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Etheridge T, Swiston C, Harrie RP, Bernstein PS. ACUTE POST-TRAUMATIC ENDOPHTHALMITIS SECONDARY TO BACILLUS PUMILUS / SAFENSIS. Retin Cases Brief Rep 2024; 18:305-307. [PMID: 36729827 DOI: 10.1097/icb.0000000000001391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 11/26/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE To report a case of post-traumatic endophthalmitis secondary to Bacillus pumilus/safensis . METHODS Observational case report of a single patient. RESULTS A 62-year-old man presented with a traumatic corneal laceration because of baling wire while working on a sheep farm. Appropriate corneal laceration repair with injection of intravitreal antibiotics (ceftazidime, clindamycin, and vancomycin) was performed. A single organism, identified as B. pumilus or Bacillus safensis, was isolated from the vitreous aspirate. A subsequent pars plana vitrectomy, pars plana lensectomy, anterior capsulotomy, and fluid-air exchange was required because of severe inflammatory reaction from retained lens material, retinal edema, and vitreous opacities. Vision improved from hand motion to 20/60 at the three-month follow-up visit. CONCLUSION We describe a case of acute post-traumatic endophthalmitis secondary to B. pumilus/safensis.
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Affiliation(s)
- Tyler Etheridge
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
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Etheridge T, Jones J, Caskey E, Zielinski BA, Seay MD, Warner JEA. Ophthalmic Artery Obstruction With Focal Cerebral Arteriopathy of Childhood. J Neuroophthalmol 2024; 44:e14-e16. [PMID: 35921587 DOI: 10.1097/wno.0000000000001686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Tyler Etheridge
- Department of Ophthalmology (TE, EC, MDS, JEAW), John A. Moran Eye Center, University of Utah, Salt Lake City, Utah; Department of Radiology and Imaging Sciences (JJ), University of Utah, Salt Lake City, Utah; and Department of Pediatrics and Neurology (BAZ), University of Utah, Salt Lake City, Utah
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Lawler T, Mares JA, Liu Z, Thuruthumaly C, Etheridge T, Vajaranant TS, Domalpally A, Hammond BR, Wallace RB, Tinker LF, Nalbandyan M, Klein BEK, Liu Y. Association of macular pigment optical density with retinal layer thicknesses in eyes with and without manifest primary open-angle glaucoma. BMJ Open Ophthalmol 2023; 8:e001331. [PMID: 37890895 PMCID: PMC10619120 DOI: 10.1136/bmjophth-2023-001331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE To investigate associations between baseline macular pigment optical density (MPOD) and retinal layer thicknesses in eyes with and without manifest primary open-angle glaucoma (POAG) in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2). METHODS AND ANALYSIS MPOD was measured at CAREDS baseline (2001-2004) via heterochromatic flicker photometry (0.5° from foveal centre). Peripapillary retinal nerve fibre layer (RNFL), macular ganglion cell complex (GCC), ganglion cell layer (GCL), inner plexiform layer (IPL), and RNFL thicknesses were measured at CAREDS2 (2016-2019) via spectral-domain optical coherence tomography. Associations between MPOD and retinal thickness were assessed using multivariable linear regression. RESULTS Among 742 eyes (379 participants), manifest POAG was identified in 50 eyes (32 participants). In eyes without manifest POAG, MPOD was positively associated with macular GCC, GCL and IPL thicknesses in the central subfield (P-trend ≤0.01), but not the inner or outer subfields. Among eyes with manifest POAG, MPOD was positively associated with macular GCC, GCL, IPL and RNFL in the central subfield (P-trend ≤0.03), but not the inner or outer subfields, and was positively associated with peripapillary RNFL thickness in the superior and temporal quadrants (P-trend≤0.006). CONCLUSION We observed a positive association between MPOD and central subfield GCC thickness 15 years later. MPOD was positively associated with peripapillary RNFL superior and temporal quadrant thicknesses among eyes with manifest POAG. Our results linking low MPOD to retinal layers that are structural indicators of early glaucoma provide further evidence that carotenoids may be protective against manifest POAG.
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Affiliation(s)
- Thomas Lawler
- Department of Nutritional Sciences, College of Agricultural & Life Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - J A Mares
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Zhe Liu
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Catherine Thuruthumaly
- Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Tyler Etheridge
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Thasarat S Vajaranant
- Department of Ophthalmology & Visual Sciences, University of Illinois, Chicago, Illinois, USA
| | - Amitha Domalpally
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Billy R Hammond
- Department of Psychology, University of Georgia, Athens, Georgia, USA
| | - Robert B Wallace
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Lesley F Tinker
- Department of Cancer Prevention, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Marine Nalbandyan
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
| | - Yao Liu
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin, USA
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Etheridge T, Brintz BJ, Jensen MS, Peralta E, Ayesha A, Jebaraj A, Marx DP. Incidence and severity of asymptomatic ocular injury in adult and pediatric orbital fractures. Orbit 2023; 42:273-278. [PMID: 35801838 PMCID: PMC9943542 DOI: 10.1080/01676830.2022.2095648] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/24/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate the incidence of severe ocular injury requiring emergent ophthalmic evaluation in visually asymptomatic patients presenting with orbital fractures. METHODS We performed a retrospective chart review of all adult and pediatric orbital fractures between 2012-2022 at a level 1 trauma center. Ocular injuries were categorized into severe, moderate, and mild. We evaluated symptoms, mechanism of injury, visual acuity (VA), and severity of injuries using the Cochran-Armitage and linear-by-linear tests. RESULTS Of the 2495 cases, 1534 had ophthalmology evaluation. The mean ± standard deviation age was 40.4 ± 20.4 years. Most patients were male (73.1%) and Caucasian (75.9%). The mean time to evaluation was 0.6 ± 2.5 days. 486 (31.7%) were visually symptomatic, 760 (49.5%) were asymptomatic, and 288 (18.8%) were unknown. Of the symptomatic, 135 (27.8%) had severe injuries, 108 (22.2%) had moderate injuries, 216 (44.4%) had mild injuries, and 27 (5.6%) had no injuries. Of the asymptomatic, 67 (8.8%) had severe injuries, 183 (24.1%) had moderate injuries, 468 (61.6%) had mild injuries, and 42 (5.5%) had no injuries. Symptoms correlated with injury severity (p-value <.001). The most common mechanism of injury were falls (24.0%), assaults (22.2%), and motor vehicle accidents (14.8%). CONCLUSIONS Visually asymptomatic orbital fractures were less likely to have severe ocular injuries; however, many patients were unable to express symptoms. Emergent ophthalmology evaluation should be considered in all patients presenting with orbital fractures, especially patients with visual symptoms or are unable to report symptoms.
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Affiliation(s)
- Tyler Etheridge
- Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Ben J. Brintz
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Michael S. Jensen
- Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Esteban Peralta
- Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Azraa Ayesha
- Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Abigail Jebaraj
- Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
| | - Douglas P. Marx
- Department of Ophthalmology, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah
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Hu WF, Etheridge T, Larochelle MB. Use of Intracameral Tissue Plasminogen Activator During Uveitic Cataract Surgery. Ocul Immunol Inflamm 2023:1-5. [PMID: 37079881 PMCID: PMC10587359 DOI: 10.1080/09273948.2023.2194410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 03/16/2023] [Accepted: 03/18/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE To report the outcomes of intracameral tissue plasminogen activator (tPA) use during uveitic cataract surgery. DESIGN Retrospective case series from a single United States tertiary center of 36 eyes from 31 consecutive patients with established uveitis who received intraoperative intracameral tPA during cataract surgery between 2016 and 2020. RESULTS Mean visual acuity (VA) improved from logMAR 1.0 ± 0.7 preoperatively to logMAR 0.7 ± 0.8 by POM12. VA improved from baseline postoperatively (POM1 p = 0.0002, POM6 p = 0.006 and POM12 p = 0.007). Minimal to no anterior chamber inflammation was achieved in 47.2% of the eyes by POW1 and 80.0% of the eyes by POM1. Mean clock-hours of posterior synechiae improved from 8.2 ± 3.8 preoperatively to 0.1 ± 0.6 by POM12. Six eyes developed hyphema and/or vitreous hemorrhage, four of which resolved spontaneously. CONCLUSIONS Adjunctive intracameral tPA during uveitic cataract surgery improves VA and intraocular inflammation, but risks postoperative hemorrhage. Intraoperative tPA as adjunctive anti-inflammatory therapy warrants randomized prospective studies.
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Affiliation(s)
- Wen F. Hu
- Flaum Eye Institute, University of Rochester, 210 Crittenden Blvd, Rochester, NY 14642
| | - Tyler Etheridge
- John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Dr, Salt Lake City, UT 84132
| | - Marissa B. Larochelle
- John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Dr, Salt Lake City, UT 84132
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6
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Schildroth KR, Mititelu M, Etheridge T, Holman I, Chang JS. STELLATE NONHEREDITARY IDIOPATHIC FOVEOMACULAR RETINOSCHISIS: NOVEL FINDINGS AND OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY ANALYSIS. Retin Cases Brief Rep 2023; 17:165-169. [PMID: 34709007 DOI: 10.1097/icb.0000000000001132] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE To present novel findings in stellate nonhereditary idiopathic foveomacular retinoschisis, including the largest series of optical coherence tomography angiography findings to date. METHODS A retrospective case series with multimodal imaging was obtained and reviewed. RESULTS All three patients were women, aged 59-63. Two cases were unilateral, and one was bilateral. Vision ranged from 20/20 to 20/60 in the affected eyes. Peripheral retinoschisis was observed in all three patients. All patients were followed for a minimum of 1 year. In one case, progressive macular retinoschisis leading to foveal involvement was observed over two years, with an associated vision decline from 20/25 to 20/60. Attempted interventions included topical dorzolamide in all cases and intravitreal bevacizumab in one patient; however, no treatment effect was observed. The foveal avascular zone size was within normal limits (mean 280 µ m). In all stellate nonhereditary idiopathic foveomacular retinoschisis eyes, the retinoschisis cavities were nonvascular. CONCLUSION Novel findings regarding stellate nonhereditary idiopathic foveomacular retinoschisis include the progressive nature of foveal involvement and the lack of response to topical dorzolamide and intravitreal bevacizumab. Foveal avascular zone was normal in all eyes, consistent with the relatively preserved vision in these cases. Retinoschisis cavities were nonvascular in all eyes, a finding which may give insight into the mechanism of this disease.
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Affiliation(s)
- Kathleen R Schildroth
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
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7
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Peralta E, Etheridge T, Harrie R, Lin A. Implantation Cyst of Anterior Chamber: A Case Report. Case Rep Ophthalmol 2022; 13:929-935. [DOI: 10.1159/000526900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/24/2022] [Indexed: 11/18/2022] Open
Abstract
This clinical case report describes a single case of a progressively enlarging anterior chamber cyst arising in a patient with prior cataract surgery. We detail findings of a large implantation cyst within the anterior chamber, confirmed on ultrasound biomicroscopy. The patient was successfully treated with needle aspiration and injection of 5-fluorouracil without recurrence at 5 months. Anterior chamber cysts are a rare side effect of cataract surgery caused by intrusion of epithelial cells during surgery. Patients may present with a progressively enlarging mass requiring surgical intervention. Aspiration and injection of a cytodestructive chemical agent is one conservative approach in the management of an implantation cyst, with our patient exhibiting favorable visual outcomes.
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8
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Etheridge T, Kennedy B, Millar MM, Brintz BJ, Wu C, Pettey J. Cognitive enhancing supplements and medications in United States Resident Physicians. BMC Med Educ 2022; 22:744. [PMID: 36303156 PMCID: PMC9615194 DOI: 10.1186/s12909-022-03778-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/10/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The use of cognitive-enhancing medications and supplements among healthy adults continues to rise. Limited data exists on their use among resident physicians. Given their highly competitive and stressful lifestyle, we sought to evaluate the prevalence, motivations, and side effects of using cognitive-enhancing supplements and medications among resident physicians at a large United States academic institution. METHODS An anonymous web-based survey was circulated to resident physicians inquiring about using cognitive-enhancing supplements and medications, as well as personal characteristics such as gender, marital and parental status, medical diagnoses, and medical specialty. Before circulation, we performed a pilot study. Weighted logistic regression analyses estimated the impact of personal characteristics on the probability of using both supplements and medications. RESULTS Survey response rate was 46.4%. Of respondents, 48.6% were female, 45.9% were married, 70.9% were without children, and 67.2% were in a non-surgical medical specialty. Few respondents had a related medical diagnosis, with attention deficit hyperactivity disorder being the most common (7.1%). Male, non-married, surgical residents were more likely to take supplements (odds ratio (OR) = 1.06, 1.05, and 1.05). Males, without children, and those who felt pressure to perform well, were afraid of being left behind, felt pressure because colleagues take them, or felt they could not reach their current level of training without medications were more likely to take medications (OR = 1.11, 1.04, 1.05, and 1.08). Adverse effects with medications were common. CONCLUSION Supplement and medication use for cognitive enhancement was high among resident physicians at a single institution despite few having a related medical diagnosis. This study raises awareness of the growing pressure in competitive residency environments to use cognitive enhancement regardless of the potential side effects.
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Affiliation(s)
- Tyler Etheridge
- Department of Ophthalmology, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Dr, 84123, Salt Lake City, UT, USA.
| | - Brandon Kennedy
- Department of Ophthalmology, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Dr, 84123, Salt Lake City, UT, USA
| | - Morgan M Millar
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Ben J Brintz
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Chaorong Wu
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Jeff Pettey
- Department of Ophthalmology, John A. Moran Eye Center, University of Utah, 65 Mario Capecchi Dr, 84123, Salt Lake City, UT, USA
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Wilkinson S, Etheridge T, Monson BK, Larochelle MB. Chronic postoperative Cutibacterium acnes endophthalmitis with implantable collamer lens. Am J Ophthalmol Case Rep 2022; 26:101500. [PMID: 35372713 PMCID: PMC8965848 DOI: 10.1016/j.ajoc.2022.101500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose We report a case of chronic post-operative endophthalmitis secondary to Cutibacterium acnes (C. acnes) in a patient with an implantable collamer lens (ICL). Observations A 45-year-old male presented three months after ICL implantation of the right eye with blurry vision, redness, and ocular pain in the setting of prolonged post-operative anterior chamber (AC) cell. Reduced visual acuity (VA) at 20/30-1, keratic precipitates, 1+ AC cell, and white ICL precipitates were concerning for chronic post-operative endophthalmitis. Anaerobic cultures from a vitreous tap grew C. acnes. Multiple intravitreal and intracameral injections with topical steroids were required to maintain a stable VA at 20/30; however, inflammation persisted and removal of the ICL and his native lens was ultimately required. Conclusions and importance Chronic post-operative inflammation and white plaque after ICL implantation should raise high suspicion for endophthalmitis secondary to C. acnes. Anaerobic vitreous cultures can confirm the diagnosis. Removal of the ICL implant is often necessary for treatment. More research is needed to best manage this vision threatening condition.
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Affiliation(s)
- Samuel Wilkinson
- John A. Moran Eye Center, University of Utah, 65 N Mario Capecchi, Salt Lake City, UT, 84132, USA
- Corresponding author. John A. Moran Eye Center, 65 N Mario Capecchi, Salt Lake City, UT, 84132, USA.
| | - Tyler Etheridge
- John A. Moran Eye Center, University of Utah, 65 N Mario Capecchi, Salt Lake City, UT, 84132, USA
| | | | - Marissa B. Larochelle
- John A. Moran Eye Center, University of Utah, 65 N Mario Capecchi, Salt Lake City, UT, 84132, USA
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Abstract
Tolosa-Hunt syndrome (THS) is a rare, idiopathic, non-specific inflammation within the cavernous sinus and/or superior orbital fissure leading to painful ophthalmoplegia. The authors describe the first case of a 12-year-old otherwise healthy girl who presented with painful ophthalmoplegia after a documented COVID-19 infection. Neuroimaging revealed inflammation within the ipsilateral cavernous sinus, Meckel’s cave, and orbital apex. After a comprehensive work-up was negative, the patient experienced prompt clinical and radiographic improvement with high-dose corticosteroids, and a diagnosis of THS was made.
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Affiliation(s)
- Tyler Etheridge
- John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | - Jordan Jones
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Eric L Caskey
- John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | - Kathleen B Digre
- John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | - Judith EA Warner
- John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
| | - Meagan D Seay
- John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA
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11
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Etheridge T, Liu Z, Nalbandyan M, Cleland S, Blodi BA, Mares JA, Bailey S, Wallace R, Gehrs K, Tinker LF, Gangnon R, Domalpally A. Association of Macular Thickness With Age and Age-Related Macular Degeneration in the Carotenoids in Age-Related Eye Disease Study 2 (CAREDS2), An Ancillary Study of the Women's Health Initiative. Transl Vis Sci Technol 2021; 10:39. [PMID: 34003924 PMCID: PMC7910637 DOI: 10.1167/tvst.10.2.39] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the relationship of retinal layer thickness with age and age-related macular degeneration (AMD) in the Carotenoids in Age-Related Eye Disease Study 2. Methods Total retinal thickness within the macular area, and individual layer thickness was determined for CAREDS2 participants (n = 906 eyes, 473 women) from the Women's Health Initiative using Heidelberg optical coherence tomography (OCT). Mean measurements within the OCT grid were compared across age tertiles (69–78, 78–83, and 83–101 years) and AMD outcomes. Results Mean retinal thickness in the central circle, inner ring, and outer ring were 277 ± 34 µm, 326 ± 20 µm, and 282 ± 15 µm, respectively. Thickness did not vary by age in the central circle, but decreased with age in the inner and outer circles (P ≤ 0.004). Specifically, ganglion cell (GCL), inner plexiform, and outer nuclear (ONL) layer thickness decreased with age (P ≤ 0.003). Age-adjusted retinal thickness in all three circles did not vary by AMD outcomes (486 without AMD and 413 with AMD). However, individual layers showed changes with GCL and photoreceptor thinning and retinal pigment epithelial thicknening in eyes with late AMD. After controlling for age and AMD, higher ONL thickness was associated with better visual acuity. Conclusions In this cohort of older women, a decrease in perifoveal thickness was associated with increasing age, particularly in the inner retinal layers. Variabilty in thickness in AMD eyes was primarily due to outer retinal layers. Among all retinal layers, the ONL plays an important role in preserving visual acuity. Translational Relevance The study provides a deeper understanding of age related changes to the retinal layers and their effect on visual loss.
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Affiliation(s)
- Tyler Etheridge
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Zhe Liu
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Marine Nalbandyan
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Spencer Cleland
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Barbara A Blodi
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Julie A Mares
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Steven Bailey
- Oregon Health Sciences University Casey Eye Institute, Portland, OR, USA
| | - Robert Wallace
- University of Iowa, College of Public Health, Department of Epidemiology, Iowa City, IA, USA
| | - Karen Gehrs
- University of Iowa, Department of Ophthalmology, University of Iowa, Iowa City, IA, USA
| | - Lesley F Tinker
- Cancer Research Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Ronald Gangnon
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Department of Biostatistics & Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA
| | - Amitha Domalpally
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Etheridge T, Dobson ETA, Wiedenmann M, Oden N, VanVeldhuisen P, Scott IU, Ip MS, Eliceiri KW, Blodi BA, Domalpally A. Ellipsoid Zone Defects in Retinal Vein Occlusion Correlates With Visual Acuity Prognosis: SCORE2 Report 14. Transl Vis Sci Technol 2021; 10:31. [PMID: 34003964 PMCID: PMC7998009 DOI: 10.1167/tvst.10.3.31] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose To evaluate the association between ellipsoid zone (EZ) on spectral domain optical coherence tomography (SD-OCT) and visual acuity letter score (VALS) in participants with retinal vein occlusion in the Study of Comparative Treatments for Retinal Vein Occlusion 2. Methods SD-OCT scans of 362 participants were qualitatively assessed at baseline and months 1, 6, 12, and 24 for EZ status as normal, patchy, or absent. The thickness of EZ layer in the central subfield was also obtained using machine learning. Results EZ assessments were not possible at baseline due to signal blockage in >75% of eyes. At month 1, EZ was normal in 37.6%, patchy in 48.1%, and absent in 14.3%. EZ was measurable in 48.7% with a mean area of 0.07 ± 0.16 mm2. Mean VALS was better in eyes without an EZ defect compared to eyes with an EZ defect (P < 0.0001 at all visits). EZ defect at month 1 was associated with poorer VALS at all follow-up visits (P < 0.0001). Conclusions Both qualitative and quantitative assessments of EZ status strongly correlated with VALS. Absence of EZ was associated with poorer VALS at both corresponding and future visits, with larger areas of EZ loss associated with worse VALS. Translational Relevance Assessment of EZ can be used to identify patients with potentially poor response in eyes with retinal vein occlusion.
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Affiliation(s)
- Tyler Etheridge
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Ellen T A Dobson
- Laboratory for Optical and Computational Instrumentation, Center for Quantitative Cell Imaging, University of Wisconsin-Madison, Madison, WI, USA
| | | | - Neal Oden
- The Emmes Company, LLC, Rockville, MD, USA
| | | | - Ingrid U Scott
- Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Michael S Ip
- Doheny Eye Institute, University of California Los Angeles Stein Eye Institute, Los Angeles, CA, USA
| | - Kevin W Eliceiri
- Laboratory for Optical and Computational Instrumentation, Center for Quantitative Cell Imaging, University of Wisconsin-Madison, Madison, WI, USA.,McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA.,Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, USA
| | - Barbara A Blodi
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA
| | - Amitha Domalpally
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,McPherson Eye Research Institute, University of Wisconsin-Madison, Madison, WI, USA
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13
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Etheridge T, Oakey Z, Altaweel MM. Management of Retinal Detachment Associated with Morning Glory Disc Syndrome. Case Rep Ophthalmol 2021; 12:457-463. [PMID: 34177542 PMCID: PMC8215972 DOI: 10.1159/000516205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 03/21/2021] [Indexed: 11/19/2022] Open
Abstract
We report a case of morning glory disc anomaly in a young patient with tractional retinal detachment successfully repaired with complex pars plana vitrectomy, membrane peel, laser, and oil tamponade. A 19-year-old female with a history of right morning glory disc anomaly associated with PAX6 gene mutation presented with floaters, photopsia, central scotoma, and visual acuity (VA) of 1/200. A complex macula-involving tractional retinal detachment centered around the optic nerve with a morning glory disc anomaly. Retinal detachment was treated with 25-gauge pars plana vitrectomy with difficult separation of the posterior hyaloid. Fibrous preretinal membranes were peeled, a temporal relaxing retinotomy was required, subretinal fluid was drained through a superonasal retinotomy during air-fluid exchange, endolaser was applied, and tamponade was achieved with 1,000-centistoke silicone oil. The retina remained attached at 1-year follow-up, with VA count fingers throughout. Morning glory disc is a rare congenital anomaly associated with PAX6 gene mutation that most often occurs unilaterally. It is rarely associated with tractional retinal detachment. Optimization of visual outcome is imperative despite a poor visual prognosis.
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Affiliation(s)
- Tyler Etheridge
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA
| | - Zackery Oakey
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Michael M Altaweel
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Etheridge T, Blodi B, Oden N, Van Veldhuisen P, Scott IU, Ip MS, Mititelu M, Domalpally A. Spectral Domain OCT Predictors of Visual Acuity in the Study of COmparative Treatments for REtinal Vein Occlusion 2: SCORE 2 Report 15. Ophthalmol Retina 2020; 5:991-998. [PMID: 33373715 DOI: 10.1016/j.oret.2020.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/07/2020] [Accepted: 12/21/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the association between baseline demographic and spectral domain OCT (SD-OCT) features with visual acuity (VA) in the Study of COmparative Treatments for REtinal Vein Occlusion 2 (SCORE2) over 2 years. DESIGN Post hoc analysis of prospective clinical trial data. PARTICIPANTS A total of 362 SCORE2 participants with macular edema secondary to central retinal (CRVO) or hemiretinal vein occlusion (HRVO). METHODS Spectral domain OCT volume scans were assessed at the SCORE2 reading center at baseline, month 01 (M01), month 06 (M06), month 12 (M12), and month 24 (M24) for central subfield thickness (CST), subretinal fluid, intraretinal fluid, vitreoretinal interface abnormalities, disorganization of retinal inner layers (DRIL), and ellipsoid zone (EZ) within the central subfield (CSF). MAIN OUTCOME MEASURES Visual acuity at M06, M12, and M24. RESULTS Mean baseline age was 68.9 years. Mean VA at M01 was 63.2 letters, and CST was 299.7 μm. At M01, subretinal fluid was seen in 28.5% intraretinal fluid in 67.2%, DRIL was seen in 73.8%, mostly within the CSF, and the EZ was absent in 9.8 and patchy in 31.7%. In multivariate analysis including all M01 demographics and SD-OCT parameters and their association with VA at M06, M12, and M24, VA at M01 remained significant across all time points up to M24 (P < 0.001). CONCLUSIONS In this 2-year follow-up of eyes that were treated with both per protocol and off protocol for RVO, VA at M01 was an important predictor of long-term vision and change in vision. Establishing predictors of visual recovery helps identify causes for poor responders to treatment in patients with RVO.
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Affiliation(s)
- Tyler Etheridge
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Barbara Blodi
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Neal Oden
- The Emmes Company, LLC, Rockville, Maryland
| | | | - Ingrid U Scott
- Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Michael S Ip
- Doheny Eye Institute, University of California Los Angeles Stein Eye Institute, Los Angeles, California
| | - Mihai Mititelu
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Amitha Domalpally
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
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15
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Yang B, Damodaran S, Khemees TA, Filon MJ, Schultz A, Gawdzik J, Etheridge T, Malin D, Richards KA, Cryns VL, Jarrard DF. Synthetic Lethal Metabolic Targeting of Androgen-Deprived Prostate Cancer Cells with Metformin. Mol Cancer Ther 2020; 19:2278-2287. [DOI: 10.1158/1535-7163.mct-19-1141] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/28/2020] [Accepted: 09/01/2020] [Indexed: 11/16/2022]
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Etheridge T, Kellom ER, Sullivan R, Ver Hoeve JN, Schmitt MA. Ocular evaluation and genetic test for an early Alström Syndrome diagnosis. Am J Ophthalmol Case Rep 2020; 20:100873. [PMID: 32944671 PMCID: PMC7481517 DOI: 10.1016/j.ajoc.2020.100873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 07/18/2020] [Accepted: 08/09/2020] [Indexed: 11/05/2022] Open
Abstract
Purpose We present 3 cases of Alström syndrome (ALMS) that highlight the importance of the ophthalmic exam, as well as the diagnostic challenges and management considerations of this ultra-rare disease. Observations The first case is of a 2-year-old boy with history of spasmus nutans who presented with head bobbing and nystagmus. The second patient is a 5-year-old boy with history of infantile dilated cardiomyopathy status post heart transplant, Burkitt lymphoma status post chemotherapy, obesity, global developmental delay, and high hyperopia previously thought to have cortical visual impairment secondary to heart surgery/possible ischemic event. This patient presented with nystagmus, photophobia, and reduced vision. The third case involves a 8-year-old boy with history of obesity, bilateral optic nerve atrophy, hyperopic astigmatism, exotropia, and nystagmus. Upon presentation to the consulting pediatric ophthalmologist, none of the patients had yet been diagnosed with ALMS. All 3 cases were subsequently found to have an electroretinogram (ERG) that exhibited severe global depression and to carry ALMS1 pathogenic variants. Conclusions and Importance ALMS is an autosomal recessive disease caused by ALMS1 variations, characterized by cone-rod dystrophy, obesity, progressive sensorineural hearing loss, cardiomyopathy, insulin resistance, and multiorgan dysfunction. Retinal dystrophy diagnosis is critical given clinical criteria and detection rates of genetic testing. Early diagnosis is extremely important because progression to flat ERG leads to the inability to differentiate between rod-cone or cone-rod involvement, either of which have their own differential diagnoses. In our series, the ophthalmic exam and abnormal ERG prompted further genetic testing and the subsequent diagnosis of ALMS. Multidisciplinary care ensures the best possible outcome with the ophthalmologist playing a key role.
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Key Words
- ALMS, Alström Syndrome
- ALMS1 gene
- APD, Afferent pupillary defect
- Alström syndrome
- Autosomal recessive
- BMI, Body mass index
- CHF, Congestive heart failure
- CLIA, Clinical Laboratory Improvement Amendments
- Cone-rod dystrophy
- DA, Dark-adapted
- DFE, Dilated fundus exam
- EEG, Electroencephalogram
- ERG, Electroretinogram
- EUA, Exam under anesthesia
- FAF, Fundus autofluorescence
- IGF, Insulin-like growth factor
- IR, Insulin resistance
- ISCEV, International Society for Clinical Electrophysiology of Vision
- LA, Light-adapted
- MRI, Magnetic resonance imaging
- OCT, Optical coherence tomography
- OD, Right eye
- OPs, Oscillatory potentials
- OS, Left eye
- OU, Both eyes
- RPE, Retinal pigment epithelium
- T2DM, Type II diabetes mellitus
- VA, Visual acuity
- VEP, Visual evoked potential
- VGB, Vigabatrin
- cDNA, complementary DNA
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Affiliation(s)
- Tyler Etheridge
- University of Wisconsin School of Medicine and Public Health, Department of Ophthalmology & Visual Sciences, Madison, WI, United States
| | - Elizabeth R Kellom
- University of Wisconsin School of Medicine and Public Health, Department of Ophthalmology & Visual Sciences, Madison, WI, United States
| | - Rachel Sullivan
- University of Wisconsin School of Medicine and Public Health, Department of Ophthalmology & Visual Sciences, Madison, WI, United States
| | - James N Ver Hoeve
- University of Wisconsin School of Medicine and Public Health, Department of Ophthalmology & Visual Sciences, Madison, WI, United States
| | - Melanie A Schmitt
- University of Wisconsin School of Medicine and Public Health, Department of Ophthalmology & Visual Sciences, Madison, WI, United States
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Etheridge T, Dobson ETA, Wiedenmann M, Papudesu C, Scott IU, Ip MS, Eliceiri KW, Blodi BA, Domalpally A. A semi-automated machine-learning based workflow for ellipsoid zone analysis in eyes with macular edema: SCORE2 pilot study. PLoS One 2020; 15:e0232494. [PMID: 32353052 PMCID: PMC7192485 DOI: 10.1371/journal.pone.0232494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/15/2020] [Indexed: 12/11/2022] Open
Abstract
Background and objective To develop a semi-automated, machine-learning based workflow to evaluate the ellipsoid zone (EZ) assessed by spectral domain optical coherence tomography (SD-OCT) in eyes with macular edema secondary to central retinal or hemi-retinal vein occlusion in SCORE2 treated with anti-vascular endothelial growth factor agents. Methods SD-OCT macular volume scans of a randomly selected subset of 75 SCORE2 study eyes were converted to the Digital Imaging and Communications in Medicine (DICOM) format, and the EZ layer was segmented using nonproprietary software. Segmented layer coordinates were exported and used to generate en face EZ thickness maps. Within the central subfield, the area of EZ defect was measured using manual and semi-automated approaches via a customized workflow in the open-source data analytics platform, Konstanz Information Miner (KNIME). Results A total of 184 volume scans from 74 study eyes were analyzed. The mean±SD area of EZ defect was similar between manual (0.19±0.22 mm2) and semi-automated measurements (0.19±0.21 mm2, p = 0.93; intra-class correlation coefficient = 0.90; average bias = 0.01, 95% confidence interval of limits of agreement -0.18–0.20). Conclusions A customized workflow generated via an open-source data analytics platform that applied machine-learning methods demonstrated reliable measurements of EZ area defect from en face thickness maps. The result of our semi-automated approach were comparable to manual measurements.
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Affiliation(s)
- Tyler Etheridge
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Ellen T. A. Dobson
- Laboratory for Optical and Computational Instrumentation, University of Wisconsin-Madison, Madison, WI, United States of America
| | | | - Chandana Papudesu
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Ingrid U. Scott
- Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States of America
| | - Michael S. Ip
- Doheny Eye Institute, University of California Los Angeles Stein Eye Institute, Los Angeles, CA, United States of America
| | - Kevin W. Eliceiri
- Laboratory for Optical and Computational Instrumentation, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Barbara A. Blodi
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Amitha Domalpally
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
- * E-mail:
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Etheridge T, Larson JC, Nork TM, Momont AC. Schwartz-Matsuo syndrome: An important cause of secondary glaucoma. Am J Ophthalmol Case Rep 2020; 17:100586. [PMID: 31956728 PMCID: PMC6962651 DOI: 10.1016/j.ajoc.2020.100586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 11/19/2019] [Accepted: 12/31/2019] [Indexed: 11/05/2022] Open
Abstract
Purpose We report a case of Schwartz-Matsuo syndrome that highlights the pathophysiology, diagnostic challenges, and management considerations of this rare disease. Observations 31-year-old man with a history of left eye cataract presented with left eye photophobia and elevated intraocular pressure (IOP) of 64 mm Hg. Visual acuity 20/40. Open angles with an increased pigment of trabecular meshwork by gonioscopy, 2 + anterior chamber (AC) cell, superior retinal detachment, and 0.6 cup-to-disc ratio. Electron microscopy of AC fluid demonstrated outer segments of photoreceptors. IOP was lowered with oral and topical ophthalmic antihypertensives. Retinal detachment was treated with pars plana vitrectomy with endolaser, gas tamponade, and AC paracentesis. Follow-up VA 20/20 with normal IOP. Conclusions and importance Schwartz-Matsuo syndrome is characterized by elevated IOP with marked fluctuations, open angles, aqueous cells, and retinal detachment. Diagnosis is supported by electron microscopy of AC fluid with outer segments of photoreceptors. Treatment includes retinal detachment repair and antihypertensive therapy.
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Affiliation(s)
- Tyler Etheridge
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jennifer C Larson
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - T Michael Nork
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Anna C Momont
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Etheridge T, Bowen RC, Raven M, Snow KB, Urban AW, Chang JS. Ocular Syphilis: Clinical Manifestations and Treatment Course. WMJ 2019; 118:191-195. [PMID: 31978289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION We report 3 ocular syphilis cases that highlight the increasing incidence, variable presentation, diagnostic challenges, and treatment considerations of this potentially visionthreatening disease. CASE SERIES A 39-year-old woman with diabetes and intravenous (IV) drug use presented with 3 weeks of decreased vision, left-eye photopsia, and rash. A 52-year-old man who has sex with men (MSM), presented with a 1-month history of upper respiratory infection-like symptoms, right-eye scotoma, redness, headache, and muffled hearing. A 24-year-old man with a history of MSM presented with right-eye scotoma and a history of transaminitis, rash, and systemic symptoms months prior. DISCUSSION Syphilis rates are increasing. Each patient presented with nonspecific symptoms that, in retrospect, were early signs of infection. Vision recovery depends on the extent of ocular involvement, early recognition, and prompt initiation of appropriate therapy. CONCLUSION Ocular syphilis must be considered in at-risk groups, but systemic signs may precede vision changes. Diagnosis requires a high index of suspicion and treatment with IV penicillin is effective.
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Affiliation(s)
- Tyler Etheridge
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Randy C Bowen
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Meisha Raven
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Karisa B Snow
- Department of Pharmacy, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Andrew W Urban
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Jonathan S Chang
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin,
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20
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Yang B, Etheridge T, McCormick J, Schultz A, Khemees TA, Damaschke N, Leverson G, Woo K, Sonn GA, Klein EA, Fumo M, Huang W, Jarrard DF. Validation of an epigenetic field of susceptibility to detect significant prostate cancer from non-tumor biopsies. Clin Epigenetics 2019; 11:168. [PMID: 31779677 PMCID: PMC6883627 DOI: 10.1186/s13148-019-0771-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 10/22/2019] [Indexed: 12/18/2022] Open
Abstract
Background An epigenetic field of cancer susceptibility exists for prostate cancer (PC) that gives rise to multifocal disease in the peripheral prostate. In previous work, genome-wide DNA methylation profiling identified altered regions in the normal prostate tissue of men with PC. In the current multicenter study, we examined the predictive strength of a panel of loci to detect cancer presence and grade in patients with negative biopsy tissue. Results Four centers contributed benign prostate biopsy tissues blocks from 129 subjects that were either tumor associated (TA, Grade Group [GG] ≥ 2, n = 77) or non-tumor associated (NTA, n = 52). Biopsies were analyzed using pyrosequencing for DNA methylation encompassing CpG loci near CAV1, EVX1, FGF1, NCR2, PLA2G16, and SPAG4 and methylation differences were detected within all gene regions (p < 0.05). A multiplex regression model for biomarker performance incorporating a gene combination discriminated TA from NTA tissues (area under the curve [AUC] 0.747, p = 0.004). A multiplex model incorporating all the above genes and clinical information (PSA, age) identified patients with GG ≥ 2 PC (AUC 0.815, p < 0.0001). In patients with cancer, increased variation in gene methylation levels occurs between biopsies across the prostate. Conclusions A widespread epigenetic field defect is utilized to detect GG ≥ 2 PC in patients with histologically negative biopsies. These alterations in non-tumor cells display increased heterogeneity of methylation extent and are spatially distant from tumor foci. These findings have the potential to decrease the need for repeated prostate biopsy.
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Affiliation(s)
- Bing Yang
- University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA
| | - Tyler Etheridge
- University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA
| | - Johnathon McCormick
- University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA
| | - Adam Schultz
- University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA
| | - Tariq A Khemees
- University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA.,Department of Urology, University of Wisconsin, Madison, WI, 53705, USA
| | - Nathan Damaschke
- University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA
| | - Glen Leverson
- University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA
| | - Kaitlin Woo
- University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA
| | | | - Eric A Klein
- Cleveland Clinic, Glickman Urological and Kidney Institute, Cleveland, OH, USA
| | - Mike Fumo
- Rockford Urologic, Rockford, IL, USA
| | - Wei Huang
- University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA.,Carbone Comprehensive Cancer Center, University of Wisconsin, Madison, WI, 53705, USA
| | - David F Jarrard
- University of Wisconsin School of Medicine and Public Health, Madison, WI, 53705, USA. .,Department of Urology, University of Wisconsin, Madison, WI, 53705, USA. .,Carbone Comprehensive Cancer Center, University of Wisconsin, Madison, WI, 53705, USA. .,Molecular and Environmental Toxicology Program, University of Wisconsin, Madison, WI, 53705, USA.
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21
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Jarrard WE, Schultz A, Etheridge T, Damodaran S, Allen GO, Jarrard D, Yang B. Screening of urine identifies PLA2G16 as a field defect methylation biomarker for prostate cancer detection. PLoS One 2019; 14:e0218950. [PMID: 31233548 PMCID: PMC6590820 DOI: 10.1371/journal.pone.0218950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 06/12/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Prostate cancer (PC) is a multifocal disease. DNA methylation alterations are not restricted to the immediate peritumor environment, but spatially widespread in the adjacent and distant histologically normal prostate tissues. In the current study, we utilized high-throughput methylation arrays to identify epigenetic changes in the urine from men with and without cancer. DESIGN, SETTING, AND PARTICIPANTS DNA urine samples were enriched for methylated fragments using MBD methyl-binding antibodies and applied to high density CytoScanHD arrays. Significant loci were validated using quantitative pyrosequencing and binary logistic regression modeling applied to urine sample analyses in a training (n = 83) and validation approach (n = 84). Methylation alterations in prostate tissues using pyrosequencing at the PLA2G16 locus were examined in 38 histologically normal specimens from men with (TA, n = 26) and without (NTA, n = 12) cancer and correlated to gene expression. RESULTS Methylation microarrays identified 3,986 loci showing significantly altered methylation in the urine samples from patients with PC compared to those without (TA vs NTA; p<0.01). These loci were then compared against subjects with their prostates removed to exclude non-prostate cell markers yielding 196 significant regions. Multiple CpGs adjacent to PLA2G16 CpG island showed increased methylation in TA compared to NTA (p<0.01) in a large validation study of urine samples. The predictive accuracy of PLA2G16 methylation at CG2 showed the highest predictive value at 0.8 (odds ratio, 1.37; 95% confidence interval, 1.16-1.62; p<0.001). Using a probability cutoff of 0.065, the sensitivity and specificity of the multivariate model was 92% and 35%. When histologically normal prostate tissues/biopsies from patients with PC (TA) were compared to subjects without cancer, significant hypermethylation of PLA2G16 was noted (odds ratio, 1.35; 95% confidence interval, 1.07-1.71; p = 0.01). CONCLUSION PLA2G16 methylation defines an extensive field defect in histologically normal prostate tissue associated with PC. PLA2G16 methylation in urine and prostate tissues can detect the presence of PC.
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Affiliation(s)
- William E. Jarrard
- Carbone Comprehensive Cancer Center, University of Wisconsin, Madison, WI, United States of America
| | - Adam Schultz
- Carbone Comprehensive Cancer Center, University of Wisconsin, Madison, WI, United States of America
| | - Tyler Etheridge
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Shivashankar Damodaran
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Glenn O. Allen
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - David Jarrard
- Carbone Comprehensive Cancer Center, University of Wisconsin, Madison, WI, United States of America
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Bing Yang
- Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
- * E-mail:
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Abstract
PURPOSE In this study we explored the effect of Agent Orange exposure on prostate cancer survival in VA (Veterans Affairs) patients receiving androgen deprivation therapy for advanced prostate cancer. MATERIALS AND METHODS We retrospectively examined the association between Agent Orange exposure in men with prostate cancer in national VA databases who were being treated with androgen deprivation therapy. Patients were diagnosed with prostate cancer from 2000 to 2008 with followup through May 2016. Clinical, pathological and demographic variables were compared by Agent Orange exposure. Associations of Agent Orange with overall survival, skeletal related events and cancer specific survival were performed using adjusted Cox proportional hazard models after IPSW (inverse propensity score weighted) adjustment. RESULTS Overall 87,344 patients were identified. The 3,475 Agent Orange exposed patients were younger (p <0.001), had lower prostate specific antigen (p = 0.002) and were more likely to receive local therapy and chemotherapy (p <0.001) than the 83,869 nonexposed patients. The Charlson comorbidity index was similar in the groups (p = 0.40). After IPSW adjustment Agent Orange exposure was associated with improved overall survival (HR 0.84, 95% CI 0.73-0.97, p = 0.02). However, no difference was observed in the risk of skeletal related events (HR 1.04, 95% CI 0.80-1.35, p = 0.77) or cancer specific survival (HR 0.79, 95% CI 0.60-1.03, p = 0.08). CONCLUSIONS Agent Orange exposure was associated with a decreased risk of death in men receiving androgen deprivation therapy for advanced prostate cancer. It does not appear to be associated with worse oncologic outcomes.
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Affiliation(s)
- Tyler Etheridge
- Department of Urology, University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin
| | - Jinn-Ing Liou
- Department of Medicine, University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin
| | - Tracy M Downs
- Department of Urology, University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin
| | - E Jason Abel
- Department of Urology, University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin
| | - David F Jarrard
- Department of Urology, University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin
| | - Kyle A Richards
- Department of Urology, University of Wisconsin School of Medicine and Public Health , Madison , Wisconsin.,William S. Middleton Memorial Veterans Hospital , Madison , Wisconsin
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Etheridge T, Schultz A, McCormick J, Damodaran S, Yang* B, Allen GO, Huang W, LaViolette P, Jarrard D. MP81-20 AUTOMATED IMAGE ANALYSIS OF HISTOLOGICALLY BENIGN PROSTATE BIOPSIES PREDICTS CANCER PRESENCE. J Urol 2019. [DOI: 10.1097/01.ju.0000557439.15646.cd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Etheridge T, Straus J, Ritter MA, Jarrard DF, Huang W. Semen AMACR protein as a novel method for detecting prostate cancer. Urol Oncol 2018; 36:532.e1-532.e7. [PMID: 30337219 DOI: 10.1016/j.urolonc.2018.09.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 09/02/2018] [Accepted: 09/12/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Alpha methylacyl A coenzyme racemase (AMACR) has shown to be an excellent immunohistological biomarker for prostate cancer (CaP). Given the connection between prostate and urethra, we hypothesized that semen ejaculate would be an ideal specimen for detection of CaP specific biomarkers, such as AMACR. This study explores the detection of semen AMACR protein in men with and without CaP. METHODS Semen ejaculates from 28 biopsy proven CaP patients prior to radical prostatectomy and 15 age-comparable controls were analyzed. An indirect sandwich ELISA chemiluminescence assay was used to detect semen AMACR, PSA, and Matriptase proteins. Tissue AMACR protein was quantified in 12 corresponding prostatectomy specimens using automated quantitative analysis (AQUA). RESULTS Semen AMACR protein was detected in 23 of 28 (82%) CaP patients and 23 of 24 (96%) CaP patients with significant tumor volume (>0.5 cc or 0.3 g). Among the 5 cancer patients with undetectable semen AMACR, 4 patients had small tumor volumes (<1% or 0.3 g). Semen AMACR protein was also detected in 7 of 15 (47%) control noncancer patients. Using 76 ng/ml as a cutoff value, 20 of 28 (71%) patients and 20 of 24 (83%) patients with significant tumor volume were positive for semen AMACR protein, whereas only 5 of 15 (33%) age-comparable controls were positive. AMACR levels degrade with time. CONCLUSIONS This is the first study to demonstrate that AMACR protein is detectable in semen ejaculate. The higher AMACR levels detected in cancer patients suggests that semen AMACR protein may be useful as a noninvasive test for prostate cancer. Further validation is warranted.
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Affiliation(s)
- Tyler Etheridge
- Department of Urology, University of Wisconsin-Madison, Madison, WI
| | - Jane Straus
- UW Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Mark A Ritter
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI; UW Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - David F Jarrard
- Department of Urology, University of Wisconsin-Madison, Madison, WI; UW Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI
| | - Wei Huang
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI; UW Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI.
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25
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Etheridge T, Atherton PJ. Food texture: A potential dietary consideration for obesity prevention? Exp Physiol 2018; 103:1298-1299. [PMID: 30145804 DOI: 10.1113/ep087241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 11/08/2022]
Affiliation(s)
- T Etheridge
- University of Exeter, Sport and Health Sciences, St Luke's Campus, Exeter, UK
| | - P J Atherton
- University of Nottingham, MRC-ARUK Centre of Excellence, NIHR Biomedical Research Centre, School of Medicine, Division of Medical Sciences & Graduate Entry Medicine, Derby, UK
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Etheridge T, Liou J, Downs TM, Abel EJ, Richards KA, Jarrard DF. The impact of celecoxib on outcomes in advanced prostate cancer patients undergoing androgen deprivation therapy. Am J Clin Exp Urol 2018; 6:123-132. [PMID: 30038944 PMCID: PMC6055075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 04/23/2018] [Indexed: 06/08/2023]
Abstract
Recent work suggests the selective Cox-2 inhibitor celecoxib delays progression to androgen independence in hormone sensitive prostate cancer (HSPC) through inhibition of the androgen receptor (AR) and ErbB signaling. However, human studies examining its effect on delaying disease progression while on hormone therapy are limited. This study explores the effect of celecoxib use on PC survival in VA patients undergoing androgen deprivation therapy (ADT) for advanced PC. We retrospectively examined the association between celecoxib use (defined as duration of medication use ≥180 days) in men with PC being treated with ADT in national VA databases. Patients were diagnosed with PC from 2000-2008 and had follow-up through May 2016. Clinical, pathologic and demographic variables were compared by celecoxib use, using Mann-Whitney U test and Chi-squared tests. Associations between celecoxib use and overall survival (OS), skeletal related events (SRE), and cancer specific survival (CSS) were performed using adjusted Cox proportional hazard models. Overall, 87,344 patients with PC on ADT were identified. Patients on celecoxib (n=1,581) had lower PSA levels at both diagnosis (7.0 versus 8.7 ng/mL, P<0.001) and initiation of ADT (6.2 versus 7.3 ng/mL, P=0.002) compared to patients not taking celecoxib (n=85,763). Gleason score (P=0.14), death from PC (P=0.07), and number of SREs (P=0.18) were similar between groups. In the Cox multivariable analysis, celecoxib use was not associated with improved OS (hazard ratio, HR, 1.06, 95% confidence interval, CI, 0.93-1.21, P=0.38), risk of SRE (HR 0.95, 95% CI 0.62-1.44, P=0.80), or improved CSS (HR 1.00, 95% CI 0.78-1.28, P=0.98). Despite an association with lower PSA levels, celecoxib use in PC patients on ADT was not associated with improved cancer outcomes.
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Affiliation(s)
- Tyler Etheridge
- Department of Urology, University of Wisconsin School of Medicine and Public HealthMadison, WI
| | - Jinning Liou
- Department of Medicine, University of Wisconsin School of Medicine and Public HealthMadison, WI
| | - Tracy M Downs
- Department of Urology, University of Wisconsin School of Medicine and Public HealthMadison, WI
| | - E Jason Abel
- Department of Urology, University of Wisconsin School of Medicine and Public HealthMadison, WI
| | - Kyle A Richards
- Department of Urology, University of Wisconsin School of Medicine and Public HealthMadison, WI
| | - David F Jarrard
- Department of Urology, University of Wisconsin School of Medicine and Public HealthMadison, WI
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Cesnik AJ, Yang B, Truong A, Etheridge T, Spiniello M, Steinbrink MI, Shortreed MR, Frey BL, Jarrard DF, Smith LM. Long Noncoding RNAs AC009014.3 and Newly Discovered XPLAID Differentiate Aggressive and Indolent Prostate Cancers. Transl Oncol 2018; 11:808-814. [PMID: 29723810 PMCID: PMC6154865 DOI: 10.1016/j.tranon.2018.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 03/30/2018] [Accepted: 04/02/2018] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION: The molecular mechanisms underlying aggressive versus indolent disease are not fully understood. Recent research has implicated a class of molecules known as long noncoding RNAs (lncRNAs) in tumorigenesis and progression of cancer. Our objective was to discover lncRNAs that differentiate aggressive and indolent prostate cancers. METHODS: We analyzed paired tumor and normal tissues from six aggressive Gleason score (GS) 8-10 and six indolent GS 6 prostate cancers. Extracted RNA was split for poly(A)+ and ribosomal RNA depletion library preparations, followed byRNA sequencing (RNA-Seq) using an Illumina HiSeq 2000. We developed an RNA-Seq data analysis pipeline to discover and quantify these molecules. Candidate lncRNAs were validated using RT-qPCR on 87 tumor tissue samples: 28 (GS 6), 28 (GS 3+4), 6 (GS 4+3), and 25 (GS 8-10). Statistical correlations between lncRNAs and clinicopathologic variables were tested using ANOVA. RESULTS: The 43 differentially expressed (DE) lncRNAs between aggressive and indolent prostate cancers included 12 annotated and 31 novel lncRNAs. The top six DE lncRNAs were selected based on large, consistent fold-changes in the RNA-Seq results. Three of these candidates passed RT-qPCR validation, including AC009014.3 (P < .001 in tumor tissue) and a newly discovered X-linked lncRNA named XPLAID (P = .049 in tumor tissue and P = .048 in normal tissue). XPLAID and AC009014.3 show promise as prognostic biomarkers. CONCLUSIONS: We discovered several dozen lncRNAs that distinguish aggressive and indolent prostate cancers, of which four were validated using RT-qPCR. The investigation into their biology is ongoing.
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Affiliation(s)
- Anthony J Cesnik
- Department of Chemistry, University of Wisconsin-Madison, Madison, WI, USA.
| | - Bing Yang
- Department of Urology, University of Wisconsin-Madison, Madison, WI, USA; Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA.
| | - Andrew Truong
- Department of Urology, University of Wisconsin-Madison, Madison, WI, USA; Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA.
| | - Tyler Etheridge
- Department of Urology, University of Wisconsin-Madison, Madison, WI, USA; Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA.
| | - Michele Spiniello
- Department of Chemistry, University of Wisconsin-Madison, Madison, WI, USA.
| | | | | | - Brian L Frey
- Department of Chemistry, University of Wisconsin-Madison, Madison, WI, USA.
| | - David F Jarrard
- Department of Urology, University of Wisconsin-Madison, Madison, WI, USA; Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA.
| | - Lloyd M Smith
- Department of Chemistry, University of Wisconsin-Madison, Madison, WI, USA; Genome Center of Wisconsin, University of Wisconsin-Madison, Madison, WI, USA.
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Wilkinson DJ, Hossain T, Hill DS, Phillips BE, Crossland H, Williams J, Loughna P, Churchward-Venne TA, Breen L, Phillips SM, Etheridge T, Rathmacher JA, Smith K, Szewczyk NJ, Atherton PJ. Effects of leucine and its metabolite β-hydroxy-β-methylbutyrate on human skeletal muscle protein metabolism. J Physiol 2013; 591:2911-23. [PMID: 23551944 PMCID: PMC3690694 DOI: 10.1113/jphysiol.2013.253203] [Citation(s) in RCA: 327] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Maintenance of skeletal muscle mass is contingent upon the dynamic equilibrium (fasted losses–fed gains) in protein turnover. Of all nutrients, the single amino acid leucine (Leu) possesses the most marked anabolic characteristics in acting as a trigger element for the initiation of protein synthesis. While the mechanisms by which Leu is ‘sensed’ have been the subject of great scrutiny, as a branched-chain amino acid, Leu can be catabolized within muscle, thus posing the possibility that metabolites of Leu could be involved in mediating the anabolic effect(s) of Leu. Our objective was to measure muscle protein anabolism in response to Leu and its metabolite HMB. Using [1,2-13C2]Leu and [2H5]phenylalanine tracers, and GC-MS/GC-C-IRMS we studied the effect of HMB or Leu alone on MPS (by tracer incorporation into myofibrils), and for HMB we also measured muscle proteolysis (by arteriovenous (A–V) dilution). Orally consumed 3.42 g free-acid (FA-HMB) HMB (providing 2.42 g of pure HMB) exhibited rapid bioavailability in plasma and muscle and, similarly to 3.42 g Leu, stimulated muscle protein synthesis (MPS; HMB +70%vs. Leu +110%). While HMB and Leu both increased anabolic signalling (mechanistic target of rapamycin; mTOR), this was more pronounced with Leu (i.e. p70S6K1 signalling ≤90 min vs. ≤30 min for HMB). HMB consumption also attenuated muscle protein breakdown (MPB; −57%) in an insulin-independent manner. We conclude that exogenous HMB induces acute muscle anabolism (increased MPS and reduced MPB) albeit perhaps via distinct, and/or additional mechanism(s) to Leu.
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Affiliation(s)
- D J Wilkinson
- Metabolic and Molecular Physiology Research Group, MRC-ARUK Centre of Excellence for Musculoskeletal Ageing Research, School of Graduate Entry Medicine and Health, Derby DE22 3DT, UK.
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