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Cui X, Buonfiglio F, Pfeiffer N, Gericke A. Aging in Ocular Blood Vessels: Molecular Insights and the Role of Oxidative Stress. Biomedicines 2024; 12:817. [PMID: 38672172 PMCID: PMC11048681 DOI: 10.3390/biomedicines12040817] [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: 03/13/2024] [Revised: 04/01/2024] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
Acknowledged as a significant pathogenetic driver for numerous diseases, aging has become a focal point in addressing the profound changes associated with increasing human life expectancy, posing a critical concern for global public health. Emerging evidence suggests that factors influencing vascular aging extend their impact to choroidal and retinal blood vessels. The objective of this work is to provide a comprehensive overview of the impact of vascular aging on ocular blood vessels and related diseases. Additionally, this study aims to illuminate molecular insights contributing to vascular cell aging, with a particular emphasis on the choroid and retina. Moreover, innovative molecular targets operating within the domain of ocular vascular aging are presented and discussed.
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Affiliation(s)
- Xiuting Cui
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (F.B.); (N.P.)
| | | | | | - Adrian Gericke
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany; (F.B.); (N.P.)
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2
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Taylor TRP, Menten MJ, Rueckert D, Sivaprasad S, Lotery AJ. The role of the retinal vasculature in age-related macular degeneration: a spotlight on OCTA. Eye (Lond) 2024; 38:442-449. [PMID: 37673970 PMCID: PMC10858204 DOI: 10.1038/s41433-023-02721-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/27/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023] Open
Abstract
Age-related macular degeneration (AMD) remains a disease with high morbidity and an incompletely understood pathophysiological mechanism. The ocular blood supply has been implicated in the development of the disease process, of which most research has focused on the role of the choroid and choriocapillaris. Recently, interest has developed into the role of the retinal vasculature in AMD, particularly with the advent of optical coherence tomography angiography (OCTA), which enables non-invasive imaging of the eye's blood vessels. This review summarises the up-to-date body of work in this field including the proposed links between observed changes in the retinal vessels and the development of AMD and potential future directions for research in this area. The review highlights that the strongest evidence supports the observation that patients with early to intermediate AMD have reduced vessel density in the superficial vascular complex of the retina, but also emphasises the need for caution when interpreting such studies due to their variable methodologies and nomenclature.
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Affiliation(s)
- Thomas R P Taylor
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Martin J Menten
- BioMedIA, Imperial College London, London, UK
- Institute for AI and Informatics in Medicine, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - Daniel Rueckert
- BioMedIA, Imperial College London, London, UK
- Institute for AI and Informatics in Medicine, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Andrew J Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
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3
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Aydın N, Tufek M. The effect of polycythemia vera on choroidal thickness and retrobulbar blood flow. Photodiagnosis Photodyn Ther 2024; 45:103985. [PMID: 38246214 DOI: 10.1016/j.pdpdt.2024.103985] [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: 11/05/2023] [Revised: 01/10/2024] [Accepted: 01/17/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND To evaluate the choroidal thickness and retrobulbar hemodynamic parameters in polycythemia vera (PV) patients in comparison with healthy individuals, and to investigate the relationship of these values with blood hematocrit levels. METHODS This prospective study included the 35 eyes of 35 PV patients and the 30 eyes of 30 healthy individuals. Choroidal thickness was measured at the subfoveal area and at 500 µm intervals nasal and temporal to the fovea up to a distance of 1500 µm. Color Doppler ultrasonography (CDU) was used to evaluate the retrobulbar vessels. Complete blood count values were recorded. RESULTS Choroidal thickness was found to be significantly lower in the PV group than in the control group at the subfoveal, nasal 500, and temporal 500 and 1000 µm measurement points (p = 0.01, p = 0.011, p = 0.04, p = 0.045, respectively). The central retinal artery (CRA) peak systolic velocity (PSV) and end diastolic velocity (EDV) values and the ophthalmic artery (OA) PSV value were significantly lower in the PV group than in the control group (p < 0.001, p < 0.001, p = 0.019, respectively). No significant difference was present between the groups in terms of CRA and OA resistive index (RI) and pulsatile index (PI) values (p = 0.388, p = 0.564, p = 0.897, p = 0.693, respectively). A negative correlation was found between the blood hematocrit levels and the subfoveal, nasal 500 µm, and temporal 500 µm choroidal thickness measurements and the CRA PSV and EDV and the OA PSV values. CONCLUSIONS PV may cause microvascular changes and lead to ocular vascular complications by affecting the choroidal and retrobulbar blood flow.
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Affiliation(s)
- Nihat Aydın
- Department of Ophthalmology, Amasya University, Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Turkey
| | - Melek Tufek
- Department of Ophthalmology, Amasya University, Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Turkey.
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Di Pippo M, Santia C, Rullo D, Ciancimino C, Grassi F, Abdolrahimzadeh S. The Choroidal Vascularity Index Versus Optical Coherence Tomography Angiography in the Evaluation of the Choroid with a Focus on Age-Related Macular Degeneration. Tomography 2023; 9:1456-1470. [PMID: 37624109 PMCID: PMC10458084 DOI: 10.3390/tomography9040116] [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: 06/21/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023] Open
Abstract
The choroid is the most vascularized structure of the eye and it is fundamental for the trophism of the outer retina. Its proper functioning and homeostasis represent key points in maintaining normal retinal physiology. Choroidal alterations may be implicated in the development and progression of numerous pathologies; therefore, in-depth studies using imaging techniques can be of crucial relevance to understanding the pathophysiology of retinal-choroidal diseases. The advent of spectral-domain optical coherence tomography (SDOCT) has enabled the non-invasive study of the choroid in vivo and the most recent development, optical coherence tomography angiography (OCTA), allows for the high-resolution visualization of the choriocapillaris and the choroid in regard to vascularization. The choroidal vascularity index (CVI) is a new parameter calculated on SDOCT scans and is defined as the ratio of the luminal area to the total choroidal area. In this review, a study of the choroid using OCTA and CVI will be evaluated in depth and the pros and cons of these two methods will be analyzed, with a particular focus on age-related macular degeneration.
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Affiliation(s)
| | | | | | | | | | - Solmaz Abdolrahimzadeh
- Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Faculty of Medicine and Psychology, University of Rome Sapienza, St. Andrea Hospital, 00189 Rome, Italy; (M.D.P.); (C.C.)
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5
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Scuderi L, Fragiotta S, Di Pippo M, Abdolrahimzadeh S. The Role of Diabetic Choroidopathy in the Pathogenesis and Progression of Diabetic Retinopathy. Int J Mol Sci 2023; 24:10167. [PMID: 37373315 DOI: 10.3390/ijms241210167] [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: 04/16/2023] [Revised: 06/09/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Diabetic choroidopathy was first described on histopathological specimens of diabetic eyes. This alteration was characterized by the accumulation of PAS-positive material within the intracapillary stroma. Inflammation and polymorphonuclear neutrophils (PMNs) activation are crucial elements in choriocapillaris impairment. The evidence of diabetic choroidopathy in vivo was confirmed with multimodal imaging, which provides key quantitative and qualitative features to characterize the choroidal involvement. The choroid can be virtually affected in each vascular layer, from Haller's layer to the choriocapillaris. However, the damage on the outer retina and photoreceptor cells is essentially driven by a choriocapillaris deficiency, which can be assessed through optical coherence tomography angiography (OCTA). The identification of characteristic features of diabetic choroidopathy can be significant for understanding the potential pathogenic and prognostic implications in diabetic retinopathy.
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Affiliation(s)
- Luca Scuderi
- Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy
| | - Serena Fragiotta
- Ophthalmology Unit, Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, Sapienza University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy
- UOC Ophthalmology, Department of Surgical Areas, S.M. Goretti Hospital, 04100 Latina, Italy
| | - Mariachiara Di Pippo
- Ophthalmology Unit, Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, Sapienza University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy
| | - Solmaz Abdolrahimzadeh
- Ophthalmology Unit, Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, Sapienza University of Rome, Via di Grottarossa 1035/1039, 00189 Rome, Italy
- St. Andrea Hospital, Via di Grottarossa 1035/1039, 00189 Rome, Italy
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Nawash B, Ong J, Driban M, Hwang J, Chen J, Selvam A, Mohan S, Chhablani J. Prognostic Optical Coherence Tomography Biomarkers in Neovascular Age-Related Macular Degeneration. J Clin Med 2023; 12:jcm12093049. [PMID: 37176491 PMCID: PMC10179658 DOI: 10.3390/jcm12093049] [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: 03/20/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
Optical coherence tomography has revolutionized the diagnosis and management of neovascular age-related macular degeneration. OCT-derived biomarkers have the potential to further guide therapeutic advancements with anti-vascular endothelial growth factor; however, the clinical convergence between these two tools remains suboptimal. Therefore, the aim of this review of literature was to examine the current data on OCT biomarkers and their prognostic value. Thirteen biomarkers were analyzed, and retinal fluid had the strongest-reported impact on clinical outcomes, including visual acuity, clinic visits, and anti-VEGF treatment regimens. In particular, intra-retinal fluid was shown to be associated with poor visual outcomes. Consistencies in the literature with regard to these OCT prognostic biomarkers can lead to patient-specific clinical decision making, such as early-initiated treatment and proactive monitoring. An integrated analysis of all OCT components in combination with new efforts toward automated analysis with artificial intelligence has the potential to further improve the role of OCT in nAMD therapy.
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Affiliation(s)
- Baraa Nawash
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI 48104, USA
| | - Matthew Driban
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Jonathan Hwang
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Jeffrey Chen
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Amrish Selvam
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Sashwanthi Mohan
- Ophthalmology, Medcare Hospital LLC, Dubai P.O. Box 215565, United Arab Emirates
- Education and Research, Rajan Eye Care Hospital Pvt Ltd., Chennai 600042, India
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
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Iovino C, Iodice CM, Pisani D, Rosolia A, Testa F, Giannaccare G, Chhablani J, Simonelli F. Yellow Subthreshold Micropulse Laser in Retinal Diseases: An In-Depth Analysis and Review of the Literature. Ophthalmol Ther 2023; 12:1479-1500. [PMID: 36933125 PMCID: PMC10164197 DOI: 10.1007/s40123-023-00698-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/01/2023] [Indexed: 03/19/2023] Open
Abstract
Yellow subthreshold micropulse laser (YSML) is a retinal laser capable of inducing a biologic response without causing thermal damage to the targeted tissue. The 577-nm YSML is delivered to the retina abiding by different protocols in which wavelength, power, duration, spot size and number of spots can be properly set to achieve the most effective and safe treatment response in various chorioretinal disorders. The ultrashort trains of power modulate the activation of the retinal pigment epithelium cells and intraretinal cells, such as Müller cells, causing no visible retinal scars. Subthreshold energy delivered by YSML stimulates the production of the heat-shock proteins, highly conserved molecules that protect cells against any sort of stress by blocking apoptotic and inflammatory pathways that cause cell damage. YSML treatment allows resorption of the subretinal fluid in central serous chorioretinopathy and intraretinal fluid in various conditions including diabetic macular edema, postoperative cystoid macular edema and other miscellaneous conditions. YSML also seems to modulate the development and progression of reticular pseudodrusen in dry age-related macular degeneration. The aim of this review is to discuss and summarize the safety and efficacy of YSML treatment in retinal diseases.
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Affiliation(s)
- Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Clemente Maria Iodice
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Danila Pisani
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Andrea Rosolia
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | - Jay Chhablani
- UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
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Lametschwandtner A, Minnich B. Ocular microvasculature in adult Xenopus laevis: Scanning electron microscopy of vascular casts. J Morphol 2023; 284:e21561. [PMID: 36719276 DOI: 10.1002/jmor.21561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/24/2023] [Accepted: 01/29/2023] [Indexed: 02/01/2023]
Abstract
The microvascular anatomy of choriocapillaris, iris, ciliary body, and superficial vascular hyaloid system of eyes was studied in the permanent aquatic Xenopus laevis by scanning electron microscopy of vascular casts and was compared with that published in two semiaquatic ranid species (Rana esculenta and Rana temporaria), and the urodelian species Triturus criststus carnifex. Results showed that the choriocapillaris in Xenopus consisted of a dense meshwork of wide capillaries displaying polygonal arrays at the scleral side with venules leaving the centers and arterioles supplied from the periphery. The choriocapillaris lacked the multilayered capillary meshwork described in ranids. Iris and ciliary body were supplied by nasal and temporal branches of the iridial artery, which either originated with a common stem from the hyaloid artery or arose as individual vessels from the proximal portions of the semicircular nasal and temporal branches of the hyaloid artery. These branches ran in the pupillary margin and supplied the two-dimensional capillary network of the iris, as well as the three-dimensional network of the ciliary body. Iris and ciliary body drained via parallel running vasa recta into the choriocapillaris. The superficial vascular hyaloid bed (system) was supplied by the hyaloid artery. This artery coursed along the scleral surface of the ventrotemporal choriocapillaris toward the ora serrata, where it bifurcated into a temporal and a nasal semicircular branch. Seven to 10 arterial meridional twigs arose from these branches and supplied the superficial hyaloid capillary bed. Capillaries drained into branches of the hyaloid vein, which ascended toward the ora serrata, where the hyaloid vein joined the temporal branch of the ciliary vein.
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Affiliation(s)
- Alois Lametschwandtner
- Department of Environment and Biodiversity, University of Salzburg, Vascular Biology Research Unit, Salzburg, Austria
| | - Bernd Minnich
- Department of Environment and Biodiversity, University of Salzburg, Vascular Biology Research Unit, Salzburg, Austria
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Ruan K, Zhang Y, Cheng D, Qiao Y, Yu Y, Wu M, Zhu X, Tao J, Shen M, Shen L. Short-term postoperative changes in the choroidal vascularity index in patients with a unilateral epiretinal membrane. BMC Ophthalmol 2023; 23:64. [PMID: 36782140 PMCID: PMC9923925 DOI: 10.1186/s12886-022-02748-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/19/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND To investigate short-term choroidal structural and vascular changes after epiretinal membrane (ERM) surgery. METHODS In this retrospective study, 65 patients with unilateral ERM underwent pars plana vitrectomy combined with cataract surgery and were examined one day before surgery and one week, one month, and three months after surgery. Choroidal thickness (CT) and choroidal vascular index (CVI) were evaluated using horizontal enhanced depth imaging optical coherence tomography (EDI-OCT) scans and were further calculated using semi-automatic algorithms using MATLAB R2017a. RESULTS Preoperatively, CVI was higher in eyes with ERM (61.70 ± 5.17%) than in fellow eyes (59.99 ± 5.26%). CVI increased significantly at one week after surgery (62.14 ± 5.02%) and decreased at 1 and 3 months after surgery (60.76 ± 4.97% and 60.4 ± 4.83%, respectively). The change was pronounced in the nasal region (p < 0.001) and central region (p < 0.05). CT in the temporal macula increased at 1 week (239.65 ± 72.98 μm) after surgery and decreased at 1 and 3 months after surgery (222.15 ± 71.91 μm and 222.33 ± 65.72 μm, respectively; p < 0.01). CONCLUSIONS Short-term postoperative variations in the choroid have been demonstrated in eyes with ERM. This may be related to the release of macular traction. CVI assessment using EDI-OCT may be a useful tool for investigating choroidal structural changes accompanying ERM and postoperative period.
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Affiliation(s)
- Kaiming Ruan
- grid.268099.c0000 0001 0348 3990The Affiliated Eye Hospital of Wenzhou Medical University, 618 Fengqi East Road, Zhejiang, 310000 Hangzhou China
| | - Yun Zhang
- grid.268099.c0000 0001 0348 3990The Affiliated Eye Hospital of Wenzhou Medical University, 618 Fengqi East Road, Zhejiang, 310000 Hangzhou China
| | - Dan Cheng
- grid.268099.c0000 0001 0348 3990The Affiliated Eye Hospital of Wenzhou Medical University, 618 Fengqi East Road, Zhejiang, 310000 Hangzhou China
| | - Yilin Qiao
- grid.268099.c0000 0001 0348 3990The Affiliated Eye Hospital of Wenzhou Medical University, 618 Fengqi East Road, Zhejiang, 310000 Hangzhou China
| | - Yufeng Yu
- grid.268099.c0000 0001 0348 3990The Affiliated Eye Hospital of Wenzhou Medical University, 618 Fengqi East Road, Zhejiang, 310000 Hangzhou China
| | - Minhui Wu
- grid.268099.c0000 0001 0348 3990The Affiliated Eye Hospital of Wenzhou Medical University, 618 Fengqi East Road, Zhejiang, 310000 Hangzhou China
| | - Xueying Zhu
- grid.268099.c0000 0001 0348 3990The Affiliated Eye Hospital of Wenzhou Medical University, 618 Fengqi East Road, Zhejiang, 310000 Hangzhou China
| | - Jiwei Tao
- grid.268099.c0000 0001 0348 3990The Affiliated Eye Hospital of Wenzhou Medical University, 618 Fengqi East Road, Zhejiang, 310000 Hangzhou China
| | - Meixiao Shen
- grid.268099.c0000 0001 0348 3990The Affiliated Eye Hospital of Wenzhou Medical University, 618 Fengqi East Road, Zhejiang, 310000 Hangzhou China
| | - Lijun Shen
- The Affiliated Eye Hospital of Wenzhou Medical University, 618 Fengqi East Road, Zhejiang, 310000, Hangzhou, China. .,Department of Ophthalmology, Zhejiang Provincial People's Hospital, Hanghzhou, Zhejiang, China.
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Venkatesh R, Mangla R, Sharief S, Chhablani J. Long-term effects of combined brilliant blue G and xenon light induced retinal toxicity following macular hole repair surgery. BMC Ophthalmol 2023; 23:57. [PMID: 36759787 PMCID: PMC9909863 DOI: 10.1186/s12886-023-02811-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 02/08/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND The purpose of this study was to look at the long-term effects of retinal phototoxicity after macular hole repair surgery using xenon endolight illumination and Brilliant blue G (BBG) dye. CASE PRESENTATION An elderly man in his late seventies underwent para plana vitrectomy with BBG dye to repair an idiopathic full-thickness macular hole (MH) in his right eye. Prior to macular hole surgery, his visual acuity in the right eye was 6/60, N24 at the time of presentation. The MH closed with type 1 closure immediately after surgery, but there was extensive damage to the outer retinal layers and retinal pigment epithelium (RPE) at the macula, resulting in a reduction in visual acuity to 2/60. We presumed that the combination of BBG and xenon light, is the probable reason of retinotoxicity in the current patient. There was a progressive increase in the area of retinal and RPE layer damage and choroidal thinning over a 4-year period. CONCLUSION Due to combined BBG-induced dye and endoilluminator toxicity, a rare case of continuously progressing RPE layer damage with choroidal thinning over a long follow-up interval was described. Such long-term effects of BBG and endolight induced retinotoxicity have not been reported in the literature, to the best of our knowledge.
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Affiliation(s)
- Ramesh Venkatesh
- Narayana Nethralaya, Dept. of Retina and Vitreous, #121/C, Chord Road, 1st R block Rajaji Nagar, 560010, Bangalore, India.
| | - Rubble Mangla
- grid.464939.50000 0004 1803 5324Narayana Nethralaya, Dept. of Retina and Vitreous, #121/C, Chord Road, 1st R block Rajaji Nagar, 560010 Bangalore, India
| | - Shama Sharief
- grid.464939.50000 0004 1803 5324Narayana Nethralaya, Dept. of Retina and Vitreous, #121/C, Chord Road, 1st R block Rajaji Nagar, 560010 Bangalore, India
| | - Jay Chhablani
- grid.21925.3d0000 0004 1936 9000Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, 15213 Pittsburg, PA USA
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