1
|
Du J, Landa G. Development of cystoid macular edema after uneventful cataract surgery in eyes with a history of vitrectomy using silicone oil versus gas tamponade. Eye (Lond) 2024; 38:1327-1332. [PMID: 38151526 PMCID: PMC11076604 DOI: 10.1038/s41433-023-02898-x] [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: 07/02/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND/OBJECTIVES The purpose of this study is to investigate whether history of silicone oil tamponade may predispose to the development of cystoid macular edema (CMO) following uneventful post-vitrectomy cataract surgery. SUBJECTS/METHODS This is a retrospective study that was conducted at a single academic institution. Records of patients who underwent pars plana vitrectomy (PPV) with or without silicone oil tamponade and subsequent cataract surgery between 2017-2020 were reviewed. Macular optical coherence tomography (OCT) findings up to 4 years after surgery were assessed. RESULTS A total of 95 eyes were included. Forty-one eyes underwent cataract surgery and had a history of PPV with silicone oil tamponade (Group 1). Fifty-four eyes underwent cataract surgery by phacoemulsification and had a history of PPV with gas tamponade (Group 2). Average follow up time after cataract surgery was 41.1 months. In Group 1, the incidence of OCT-detected CMO was 39.0%, compared to 27.8% in Group 2 (p = 0.247). The incidence of clinically significant CMO in Group 1 was 22.0%, compared to 18.5% in Group 2 (p = 0.679). The duration of CMO was significantly longer in Group 1 (p = 0.041) and cases were less likely to resolve by the last follow up visit (p = 0.040). CONCLUSIONS The incidence of OCT-detected or clinically significant pseudophakic CMO is not significantly different between eyes with prior PPV with gas tamponade versus silicone oil tamponade. However, CMO after uneventful cataract surgery may have a prolonged course if there is history of silicone oil tamponade, requiring longer treatment.
Collapse
Affiliation(s)
- Jeanette Du
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA.
| | - Gennady Landa
- Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
2
|
Zhang Q, Qi S, You J, Wang C. The role of retinal glial cells and related factors in macular edema. Biochem Biophys Res Commun 2024; 695:149415. [PMID: 38159411 DOI: 10.1016/j.bbrc.2023.149415] [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: 10/31/2023] [Revised: 12/09/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
Macular edema (ME) has emerged as a leading cause of visual impairment, representing a critical clinical manifestation and complication associated with many eye diseases. In the occurrence and development of ME, retinal glial cells like Müller cells and microglial cells play vital roles. Moreover, growth factor and cytokines associated with them, such as vascular endothelial growth factor (VEGF), pigment epithelium-derived factor (PEDF), hypoxia-inducible factor-1α (HIF-1α), angiopoietin-like protein 4 (ANGPTL4), interleukin-6(IL-6), interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1), prostaglandin, etc., also take part in the pathogenesis of ME. Changes in these cytokines can lead to retinal angiogenesis, increased vascular permeability, blood-retinal barrier (BRB) breakdown, and fluid leakage, further causing ME to occur or deteriorate. Research on the role of retinal glial cells and related cytokines in ME will provide new therapeutic directions and effective remedies. This article is a literature review on the role of Müller cells, microglial cells and related factors in ME pathogenesis.
Collapse
Affiliation(s)
- Qi Zhang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China.
| | - Shounan Qi
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China.
| | - Jiaxin You
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China.
| | - Chenguang Wang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China.
| |
Collapse
|
3
|
Bianco L, Arrigo A, Antropoli A, Saladino A, Aragona E, Bandello F, Parodi MB. Non-vasogenic cystoid maculopathy in autosomal recessive bestrophinopathy: novel insights from NIR-FAF and OCTA imaging. Ophthalmic Genet 2024; 45:44-50. [PMID: 37041716 DOI: 10.1080/13816810.2023.2191711] [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: 06/17/2022] [Accepted: 03/11/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND Autosomal Recessive Bestrophinopathy (ARB) is an inherited retinal disease caused by biallelic mutations in the BEST1 gene. Herein, we report the multimodal imaging findings of ARB presenting with cystoid maculopathy and investigate the short-term response to combined systemic and topical carbonic anhydrase inhibitors (CAIs). MATERIAL AND METHODS An observational, prospective, case series on two siblings affected by ARB is presented. Patients underwent genetic testing and optical coherence tomography (OCT), blue-light fundus autofluorescence (BL-FAF), near-infrared fundus autofluorescence (NIR-FAF), fluorescein angiography (FA), MultiColor imaging, and OCT angiography (OCTA). RESULTS Two male siblings, aged 22 and 16, affected by ARB resulting from c.598C>T, p.(Arg200*) and c.728C>A, p.(Ala243Glu) BEST1 compound heterozygous variants, presented with bilateral multifocal yellowish pigment deposits scattered through the posterior pole that corresponded to hyperautofluorescent deposits on BL-FAF. Vice versa, NIR-FAF mainly disclosed wide hypoautofluorescent areas in the macula. A cystoid maculopathy and shallow subretinal fluid were evident on structural OCT, albeit without evidence of dye leakage or pooling on FA. OCTA demonstrated disruption of the choriocapillaris throughout the posterior pole and sparing of intraretinal capillary plexuses. Six months of combined therapy with oral acetazolamide and topical brinzolamide resulted in limited clinical benefit. CONCLUSIONS We reported two siblings affected by ARB, presenting as non-vasogenic cystoid maculopathy. Prominent alteration of NIR-FAF signal and concomitant choriocapillaris rarefaction on OCTA were noted in the macula. The limited short-term response to combined systemic and topical CAIs might be explained by the impairment of the RPE-CC complex.
Collapse
Affiliation(s)
- Lorenzo Bianco
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessandro Arrigo
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessio Antropoli
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Saladino
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Emanuela Aragona
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | |
Collapse
|
4
|
Wang XN, Cai X, He S, Zhang X, Wu Q. Subfoveal choroidal thickness changes after intravitreal ranibizumab injections in different patterns of diabetic macular edema using a deep learning-based auto-segmentation. Int Ophthalmol 2023; 43:4399-4407. [PMID: 33783677 DOI: 10.1007/s10792-021-01806-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate the effect of intravitreal injection of ranibizumab (IVR) on subfoveal choroidal thickness (SFCT) and its relationship with central macular thickness (CMT) and best-corrected visual acuity (BCVA) changes in eyes with center-involving DME (CI-DME) using a deep learning-based auto-segmentation. METHODS This prospective interventional case series included 68 eyes of 68 patients with CI-DME naive to treatment. Morphological optical coherence tomography (OCT) findings of DME were classified into three patterns of structural change: (i) diffuse retinal thickening (DRT), (ii) cystoid macular edema (CME), and (iii) serous retinal detachment (SRD). All patients underwent 3+prorenata IVR. The treated eyes underwent BCVA evaluation and OCT scanning at baseline and months 1, 3, and 6 after the first injection. Then, the choroid layer was measured using a deep learning-based auto-segmentation. RESULTS At baseline, the mean SFCT and CMT for SRD, DRT, and CME groups were 324.68 ± 65.58 μm and 624.37 ± 77.92 μm, 348.91 ± 45.81 μm and 443.5 ± 78.33 μm, 361.4 ± 64.62 μm, and 536.5 ± 66.02 μm, respectively. After anti-VEGF treatment, the SFCT and CMT have decreased by varying degrees. At 3 and 6 months of treatment, there were no significant changes among these groups. There was no correlation between baseline SFCT and the resulting BCVA (P = 0.670, P = 0.584). There was also no correlation between changes in SFCT and BCVA, CMT (P = 0.344, P = 0.336). CONCLUSION After treating CI-DME with IVR, SFCT and CMT significantly decreased. However, there were no significant changes among the SRD, DRT, and CME groups. TRIAL REGISTRATION Trial registration: ChiCTR, ChiCTR-ROC-17013360. Registered 13 November 2017, http://www.chictr.org.cn/ChiCTR-ROC-17013360 .
Collapse
Affiliation(s)
- Xiang-Ning Wang
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Xuan Cai
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Sijin He
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Xueyan Zhang
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, 200233, China
| | - Qiang Wu
- Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Xuhui District, Shanghai, 200233, China.
- Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, 200233, China.
| |
Collapse
|
5
|
Berlin A, Messinger JD, Balaratnasingam C, Mendis R, Ferrara D, Freund KB, Curcio CA. Imaging Histology Correlations of Intraretinal Fluid in Neovascular Age-Related Macular Degeneration. Transl Vis Sci Technol 2023; 12:13. [PMID: 37943552 PMCID: PMC10637202 DOI: 10.1167/tvst.12.11.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/04/2023] [Indexed: 11/10/2023] Open
Abstract
Purpose Fluid presence and dynamism is central to the diagnosis and management of neovascular age-related macular degeneration. On optical coherence tomography (OCT), some hyporeflective spaces arise through vascular permeability (exudation) and others arise through degeneration (transudation). Herein we determined whether the histological appearance of fluid manifested this heterogeneity. Methods Two eyes of a White woman in her 90s with anti-vascular endothelial growth factor treated bilateral type 3 neovascularization secondary to age-related macular degeneration were osmicated, prepared for submicrometer epoxy resin sections, and correlated to eye-tracked spectral domain OCT. Examples of intraretinal tissue fluid were sought among similarly prepared donor eyes with fibrovascular scars, in a web-based age-related macular degeneration histopathology resource. Fluid stain intensity was quantified in reference to Bruch's membrane and the empty glass slide. Results Exudative fluid by OCT was slightly reflective and dynamically responded to anti-vascular endothelial growth factor. On histology, this fluid stained moderately, possessed a smooth and homogenous texture, and contained blood cells and fibrin. Nonexudative fluid in degenerative cysts and in outer retinal tubulation was minimally reflective on OCT and did not respond to anti-vascular endothelial growth factor. By histology, this fluid stained lightly, possessed a finely granular texture, and contained mainly tissue debris. Quantification supported the qualitative impressions of fluid stain density. Cells containing retinal pigment epithelium organelles localized to both fluid types. Conclusions High-resolution histology of osmicated tissue can distinguish between exudative and nonexudative fluid, some of which is transudative. Translational Relevance OCT and histological features of different fluid types can inform clinical decision-making and assist in the interpretation of newly available automated fluid detection algorithms.
Collapse
Affiliation(s)
- Andreas Berlin
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Ophthalmology, University Hospital Würzburg, Würzburg, Germany
| | - Jeffrey D. Messinger
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Chandrakumar Balaratnasingam
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
- Lions Eye Institute, Nedlands, Western Australia, Australia
- Department of Ophthalmology, Sir Charles Gairdner Hospital, Western Australia, Australia
| | | | | | - K. Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, NY, USA
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, USA
| | - Christine A. Curcio
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
6
|
Hwang S, Seong M, Kang MH, Thng ZX, Cho H, Shin YU. Association of a Bioimpedance Profile with Optical Coherence Tomography Features in Diabetic Macular Edema. J Clin Med 2023; 12:6676. [PMID: 37892814 PMCID: PMC10607216 DOI: 10.3390/jcm12206676] [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: 08/31/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
We examined the association between bioimpedance profiles and optical coherence tomography (OCT) features in patients with diabetic macular edema (DME). This cross-sectional study included 100 eyes of 100 patients with type 2 diabetes mellitus. The systemic fluid status was assessed using extracellular water-to-total body water ratio (ECW/TBW) and phase angle (PhA), which was measured using bioimpedance equipment. ECW/TBW was higher in the DR (diabetic retinopathy) with DME group than in the no DR and DR without DME groups (p = 0.007 and p = 0.047, respectively); however, no significant difference was observed between the no DR and DR without DME groups. The PhA values were significantly lower in the DR with DME group (5.45 ± 0.84) than in the no DR (6.69 ± 0.69) and DR without DME groups (6.05 ± 1.15) (p < 0.001, p = 0.032, respectively). The presence of multiple HRF (hyper-reflective foci) was associated with a significantly higher ECW/TBW (p = 0.001). In the group with the most significant HRF, PhA was lower than in those with none or moderate amounts of HRF (p < 0.05). Bioimpedance fluid profiles of patients with OCT features of DME suggest a connection between the overall systemic state, including fluid status and DME development. Further research is required to fully understand and utilize this information for effective clinical assessment and treatment planning.
Collapse
Affiliation(s)
- Sunjin Hwang
- Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (S.H.); (M.S.); (M.H.K.)
| | - Mincheol Seong
- Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (S.H.); (M.S.); (M.H.K.)
| | - Min Ho Kang
- Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (S.H.); (M.S.); (M.H.K.)
| | - Zheng Xian Thng
- Byers Eye Institute, Stanford University, Palo Alto, CA 94305, USA;
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore 308433, Singapore
| | - Heeyoon Cho
- Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (S.H.); (M.S.); (M.H.K.)
| | - Yong Un Shin
- Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (S.H.); (M.S.); (M.H.K.)
- Byers Eye Institute, Stanford University, Palo Alto, CA 94305, USA;
| |
Collapse
|
7
|
Anwar S, Nath M, Gottlob I, Proudlock FA. Severity of cystoid macular oedema in preterm infants observed using hand-held spectral domain optical coherence tomography improves weekly with postmenstrual age. Eye (Lond) 2023; 37:3009-3014. [PMID: 36928228 PMCID: PMC10516860 DOI: 10.1038/s41433-023-02461-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 12/09/2022] [Accepted: 02/20/2023] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVE To investigate the relationship between cystoid macular oedema (CMO) measured in preterm infants using hand-held spectral domain optical coherence tomography (HH SD-OCT), with gestational age at birth (GA), birthweight (BW), diagnosis of retinopathy of prematurity (ROP) and the presence or absence of the external limiting membrane (ELM). METHODS We conducted a prospective mixed cross-sectional/longitudinal observational study of 112 participants (23 to 36 weeks GA; n = 25 with, and n = 87 without, CMO). Retinal images were acquired using 344 HH SD-OCT (n = 66 with and n = 278 without, CMO) between 31 to 44 weeks postmenstrual age (PMA). CMO type ('fovea' and 'dome') was measured using thickness, width, area and peak. RESULTS CMO was observed in 22.9% of preterm infants, and 19.2% of images. The mean values for thickness, width, area and peak of 'dome' CMO were 128.47 µm (SD +/- 34.23), 3624.45 µm (SD +/- 1323.03), 0.49 mm2 (SD +/- 0.28) and 279.81 µm (SD +/- 13.57) respectively. The mean values for thickness, width, area and peak of 'fovea' CMO were 64.37 µm (SD +/- 17.11), 2226.28 µm (SD +/- 1123.82), 0.16 mm2 (SD +/- 0.11) and 95.03 µm (SD +/- 26.99) respectively. Thickness, area width and peak were significantly greater for 'dome CMO compared with 'fovea' CMO (P < 0.0001 for thickness, area and peak; P < 0.01 for width). Area and width significantly decreased with PMA for 'dome' and 'fovea' CMO (p = 0.0028; p < 0.001 respectively). No association was found between the presence of ROP and the detection of CMO or detection of CMO with absence of ELM. CONCLUSIONS HH -OCT in preterm infants demonstrates that the severity of CMO appearance improves each week for both fovea and dome CMO.
Collapse
Affiliation(s)
- Samira Anwar
- Department of Ophthalmology, University Hospitals of Leicester NHS Trust, Leicester, UK.
- University of Leicester Ulverscroft Eye Unit, Robert Kilpatrick Clinical Sciences Building Leicester Royal Infirmary, Leicester, UK.
| | - Mintu Nath
- Institute of Applied Health Sciences, Polwarth Building, University of Aberdeen, Aberdeen, Scotland
| | - Irene Gottlob
- University of Leicester Ulverscroft Eye Unit, Robert Kilpatrick Clinical Sciences Building Leicester Royal Infirmary, Leicester, UK
| | - F A Proudlock
- University of Leicester Ulverscroft Eye Unit, Robert Kilpatrick Clinical Sciences Building Leicester Royal Infirmary, Leicester, UK
| |
Collapse
|
8
|
Beuse A, Deissler HL, Hollborn M, Unterlauft JD, Busch C, Rehak M. Different responses of the MIO‑M1 Mueller cell line to angiotensin II under hyperglycemic or hypoxic conditions. Biomed Rep 2023; 19:62. [PMID: 37614982 PMCID: PMC10442740 DOI: 10.3892/br.2023.1644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/20/2023] [Indexed: 08/25/2023] Open
Abstract
Members of the renin-angiotensin aldosterone system (RAAS) are expressed by various retinal tissues including Mueller glial cells. As the RAAS is hypothesized to play an important role in the pathogenesis of diseases that threaten vision, such as diabetic macular edema or retinal vein occlusion, the possible changes induced by exposure of the human cell line MIO-M1, an established model of Mueller cells, to angiotensin II or aldosterone for 6 h under hypoxic and/or hyperglycemic conditions were investigated. The mRNA expression levels of the members of the RAAS were assessed by reverse transcription-quantitative PCR, and the secretion of cytokines was assessed by ELISA. Under hyperglycemic conditions, the mRNA expression levels of the angiotensin-converting enzyme 2 (ACE2), angiotensin II receptors, AT1 and AT2, and the receptor of angiotensin (1-7) MAS1 were significantly higher after exposure to angiotensin II, and the expression of ACE2, AT2, and IL-6 (a marker of inflammation) was significantly increased after treatment with aldosterone; the expression of the other targets investigated remained unchanged. Significantly more IL-6 was secreted by MIO-M1 cells exposed to hyperglycemia and angiotensin. When cells were cultured in a hypoxic environment, additional treatment with aldosterone significantly increased the mRNA expression levels of ACE, but significantly more ACE2 mRNA was expressed in the presence of angiotensin II. Under hypoxic plus hyperglycemic conditions, significantly less ACE but more AT2 was expressed after treatment with angiotensin II, which also led to strongly elevated expression of IL-6. The mRNA expression levels of the angiogenic growth factor VEGF-A and secretion of the encoded protein were notably increased under hypoxic and hypoxic plus hyperglycemic conditions, irrespective of additional treatment with angiotensin II or aldosterone. These findings suggest that angiotensin II induces a pro-inflammatory response in MIO-M1 cells under hyperglycemic conditions despite activation of the counteracting ACE2/MAS1 signaling cascade. However, hypoxia results in an increased expression of angiogenic VEGF-A by these cells, which is not altered by angiotensin II or aldosterone.
Collapse
Affiliation(s)
- Ansgar Beuse
- Department of Ophthalmology, University of Leipzig, D-04103 Leipzig, Germany
| | - Heidrun L. Deissler
- Department of Ophthalmology, Justus-Liebig-University Giessen, D-35392 Giessen, Germany
| | - Margrit Hollborn
- Department of Ophthalmology, University of Leipzig, D-04103 Leipzig, Germany
| | - Jan Darius Unterlauft
- Department of Ophthalmology, University of Leipzig, D-04103 Leipzig, Germany
- Department of Ophthalmology, University of Bern, 3010 Bern, Switzerland
| | - Catharina Busch
- Department of Ophthalmology, University of Leipzig, D-04103 Leipzig, Germany
| | - Matus Rehak
- Department of Ophthalmology, University of Leipzig, D-04103 Leipzig, Germany
- Department of Ophthalmology, Justus-Liebig-University Giessen, D-35392 Giessen, Germany
| |
Collapse
|
9
|
Tsai MJ, Cheng CK. Morphological changes of foveal cysts as a predictor for visual response to anti-vascular endothelial growth factor treatments in diabetic macular edema : Degenerative cyst in DME. Int Ophthalmol 2023; 43:2751-2762. [PMID: 36939978 DOI: 10.1007/s10792-023-02674-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 02/22/2023] [Indexed: 03/21/2023]
Abstract
PURPOSE To investigate morphological changes of intraretinal cyst in association with visual acuity following treatment for diabetic macular edema. METHODS This retrospective study enrolled 105 eyes from 105 treatment naïve patients with diabetic macular edema following anti-vascular endothelial growth factor injections. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) data were obtained at baseline, 1, 3, 6, and 12 months. The width and height of the largest intraretinal cyst (IRC) at all different visits were measured and were correlated to final visual acuity by receiver operating characteristic curve. The exudative feature was defined by the presence of hard exudates. Multivariate logistic regression was used to select the independent predictor for visual outcomes. RESULTS Intraretinal cyst width but not the cyst height after treatment at 1 month independently predicted final visual loss of ten letters or more (multivariate P = 0.009). The optimal cutoff value was 196 um with a sensitivity of 0.889 and a specificity of 0.656. Eyes with large IRC width using this cutoff were consistently larger than those with small IRC width through 12 months (P = 0.008, Mann-Whitney U test). Small IRC width < 196 um at 1 month was more likely to coexist with exudative feature (P = 0.011, Fisher's exact test). Among baseline factors, large IRC width predicted IRC width ≥ 196 um at 1 month (multivariate P < 0.001). CONCLUSION Cyst morphology following intravitreal injection predicts visual outcomes. Eyes with IRC width ≥ 196 um after treatment at 1 month tends to be more degenerative, and less likely to coexist with exudative feature.
Collapse
Affiliation(s)
- Meng-Ju Tsai
- Department of Ophthalmology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital, No 95, Wen-chang Road, Shih-lin District, Taipei, Taiwan
| | - Cheng-Kuo Cheng
- Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital, No 95, Wen-chang Road, Shih-lin District, Taipei, Taiwan.
- Department of Medicine, School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
- School of Medicine, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
10
|
Naseripour M, Hemmati S, Chaibakhsh S, Gordiz A, Miri L, Abdi F. Cystoid macular oedema without leakage in fluorescein angiography: a literature review. Eye (Lond) 2023; 37:1519-1526. [PMID: 36088420 PMCID: PMC10219944 DOI: 10.1038/s41433-022-02230-z] [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: 04/29/2022] [Revised: 07/21/2022] [Accepted: 08/30/2022] [Indexed: 11/09/2022] Open
Abstract
Cystoid macular oedema (CMO), which is defined as a macular thickening and cystic changes due to accumulation of fluid, could be asymptomatic and only diagnosed using paraclinical techniques. Fluorescein angiography (FA) and optical coherence tomography (OCT) are useful in detecting CMO in clinical practice. Non-leaking CMO, also known as angiographically silent CMO, is referred to as cases of CMO without leakage in fluorescein angiography. This type of CMO has been reported in some retinal dystrophies, in cases of maculopathy as a side effect of certain drugs, and also in some systemic disorders. The exact mechanism and treatment options for this type of CMO are still not clear. This literature review aims to discuss different causes of non-leaking CMO, proposed mechanisms, and management options. Three sections including drugs, retinal dystrophies, and systemic disorders are discussed in this review.
Collapse
Affiliation(s)
- Masood Naseripour
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Sara Hemmati
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Samira Chaibakhsh
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Arzhang Gordiz
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Miri
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Abdi
- Eye Research Center, The five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
11
|
Arrigo A, Aragona E, Perra C, Saladino A, Amato A, Bianco L, Pina A, Basile G, Bandello F, Battaglia Parodi M. Morphological and functional involvement of the inner retina in retinitis pigmentosa. Eye (Lond) 2023; 37:1424-1431. [PMID: 35768721 PMCID: PMC10169765 DOI: 10.1038/s41433-022-02139-7] [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: 01/16/2022] [Revised: 05/09/2022] [Accepted: 06/10/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To investigate the morphological retinal parameters associated with retinal sensitivity status in retinitis pigmentosa (RP) through a quantitative multimodal imaging approach. METHODS The study was designed as an observational, prospective case series, including RP patients and healthy controls. Multimodal imaging included fundus autofluorescence (FAF), structural optical coherence tomography (OCT), OCT angiography (OCTA) and microperimetry (MP). The follow-up lasted 12 months. For each imaging modality, we performed an overall quantitative analysis and a detailed investigation based on the ETDRS-9 sectors grid. Quantitative parameters included the thickness of each retinal and choroidal layer, vessel density (VD), choriocapillaris porosity (CCP), FAF intensity and MP retinal sensitivity. RESULTS We included 40 eyes (40 patients) affected by RP and 40 healthy eyes (40 controls). Mean baseline BCVA was 0.14 ± 0.18 LogMAR, with 0.18 ± 0.24 LogMAR after 1-year of follow-up. RP eyes showed statistically significant alterations of retinal and choroidal layers on the ETDRS-9 sectors grid, significant reduction of VD values and MP retinal sensitivity, and significantly higher CCP than controls. The inner retinal layers proved closely associated with the functional integrity of the posterior pole. In addition, our ROC analysis provided quantitative cutoffs connected significantly with a high probability of observing a partial sparing of MP retinal sensitivity. CONCLUSIONS The inner retinal layers are closely associated with the functional integrity of the posterior pole in RP. FAF intensity reduction may be interpreted as lipofuscin metabolism impairment inducing increased phototoxic distress for retinal structures. Vascular involvement contributes to the morpho-functional deterioration of the macular region in RP.
Collapse
Affiliation(s)
- Alessandro Arrigo
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Emanuela Aragona
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristian Perra
- Department of Electrical and Electronic Engineering (DIEE), CNIT Research Unit, University of Cagliari, Cagliari, Italy
| | - Andrea Saladino
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Alessia Amato
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Bianco
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Adelaide Pina
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giulia Basile
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Bandello
- Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | |
Collapse
|
12
|
Chapelle AC, Rakic JM, Plant GT. Nonarteritic Anterior Ischemic Optic Neuropathy. OPHTHALMOLOGY SCIENCE 2023; 3:100230. [PMID: 36439696 PMCID: PMC9692034 DOI: 10.1016/j.xops.2022.100230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022]
Abstract
Purpose Microcystic macular edema (MME), also known as retrograde maculopathy (RM), is associated with severe optic atrophy because of a range of causes. However, similar changes have also been described in primary retinal pathology and the pathogenesis of MME is debated. Design A retrospective observational case series. Participants Patients with nonarteritic ischemic optic neuropathy. Methods A retrospective observational case series was performed at the University Hospital of Liège, Belgium. The medical records of patients who were referred to our Neuro-ophthalmology department with a diagnosis of nonarteritic anterior ischemic optic neuropathy (NA-AION), between 2014 and 2021, were reviewed. Main Outcome Measures Ganglion cell complex thickness, acute and chronic inner nuclear change. Results In a cohort of 34 patients (mean age: 60 ± 12.5 years; 65.6% men) with NA-AION, we identified a transient microcystic change in the inner nuclear layer (INL) associated with optic disc swelling in 19 eyes at presentation. This early change was associated with a transudate of intraretinal and subretinal fluid originating from the optic disc. Among patients who had shown this transient change 3 subsequently developed MME, which remained fixed during the period of observation (range, 12–34 months). No MME was observed in patients without an early INL transient change. Microcystic macular edema was observed in patients with severe ganglion cell complex thinning at 6 months: mean (± SD) loss in superior hemimacula (−28.2 ± 5.2 μm [−33.3%, range, −22.3 to −30.3 μm]) and in inferior hemimacula (−30.7 ± 5.6 μm [−31.0%, range, −24.3 to 34.8 μm]). Conclusions Our study has revealed 2 causes of INL cystic change in the same patients experiencing NA-AION, 1 reversible and the other likely permanent. This finding highlights the distinction between genuine edema related to transudation of fluid (in this case secondary to ischemic optic disc swelling) and the phenomenon observed in RM that is related to the degree of retinal nerve fiber layer/ganglion cell complex thinning. Cystic change in the INL is associated with severe optic atrophy (MME). However, similar changes have been described in retinal pathology and the pathogenesis of MME is debated.
Collapse
|
13
|
Güven YZ, Akbalık T. A novel therapy in paclitaxel-related cystoid macular edema: Brimonidine. J Fr Ophtalmol 2023; 46:e154-e156. [PMID: 36828725 DOI: 10.1016/j.jfo.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 10/12/2022] [Indexed: 02/24/2023]
Affiliation(s)
- Y Z Güven
- İzmir Katip Çelebi University Atatürk Educating and Research Hospital, Department of Ophthalmology, İzmir, Turkey.
| | - T Akbalık
- İzmir Katip Çelebi University Atatürk Educating and Research Hospital, Department of Ophthalmology, İzmir, Turkey
| |
Collapse
|
14
|
Sutton SS, Magagnoli J, Cummings TH, Hardin JW, Ambati J. Allopurinol and the Risk of Diabetic Macular Edema among U.S. Veterans with Type 2 Diabetes. Ocul Immunol Inflamm 2023:1-7. [PMID: 36749950 PMCID: PMC10404628 DOI: 10.1080/09273948.2023.2170886] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 11/05/2022] [Accepted: 01/16/2023] [Indexed: 02/09/2023]
Abstract
BACKGROUND By inhibiting xanthine oxidase, subsequent inflammatory cytokine release and the resulting breakdown of the blood-retina barrier, allopurinol may limit the inflammation-driving diabetic macular edema (DME). METHODS We examined the relationship between allopurinol and DME among type 2 diabetic United States veterans using a retrospective cohort study. We used propensity score matching and Cox hazard models to estimate the risk of DME. RESULTS Propensity score-matched Cox models revealed allopurinol was associated with a 24.6% reduction in the risk of DME (HR = 0.754; 95% CI = (0.684-0.831)). CONCLUSION Allopurinol could reduce the risk of DME, one of the major causes of visual disturbance among diabetic patients. Further research into the effects of allopurinol on DME is warranted.
Collapse
Affiliation(s)
- S Scott Sutton
- Dorn Research Institute, Columbia VA Health Care System, Columbia, South Carolina & Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina, USA
| | - Joseph Magagnoli
- Dorn Research Institute, Columbia VA Health Care System, Columbia, South Carolina & Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina, USA
| | - Tammy H Cummings
- Dorn Research Institute, Columbia VA Health Care System, Columbia, South Carolina & Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina, USA
| | - James W Hardin
- Dorn Research Institute, Columbia VA Health Care System, Columbia, South Carolina & Department of Epidemiology & Biostatistics, University of South Carolina, Columbia, South Carolina, USA
| | - Jayakrishna Ambati
- Department of Ophthalmology, University of Virginia, Charlottesville, Virginia, USA
| |
Collapse
|
15
|
Anti-TNF vs tocilizumab in refractory uveitic cystoid macular edema due to Behcet's disease. Multicenter study of 49 patients. Semin Arthritis Rheum 2023; 58:152153. [PMID: 36549244 DOI: 10.1016/j.semarthrit.2022.152153] [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: 09/06/2022] [Revised: 11/29/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To compare the efficacy of TNF inhibitors (adalimumab (ADA) and infliximab (IFX)) vs tocilizumab (TCZ) in patients with refractory cystoid macular edema (CME) due to Behçet's disease (BD). METHODS Multicenter study of patients with BD-associated CME refractory to conventional and/or biological immunosuppressive drugs. From a cohort of 177 patients treated with anti-TNF and 14 patients treated with TCZ, we selected those with CME at baseline. We analyzed the evolution of macular thickness (main outcome), best-corrected visual acuity (BCVA) and intraocular inflammation (Tyndall and vitritis) from baseline up to 4 years in the 3 groups mentioned. RESULTS 49 patients and 72 eyes with CME were included. ADA was used in 25 patients (40 eyes), IFX in 15 (21 eyes) and TCZ in 9 (11 eyes). No statistically significant baseline differences were observed between the 3 groups except for a lower basal BCVA in TCZ group and a higher basal degree of intraocular inflammation in ADA group. Most patients from all groups had received several conventional immunosuppressive drugs. In addition, most patients in the group of TCZ had also received anti-TNF agents. Biological therapy was used in monotherapy (n=8) or combined with conventional immunosuppressive drugs (n=41). Macular thickness progressively decreased in the 3 groups, with no signs of CME after 1 year of treatment. Similarly, BCVA improvement and inflammatory intraocular remission was achieved in all groups. CONCLUSION Refractory CME associated with BD uveitis can be effectively treated either with ADA, IFX or TCZ. Furthermore, TCZ is effective in patients resistant to anti-TNF therapy.
Collapse
|
16
|
Diabetic Macular Edema: Current Understanding, Molecular Mechanisms and Therapeutic Implications. Cells 2022; 11:cells11213362. [PMID: 36359761 PMCID: PMC9655436 DOI: 10.3390/cells11213362] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/24/2022] Open
Abstract
Diabetic retinopathy (DR), with increasing incidence, is the major cause of vision loss and blindness worldwide in working-age adults. Diabetic macular edema (DME) remains the main cause of vision impairment in diabetic patients, with its pathogenesis still not completely elucidated. Vascular endothelial growth factor (VEGF) plays a pivotal role in the pathogenesis of DR and DME. Currently, intravitreal injection of anti-VEGF agents remains as the first-line therapy in DME treatment due to the superior anatomic and functional outcomes. However, some patients do not respond satisfactorily to anti-VEGF injections. More than 30% patients still exist with persistent DME even after regular intravitreal injection for at least 4 injections within 24 weeks, suggesting other pathogenic factors, beyond VEGF, might contribute to the pathogenesis of DME. Recent advances showed nearly all the retinal cells are involved in DR and DME, including breakdown of blood-retinal barrier (BRB), drainage dysfunction of Müller glia and retinal pigment epithelium (RPE), involvement of inflammation, oxidative stress, and neurodegeneration, all complicating the pathogenesis of DME. The profound understanding of the changes in proteomics and metabolomics helps improve the elucidation of the pathogenesis of DR and DME and leads to the identification of novel targets, biomarkers and potential therapeutic strategies for DME treatment. The present review aimed to summarize the current understanding of DME, the involved molecular mechanisms, and the changes in proteomics and metabolomics, thus to propose the potential therapeutic recommendations for personalized treatment of DME.
Collapse
|
17
|
Ocular Lymphatic and Glymphatic Systems: Implications for Retinal Health and Disease. Int J Mol Sci 2022; 23:ijms231710139. [PMID: 36077535 PMCID: PMC9456449 DOI: 10.3390/ijms231710139] [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: 07/31/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Clearance of ocular fluid and metabolic waste is a critical function of the eye in health and disease. The eye has distinct fluid outflow pathways in both the anterior and posterior segments. Although the anterior outflow pathway is well characterized, little is known about posterior outflow routes. Recent studies suggest that lymphatic and glymphatic systems play an important role in the clearance of fluid and waste products from the posterior segment of the eye. The lymphatic system is a vascular network that runs parallel to the blood circulatory system. It plays an essential role in maintenance of fluid homeostasis and immune surveillance in the body. Recent studies have reported lymphatics in the cornea (under pathological conditions), ciliary body, choroid, and optic nerve meninges. The evidence of lymphatics in optic nerve meninges is, however, limited. An alternative lymphatic system termed the glymphatic system was recently discovered in the rodent eye and brain. This system is a glial cell-based perivascular network responsible for the clearance of interstitial fluid and metabolic waste. In this review, we will discuss our current knowledge of ocular lymphatic and glymphatic systems and their role in retinal degenerative diseases.
Collapse
|
18
|
Kim K, Kim ES, Kim DG, Yu SY. The effect of intravitreal dexamethasone implantation on diabetic macular edema refractory to anti-vascular endothelial growth factor treatment. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2118715] [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: 10/14/2022]
Affiliation(s)
- Kiyoung Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, South Korea
| | - Eung Suk Kim
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, South Korea
| | - Do Gyun Kim
- Department of Ophthalmology, Myongji Hospital, Hanyang University Medical Center, Goyang-si, South Korea
| | - Seung-Young Yu
- Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University, Seoul, South Korea
| |
Collapse
|
19
|
Gabrielle PH. Lipid metabolism and retinal diseases. Acta Ophthalmol 2022; 100 Suppl 269:3-43. [PMID: 36117363 DOI: 10.1111/aos.15226] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/24/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The retina has enormous lipids demands and must meet those needs. Retinal lipid homeostasis appears to be based on the symbiosis between neurons, Müller glial cells (MGC), and retinal pigment epithelium (RPE) cells, which can be impacted in several retinal diseases. The current research challenge is to better understand lipid-related mechanisms involved in retinal diseases, such as age-related macular degeneration (AMD) and glaucoma. RESULTS In a first axis, in vitro and focus on Müller glial cell, we aimed to characterize whether the 24S-hydroxycholesterol (24S-OHC), an overexpressed end-product of cholesterol elimination pathway in neural tissue and likely produced by suffering retinal ganglion cells in glaucoma, may modulate MGC membrane organization, such as lipid rafts, to trigger cellular signalling pathways related to retinal gliosis. We have found that lipid composition appears to be a key factor of membrane architecture, especially for lipid raft microdomain formation, in MGC. However, 24S-OHC did not appear to trigger retinal gliosis via the modulation of lipid or protein composition within lipid rafts microdomains. This study provided a better understanding of the complex mechanisms involved in the pathophysiology of glaucoma. On a second clinical ax, we focused on the lipid-related mechanisms involved in the dysfunction of aging RPE and the appearance of drusenoid deposits in AMD. Using the Montrachet population-based study, we intend to report the frequency of reticular pseudodrusen (RPD) and its ocular and systemic risk factors, particularly related to lipid metabolisms, such as plasma lipoprotein levels, carotenoids levels, and lipid-lowering drug intake. Our study showed that RPD was less common in subjects taking lipid-lowering drugs. Lipid-lowering drugs, such as statins, may reduce the risk of RPD through their effect on the production and function of lipoproteins. This observation highlights the potential role of retinal lipid trafficking via lipoproteins between photoreceptors and retinal pigment epithelium cells in RPD formation. Those findings have been complemented with preliminary results on the analysis of plasma fatty acid (FA) profile, a surrogate marker of short-term dietary lipid intake, according to the type of predominant drusenoid deposit, soft drusen or RPD, in age-related maculopathy. CONCLUSION Further research on lipid metabolism in retinal diseases is warranted to better understand the pathophysiology of retinal diseases and develop new promising diagnostic, prognostic, and therapeutic tools for our patients.
Collapse
Affiliation(s)
- Pierre-Henry Gabrielle
- Eye and Nutrition Research Group, Center for Taste and Feeding Behaviour, AgroSup Dijon, CNRS, INRAe, The University Bourgogne Franche-Comté, Dijon, France.,Department of Ophthalmology, Dijon University Hospital, Dijon, France.,The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
20
|
Majander A, Jurkute N, Burté F, Brock K, João C, Huang H, Neveu MM, Chan CM, Duncan HJ, Kelly S, Burkitt-Wright E, Khoyratty F, Lai YT, Subash M, Chinnery PF, Bitner-Glindzicz M, Arno G, Webster AR, Moore AT, Michaelides M, Stockman A, Robson AG, Yu-Wai-Man P. WFS1-Associated Optic Neuropathy: Genotype-Phenotype Correlations and Disease Progression. Am J Ophthalmol 2022; 241:9-27. [PMID: 35469785 DOI: 10.1016/j.ajo.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the pattern of vision loss and genotype-phenotype correlations in WFS1-associated optic neuropathy (WON). DESIGN Multicenter cohort study. METHODS The study involved 37 patients with WON carrying pathogenic or candidate pathogenic WFS1 variants. Genetic and clinical data were retrieved from the medical records. Thirteen patients underwent additional comprehensive ophthalmologic assessment. Deep phenotyping involved visual electrophysiology and advanced psychophysical testing with a complementary metabolomic study. MAIN OUTCOME MEASURES WFS1 variants, functional and structural optic nerve and retinal parameters, and metabolomic profile. RESULTS Twenty-two recessive and 5 dominant WFS1 variants were identified. Four variants were novel. All WFS1 variants caused loss of macular retinal ganglion cells (RGCs) as assessed by optical coherence tomography (OCT) and visual electrophysiology. Advanced psychophysical testing indicated involvement of the major RGC subpopulations. Modeling of vision loss showed an accelerated rate of deterioration with increasing age. Dominant WFS1 variants were associated with abnormal reflectivity of the outer plexiform layer (OPL) on OCT imaging. The dominant variants tended to cause less severe vision loss compared with recessive WFS1 variants, which resulted in more variable phenotypes ranging from isolated WON to severe multisystem disease depending on the WFS1 alleles. The metabolomic profile included markers seen in other neurodegenerative diseases and type 1 diabetes mellitus. CONCLUSIONS WFS1 variants result in heterogenous phenotypes influenced by the mode of inheritance and the disease-causing alleles. Biallelic WFS1 variants cause more variable, but generally more severe, vision and RGC loss compared with heterozygous variants. Abnormal cleftlike lamination of the OPL is a distinctive OCT feature that strongly points toward dominant WON.
Collapse
Affiliation(s)
- Anna Majander
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom; Department of Ophthalmology, Helsinki University Hospital, University of Helsinki (A.M.), Helsinki, Finland.
| | - Neringa Jurkute
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Florence Burté
- Biosciences Institute, International Centre for Life, Newcastle University (F.B.), Newcastle upon Tyne, United Kingdom
| | - Kristian Brock
- Cancer Research UK Clinical Trials Unit, University of Birmingham (K.B.), Birmingham, United Kingdom
| | - Catarina João
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Houbin Huang
- Hainan Hospital of the General Hospital of Chinese People's Liberation Army (H.H.), Sanya, China
| | - Magella M Neveu
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Choi Mun Chan
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Holly J Duncan
- Newcastle Eye Centre, Royal Victoria Infirmary (H.J.D.), Newcastle upon Tyne, United Kingdom
| | - Simon Kelly
- Bolton NHS Foundation Trust (S.K., F.K., Y.T.L.), Bolton, United Kingdom
| | - Emma Burkitt-Wright
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust (E.B.-W.), Manchester, United Kingdom; Division of Evolution and Genomic Sciences, University of Manchester, Manchester Academic Health Sciences Centre (E.B.-W.), Manchester, United Kingdom
| | - Fadil Khoyratty
- Bolton NHS Foundation Trust (S.K., F.K., Y.T.L.), Bolton, United Kingdom
| | - Yoon Tse Lai
- Bolton NHS Foundation Trust (S.K., F.K., Y.T.L.), Bolton, United Kingdom
| | - Mala Subash
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Patrick F Chinnery
- MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge (P.F.C.), Cambridge, United Kingdom
| | | | - Gavin Arno
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Andrew R Webster
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Anthony T Moore
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom; Department of Ophthalmology, UCSF School of Medicine (A.T.M.), San Francisco, California, USA
| | - Michel Michaelides
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Andrew Stockman
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Anthony G Robson
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom
| | - Patrick Yu-Wai-Man
- From the UCL Institute of Ophthalmology (A.M., N.J., C.J., M.M.N., C.M.C., M.S., G.A., A.R.W., A.T.M., M.M., A.S., A.G.R., P.Y.-W.-M.), London, United Kingdom; Moorfields Eye Hospital (A.M., N.J., M.M.N., C.M.C., G.A., A.R.W., A.T.M., M.M., A.G.R., P.Y.-W.-M.), London, United Kingdom; John van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge (P.Y.-W.-M.), Cambridge, United Kingdom; and Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals (P.Y.-W.-M.), Cambridge, United Kingdom
| |
Collapse
|
21
|
Merad M, Vérité F, Baudin F, Ghezala IB, Meillon C, Bron AM, Arnould L, Eid P, Creuzot-Garcher C, Gabrielle PH. Cystoid Macular Edema after Rhegmatogenous Retinal Detachment Repair with Pars Plana Vitrectomy: Rate, Risk Factors, and Outcomes. J Clin Med 2022; 11:jcm11164914. [PMID: 36013153 PMCID: PMC9410086 DOI: 10.3390/jcm11164914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 11/26/2022] Open
Abstract
(1) Background: The aim was to describe the rate and outcomes of cystoid macular edema (CME) after pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD) and to identify risk factors and imaging characteristics. (2) Methods: A retrospective consecutive case study was conducted over a 5-year period among adult patients who underwent PPV for primary RRD repair. The main outcome measure was the rate of CME at 12 months following PPV. (3) Results: Overall, 493 eyes were included. The CME rate was 28% (93 patients) at 12 months. In multivariate analysis, eyes with worse presenting visual acuity (VA) (odds ratio [OR], 1.55; 95% CI, 1.07–2.25; p = 0.02) and grade C proliferative vitreoretinopathy (PVR) (OR, 2.88; 95% CI, 1.04–8.16; p = 0.04) were more at risk of developing CME 1 year after PPV. Endolaser retinopexy was associated with a greater risk of CME than cryotherapy retinopexy (OR, 3.06; 95% CI, 1.33–7.84; p = 0.01). Eyes undergoing cataract surgery within 6 months of the initial RRD repair were more likely to develop CME at 12 months (OR, 1.96; 95% CI, 1.06–3.63; p = 0.03). (4) Conclusions: CME is a common complication after PPV for primary RRD repair. Eyes with worse presenting VA, severe PVR at initial presentation, endolaser retinopexy, and cataract surgery within 6 months of initial RRD repair were risk factors for postoperative CME at 12 months.
Collapse
Affiliation(s)
- Malik Merad
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Fabien Vérité
- Agathe Group INSERM U 1150, UMR 7222 CNRS, ISIR (Institute of Intelligent Systems and Robotics), Sorbonne Université, 75005 Paris, France
| | - Florian Baudin
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Inès Ben Ghezala
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Cyril Meillon
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Alain Marie Bron
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
- Eye and Nutrition Research Group, Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, 21000 Dijon, France
| | - Louis Arnould
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Pétra Eid
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
| | - Catherine Creuzot-Garcher
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
- Eye and Nutrition Research Group, Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, 21000 Dijon, France
| | - Pierre-Henry Gabrielle
- Department of Ophthalmology, Dijon University Hospital, 21000 Dijon, France
- Eye and Nutrition Research Group, Centre des Sciences du Goût et de l’Alimentation, AgroSup Dijon, CNRS, INRAE, Université de Bourgogne Franche-Comté, 21000 Dijon, France
- Correspondence: ; Tel.: +33-380-293-031
| |
Collapse
|
22
|
Non-vasogenic cystoid maculopathies. Prog Retin Eye Res 2022; 91:101092. [PMID: 35927124 DOI: 10.1016/j.preteyeres.2022.101092] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022]
Abstract
Besides cystoid macular edema due to a blood-retinal barrier breakdown, another type of macular cystoid spaces referred to as non-vasogenic cystoid maculopathies (NVCM) may be detected on optical coherence tomography but not on fluorescein angiography. Various causes may disrupt retinal cell cohesion or impair retinal pigment epithelium (RPE) and Müller cell functions in the maintenance of retinal dehydration, resulting in cystoid spaces formation. Tractional causes include vitreomacular traction, epiretinal membranes and myopic foveoschisis. Surgical treatment does not always allow cystoid space resorption. In inherited retinal dystrophies, cystoid spaces may be part of the disease as in X-linked retinoschisis or enhanced S-cone syndrome, or occur occasionally as in bestrophinopathies, retinitis pigmentosa and allied diseases, congenital microphthalmia, choroideremia, gyrate atrophy and Bietti crystalline dystrophy. In macular telangiectasia type 2, cystoid spaces and cavitations do not depend on the fluid leakage from telangiectasia. Various causes affecting RPE function may result in NVCM such as chronic central serous chorioretinopathy and paraneoplastic syndromes. Non-exudative age macular degeneration may also be complicated by intraretinal cystoid spaces in the absence of fluorescein leakage. In these diseases, cystoid spaces occur in a context of retinal cell loss. Various causes of optic atrophy, including open-angle glaucoma, result in microcystoid spaces in the inner nuclear layer due to a retrograde transsynaptic degeneration. Lastly, drug toxicity may also induce cystoid maculopathy. Identifying NVCM on multimodal imaging, including fluorescein angiography if needed, allows guiding the diagnosis of the causative disease and choosing adequate treatment when available.
Collapse
|
23
|
Tang W, Ye Y, Chen X, Shi F, Xiang D, Chen Z, Zhu W. Multi-class retinal fluid joint segmentation based on cascaded convolutional neural networks. Phys Med Biol 2022; 67. [DOI: 10.1088/1361-6560/ac7378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/25/2022] [Indexed: 11/12/2022]
Abstract
Abstract
Objective. Retinal fluid mainly includes intra-retinal fluid (IRF), sub-retinal fluid (SRF) and pigment epithelial detachment (PED), whose accurate segmentation in optical coherence tomography (OCT) image is of great importance to the diagnosis and treatment of the relative fundus diseases. Approach. In this paper, a novel two-stage multi-class retinal fluid joint segmentation framework based on cascaded convolutional neural networks is proposed. In the pre-segmentation stage, a U-shape encoder–decoder network is adopted to acquire the retinal mask and generate a retinal relative distance map, which can provide the spatial prior information for the next fluid segmentation. In the fluid segmentation stage, an improved context attention and fusion network based on context shrinkage encode module and multi-scale and multi-category semantic supervision module (named as ICAF-Net) is proposed to jointly segment IRF, SRF and PED. Main results. the proposed segmentation framework was evaluated on the dataset of RETOUCH challenge. The average Dice similarity coefficient, intersection over union and accuracy (Acc) reach 76.39%, 64.03% and 99.32% respectively. Significance. The proposed framework can achieve good performance in the joint segmentation of multi-class fluid in retinal OCT images and outperforms some state-of-the-art segmentation networks.
Collapse
|
24
|
Microvascular changes in the recurrent cystoid macular edema secondary to posterior noninfectious uveitis on optical coherence tomography angiography. Int Ophthalmol 2022; 42:3285-3293. [PMID: 35598227 PMCID: PMC9587930 DOI: 10.1007/s10792-022-02327-0] [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: 08/06/2021] [Accepted: 04/18/2022] [Indexed: 12/03/2022]
Abstract
Background Posterior uveitis represents the second most frequent type of uveitis (15–30% of all uveitis). Noninfectious posterior uveitis complicated with secondary cystoid macular edema (CME) affects the visual prognosis negatively. The objective of the current study is to detect possible microvascular changes causing relapsing uveitis-related CME using optical coherence tomography angiography (OCTA). Methods This is an interventional, observational, retrospective study with 1 year follow-up. Patients with noninfectious, posterior uveitis-related CME undergoing dexamethasone (DEX) implant were evaluated. Following the DEX-implant were carried out control visits after 1 month, 2-months, 4-months, 6-months, and for up 1-year. A total of 76 eyes of 38 consecutive patients with noninfectious posterior uveitis were enrolled (consecutive sample). Complicated noninfectious posterior uveitis with secondary CME was diagnosed in 56 eyes of uveitis patients (73.7%) and reviewed. Results Our investigation showed (1) a reduction in superficial vessel plexus (SVP) measurements within 2-month (84%), reaching 96.4% for up 1-year, (2) an irregular profile of SVP in 69.6% of cases, persisting for up 1-year; relapsing uveitis-related CME eyes with irregular superficial foveal avascular zone (FAZ) profile were in 51%, while the SVP measurements reestablished in 100% of cases. Conversely, (3) the deep vascular plexus (DVP) parameters restored in a lower number of eyes within the 2-month (39.3%), remaining abnormal in 46.4% of cases for up 1-year; despite DVP restored in 53.6% of cases for up 1 year, (4) a capillary rarefaction ring around the FAZ appeared in 80.4% of cases; the relapsing uveitis-related CME eyes with abnormal DVP parameters were present in 41% of cases, of which 92.1% showed a rarefaction ring had abnormal DVP. Conclusions The use of OCTA enabled the evaluation in detail of retinal microvascular changes. We suggested that the possibility of the recurrence of the uveitis-related CME depends on the persistence of modifications of the superficial and deep layers. In this regard, we propose to implement the current imaging armamentarium with OCTA for the follow-up of patients with noninfectious uveitis-related CME.
Collapse
|
25
|
Ohashi K, Hayashi T, Utsunomiya K, Nishimura R. The Mineralocorticoid receptor signal could be a new molecular target for the treatment of diabetic retinal complication. Expert Opin Ther Targets 2022; 26:479-486. [PMID: 35487592 DOI: 10.1080/14728222.2022.2072730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Activation of the mineralocorticoid receptor (MR) is involved in the pathophysiology of diabetic vascular complications. In recent years, it has been indicated that the MR expressed in retinal Müller cells plays an important role in regulating the potassium and water balance in the retina. Therefore, it has also been speculated that abnormal MR signaling contributes to edematous diseases of the retina. RESEARCH DESIGN AND METHODS We examined the effect of high-glucose conditions on MR protein and mRNA levels in human retinal Müller cells and changes in cell size in vitro. We also investigated MR transcriptional activity and signaling in high-glucose conditions. RESULTS The MR protein increased by 2.2-fold with high-glucose treatment. Additionally, high-glucose treatment induced Müller cell swelling. Aldosterone-induced MR transcriptional activity was enhanced in high-glucose conditions, resulting in the upregulation of αENaC, AQP4 and Kir4.1 mRNA. Treatment with an MR antagonist led to the suppression of aldosterone-induced cell swelling, MR transcriptional activity and upregulation of the target genes in high-glucose conditions. CONCLUSIONS High glucose induces Müller cell swelling through activation of MR signaling, which could be associated with aggravation of macular edema. Thus, Müller cell swelling and diabetic macular edema may represent a target for treatment with MR antagonists.
Collapse
Affiliation(s)
- Kennosuke Ohashi
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine
| | - Takeshi Hayashi
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine
| | | | - Rimei Nishimura
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine
| |
Collapse
|
26
|
Thiel WA, Blume ZI, Mitchell DM. Compensatory engulfment and Müller glia reactivity in the absence of microglia. Glia 2022; 70:1402-1425. [PMID: 35451181 DOI: 10.1002/glia.24182] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 01/25/2023]
Abstract
Microglia are known for important phagocytic functions in the vertebrate retina. Reports also suggest that Müller glia have phagocytic capacity, though the relative levels and contexts in which this occurs remain to be thoroughly examined. Here, we investigate Müller glial engulfment of dying cells in the developing zebrafish retina in the presence and absence of microglia, using a genetic mutant in which microglia do not develop. We show that in normal conditions clearance of dying cells is dominated by microglia; however, Müller glia do have a limited clearance role. In retinas lacking intact microglial populations, we found a striking increase in the engulfment load assumed by the Müller glia, which displayed prominent cellular compartments containing apoptotic cells, several of which localized with the early phagosome/endosome marker Rab5. Consistent with increased engulfment, lysosomal staining was also increased in Müller glia in the absence of microglia. Increased engulfment load led to evidence of Müller glia reactivity including upregulation of gfap but did not trigger cell cycle re-entry by differentiated Müller glia. Our work provides important insight into the phagocytic capacity of Müller glia and the ability for compensatory functions and downstream effects. Therefore, effects of microglial deficiency or depletion on other glial cell types should be well-considered in experimental manipulations, in neurodegenerative disease, and in therapeutic approaches that target microglia. Our findings further justify future work to understand differential mechanisms and contexts of phagocytosis by glial cells in the central nervous system, and the significance of these mechanisms in health and disease.
Collapse
Affiliation(s)
- Whitney A Thiel
- Department of Biological Sciences, University of Idaho, Moscow, Idaho, USA
| | - Zachary I Blume
- Department of Biological Sciences, University of Idaho, Moscow, Idaho, USA
| | - Diana M Mitchell
- Department of Biological Sciences, University of Idaho, Moscow, Idaho, USA
| |
Collapse
|
27
|
Understanding Neurodegeneration from a Clinical and Therapeutic Perspective in Early Diabetic Retinopathy. Nutrients 2022; 14:nu14040792. [PMID: 35215442 PMCID: PMC8877033 DOI: 10.3390/nu14040792] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 02/05/2023] Open
Abstract
Recent evidence indicates that neurodegeneration is a critical element of diabetic retinopathy (DR) pathogenesis. The neuronal cells’ apoptosis contributes to microvascular impairment and blood–retinal barrier breakdown. Therefore, neurodegeneration represents an early intervention target to slow and prevent the development of microvascular alterations visible on clinical examination. Multimodal imaging features and functional assessment can permit the identification of neuronal damage in a subclinical stage before the recognition of DR signs. Clinical features of neurodegeneration are crucial in identifying patients at high risk of developing a vascular impairment and, thus, serve as outcome measures to understand the efficacy of supplementation. The optimal approach for targeting neurodegeneration contemplates the use of topical compounds that possibly act on different elements of the pathogenic cascade. To date, clinical trials available on humans tested three different topical agents, including brimonidine, somatostatin, and citicoline, with promising results.
Collapse
|
28
|
Missaka RFBG, Goldbaum M, Machado CG, Cunningham ET, Souto FMS, Lavezzo MM, da Nóbrega PFC, Sakata VM, Oyamada MK, Hirata CE, Yamamoto JH. Fingerprint sign in Vogt-Koyanagi-Harada disease: a case series. Int J Retina Vitreous 2022; 8:7. [PMID: 35012686 PMCID: PMC8751277 DOI: 10.1186/s40942-021-00356-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The tomographic finding, which has been called the "fingerprint sign" in en face reconstructions, seems to be the result of a variety of processes that cause distension of the outer plexiform layer (OPL) and the Henle fiber layer (HFL). The aim of this paper is to describe the appearance of concentric rings at the OPL/HFL interface visualized using en face reconstructions of cross-sectional optical coherence tomography images of patients with Vogt-Koyanagi-Harada disease. METHODS Retrospective analysis of images of six eyes of three patients obtained by cross-sectional OCT imaging and en face reconstruction at the level of the OPL/HFL interface. RESULTS All eyes presented with a dentate or saw-tooth pattern of the OPL/HFL interface on cross-sectional OCT with corresponding concentric rings on en face OCT reconstruction, consistent with the recently published "fingerprint sign". Initial OPL/HFL interface changes were observed between the first and fourth months after treatment and resolution of VKHD associated serous retinal detachments. These OPL/HFL interface changes have persisted for many years following the resolution of the active inflammation. CONCLUSIONS Changes in the OPL/HFL interface can be identified following successful treatment of VKHD. These included both a dentate or saw-tooth pattern on cross-sectional imaging and concentric rings or the "fingerprint sign" on en face reconstructions. These changes persisted for many years despite disease quiescence.
Collapse
Affiliation(s)
- Ruy Felippe Brito Gonçalves Missaka
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil. .,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil.
| | - Mauro Goldbaum
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil
| | - Cleide Guimarães Machado
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil
| | - Emmett T Cunningham
- West Coast Medical Group, San Francisco, CA, USA.,Department of Ophthalmology, California Pacifical Medical Center, San Francisco, CA, USA.,Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.,The Francis I Proctor Foundation, UCSF School of Medicine, San Francisco, CA, USA
| | - Fernanda Maria Silveira Souto
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| | - Marcelo Mendes Lavezzo
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| | - Priscilla Figueiredo Campos da Nóbrega
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| | - Viviane Mayumi Sakata
- Department of Ophthalmology, Federal University of Paraná, Curitiba, PR, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| | - Maria Kiyoko Oyamada
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| | - Carlos Eduardo Hirata
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| | - Joyce Hisae Yamamoto
- Department of Ophthalmology, LIM-33, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, 01246-000, Brazil.,Brazilian Vogt-Koyanagi-Harada Disease Study Group, São Paulo, SP, Brazil
| |
Collapse
|
29
|
Colman K, Andrews RN, Atkins H, Boulineau T, Bradley A, Braendli-Baiocco A, Capobianco R, Caudell D, Cline M, Doi T, Ernst R, van Esch E, Everitt J, Fant P, Gruebbel MM, Mecklenburg L, Miller AD, Nikula KJ, Satake S, Schwartz J, Sharma A, Shimoi A, Sobry C, Taylor I, Vemireddi V, Vidal J, Wood C, Vahle JL. International Harmonization of Nomenclature and Diagnostic Criteria (INHAND): Non-proliferative and Proliferative Lesions of the Non-human Primate ( M. fascicularis). J Toxicol Pathol 2021; 34:1S-182S. [PMID: 34712008 PMCID: PMC8544165 DOI: 10.1293/tox.34.1s] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for
Lesions Project (www.toxpath.org/inhand.asp) is a joint initiative of the Societies of
Toxicologic Pathology from Europe (ESTP), Great Britain (BSTP), Japan (JSTP) and North
America (STP) to develop an internationally accepted nomenclature for proliferative and
nonproliferative lesions in laboratory animals. The purpose of this publication is to
provide a standardized nomenclature for classifying microscopic lesions observed in most
tissues and organs from the nonhuman primate used in nonclinical safety studies. Some of
the lesions are illustrated by color photomicrographs. The standardized nomenclature
presented in this document is also available electronically on the internet
(http://www.goreni.org/). Sources of material included histopathology databases from
government, academia, and industrial laboratories throughout the world. Content includes
spontaneous lesions as well as lesions induced by exposure to test materials. Relevant
infectious and parasitic lesions are included as well. A widely accepted and utilized
international harmonization of nomenclature for lesions in laboratory animals will provide
a common language among regulatory and scientific research organizations in different
countries and increase and enrich international exchanges of information among
toxicologists and pathologists.
Collapse
Affiliation(s)
- Karyn Colman
- Novartis Institutes for BioMedical Research, Cambridge, MA, USA
| | - Rachel N Andrews
- Wake Forest School of Medicine, Department of Radiation Oncology, Winston-Salem, NC, USA
| | - Hannah Atkins
- Penn State College of Medicine, Department of Comparative Medicine, Hershey, PA, USA
| | | | - Alys Bradley
- Charles River Laboratories Edinburgh Ltd., Tranent, Scotland, UK
| | - Annamaria Braendli-Baiocco
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, Switzerland
| | - Raffaella Capobianco
- Janssen Research & Development, a Division of Janssen Pharmaceutica NV, Beerse, Belgium
| | - David Caudell
- Department of Pathology, Section on Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mark Cline
- Department of Pathology, Section on Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Takuya Doi
- LSIM Safety Institute Corporation, Ibaraki, Japan
| | | | | | - Jeffrey Everitt
- Department of Pathology, Duke University School of Medicine, Durham, NC, USA
| | | | | | | | - Andew D Miller
- Cornell University College of Veterinary Medicine, Ithaca, NY, USA
| | | | - Shigeru Satake
- Shin Nippon Biomedical Laboratories, Ltd., Kagoshima and Tokyo, Japan
| | | | - Alok Sharma
- Covance Laboratories, Inc., Madison, WI, USA
| | | | | | | | | | | | - Charles Wood
- Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA
| | - John L Vahle
- Lilly Research Laboratories, Indianapolis IN, USA
| |
Collapse
|
30
|
Sirés A, Turch-Anguera M, Bogdanov P, Sampedro J, Ramos H, Ruíz Lasa A, Huo J, Xu S, Lam KP, López-Soriano J, Pérez-García MJ, Hernández C, Simó R, Solé M, Comella JX. Faim knockout leads to gliosis and late-onset neurodegeneration of photoreceptors in the mouse retina. J Neurosci Res 2021; 99:3103-3120. [PMID: 34713467 DOI: 10.1002/jnr.24978] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/13/2021] [Accepted: 09/21/2021] [Indexed: 01/08/2023]
Abstract
Fas Apoptotic Inhibitory Molecule protein (FAIM) is a death receptor antagonist and an apoptosis regulator. It encodes two isoforms, namely FAIM-S (short) and FAIM-L (long), both with significant neuronal functions. FAIM-S, which is ubiquitously expressed, is involved in neurite outgrowth. In contrast, FAIM-L is expressed only in neurons and it protects them from cell death. Interestingly, FAIM-L is downregulated in patients and mouse models of Alzheimer's disease before the onset of neurodegeneration, and Faim transcript levels are decreased in mouse models of retinal degeneration. However, few studies have addressed the role of FAIM in the central nervous system, yet alone the retina. The retina is a highly specialized tissue, and its degeneration has proved to precede pathological mechanisms of neurodegenerative diseases. Here we describe that Faim depletion in mice damages the retina persistently and leads to late-onset photoreceptor death in older mice. Immunohistochemical analyses showed that Faim knockout (Faim-/- ) mice present ubiquitinated aggregates throughout the retina from early ages. Moreover, retinal cells released stress signals that can signal to Müller cells, as shown by immunofluorescence and qRT-PCR. Müller cells monitor retinal homeostasis and trigger a gliotic response in Faim-/- mice that becomes pathogenic when sustained. In this regard, we observed pronounced vascular leakage at later ages, which may be caused by persistent inflammation. These results suggest that FAIM is an important player in the maintenance of retinal homeostasis, and they support the premise that FAIM is a plausible early marker for late photoreceptor and neuronal degeneration.
Collapse
Affiliation(s)
- Anna Sirés
- Cell Signaling and Apoptosis Group, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), ISCIII, Madrid, Spain.,Departament de Bioquímica i Biologia Molecular, Facultat de Medicina, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Mireia Turch-Anguera
- Cell Signaling and Apoptosis Group, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.,Departament de Bioquímica i Biologia Molecular, Facultat de Medicina, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain.,Diabetes and Metabolism Research Unit, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - Patricia Bogdanov
- Diabetes and Metabolism Research Unit, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - Joel Sampedro
- Diabetes and Metabolism Research Unit, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - Hugo Ramos
- Diabetes and Metabolism Research Unit, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - Agustín Ruíz Lasa
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), ISCIII, Madrid, Spain.,Research Center and Memory Clinic. Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Jianxin Huo
- Singapore Immunology Network (SIgN), A*STAR (Agency for Science, Technology and Research), Singapore, Singapore
| | - Shengli Xu
- Singapore Immunology Network (SIgN), A*STAR (Agency for Science, Technology and Research), Singapore, Singapore
| | - Kong-Peng Lam
- Singapore Immunology Network (SIgN), A*STAR (Agency for Science, Technology and Research), Singapore, Singapore
| | - Joaquín López-Soriano
- Cell Signaling and Apoptosis Group, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), ISCIII, Madrid, Spain.,Departament de Bioquímica i Biologia Molecular, Facultat de Medicina, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - M Jose Pérez-García
- Cell Signaling and Apoptosis Group, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), ISCIII, Madrid, Spain
| | - Cristina Hernández
- Diabetes and Metabolism Research Unit, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - Rafael Simó
- Diabetes and Metabolism Research Unit, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), ISCIII, Madrid, Spain
| | - Montse Solé
- Cell Signaling and Apoptosis Group, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), ISCIII, Madrid, Spain.,Departament de Bioquímica i Biologia Molecular, Facultat de Medicina, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| | - Joan X Comella
- Cell Signaling and Apoptosis Group, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), ISCIII, Madrid, Spain.,Departament de Bioquímica i Biologia Molecular, Facultat de Medicina, Universitat Autònoma de Barcelona (UAB), Bellaterra, Spain
| |
Collapse
|
31
|
CLINICAL CHARACTERISTICS AND OUTCOME OF POSTERIOR CYSTOID MACULAR DEGENERATION IN CHRONIC CENTRAL SEROUS CHORIORETINOPATHY. Retina 2021; 40:1742-1750. [PMID: 31815880 PMCID: PMC7447130 DOI: 10.1097/iae.0000000000002683] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Supplemental Digital Content is Available in the Text. Posterior cystoid retinal degeneration in chronic central serous chorioretinopathy is often accompanied by active subretinal fluid leakage and associated diffuse atrophic retinal pigment epithelium alterations. Treatment results in posterior cystoid retinal degeneration resolution in less than half of the cases, and final visual outcome remains poor even after posterior cystoid retinal degeneration resolution. A degenerative process may underlie posterior cystoid retinal degeneration development, causing retinal tissue loss, and irreversible vision loss. Purpose: To assess clinical characteristics and visual outcome in chronic central serous chorioretinopathy patients with posterior cystoid retinal degeneration (PCRD). Methods: Patients' medical records were reviewed retrospectively in 62 cases (83 eyes, mean age = 59 years, 88% male). Data were collected at central serous chorioretinopathy diagnosis, at PCRD manifestation, and at final visit. All treatment modalities were reviewed. Main outcome measures were treatment efficacy in achieving PCRD resolution, and final best-corrected visual acuity. Results: In 63 eyes (76%), subretinal fluid was present at first PCRD manifestation, whereas fluorescein angiography showed active focal or diffuse leakage in 65 eyes (78%). Seventy-six eyes (81%) received treatment, and PCRD had resolved completely in 31 eyes (37%) at the final visit. Photodynamic therapy was most successful in achieving a complete PCRD resolution. Best-corrected visual acuity did not improve, even after complete PCRD resolution (mean baseline best corrected visual acuity = 69 ± 19, and mean final best corrected visual acuity = 67 ± 20 ETDRS letters [20/40 and 20/50 in Snellen equivalent respectively], P = 0.354). Conclusion: Posterior cystoid retinal degeneration is a relatively common finding in chronic central serous chorioretinopathy, which is often accompanied by active subretinal fluid leakage. Treatment may be beneficial to stop the subretinal fluid leakage component, but is less likely to result in a complete PCRD resolution and/or a best-corrected visual acuity improvement.
Collapse
|
32
|
Bringmann A, Karol M, Unterlauft JD, Barth T, Wiedemann R, Kohen L, Rehak M, Wiedemann P. Foveal regeneration after resolution of cystoid macular edema without and with internal limiting membrane detachment: presumed role of glial cells for foveal structure stabilization. Int J Ophthalmol 2021; 14:818-833. [PMID: 34150536 DOI: 10.18240/ijo.2021.06.06] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 03/29/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To document with spectral-domain optical coherence tomography the morphological regeneration of the fovea after resolution of cystoid macular edema (CME) without and with internal limiting membrane (ILM) detachment and to discuss the presumed role of the glial scaffold for foveal structure stabilization. METHODS A retrospective case series of 38 eyes of 35 patients is described. Of these, 17 eyes of 16 patients displayed foveal regeneration after resolution of CME, and 6 eyes of 6 patients displayed CME with ILM detachment. Eleven eyes of 9 patients displayed other kinds of foveal and retinal disorders associated with ILM detachment. RESULTS The pattern of edematous cyst distribution, with or without a large cyst in the foveola and preferred location of cysts in the inner nuclear layer or Henle fiber layer (HFL), may vary between different eyes with CME or in one eye during different CME episodes. Large cysts in the foveola may be associated with a tractional elevation of the inner foveal layers and the formation of a foveoschisis in the HFL. Edematous cysts are usually not formed in the ganglion cell layer. Eyes with CME and ILM detachment display a schisis between the detached ILM and nerve fiber layer (NFL) which is traversed by Müller cell trunks. ILM detachment was also found in single eyes with myopic traction maculopathy, macular pucker, full-thickness macular holes, outer lamellar holes, and glaucomatous parapapillary retinoschisis, and in 3 eyes with Müller cell sheen dystrophy (MCSD). As observed in eyes with MCSD, cellophane maculopathy, and macular pucker, respectively, fundus light reflections can be caused by different highly reflective membranes or layers: the thickened and tightened ILM which may or may not be detached from the NFL, the NFL, or idiopathic epiretinal membranes. In eyes with short single or multiple CME episodes, the central fovea regenerated either completely, which included the disappearance of irregularities of the photoreceptor layer lines and the reformation of a fovea externa, or with remaining irregularities of the photoreceptor layer lines. CONCLUSION The examples of a complete regeneration of the foveal morphology after transient CME show that the fovea may withstand even large tractional deformations and has a conspicuous capacity of structural regeneration as long as no cell degeneration occurs. It is suggested that the regenerative capacity depends on the integrity of the threedimensional glial scaffold for foveal structure stabilization composed of Müller cell and astrocyte processes. The glial scaffold may also maintain the retinal structure after loss of most retinal neurons as in late-stage MCSD.
Collapse
Affiliation(s)
- Andreas Bringmann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany
| | | | - Jan Darius Unterlauft
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany
| | - Thomas Barth
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany
| | - Renate Wiedemann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany
| | - Leon Kohen
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany.,Helios Klinikum Aue, Aue 08280, Germany
| | - Matus Rehak
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany
| | - Peter Wiedemann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany
| |
Collapse
|
33
|
Bringmann A, Unterlauft JD, Barth T, Wiedemann R, Rehak M, Wiedemann P. Müller cells and astrocytes in tractional macular disorders. Prog Retin Eye Res 2021; 86:100977. [PMID: 34102317 DOI: 10.1016/j.preteyeres.2021.100977] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 02/04/2023]
Abstract
Tractional deformations of the fovea mainly arise from an anomalous posterior vitreous detachment and contraction of epiretinal membranes, and also occur in eyes with cystoid macular edema or high myopia. Traction to the fovea may cause partial- and full-thickness macular defects. Partial-thickness defects are foveal pseudocysts, macular pseudoholes, and tractional, degenerative, and outer lamellar holes. The morphology of the foveal defects can be partly explained by the shape of Müller cells and the location of tissue layer interfaces of low mechanical stability. Because Müller cells and astrocytes provide the structural scaffold of the fovea, they are active players in mediating tractional alterations of the fovea, in protecting the fovea from such alterations, and in the regeneration of the foveal structure. Tractional and degenerative lamellar holes are characterized by a disruption of the Müller cell cone in the foveola. After detachment or disruption of the cone, Müller cells of the foveal walls support the structural stability of the foveal center. After tractional elevation of the inner layers of the foveal walls, possibly resulting in foveoschisis, Müller cells transmit tractional forces from the inner to the outer retina leading to central photoreceptor layer defects and a detachment of the neuroretina from the retinal pigment epithelium. This mechanism plays a role in the widening of outer lameller and full-thickness macular holes, and contributes to visual impairment in eyes with macular disorders caused by conractile epiretinal membranes. Müller cells of the foveal walls may seal holes in the outer fovea and mediate the regeneration of the fovea after closure of full-thickness holes. The latter is mediated by the formation of temporary glial scars whereas persistent glial scars impede regular foveal regeneration. Further research is required to improve our understanding of the roles of glial cells in the pathogenesis and healing of tractional macular disorders.
Collapse
Affiliation(s)
- Andreas Bringmann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, 04103, Leipzig, Germany.
| | - Jan Darius Unterlauft
- Department of Ophthalmology and Eye Hospital, University of Leipzig, 04103, Leipzig, Germany
| | - Thomas Barth
- Department of Ophthalmology and Eye Hospital, University of Leipzig, 04103, Leipzig, Germany
| | - Renate Wiedemann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, 04103, Leipzig, Germany
| | - Matus Rehak
- Department of Ophthalmology and Eye Hospital, University of Leipzig, 04103, Leipzig, Germany
| | - Peter Wiedemann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, 04103, Leipzig, Germany
| |
Collapse
|
34
|
Koc F, Güven YZ, Egrilmez D, Aydın E. Optical Coherence Tomography Biomarkers in Bilateral Diabetic Macular Edema Patients with Asymmetric anti-VEGF Response. Semin Ophthalmol 2021; 36:444-451. [PMID: 33780313 DOI: 10.1080/08820538.2021.1907423] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: This study aimed to identify optical coherence tomography (OCT) biomarkers for predicting response to anti-VEGF treatment in diabetic macular edema (DME)Methods: Bilateral DME patients with asymmetric response to a loading dose of anti-VEGF (ranibizumab/aflibercept) treatment were retrospectively studied. The morphologic response criterion was central subfield thickness (CST) ≤300 µm; asymmetric response was defined as ≥10% difference in CST reduction between the eyes. The functional response criterion was an increase in logMAR acuity of ≥3 lines, with an increase below this threshold in the fellow eye considered asymmetric response. Relationships between final morphologic and functional responses to anti-VEGF therapy and baseline values of the following OCT-derived biomarkers were evaluated: DME subtype, CST, vitreoretinal interface anomalies, disorganization of the inner retinal layers (DRIL), external limiting membrane (ELM) disruption, ellipsoid zone (EZ) disruption, and subretinal fluid (SRF).Results: After a loading dose of anti-VEGF, 31 eyes that met both morphologic and functional response criteria were classified as responders (RR) and 27 eyes that did not respond morphologically or functionally based on the defined criteria were classified as resistant (RT). Eyes that showed only functional (n = 5) or morphological response (n = 1) were excluded due to their small number. The presence of SRF or simple epiretinal membrane (ERM) was not associated with any difference in treatment responses (p > .05), while tractional ERM, extensive DRIL (≥500 µm), and ELM and EZ disruptions in the fovea-centered 1000-µm zone were important OCT biomarkers in predicting resistance (p < .001). A multilayer perceptron model ranked predictive power as 100% for ELM disruption, 51.7% for tractional ERM, 25.4% for DRIL, and 24.5% for EZ disruption.Conclusion: Extensive ELM disruption was the strongest OCT biomarker to predict anti-VEGF resistance, followed by tractional ERM. EZ disruption and DRIL had relatively lower predictive value.
Collapse
Affiliation(s)
- Feray Koc
- Medicine, Department of Ophthalmology, Izmir Katip Celebi University, Izmir, Turkey
| | - Yusuf Ziya Güven
- Medicine, Department of Ophthalmology, Izmir Katip Celebi University, Izmir, Turkey
| | - Deniz Egrilmez
- Department of Ophthalmology, Ataturk Education and Research HospitalEye Clinic, Izmir, Turkey
| | - Erdinç Aydın
- Medicine, Department of Ophthalmology, Izmir Katip Celebi University, Izmir, Turkey
| |
Collapse
|
35
|
Cell Surface Profiling of Retinal Müller Glial Cells Reveals Association to Immune Pathways after LPS Stimulation. Cells 2021; 10:cells10030711. [PMID: 33806940 PMCID: PMC8004686 DOI: 10.3390/cells10030711] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 12/19/2022] Open
Abstract
Retinal Müller glial cells (RMG) are involved in virtually every retinal disease; however, the role of these glial cells in neuroinflammation is still poorly understood. Since cell surface proteins play a decisive role in immune system signaling pathways, this study aimed at characterizing the changes of the cell surface proteome of RMG after incubation with prototype immune system stimulant lipopolysaccharide (LPS). While mass spectrometric analysis of the human Müller glia cell line MIO-M1 revealed 507 cell surface proteins in total, with 18 proteins significantly more abundant after stimulation (ratio ≥ 2), the surfaceome of primary RMG comprised 1425 proteins, among them 79 proteins with significantly higher abundance in the stimulated state. Pathway analysis revealed notable association with immune system pathways such as “antigen presentation”, “immunoregulatory interactions between a lymphoid and a non-lymphoid cell” and “cell migration”. We could demonstrate a higher abundance of proteins that are usually ascribed to antigen-presenting cells (APCs) and function to interact with T-cells, suggesting that activated RMG might act as atypical APCs in the course of ocular neuroinflammation. Our data provide a detailed description of the unstimulated and stimulated RMG surfaceome and offer fundamental insights regarding the capacity of RMG to actively participate in neuroinflammation in the retina.
Collapse
|
36
|
Redmon SN, Yarishkin O, Lakk M, Jo A, Mustafić E, Tvrdik P, Križaj D. TRPV4 channels mediate the mechanoresponse in retinal microglia. Glia 2021; 69:1563-1582. [PMID: 33624376 PMCID: PMC8989051 DOI: 10.1002/glia.23979] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 02/02/2021] [Accepted: 02/02/2021] [Indexed: 12/12/2022]
Abstract
The physiological and neurological correlates of plummeting brain osmolality during edema, traumatic CNS injury, and severe ischemia are compounded by neuroinflammation. Using multiple approaches, we investigated how retinal microglia respond to challenges mediated by increases in strain, osmotic gradients, and agonists of the stretch-activated cation channel TRPV4. Dissociated and intact microglia were TRPV4-immunoreactive and responded to the selective agonist GSK1016790A and substrate stretch with altered motility and elevations in intracellular calcium ([Ca2+ ]i ). Agonist- and hypotonicity-induced swelling was associated with a nonselective outwardly rectifying cation current, increased [Ca2+ ]i , and retraction of higher-order processes. The antagonist HC067047 reduced the extent of hypotonicity-induced microglial swelling and inhibited the suppressive effects of GSK1016790A and hypotonicity on microglial branching. Microglial TRPV4 signaling required intermediary activation of phospholipase A2 (PLA2), cytochrome P450, and epoxyeicosatrienoic acid production (EETs). The expression pattern of vanilloid thermoTrp genes in retinal microglia was markedly different from retinal neurons, astrocytes, and cortical microglia. These results suggest that TRPV4 represents a primary retinal microglial sensor of osmochallenges under physiological and pathological conditions. Its activation, associated with PLA2, modulates calcium signaling and cell architecture. TRPV4 inhibition might be a useful strategy to suppress microglial overactivation in the swollen and edematous CNS.
Collapse
Affiliation(s)
- Sarah N Redmon
- Department of Ophthalmology & Visual Sciences, Moran Eye Institute, Salt Lake City, Utah, USA
| | - Oleg Yarishkin
- Department of Ophthalmology & Visual Sciences, Moran Eye Institute, Salt Lake City, Utah, USA
| | - Monika Lakk
- Department of Ophthalmology & Visual Sciences, Moran Eye Institute, Salt Lake City, Utah, USA
| | - Andrew Jo
- Department of Ophthalmology & Visual Sciences, Moran Eye Institute, Salt Lake City, Utah, USA
| | - Edin Mustafić
- Department of Ophthalmology & Visual Sciences, Moran Eye Institute, Salt Lake City, Utah, USA
| | - Petr Tvrdik
- Department of Neurological Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - David Križaj
- Department of Ophthalmology & Visual Sciences, Moran Eye Institute, Salt Lake City, Utah, USA.,Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, Utah, USA.,Department of Bioengineering, University of Utah, Salt Lake City, Utah, USA.,Department of Neurobiology & Anatomy, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
37
|
Long-term full-field and multifocal electroretinographic changes after treatment with ranibizumab in patients with diabetic macular edema. Int Ophthalmol 2021; 41:1487-1501. [PMID: 33486648 DOI: 10.1007/s10792-021-01712-5] [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: 08/26/2020] [Accepted: 01/09/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate changes in macular and panretinal neuroretinal functions by electroretinographic examinations in eyes with diabetic macular edema (DME) treated with intravitreal ranibizumab. MATERIAL AND METHODS Sixty-four patients with DME were included in this prospective study. Patients were treated with ranibizumab injection according to the PRN regimen for over 12 months. Before treatment, all patients underwent fundus fluorescein angiography, optical coherence tomography (OCT), best-corrected visual acuity (BCVA) assessment, full-field (ff-ERG), and multifocal electroretinography (mf-ERG). In monthly visits, BCVA and OCT were performed. Besides, mf-ERG recordings were obtained at months 3, 6, 9, and 12, and ff-ERG was performed at month 12. RESULTS Fifty-eight patients completed the study. The mean age was 61.1 ± 8.5 (39-80) years. The mean number of injections was 6.19 ± 1.9. The decimal BCVA improved from 0.30 to 0.45 during the 12-month follow-up (p < 0.05). Macular thickness decreased from 413.5 μm to 329.5 μm (p < 0.05). The mf-ERG recordings in the central macular region showed improvements N1 and P1 amplitudes at months 9 and 12. There was a positive correlation between the baseline central (p < 001; r: - 0.378 and p < 0.05; r:-0.335, respectively), the second ring (p < 0.05; r: - 0.260 and p < 0.05; r: - 0.270, respectively) P1- and N1-wave amplitudes, and the BCVA at month 12. Full-field ERG recordings showed that peripheral neuroretinal responses were maintained or improved at month 12. Statistically significant improvements in BCVA and macular thickness were observed at all follow-up visits. CONCLUSION Multifocal electroretinographic recording started to improve 6 months after the beginning of intravitreal ranibizumab treatment in eyes with DME. This improvement was significant at months 9 and 12. A significant improvement in ff-ERG was observed at month 12.
Collapse
|
38
|
Iwase T, Tomita R, Ra E, Iwase C, Terasaki H. Investigation of causative factors for unusual shape of macula in eyes with macula-off rhegmatogenous retinal detachment. Jpn J Ophthalmol 2021; 65:363-371. [PMID: 33423136 DOI: 10.1007/s10384-020-00810-8] [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: 10/19/2020] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To determine the factors significantly associated with anterior protrusion of the macula in eyes with a macula-off rhegmatogenous retinal detachment (RRD) and to determine the relationship between the intraretinal cystoid cavities (ICCs) and the anterior protrusion and function of the fovea. STUDY DESIGN Retrospective cross-sectional study. METHODS Sixty-nine eyes of 69 patients with successfully reattached macula-off RRD were retrospectively analyzed. Six radial spectral-domain optical coherence tomographic (OCT) images were used to evaluate the effects of the ICCs on detached macula and to measure the angle of the retina at the macula as a parameter to evaluate the anterior protrusion of the detached retina. The findings were compared to other parameters. RESULTS The mean angle of the retina at the macula was 143.1 ± 15.9° with a range of 108 to 172°. Preoperatively, 51 eyes (74%) had ICCs in the inner nuclear layer and/or the outer plexiform layer and Henle fiber layer complex, but none was present after surgery. Multivariate regression analyses revealed that the angle of the retina was significantly associated with the presence of ICCs (β = -0.637, P<0.001) and the height of subretinal fluid (β = -0.256, P = 0.005). Eyes with ICCs had poorer preoperative vision (P<0.001), narrower angle of the retina (P<0.001), and thicker subretinal fluid (P<0.001) than eyes without cavities. CONCLUSIONS The anterior protrusion in eyes with macula-off RRD is associated with the presence of ICCs. The presence of ICCs can affect preoperative function and morphology but does not affect postoperative function and morphology.
Collapse
Affiliation(s)
- Takeshi Iwase
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan. .,Department of Ophthalmology, Akita University Graduate School of Medicine, 1-1-1 Hondou, Akita, Akita, 010-8543, Japan.
| | - Ryo Tomita
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eimei Ra
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chie Iwase
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
39
|
Different modes of full-thickness macular hole formation. Exp Eye Res 2020; 202:108393. [PMID: 33301774 DOI: 10.1016/j.exer.2020.108393] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/02/2020] [Accepted: 12/05/2020] [Indexed: 02/07/2023]
Abstract
Full-thickness macular holes (FTMH) are an important cause of visual deterioration. However, different modes of FTMH formation are less investigated. It is also not clear whether the development of edematous cysts contributes to FTMH formation. In this retrospective case series of 30 eyes of 30 patients, we describe using spectral-domain optical coherence tomography different modes of FTMH formation. Morphological alterations of established FTMH are shown in 5 eyes of 5 patients. We found in 2 of 30 eyes investigated that anterior hyaloidal traction induced a hyperreflectivity of the inner Müller cell layer of the foveola prior to FTMH formation. In 3 eyes, FTMH were caused by anterior hyaloidal traction which produced foveal pseudocysts that developed to an outer lamellar hole (OLH) characterized by a disruption of the central outer retina. The OLH developed to a FTMH by the disruption of the inner layer of the foveola. FTMH formation from an OLH by hyaloidal traction was observed also in further 7 eyes. In 2 eyes, the OLH, which preceded FTMH formation, was generated by a serous retinal detachment. In 3 eyes, anterior hyaloidal traction caused a detachment of the fovea from the retinal pigment epithelium (RPE); the subsequent disruption of the foveola resulted in a FTMH. Six eyes showed the development of a FTMH from a degenerative lamellar hole (DLH). In 5 eyes with macular pucker, FTMH were formed by traction of epiretinal membranes (ERM) or hyaloidal traction. Two eyes showed the development of a FTMH by anterior or tangential hyaloidal traction likely without a formation of an OLH. FTMH formation from an OLH proceeded with or without an enlargement of cystic cavities in the foveal walls. The formation of FTMH from a DLH, after a detachment of the fovea, and in macular pucker eyes was associated with a formation of cystic cavities in the foveal walls. The best-corrected visual acuity (BCVA) of eyes with an OLH or FTMH was inversely correlated to the base and minimum diameters of the holes, and with the height of the foveal walls; the highest correlation coefficients were found between the BCVA and the base diameter. The data show that FTMH may be formed via different modes by hyaloidal traction and/or traction of ERM, or after a serous retinal detachment. It is suggested that, after FTMH formation, the impaired fluid clearance through the RPE after detachment of the central outer retina causes the development of edematous cysts in the foveal walls which enlarges the FTMH. The BCVA of eyes with an OLH or FTMH mainly depends on the size of the central photoreceptor-free area.
Collapse
|
40
|
Chen Z, Yang Z, Li X, Wang H, Wang Y, Ding C, Yang J, Ni N, Mei Y, Zhang S. microRNA-320a prevent Müller cells from hypoxia injury by targeting aquaporin-4. J Cell Biochem 2020; 121:4711-4723. [PMID: 32830348 DOI: 10.1002/jcb.29524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 10/08/2019] [Indexed: 12/15/2022]
Abstract
Müller cells are closely related to diabetic retinopathy (DR). Aquaporin-4 (AQP4) can effectively promote the diffusion of water across cellular membranes. However, the dynamic balance of water plays key role in many diseases, such as cerebral edema. Meanwhile, the unusual expression and distribution of AQP4 in the retina are the significant causes of ocular hypertension and reperfusion injury. To explore the functional significance between microRNA-320a (miR-320a) and AQP4 in pathological hypoxia-induced DR related retinal edema, we hypothesized that miR-320a regulates AQP4 expression and internalization to relieve the edema of Müller cells under the pathological retinal hypoxia stress by targeting AQP4, thereby attenuate the damage of Müller cells. Results demonstrated that miR-320a mimics inhibited the expressions of AQP4 in Müller cells. Furthermore, overexpression miR-320a protected Müller cells by suppressing superoxide anion. In addition, overexpression miR-320a markedly attenuated hypoxia-induced injury, significantly increased the cell viability, and promoted the internalization of AQP4. Furthermore, miR-320a can also regulate the stable anchoring of AQP4 on the cell membrane. Our study indicated that miR-320a may be a potential modulator which can mediate AQP4 expression and attenuate the hypoxia damage of Müller cells. In conclusion, miR-320a may be a potential target for DR therapy by targeting AQP4.
Collapse
Affiliation(s)
- Zhen Chen
- Department of Ophthalmology, The First People's Hospital of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Research Center of Fundus Disease of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Kunming University of Science and Technology Affiliated Hospital, Kunming, Yunnan, China
- Medical college, Kunming University of Science and Technology, Kunming, Yunnan, China
- Department of Ophthalmology, Dali University, Dali, Yunnan, China
| | - Zhengrong Yang
- Department of Ophthalmology, The First People's Hospital of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Research Center of Fundus Disease of Yunnan, Kunming, Yunnan, China
| | - Xiaoliang Li
- Department of Ophthalmology, The First People's Hospital of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Research Center of Fundus Disease of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Kunming University of Science and Technology Affiliated Hospital, Kunming, Yunnan, China
- Medical college, Kunming University of Science and Technology, Kunming, Yunnan, China
| | - He Wang
- Department of Ophthalmology, The First People's Hospital of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Research Center of Fundus Disease of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Kunming University of Science and Technology Affiliated Hospital, Kunming, Yunnan, China
| | - Yonggang Wang
- Department of Ophthalmology, The First People's Hospital of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Research Center of Fundus Disease of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Kunming University of Science and Technology Affiliated Hospital, Kunming, Yunnan, China
| | - Chao Ding
- Department of Ophthalmology, The First People's Hospital of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Research Center of Fundus Disease of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Kunming University of Science and Technology Affiliated Hospital, Kunming, Yunnan, China
| | - JingYing Yang
- Department of Ophthalmology, The First People's Hospital of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Research Center of Fundus Disease of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Kunming University of Science and Technology Affiliated Hospital, Kunming, Yunnan, China
| | - Ninghua Ni
- Department of Ophthalmology, The First People's Hospital of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Research Center of Fundus Disease of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Kunming University of Science and Technology Affiliated Hospital, Kunming, Yunnan, China
| | - Yan Mei
- Department of Ophthalmology, The First People's Hospital of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Research Center of Fundus Disease of Yunnan, Kunming, Yunnan, China
- Department of Ophthalmology, Kunming University of Science and Technology Affiliated Hospital, Kunming, Yunnan, China
- Medical college, Kunming University of Science and Technology, Kunming, Yunnan, China
- Department of Ophthalmology, Dali University, Dali, Yunnan, China
| | - Shiwen Zhang
- Head and Neck Surgery, The Third Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| |
Collapse
|
41
|
Optical Coherence Tomography Parameters Related to Vision Impairment in Patients with Diabetic Macular Edema: A Quantitative Correlation Analysis. J Ophthalmol 2020; 2020:5639284. [PMID: 33062313 PMCID: PMC7537709 DOI: 10.1155/2020/5639284] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/10/2020] [Accepted: 07/31/2020] [Indexed: 11/20/2022] Open
Abstract
Purpose To quantitatively explore the correlation between optical coherence tomography (OCT) parameters and vision impairment in patients with diabetic macular edema (DME). Methods This study was a retrospective observational case series. One-hundred eyes from 66 patients with DME were retrospectively included. OCT parameters, including central macular thickness (CMT), height of intraretinal cystoid, subretinal fluid and sponge-like retinal swelling, density of hyperreflective foci (HRF), and integrity of the ellipsoidal zone (EZ), were assessed. Correlation analyses and multiple linear regression analysis were performed to quantitatively explore the relationship between best-corrected visual acuity (BCVA) and OCT parameters. Results Among all OCT parameters, CMT, height of intraretinal cystoid, height of sponge-like retinal swelling, and density of HRF and EZ integrity were significantly correlated with BCVA (r = −0.550, −0.526, −0.411, −0.277, and −0.501, respectively; P < 0.01). In multiple linear regression analysis, CMT, density of HRF, and EZ integrity fit a significant linear equation (β = 0.482, 0.184, and 0.447, respectively), with the adjusted R square reaching 0.522 (P < 0.001). In eyes without SRF, the height of intraretinal cystoid, density of HRF, and EZ integrity were included in the model and an adjusted R square of 0.605 (P < 0.001) was obtained. Conclusion In DME eyes, OCT parameters, including the density of HRF, the EZ integrity together with CMT, or the height of intraretinal cystoid, could explain 52.2% to 60.5% of the variation in BCVA and were weighted approximately 2 : 1 : 2, respectively.
Collapse
|
42
|
Wong BM, Chu A, Tsui I. Regression of Cystoid Macular Edema Three Weeks After Laser for Retinopathy of Prematurity. Ophthalmic Surg Lasers Imaging Retina 2020; 51:472-475. [PMID: 32818280 DOI: 10.3928/23258160-20200804-08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 07/01/2020] [Indexed: 11/20/2022]
Abstract
Cystoid macular edema (CME) has been reported in the neonatal period associated with preterm birth; however, its pathogenesis remains unclear and is likely multifactorial. The authors report the case of a preterm infant imaged using optical coherence tomography (OCT), which revealed severe CME that regressed after laser treatment. Because laser for retinopathy of prematurity aims to reduce vascular endothelial growth factor (VEGF) levels, this case considers the possibility of VEGF-mediated CME pathogenesis. Further, the authors provide additional evidence of the value of OCT for noninvasive visualization of the preterm retina; the modality provides an effective way to evaluate and monitor progression of CME. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:472-475.].
Collapse
|
43
|
Bringmann A, Duncker T, Jochmann C, Barth T, Duncker GIW, Wiedemann P. Spontaneous closure of small full-thickness macular holes: Presumed role of Müller cells. Acta Ophthalmol 2020; 98:e447-e456. [PMID: 31654489 DOI: 10.1111/aos.14289] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/03/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To document with spectral domain optical coherence tomography the formation and spontaneous closure of small full-thickness macular holes and to propose the active role of Müller cells in macular hole closure. METHODS A retrospective case series of five patients with spontaneous closure of macular holes is reviewed. In one patient, foveal images were recorded over a period of 18 months. RESULTS In a 66-year-old man, vitreofoveal traction caused a detachment of the inner Müller cell layer of the foveola from the outer nuclear layer (ONL) which was associated with a large pseudocyst and a horizontal gap in the central ONL. The traction caused an elongation and subsequent disruption of the stalk of the Müller cell cone in the foveola. A small full-thickness macular hole developed when a portion of the inner Müller cell layer of the foveola was pulled out. After phacoemulsification and shortly before the subsequent spontaneous closure of the hole, there were rapid increases in the number and size of the cystic cavities in the foveal walls resulting in a narrowing of the hole. The hole closed by bridging the gap in the inner part of the central ONL; a new inner Müller cell layer of the foveola was formed, and the gap of the external limiting membrane (ELM) was closed. The cystic cavities in the foveal walls rapidly disappeared within 2 weeks after the closure of the hole. One to 2.5 months after hole closure, the thickness of the central ONL increased which decreased the distance between the central ELM and retinal pigment epithelium. In three of the four other patients, the hole also closed by bridging the gap in the inner part of the ONL. CONCLUSION It is suggested that the spontaneous closure of small macular holes and the subsequent reconstruction of the normal foveal structure are mediated by active mechanisms of Müller cells which resemble those involved in ontogenetic foveal development.
Collapse
Affiliation(s)
- Andreas Bringmann
- Department of Ophthalmology and Eye Hospital University of Leipzig Leipzig Germany
| | | | - Claudia Jochmann
- Department of Ophthalmology and Eye Hospital University of Leipzig Leipzig Germany
| | - Thomas Barth
- Department of Ophthalmology and Eye Hospital University of Leipzig Leipzig Germany
| | | | - Peter Wiedemann
- Department of Ophthalmology and Eye Hospital University of Leipzig Leipzig Germany
| |
Collapse
|
44
|
Effects of an Aquaporin 4 Inhibitor, TGN-020, on Murine Diabetic Retina. Int J Mol Sci 2020; 21:ijms21072324. [PMID: 32230876 DOI: 10.3390/ijms21072324] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/20/2020] [Accepted: 03/26/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To investigate the effect of a selective aquaporin 4 (AQP4) inhibitor, 2-(nicotinamide)-1,3,4-thiadiazole (TGN-020), on the expression of vascular endothelial growth factor (VEGF) and reactive oxygen species (ROS) production, as well as on the retinal edema in diabetic retina. METHODS Intravitreal injections of bevacizumab, TGN-020, or phosphate-buffered saline (PBS) were performed on streptozotocin-induced diabetic rats. Retinal sections were immunostained for anti-glial fibrillary acidic protein (GFAP), anti-AQP4, and anti-VEGF. Protein levels of VEGF from collected retinas were determined by Western blot analysis. In addition, retinal vascular leakage of Evans Blue was observed in the flat-mounted retina from the diabetic rats in the presence or absence of TGN-020. Volumetric changes of rat retinal Müller cells (TR-MUL5; transgenic rat Müller cells) and intracellular levels of ROS were determined using flow cytometry analysis of ethidium fluorescence in the presence or absence of TGN-020 or bevacizumab under physiological and high glucose conditions. RESULTS In the diabetic retina, the immunoreactivity and protein levels of VEGF were suppressed by TGN-020. AQP4 immunoreactivity was higher than in the control retinas and the expressions of AQP4 were co-localized with GFAP. Similarly to VEGF, AQP4 and GFAP were also suppressed by TGN-020. In the Evans Blue assay, TGN-020 decreased leakage in the diabetic retinas. In the cultured Müller cells, the increase in cell volumes and intracellular ROS production under high glucose condition were suppressed by exposure to TGN-020 as much as by exposure to bevacizumab. CONCLUSION TGN-020 may have an inhibitory effect on diabetic retinal edema.
Collapse
|
45
|
Bringmann A, Jochmann C, Unterlauft JD, Wiedemann R, Rehak M, Wiedemann P. Different modes of foveal regeneration after closure of full-thickness macular holes by (re)vitrectomy and autologous platelet concentrate. Int J Ophthalmol 2020; 13:36-48. [PMID: 31956568 PMCID: PMC6942947 DOI: 10.18240/ijo.2020.01.06] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 12/03/2019] [Indexed: 11/23/2022] Open
Abstract
AIM To describe using spectral-domain optical coherence tomography the regeneration of the foveal morphology after pars plana (re)vitrectomy surgery and gas tamponade combined with injection of autologous platelet concentrate to treat full-thickness macular holes, and to describe different anatomical outcome. METHODS A retrospective case series of 8 eyes of 8 patients was described. RESULTS In all cases investigated, the platelet-assisted closure of macular holes was associated with a rapid resolution of cystic cavities in the foveal walls. In two patients, there was a regular regeneration of the foveal morphology after hole closure; the regenerated central fovea had a regular structure with a foveola and photoreceptors. In three other patients, there was an irregular regeneration of the fovea; a foveola was not formed, photoreceptor cells were absent from the foveal center, and the center was composed of Müller and retinal pigment epithelial (RPE) cells. The foveal regeneration after hole closure may proceed with or without a temporary detachment of the foveal center from the RPE, and with or without a direct contact between the central outer nuclear layer (ONL) and the RPE. Contacts between the ONL and RPE were observed only in patients with an irregular foveal regeneration after hole closure. CONCLUSION The data show that there are different modes of foveal regeneration after closure of macular holes with (re)vitrectomy and platelet concentrate. It is suggested that the regular regeneration of the foveal morphology proceeds by Müller cell-mediated tissue movements without cell proliferation, whereas the irregular foveal regeneration proceeds in part by proliferation of Müller and RPE cells.
Collapse
Affiliation(s)
- Andreas Bringmann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany
| | - Claudia Jochmann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany
| | - Jan Darius Unterlauft
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany
| | - Renate Wiedemann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany
| | - Matus Rehak
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany
| | - Peter Wiedemann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig 04103, Germany
| |
Collapse
|
46
|
Ahn J, Han S, Ahn SM, Kim SW, Oh J. Clinical Implications of Suspended Scattering Particles in Motion Observed by Optical Coherence Tomography Angiography. Sci Rep 2020; 10:15. [PMID: 31913306 PMCID: PMC6949280 DOI: 10.1038/s41598-019-55606-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 12/02/2019] [Indexed: 12/02/2022] Open
Abstract
The objective of this study was to investigate the relationship between suspended scattering particles in motion (SSPiM) in optical coherence tomography angiography (OCTA) and treatment response in diabetic macular edema (DME). We retrospectively reviewed the medical records of patients diagnosed with DME who had undergone intravitreal injection. The optical density ratio (ODR) of the intraretinal cyst and the numbers of hyperreflective foci from OCT images and SSPiM from OCTA images were compared, and their association with treatment response was analyzed. Forty-five eyes from 45 patients were included in this study. Twenty-four patients were treated with anti-vascular endothelial growth factor, and 21 patients were treated with a steroid. Binary logistic regression model showed that SSPiM in OCTA images was associated with hyperreflective foci numbers (P = 0.038) and mean ODR of the intraretinal cyst (P = 0.006). Linear regression model showed that SSPiM in the inner nuclear layer was related to treatment response (P = 0.006). SSPiM on OCTA images is related to the poor structural response to treatment in DME.
Collapse
Affiliation(s)
- Jaemoon Ahn
- Department of Ophthalmology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Sangheon Han
- Department of Chemistry, University of Illinois at Urbana-Champaign, Champaign, USA
| | - So Min Ahn
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seong-Woo Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea.
| | - Jaeryung Oh
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
47
|
Tsai MJ, Cheng CK, Wang YC. Association of Body Fluid Expansion With Optical Coherence Tomography Measurements in Diabetic Retinopathy and Diabetic Macular Edema. Invest Ophthalmol Vis Sci 2019; 60:3606-3612. [PMID: 31433457 DOI: 10.1167/iovs.19-27044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate associations of body fluid status with optical coherence tomography measurements in patients with diabetic retinopathy (DR). Methods This prospective, cross-sectional study enrolled a total of 104 eyes from 104 patients with diabetes mellitus for fundus evaluations of DR and optical coherence tomography examinations. DR severity was graded via fundus photography. Systemic body fluid status was recorded via a body composition monitor with output values of total body water, extracellular water (ECW), intracellular water, and overhydration (OH). Relative overhydration (ROH) was defined as OH/ECW. Volume overload was defined as ROH ≥7%. Correlations of central subfield thickness (CST) with body fluid status were analyzed by partial correlation with adjustment for age, sex, and body mass index (BMI). Logistic regression analysis was used to evaluate factors associated with diabetic macular edema (DME). Results Higher levels of ECW, OH, and ROH were correlated with thick CST in patients with DR (P = 0.006, 0.021, and 0.008, respectively), but not in those without any DR (all P > 0.05), after adjusting for age, sex, and BMI. Patients with DME (n = 31) had higher OH than DR patients without DME (n = 28) or those without any DR (n = 45) (P = 0.002 and P < 0.001, respectively). Multiple regression model showed that volume overload was the independent factor for the presence of DME (odds ratio, 9.532; 95% confidence interval, 2.898-31.348; P < 0.001). Conclusions While both ECW and OH reflect CST in patients with DR, overhydration had particularly strong associations with DME. This study provides a novel insight into our current understanding regarding the pathogenesis for DME.
Collapse
Affiliation(s)
- Meng-Ju Tsai
- Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Cheng-Kuo Cheng
- Department of Ophthalmology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Yi-Chun Wang
- Department of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan
| |
Collapse
|
48
|
Reichenbach A, Bringmann A. Glia of the human retina. Glia 2019; 68:768-796. [PMID: 31793693 DOI: 10.1002/glia.23727] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 12/22/2022]
Abstract
The human retina contains three types of glial cells: microglia and two types of macroglia, astrocytes and Müller cells. Macroglia provide homeostatic and metabolic support to photoreceptors and neurons required for neuronal activity. The fovea, the site of the sharpest vision which is astrocyte- and microglia-free, contains two populations of Müller glia: cells which form the Müller cell cone in the foveola and z-shaped Müller cells of the foveal walls. Both populations are characterized by morphological and functional differences. Müller cells of the foveola do not support the activity of photoreceptors and neurons, but provide the structural stability of the foveal tissue and improve the light transmission through the tissue to the photoreceptors. This article gives overviews of the glia of the human retina and the structure and function of both Müller cell types in the fovea, and describes the contributions of astrocytes and Müller cells to the ontogenetic development of the fovea.
Collapse
Affiliation(s)
- Andreas Reichenbach
- Paul Flechsig Institute of Brain Research, University of Leipzig, Leipzig, Germany
| | - Andreas Bringmann
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig, Germany
| |
Collapse
|
49
|
Liu WS, Li YJ. Comparison of conbercept and ranibizumab for the treatment efficacy of diabetic macular edema: a Meta-analysis and systematic review. Int J Ophthalmol 2019; 12:1479-1486. [PMID: 31544046 DOI: 10.18240/ijo.2019.09.17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 03/23/2019] [Indexed: 12/27/2022] Open
Abstract
AIM To evaluate the efficacy of intravitreal injection of conbercept (IVC) and ranibizumab (IVR) in patients with diabetic macular edema. METHODS Reviewers have searched 12 databases, including PubMed, Medline, EMBASE, Web of Science, Springer, ScienceDirect, OVID, Cochrane Library, ClinicalTrials.gov, cqVIP, WanFangdata and China National Knowledge Infrastructure (CNKI), up to December 28, 2018. RevMan 5.3 (Cochrane Library Software, Oxford, UK) was employed for statistical analysis. Fixed and random effects models were applied to assess heterogeneity. Odds ratio (OR) was applied for dichotomous variables; weighted mean difference (WMD) was applied for continuous variables. The confidence interval (CI) was set at 95%. Central macular thickness (CMT) and best-corrected visual acuity (BCVA) were employed to analyze the improvement of DME patients. Inclusion criteria for picking out studies were retrospective studies and randomized controlled trials (RCTs) that compared IVC and IVR for the treatment of diabetic macular edema. RESULTS Four retrospective studies and five RCTs were included with a total of 609 patients. No statistically significant difference was observed in mean CMT and mean BCVA in the baseline parameters [BCVA (WMD: -0.48; 95%CI: -1.06 to 0.10; P=0.1), CMT (WMD: -0.83; 95%CI: -15.15 to 13.49; P=0.91). No significant difference was found in the improvement of BCVA and adverse event (AE) in IVC group, compared with IVR group after treatment of loading dosage [the 1st month BCVA (WMD: 0.01; 95%CI: -0.26 to 0.27; P=0.96), the 3rd month BCVA (WMD: -0.04; 95%CI: -0.14 to 0.06; P=0.46); the 6th month BCVA (WMD: -0.24; 95%CI: -1.62 to 1.14; P=0.73)], AE (OR: 0.84; 95%CI: 0.38 to 1.84; P=0.66)]. A slight difference was found in the effectiveness rate (OR: 1.70; 95%CI: 0.97 to 2.96; P=0.06), There were statistically significant differences between IVC and IVR treatment in terms of CMT [1st month CMT (WMD: -19.88; 95%CI: -27.94 to -11.82; P<0.001), 3rd month CMT (WMD: -23.31; 95%CI: -43.30 to -3.33; P=0.02), 6th month CMT (WMD: -74.74; 95%CI: -106.22 to -43.26; P<0.001)]. CONCLUSION Pooled evidence suggests that both IVC and IVR are effective in the therapy of diabetic macular edema and affirms that IVC presents superiority over IVR therapy in regard of CMT in patients with diabetic macular edema, but no statistically significant difference with regard to visual improvement. Relevant RCTs with longer-term follow-up are necessary to back up our conclusion.
Collapse
Affiliation(s)
- Wei-Shai Liu
- Department of Ophthalmology, the First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
| | - Yan-Jie Li
- Department of Ophthalmology, the First Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
| |
Collapse
|
50
|
Wang B, Camino A, Pi S, Guo Y, Wang J, Huang D, Hwang TS, Jia Y. Three-dimensional structural and angiographic evaluation of foveal ischemia in diabetic retinopathy: method and validation. BIOMEDICAL OPTICS EXPRESS 2019; 10:3522-3532. [PMID: 31360604 PMCID: PMC6640826 DOI: 10.1364/boe.10.003522] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/14/2019] [Accepted: 06/14/2019] [Indexed: 05/05/2023]
Abstract
Optical coherence tomography angiography (OCTA) allows us to noninvasively investigate foveal ischemia, a key feature of diabetic retinopathy (DR). However, the sizes of the foveal avascular zone (FAZ) have a significant variation in normal population, preventing the objective assessment of pathological enlargement of FAZ due to capillary dropout. Based on the relationship between FAZ and ganglion cell complex (GCC) thickness in normal eyes, we defined a theoretical baseline FAZ (tbFAZ) on structural OCT and measured 2D and 3D vessel density in its vicinity on the simultaneously acquired OCTA in normal and diabetic eyes. We found that the structure-based tbFAZ was a reliable reference to identify foveal ischemia and that the 3D vessel density demonstrated ischemia more effectively than the 2D method. The proposed 3D para-FAZ vessel density correlates well with DR severity and potentially is a useful diagnostic biomarker, especially in the early stages of DR.
Collapse
Affiliation(s)
- Bingjie Wang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Acner Camino
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Shaohua Pi
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Yukun Guo
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Jie Wang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| | - David Huang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Thomas S. Hwang
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Yali Jia
- Casey Eye Institute, Oregon Health & Science University, Portland, OR, 97239, USA
- Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR 97239, USA
| |
Collapse
|