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Song H, Wang YH, Zhou HY, Cui KM. Sulforaphane alleviates LPS-induced inflammatory injury in ARPE-19 cells by repressing the PWRN2/NF-kB pathway. Immunopharmacol Immunotoxicol 2022; 44:868-876. [PMID: 35766158 DOI: 10.1080/08923973.2022.2090954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Age-related macular degeneration (AMD) is the leading cause of blindness in the elderly population and its pathogenesis has been associated with inflammatory damage to retinal pigment epithelial (RPE) cells. Here, we explored the ability of sulforaphane to protect ARPE-19 cells from lipopolysaccharide (LPS)-induced inflammatory injury and elucidated the underlying molecular mechanism. METHODS Cell viability, apoptosis, inflammation, PWRN2 expression, nuclear transcription factor-kappa B (NF-kB) activity, and the interaction between PWRN2 and the IkBa protein were assessed in RPE cells under- or over-expressing PWRN2 that had been treated with LPS and sulforaphane. RESULTS Overexpression of PWRN2 in LPS-treated cells promoted NF-kB activation by interacting with IkBa, thus reducing cell viability. In contrast, PWRN2 downregulation repressed LPS-induced NF-kB activation and apoptosis in RPE cells. Similarly, sulforaphane downregulated PWRN2 and inhibited NF-kB activation in a concentration-dependent manner. Conversely, PWRN2 overexpression or NF-kB upregulation weakened the anti-inflammatory effects of sulforaphane. CONCLUSION Our results suggest that sulforaphane protects RPE cells from LPS-induced inflammatory injury by suppressing the PWRN2/NF-kB pathway.
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Affiliation(s)
- Hui Song
- Eye Center, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, P.R. China
| | - Ying-Hao Wang
- Eye Center, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, P.R. China
| | - Hai-Yan Zhou
- Eye Center, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, P.R. China
| | - Kun-Ming Cui
- Eye Center, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, P.R. China
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2
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Cheung R, Ly A, Katalinic P, Coroneo MT, Chang A, Kalloniatis M, Madigan MC, Nivison-Smith L. Visualisation of peripheral retinal degenerations and anomalies with ocular imaging. Semin Ophthalmol 2022; 37:554-582. [DOI: 10.1080/08820538.2022.2039222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Rene Cheung
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Angelica Ly
- Centre for Eye Health, University of New South Wales, Sydney, Australia
| | - Paula Katalinic
- Centre for Eye Health, University of New South Wales, Sydney, Australia
| | - Minas Theodore Coroneo
- Department of Ophthalmology, Prince of Wales Clinical School, Faculty of Medicine, The University of New South Wales, Sydney, Australia
| | - Andrew Chang
- Sydney Institute of Vision Science, Sydney, Australia
- Save Sight Institute, The University of Sydney, Sydney, Australia
| | - Michael Kalloniatis
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Centre for Eye Health, University of New South Wales, Sydney, Australia
| | - Michele C. Madigan
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Save Sight Institute, The University of Sydney, Sydney, Australia
| | - Lisa Nivison-Smith
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Centre for Eye Health, University of New South Wales, Sydney, Australia
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3
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Benson MD, Rubin U, Cheema M, MacDonald IM, Tennant MT, Hinz BJ, Somani R. Diffuse Pigmented Lesions in the Outer Retina: An Unusual Fundus Appearance. JOURNAL OF VITREORETINAL DISEASES 2020; 4:243-247. [PMID: 37007451 PMCID: PMC9982251 DOI: 10.1177/2474126419873547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: This report describes and provides a differential diagnosis for a patient with unusual bilateral retinal pigmented lesions. Methods: A 40-year-old woman was found to have multiple flat, gray lesions scattered across her fundi, becoming larger and more confluent toward the periphery. There were small drusenlike deposits in her foveae. The hyperpigmented lesions demonstrated hypoautofluorescence with thickening of the retinal pigment epithelium and disruption of the overlying layers on optical coherence tomography (OCT). Full-field electroretinography revealed generalized reduced a- and b-wave amplitudes. Results: Chest x-ray, breast ultrasound, mammography, and pelvic ultrasound findings were negative for malignant etiologic factors. Panel testing results for hereditary retinal dystrophy were negative. Conclusions: Although the clinical and OCT appearance of the lesions is similar to congenital grouped pigmentation, the symmetric and bilateral nature of ocular findings coupled with electroretinographic changes suggest a possible retinal dystrophy. This case adds to the phenotypic diversity of pigmented fundus lesions.
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Affiliation(s)
- Matthew D. Benson
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Uriel Rubin
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Marvi Cheema
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Ian M. MacDonald
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Matthew T.S. Tennant
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Brad J. Hinz
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Rizwan Somani
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alberta, Canada
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4
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Wang H, Ly A, Yapp M, Assaad N, Kalloniatis M. Multimodal imaging characteristics of congenital grouped hyper- and hypo-pigmented fundus lesions. Clin Exp Optom 2019; 103:641-647. [PMID: 31769080 DOI: 10.1111/cxo.12984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/25/2019] [Accepted: 09/10/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The imaging characteristics of congenital grouped pigmentation of the retinal pigment epithelium (CGP-RPE) and its non-pigmented variant - grouped congenital albinotic retinal pigment epithelial spots (GCARPES) are poorly defined in the literature. Our case series reports their multimodal imaging characteristics across a spectrum of presentations. METHODS A retrospective review of patient records was conducted on patients seen at the Centre for Eye Health between January and December 2016. The multimodal imaging findings across four cases is described using optical coherence tomography (OCT), infrared imaging, ultra-widefield imaging, fundus photography and fundus autofluorescence (FAF). RESULTS Case 1 is a 55-year-old female with a bilateral presentation of CGP-RPE showing typical features. Case 2 is a 28-year-old male with a classical presentation of GCARPES in the left eye. Case 3 is a 33-year-old female with unilateral CGP-RPE and an atypical solitary congenital hypertrophy of the retinal pigment epithelium (CHRPE) in the same eye. Case 4 is a unilateral presentation in an 11-year-old female with unusual characteristics. Ocular imaging characteristics of CGP-RPE lesions varied between patients: OCT showed visible RPE changes in cases 3 and 4 but not case 1. The pattern of FAF and infrared imaging also varied with most lesions displaying a pattern of hypo-autofluorescence, but some central lesions in case 3 exhibited hyper-autofluorescence. All lesions were visible with fundus photography. CONCLUSION FAF can be helpful in alerting clinicians to the presence of lesions that may be difficult to visualise funduscopically and OCT can be helpful in differentiating between CGP-RPE and its variants from more sinister ocular conditions. All in all, these findings highlight the variable manifestation of CGP-RPE and its variants on multimodal imaging; the diagnosis of CGP-RPE and its variants should remain based on its characteristic funduscopic appearance.
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Affiliation(s)
- Henrietta Wang
- Centre for Eye Health, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Angelica Ly
- Centre for Eye Health, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Michael Yapp
- Centre for Eye Health, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Nagi Assaad
- Centre for Eye Health, Sydney, Australia.,Department of Ophthalmology, Prince of Wales Hospital, Sydney, Australia
| | - Michael Kalloniatis
- Centre for Eye Health, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
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5
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Ly A, Nivison-Smith L, Hennessy M, Kalloniatis M. The advantages of intermediate-tier, inter-optometric referral of low risk pigmented lesions. Ophthalmic Physiol Opt 2017; 37:661-668. [PMID: 29044669 PMCID: PMC6446908 DOI: 10.1111/opo.12413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 08/23/2017] [Indexed: 11/14/2022]
Abstract
Purpose Pigmented ocular lesions are commonly encountered by eye‐care professionals, and range from benign to sight or life‐threatening. After identifying a lesion, the primary care professional must establish the likely diagnosis and decide either to reassure, to monitor or to refer. The increasing use of ocular imaging technologies has contributed to an increase in the detection rate of pigmented lesions and a higher number of referrals, which may challenge existing pathways of health‐care delivery. Specialist services may be over‐burdened by referring all patients with pigmented lesions for an opinion, while inter‐optometric referrals are underutilised. The aim of this study was to describe the referral patterns of pigmented lesions to an optometry led intermediate‐tier collaborative care clinic. Methods We performed a retrospective review of patient records using the list of patients examined at Centre for Eye Health (CFEH) for an initial or follow up pigmented lesion assessment between the 1/7/2013 and the 30/6/2016. Analysis was performed on: patient demographic characteristics, the referrer's tentative diagnosis, CFEH diagnosis and recommended management plan. Results Across 182 patient records, the primary lesion prompting referral was usually located in the posterior segment: choroidal naevus (105/182, 58%), congenital hypertrophy of the retinal pigment epithelium (CHRPE; 11/182, 6%), chorioretinal scarring (10/182, 5%) or not specified (52/182, 29%). Referrals described a specific request for ocular imaging in 25 instances (14%). The number of cases with a non‐specific diagnosis was reduced after intermediate‐tier care assessment (from 29% to 10%), while the number of diagnoses with less common conditions rose (from 2% to 21%). There was a 2% false positive referral rate to intermediate‐tier care and a first visit discharge rate of 35%. A minority required on‐referral to an ophthalmologist (22/182, 12%), either for unrelated incidental ocular findings, or suspicious choroidal naevi. Conditions most amenable to optometric follow up included: 1) chorioretinal scarring, 2) choroidal naevus, and 3) CHRPE. Conclusions Intermediate‐tier optometric eye‐care in pigmented lesions (following opportunistic primary care screening) has the potential to reduce the number of cases with non‐specific diagnoses and to increase those with less common diagnoses. The majority of cases seen under this intermediate‐tier model required only ongoing optometric surveillance.
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Affiliation(s)
- Angelica Ly
- Centre for Eye Health, Sydney, NSW, Australia.,School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
| | - Lisa Nivison-Smith
- Centre for Eye Health, Sydney, NSW, Australia.,School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
| | - Michael Hennessy
- Centre for Eye Health, Sydney, NSW, Australia.,Department of Ophthalmology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Michael Kalloniatis
- Centre for Eye Health, Sydney, NSW, Australia.,School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
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6
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Ly A, Nivison-Smith L, Zangerl B, Assaad N, Kalloniatis M. Advanced imaging for the diagnosis of age-related macular degeneration: a case vignettes study. Clin Exp Optom 2017; 101:243-254. [PMID: 28994139 PMCID: PMC5873408 DOI: 10.1111/cxo.12607] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 01/21/2023] Open
Abstract
Background The aim of this study is to evaluate the diagnosis, staging, imaging and management preferences, and the effect of advanced imaging among practising optometrists in age‐related macular degeneration (AMD). Methods Up to 20 case vignettes (computer‐based case simulations) were completed online in a computer laboratory in random order by 81 practising optometrists of Australia. Each case presented findings from a randomly selected patient seen previously at the Centre for Eye Health for a macular assessment in the following order: case history, preliminary tests and colour fundus photography. Participants were prompted to provide their diagnosis, management and imaging preference. One additional imaging result (either modified fundus photographs and infrared images, fundus autofluorescence, or optical coherence tomography [OCT]) was then provided and the questions repeated. Finally, all imaging results were provided and the questions repeated a third time. Results A total of 1,436 responses were analysed. The presence of macular pathology in AMD was accurately detected in 94 per cent of instances. The overall diagnostic accuracy of AMD was 61 per cent using colour fundus photography. This improved by one per cent using one additional imaging modality and a further four per cent using all imaging. Across all responses, a greater improvement in the diagnostic accuracy of AMD occurred following the presentation of OCT findings (versus other modalities). OCT was the most preferred imaging modality for AMD, while multimodal imaging was of greatest benefit in cases more often misdiagnosed using colour fundus photography alone. Overall, the cohort also displayed a tendency to underestimate disease severity. Conclusion Despite reports that imaging technologies improve the stratification of AMD, our findings suggest that this effect may be small when applied among practising optometrists without additional or specific training.
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Affiliation(s)
- Angelica Ly
- Centre for Eye Health, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
| | - Lisa Nivison-Smith
- Centre for Eye Health, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
| | - Barbara Zangerl
- Centre for Eye Health, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
| | - Nagi Assaad
- Centre for Eye Health, Sydney, New South Wales, Australia.,Department of Ophthalmology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Michael Kalloniatis
- Centre for Eye Health, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia
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Kaur G, Anthony SA. Multimodal imaging of suspicious choroidal neoplasms in a primary eye-care clinic. Clin Exp Optom 2017; 100:549-562. [PMID: 28370509 DOI: 10.1111/cxo.12537] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/05/2017] [Indexed: 11/28/2022] Open
Abstract
Small suspicious choroidal neoplasms commonly present a diagnostic challenge in primary eye-care clinics, where they are most likely to present. Differentiating benign from malignant choroidal neoplasms is essential for facilitating early diagnosis and treatment, potentially decreasing the risk of metastasis and vision loss in some cases. The purpose of this review is to describe the clinical, spectral-domain optical coherence tomography and fundus autofluorescence features of suspicious choroidal neoplasms in a case series of patients presenting to a primary eye-care clinic at the Veterans Health Administration, Cleveland, Ohio, USA.
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Affiliation(s)
- Gurpinderjeet Kaur
- Optometry Clinic, Louis Stokes Cleveland Veterans Affairs Medical Centre, Cleveland, Ohio, USA
| | - Scott A Anthony
- Optometry Clinic, Louis Stokes Cleveland Veterans Affairs Medical Centre, Cleveland, Ohio, USA
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