure was significantly lower in the SB group (OR = 0.46; 95%CI, 0.23-0.89; p = 0.02); and no significant difference was shown in the incidence of epithelia defect (p = 0.37) between the two groups. In the late stage of post-operation, the incidence of diplopia/extraocular muscle dysfunction was significantly higher in the SB group (OR = 4.04; 95%CI, 1.30-12.52; p = 0.02); and significantly less cataract was observed in the SB group (OR = 0.20; 95%CI, 0.14-0.30; p<0.00001); no significant difference was found in the incidences of cystoid macular edema (p = 0.65), macular pucker (p = 0.52), post-operative proliferative vitreoretinopathy (p = 0.73) and epiretinal membrane (p = 0.47) in other late post-operative complications. CONCLUSIONS This meta-analysis suggests that PPV could be considered as potential surgical management on primary RRD.
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Affiliation(s)
- Zhiping Lv
- Department of Ophthalmology, Qilu Hospital of Shandong University, No. 107, Wenhuaxi Road, Jinan 250012, China
| | - Ying Li
- Department of Ophthalmology, Qilu Hospital of Shandong University, No. 107, Wenhuaxi Road, Jinan 250012, China
| | - Yongzhong Wu
- State Key Lab of Crystal Materials, Shandong University, Jinan 250100, China
| | - Yi Qu
- Department of Ophthalmology, Qilu Hospital of Shandong University, No. 107, Wenhuaxi Road, Jinan 250012, China
- * E-mail:
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Monteiro JP, Santos FM, Rocha AS, Castro-de-Sousa JP, Queiroz JA, Passarinha LA, Tomaz CT. Vitreous humor in the pathologic scope: insights from proteomic approaches. Proteomics Clin Appl 2015; 9:187-202. [PMID: 25523418 DOI: 10.1002/prca.201400133] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 12/11/2014] [Accepted: 12/15/2014] [Indexed: 12/22/2022]
Abstract
The vitreous humor (VH) is the largest component of the eye. It is a colorless, gelatinous, highly hydrated matrix that fills the posterior segment of the eye between the lens and retina in vertebrates. In VH, a diversity of proteins that can influence retinal physiology is present, including growth factors, hormones, proteins with transporter activity, and enzymes. More importantly, the protein composition of VH has been described as being altered in a number of disease states. Therefore, attempts aiming at establishing a map of VH proteins and detecting putative biomarkers for ocular illness or protein fluctuations with putative physiologic significance were conducted over the last two decades, using proteomic approaches. Proteomic strategies often involve gel-based or LC techniques as sample fractioning approaches, subsequently coupled with MS procedures. This set of studies resulted in the proteomic characterization of a range of ocular disease samples, with particular incidence on diabetic retinopathy. However, practical therapeutic applications arising from these studies are scarce at the moment. A pertinent example of therapeutic targets arising from VH proteomics has emerged concerning vasoproliferative factors present in the vitreous, which should be involved in neovascularization and subsequent fibrovascular proliferation of the retina, in ocular disease context. Therefore, this review attempts to sum up the information acquired from the proteomic approaches to ocular disease conducted in VH samples, highlighting its clinical potential for disclosing ocular disease mechanisms and engendering pharmacological therapeutic treatments.
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Affiliation(s)
- João P Monteiro
- CICS-UBI Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
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Tabibian D, Hoogewoud F, Mavrakanas N, Schutz JS. Misdirected aqueous flow in rhegmatogenous retinal detachment: A pathophysiology update. Surv Ophthalmol 2015; 60:51-9. [DOI: 10.1016/j.survophthal.2014.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 07/20/2014] [Accepted: 07/23/2014] [Indexed: 11/28/2022]
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Aniseikonia following pneumatic retinopexy for rhegmatogenous retinal detachment. Am J Ophthalmol 2014; 158:1056-61. [PMID: 25127694 DOI: 10.1016/j.ajo.2014.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 08/03/2014] [Accepted: 08/04/2014] [Indexed: 11/21/2022]
Abstract
PURPOSE To evaluate the characteristics of aniseikonia in patients with rhegmatogenous retinal detachment (RD) after pneumatic retinopexy. DESIGN Prospective, interventional case series study. METHODS Thirty patients who had undergone pneumatic retinopexy as the initial procedure for rhegmatogenous retinal detachment were selected for this study. The principal outcomes included visual acuity, postoperative aniseikonia measured by the New Aniseikonia Test, anatomical success, and measurement of central retinal thickness using optical coherence topography (OCT). These outcomes were measured postoperatively at 3, 6, and 12 months. RESULTS The median patient age was 37 years (range, 13-57 years), with 17 cases of macula-off RD and 13 cases of macula-on RD. All of these patients achieved anatomical success, proven by OCT after surgical repair. Three months after pneumatic retinopexy, 18 patients (60.0%) developed micropsic aniseikonia and aniseikonia was diagnosed in 15 patients (88.2%) in the macula-off RD group, leaving 2 patients (11.8%) unaffected. In the macula-on RD group, 3 patients (23.1%) were found to have aniseikonia, while 10 patients (76.9%) were unaffected. The presence of aniseikonia was strongly linked to the difference in central retinal thickness, between the operated eye and the fellow eye, measured at 12 months postoperatively. CONCLUSION Aniseikonia after pneumatic retinopexy for rhegmatogenous RD may be related to the preoperative macular status. Macula-off RD patients had a higher incidence of aniseikonia, compared to macula-on RD patients, following retina reattachment. There was a moderate to high correlation between the grading of aniseikonia and the difference in central retinal thickness.
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Trends and factors related to outcomes for primary rhegmatogenous retinal detachment surgery in a large asian tertiary eye center. Retina 2014; 34:684-92. [PMID: 24169100 DOI: 10.1097/iae.0b013e3182a48900] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe trends and outcomes of vitreoretinal surgery for primary rhegmatogenous retinal detachment in a large Asian tertiary eye center. METHODS Retrospective review of 1,530 eyes with primary retinal detachment between 2005 and 2011 managed at the Singapore National Eye Center by one of the following: scleral buckling (SB), pars plana vitrectomy (PPV), and combined SB and PPV (SB + PPV). Anatomical and functional outcomes were assessed. RESULTS There was a trend toward PPV and PPV + SB as the primary reattachment procedure from 2005 to 2011. The primary anatomical success rate for PPV (78.6%) was worse than that for SB (88.8%) or SB + PPV (89.0%, P = 0.000). Final anatomical success rates were similar for all 3 procedures: SB 97.7%, PPV 95.2%, and SB + PPV 96.4%. Better functional success was achieved in the SB group (86.1%) than both the PPV (72.5%) and SB + PPV groups (77.5%, P = 0.000), partly attributable to the less complex nature of retinal detachments in the SB group. Older age and proliferative vitreoretinopathy were related to the poor functional outcomes in both phakic and pseudophakic eyes. CONCLUSION There was an increasing trend toward PPV and PPV + SB as the primary retinal reattachment surgery from 2005 through to 2011. High rates of anatomical and functional outcomes were achieved with SB, PPV, and SB + PPV, proliferative vitreoretinopathy and older age were negatively correlated with the functional success in both phakic and pseudophakic eyes.
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McLean NJ, Zimmerman R. Bilateral lens luxation and intracapsular lens extractions in a Matshchie's tree kangaroo. Vet Ophthalmol 2014; 18 Suppl 1:81-5. [PMID: 25135107 DOI: 10.1111/vop.12207] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An adult, female, captive, Matshchie's tree kangaroo was diagnosed with an anterior lens luxation in the right eye and a lens subluxation in the left eye. Both eyes were treated surgically with intracapsular lens extractions. A 360° rhegmatogenous retinal detachment was diagnosed 6 months postoperatively in the left eye. Aphakic vision was maintained in the right eye 9 months postoperatively. Based on family history and the lack of antecedent ocular disease, the lens luxations were presumed to be inherited and veterinarians should be aware of this condition within the captive tree kangaroo population.
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Affiliation(s)
- Nancy Johnstone McLean
- VCA Veterinary Care Animal Hospital and Referral Center, 9901 Montgomery Boulevard NE, Albuquerque, NM, 87111, USA
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Matsumoto H, Murakami Y, Kataoka K, Lin H, Connor KM, Miller JW, Zhou D, Avruch J, Vavvas DG. Mammalian STE20-like kinase 2, not kinase 1, mediates photoreceptor cell death during retinal detachment. Cell Death Dis 2014; 5:e1269. [PMID: 24874741 PMCID: PMC4047884 DOI: 10.1038/cddis.2014.218] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 04/14/2014] [Indexed: 12/28/2022]
Abstract
Photoreceptor cell death is the definitive cause of vision loss in retinal detachment (RD). Mammalian STE20-like kinase (MST) is a master regulator of both cell death and proliferation and a critical factor in development and tumorigenesis. However, to date the role of MST in neurodegeneration has not been fully explored. Utilizing MST1−/− and MST2−/− mice we identified MST2, but not MST1, as a regulator of photoreceptor cell death in a mouse model of RD. MST2−/− mice demonstrated significantly decreased photoreceptor cell death and outer nuclear layer (ONL) thinning after RD. Additionally, caspase-3 activation was attenuated in MST2−/− mice compared to control mice after RD. The transcription of p53 upregulated modulator of apoptosis (PUMA) and Fas was also reduced in MST2−/− mice post-RD. Retinas of MST2−/− mice displayed suppressed nuclear relocalization of phosphorylated YAP after RD. Consistent with the reduction of photoreceptor cell death, MST2−/− mice showed decreased levels of proinflammatory cytokines such as monocyte chemoattractant protein 1 and interleukin 6 as well as attenuated inflammatory CD11b cell infiltration during the early phase of RD. These results identify MST2, not MST1, as a critical regulator of caspase-mediated photoreceptor cell death in the detached retina and indicate its potential as a future neuroprotection target.
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Affiliation(s)
- H Matsumoto
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - Y Murakami
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - K Kataoka
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - H Lin
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - K M Connor
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - J W Miller
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - D Zhou
- State Key Laboratory of Stress Cell Biology, School of Life Sciences, Xiamen University, Xiamen, Fujian 361102, China
| | - J Avruch
- Department of Molecular Biology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - D G Vavvas
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
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Matsumoto H, Kataoka K, Tsoka P, Connor KM, Miller JW, Vavvas DG. Strain difference in photoreceptor cell death after retinal detachment in mice. Invest Ophthalmol Vis Sci 2014; 55:4165-74. [PMID: 24854853 DOI: 10.1167/iovs.14-14238] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate the potential for mouse genetic background to effect photoreceptor cell death in response to experimental retinal detachment (RD). METHODS Retinal detachment was induced in three inbred mouse strains (C57BL/6, BALB/c, and B6129SF2) by subretinal injection of sodium hyaluronate. A time course of photoreceptor cell death was assessed by TUNEL assay. Total photoreceptor cell death was analyzed through comparing the outer nuclear layer (ONL)/inner nuclear layer (INL) ratio 7 days post RD. Western blot analysis or quantitative real-time PCR (qPCR) were performed to assess cell death signaling, expression of endogenous neurotrophin, and levels of apoptosis inhibitors 24 hours after RD. Inflammatory cytokine secretion and inflammatory cell infiltration were quantified by ELISA and immunostaining, respectively. RESULTS The peak of photoreceptor cell death after RD was at 24 hours in all strains. Photoreceptor cell death as well as monocyte chemoattractant protein 1 and interleukin 6 secretion at 24 hours after RD was the highest in BALB/c, followed in order of magnitude by C57BL/6 and B6129SF2. Conversely, nerve growth factor expression and ONL/INL ratio were the lowest in BALB/c. Apoptosis signaling was higher in C57BL/6, whereas necroptosis signaling was higher in C57BL/6 and BALB/c. Autophagic signaling was higher in BALB/c. X-linked inhibitor of apoptosis (XIAP) and survivin protein levels were lower in C57BL/6 and BALB/c, respectively. Macrophage/microglia infiltration was higher in C57BL/6 and BALB/c at 24 hours after RD. CONCLUSIONS Photoreceptor cell death after RD was significantly different among the three strains, suggesting the presence of genetic factors that affect photoreceptor cell death after RD.
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Affiliation(s)
- Hidetaka Matsumoto
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | - Keiko Kataoka
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | - Pavlina Tsoka
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | - Kip M Connor
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | - Joan W Miller
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
| | - Demetrios G Vavvas
- Retina Service, Angiogenesis Laboratory, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
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Kang HM, Lee CS, Park HJ, Lee KH, Byeon SH, Koh HJ, Lee SC. Characteristics of rhegmatogenous retinal detachment after refractive surgery: comparison with myopic eyes with retinal detachment. Am J Ophthalmol 2014; 157:666-72.e1-2. [PMID: 24321470 DOI: 10.1016/j.ajo.2013.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 12/01/2013] [Accepted: 12/02/2013] [Indexed: 12/30/2022]
Abstract
PURPOSE To evaluate the characteristics of rhegmatogenous retinal detachment (RD) in patients with previous laser in situ keratomileusis (LASIK) and compare them to RD in patients with previous laser assisted subepithelial keratomileusis (LASEK) and myopic patients with no previous refractive surgery. DESIGN Retrospective, comparative case series. METHODS In 106 eyes of 106 patients with RD, patients with previous refractive surgery included 21 eyes after LASIK and 13 eyes after LASEK; 72 myopic patients with refractive errors of -3.0 diopters or less were grouped as the R (-) group. Characteristics of RD included distribution of RD and associated retinal breaks, location and number of retinal breaks, presence of lattice degeneration, and axial lengths. RESULTS The mean interval between refractive surgery and the onset of rhegmatogenous RD was 63.7 ± 43.5 months, occurring across a broad spectrum of time intervals. There were no significant differences among the LASIK group, the LASEK group, and the R (-) group in axial length (26.8 mm vs 26.4 mm vs 26.9 mm, respectively); in mean number of retinal holes/tears, (2.1/1.5, 0.9/1.4, 1.5/1.6, respectively); or in the presence of lattice degeneration (52.4% vs 46.2% vs 43.1%, respectively). Distribution of RD and associated retinal breaks were also not significantly different; retinal holes and tears were more prevalent in the temporal quadrants, and inferotemporal quadrants were the most commonly detached areas in both the LASEK and LASIK groups and in the R (-) group. CONCLUSIONS Myopia is a well-known risk factor for rhegmatogenous RD and may contribute more to the development of RD in myopic patients after refractive surgery, rather than refractive surgery itself.
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Feltgen N, Walter P. Rhegmatogenous retinal detachment--an ophthalmologic emergency. DEUTSCHES ARZTEBLATT INTERNATIONAL 2014; 111:12-21; quiz 22. [PMID: 24565273 PMCID: PMC3948016 DOI: 10.3238/arztebl.2014.0012] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/09/2013] [Accepted: 09/09/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND Rhegmatogenous retinal detachment is the most common retinological emergency threatening vision, with an incidence of 1 in 10 000 persons per year, corresponding to about 8000 new cases in Germany annually. Without treatment, blindness in the affected eye may result. METHOD Selective review of the literature. RESULTS Rhegmatogenous retinal detachment typically presents with the perception of light flashes, floaters, or a "dark curtain." In most cases, the retinal tear is a consequence of degeneration of the vitreous body. Epidemiologic studies have identified myopia and prior cataract surgery as the main risk factors. Persons in the sixth and seventh decades of life are most commonly affected. Rhegmatogenous retinal detachment is an emergency, and all patients should be seen by an ophthalmologist on the same day that symptoms arise. The treatment consists of scleral buckle, removal of the vitreous body (vitrectomy), or a combination of the two. Anatomical success rates are in the range of 85% to 90%. Vitrectomy is followed by lens opacification in more than 70% of cases. The earlier the patient is seen by an ophthalmologist, the greater the chance that the macula is still attached, so that visual acuity can be preserved. CONCLUSION Rhegmatogenous retinal detachment is among the main emergency indications in ophthalmology. In all such cases, an ophthalmologist must be consulted at once.
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Loukovaara S, Lehti K, Robciuc A, Pessi T, Holopainen JM, Koli K, Immonen I, Keski-Oja J. Increased intravitreal angiopoietin-2 levels associated with rhegmatogenous retinal detachment. Graefes Arch Clin Exp Ophthalmol 2013; 252:881-8. [PMID: 24218041 DOI: 10.1007/s00417-013-2508-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 08/08/2013] [Accepted: 10/21/2013] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To explore factors related to pathogenesis of rhegmatogenous retinal detachment (RRD) and development of proliferative vitreoretinopathy (PVR), vitreous levels of angiopoietin-1 and -2 (Ang-1 and -2), previously undefined in RRD, transforming growth factor-(TGF) β1, vascular endothelial growth factor (VEGF), erythropoietin (EPO) and proteolytic mediators of extracellular matrix remodelling (MMP-2 and -9) were compared in eyes with RRD and eyes with idiopathic macular hole or pucker. METHODS Vitreous samples were collected from 117 eyes with RRD (study group) and 40 eyes with macular hole or pucker (control group). Growth factors were measured by ELISA and matrix metalloproteinases (MMPs) by gelatin zymography. RESULTS The mean vitreous concentrations of Ang-2, MMP-2, and MMP-9 were higher (all p < 0.01), whereas concentration of VEGF was lower (p = 0.01) in eyes with RRD relative to controls. Logistic regression analysis identified Ang-2 concentration as a novel marker of RRD (p = 0.0001, OR 48.7). Ang-1, EPO, and total TGF-β1 levels were not significantly different between the groups. However, TGF-β1 and MMP-2 were increased in eyes with total RRD compared to those with local RRD (p ≤ 0.05). In eyes with PVR, no differences were observed in any studied marker as compared with non-PVR eyes. CONCLUSIONS Current results reveal Ang-2 as a key factor upregulated in RRD. It may co-operate with fibrosis-associated factors and contribute to vascular complications such as breakdown of blood-eye barrier and PVR development.
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Affiliation(s)
- Sirpa Loukovaara
- Unit of Vitreoretinal Surgery, Department of Ophthalmology, Helsinki University Central Hospital, Haartmaninkatu 4 C, 00290, Helsinki, Finland,
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Rossi T, Querzoli G, Pasqualitto G, Iossa M, Placentino L, Repetto R, Stocchino A, Ripandelli G. Ultrasound imaging velocimetry of the human vitreous. Exp Eye Res 2012; 99:98-104. [DOI: 10.1016/j.exer.2012.03.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Revised: 03/24/2012] [Accepted: 03/27/2012] [Indexed: 11/30/2022]
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Pathogenesis of rhegmatogenous retinal detachment, predisposing anatomy and cell biology. Retina 2012; 32:645; author reply 645-6. [PMID: 22374163 DOI: 10.1097/iae.0b013e3182437ea4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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