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Park DY, Vemmou E, An S, Nikolakopoulos I, Regan CJ, Cambi BC, Frampton J, Vij A, Brilakis E, Nanna MG. Trends and impact of intravascular ultrasound and optical coherence tomography on percutaneous coronary intervention for myocardial infarction. Int J Cardiol Heart Vasc 2023; 45:101186. [PMID: 36852085 PMCID: PMC9957744 DOI: 10.1016/j.ijcha.2023.101186] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/30/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023]
Abstract
Background Intravascular imaging with either intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during percutaneous coronary intervention (PCI) is associated with improved outcomes, but these techniques have previously been underutilized in the real world. We aimed to examine the change in utilization of intravascular imaging-guided PCI over the past decade in the United States and assess the association between intravascular imaging and clinical outcomes following PCI for myocardial infarction (MI). Methods We surveyed the National Inpatient Sample from 2008 to 2019 to calculate the number of PCIs for MI guided by IVUS or OCT. Temporal trends were analyzed using Cochran-Armitage trend test or simple linear regression for categorical or continuous outcomes, respectively. Multivariable logistic regression was used to compare outcomes following PCI with and without intravascular imaging. Results A total of 2,881,746 PCIs were performed for MI. The number of IVUS-guided PCIs increased by 309.9 % from 6,180 in 2008 to 25,330 in 2019 (P-trend < 0.001). The percentage of IVUS use in PCIs increased from 3.4 % in 2008 to 8.7 % in 2019 (P-trend < 0.001). The number of OCT-guided PCIs increased 548.4 % from 246 in 2011 to 1,595 in 2019 (P-trend < 0.001). The percentage of OCT guidance in all PCIs increased from 0.0 % in 2008 to 0.6 % in 2019 (P-trend < 0.001). Intravascular imaging-guided PCI was associated with lower odds of in-hospital mortality (adjusted odds ratio 0.66, 95 % confidence interval 0.60-0.72, p < 0.001). Conclusions Although the number of intravascular imaging-guided PCIs have been increasing, adoption of intravascular imaging remains poor despite an association with lower mortality.
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Key Words
- BMS, Bare-metal stent
- CI, Confidence interval
- DES, Drug-eluting stent
- HCUP, Healthcare Cost and Utilization Project
- ICD-10-CM, International Classification of Diseases, 10th Revision, Clinical Modification
- ICD-10-PCS, International Classification of Diseases, 10th Revision, Procedural Coding System
- ICD-9-CM, International Classification of Diseases, 9th Revision, Clinical Modification
- ICD-9-PCS, International Classification of Diseases, 9th Revision, Procedural Coding System
- IVUS
- IVUS, Intravascular ultrasound
- Imaging
- Intravascular
- MI, Myocardial infarction
- Myocardial infarction
- NIS, National Inpatient Sample
- NSTEMI, Non-ST-elevation myocardial infarction
- OCT
- OCT, Optical coherence tomography
- PCI
- PCI, Percutaneous coronary intervention
- STEMI, ST-elevation myocardial infarction
- Trend
- U.S, United States
- aOR, Adjusted odds ratio
- cOR, Crude odds ratio
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Affiliation(s)
- Dae Yong Park
- Department of Medicine, Cook County Health, Chicago, IL, USA
| | - Evangelia Vemmou
- Department of Medicine, Yale New Haven Hospital, New Haven, CT, USA
| | - Seokyung An
- Department of Biomedical Science, Seoul National University, Seoul, Republic of Korea
| | | | | | - Brian C. Cambi
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Jennifer Frampton
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Aviral Vij
- Division of Cardiology, Cook County Health, Chicago, IL, USA
- Division of Cardiology, Rush Medical College, Chicago, IL, USA
| | - Emmanouil Brilakis
- Division of Cardiology, Minneapolis Heart Institute, Minneapolis, MN, USA
| | - Michael G. Nanna
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
- Corresponding author at: Yale New Haven Hospital, 20 York Street, New Haven, CT 06510, USA.
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Perzia B, Theotoka D, Li K, Moss E, Matesva M, Gill M, Kibe M, Chow J, Green S. Treatment of ocular-involving monkeypox virus with topical trifluridine and oral tecovirimat in the 2022 monkeypox virus outbreak. Am J Ophthalmol Case Rep 2023; 29:101779. [PMID: 36573234 PMCID: PMC9744718 DOI: 10.1016/j.ajoc.2022.101779] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 12/14/2022] Open
Abstract
Purpose To report a case of ocular involving monkeypox infection in the United States during the 2022 outbreak, and to review the literature regarding its clinical manifestations and management known to date. Observations A 36-year-old man with well controlled HIV presented to the emergency department with anal pain, diffuse rash, right eye pain, and right eye redness after he tested positive for monkeypox one week prior. Ocular examination showed bilateral periorbital vesicular lesions, right eye conjunctival injection, and a single white plaque on his right medial bulbar conjunctiva. Macular, vesicular, and pustular lesions were noted throughout his body, including the genital and perianal region. His ocular and systemic symptoms completely resolved after treatment with a ten-day course of 1% trifluridine and moxifloxacin drops in both eyes, as well as two weeks of oral tecovirimat. Conclusion and Importance In July of 2022, monkeypox virus was declared a global health emergency by the World Health Organization; however, there are no standard guidelines for monkeypox treatment. Data on its clinical presentation and course, especially pertaining to ocular manifestations, is limited. We highlight the importance of recognizing ophthalmic manifestations of monkeypox virus and a possible therapeutic approach to help guide the management of these patients.
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Key Words
- ART, Antiretroviral therapy
- CDC, Centers for Disease Control and Prevention
- Conjunctival lesion
- Conjunctivitis
- MPV, Monkeypox virus
- Monkeypox virus
- OCT, Optical coherence tomography
- OD, right eye
- OS, left eye
- OSSN, Ocular surface squamous neoplasia
- OU, both eyes
- Ocular manifestations
- PCP, Primary care physician
- STI, Sexually transmitted infection
- VIG, Vaccinia immune globulin
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Affiliation(s)
- Brittany Perzia
- Department of Ophthalmology and Visual Science, Yale School of Medicine, 40 Temple Street, New Haven, CT, 06510, USA
| | - Despoina Theotoka
- Department of Ophthalmology and Visual Science, Yale School of Medicine, 40 Temple Street, New Haven, CT, 06510, USA
| | - Katie Li
- Department of Ophthalmology and Visual Science, Yale School of Medicine, 40 Temple Street, New Haven, CT, 06510, USA,Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Emily Moss
- Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Mitchelle Matesva
- Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Mohsain Gill
- Department of Ophthalmology and Visual Science, Yale School of Medicine, 40 Temple Street, New Haven, CT, 06510, USA
| | - Mercy Kibe
- Department of Ophthalmology and Visual Science, Yale School of Medicine, 40 Temple Street, New Haven, CT, 06510, USA
| | - Jessica Chow
- Department of Ophthalmology and Visual Science, Yale School of Medicine, 40 Temple Street, New Haven, CT, 06510, USA
| | - Stephanie Green
- Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA,Corresponding author
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Itzam Marin A, Deitz GA, Mudie LI, Reddy AK, Palestine AG. Bilateral choroidal effusions and angle closure in the setting of systemic capillary leak syndrome from HLA-directed vaccine and pembrolizumab therapy for squamous cell carcinoma. Am J Ophthalmol Case Rep 2023; 29:101777. [PMID: 36578801 DOI: 10.1016/j.ajoc.2022.101777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/18/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Purpose Immunotherapy has become an important addition to oncology treatment plans in recent years. As these therapies become more widely employed, many unique side effects have been reported. In ophthalmology the most well-documented side effects of immune checkpoint inhibitors (ICI) include uveitis, macular edema and dry eye syndrome. This manuscript describes a rare case of bilateral choroidal effusions and secondary angle narrowing in the setting of systemic capillary leak syndrome (SCLS) from an HLA-directed vaccine and an ICI, pembrolizumab, for the treatment of stage IV squamous cell carcinoma (SCC) of the lung. Observations A 67-year-old male with a history of stage IV SCC of the lung status-post pneumonectomy presented to the emergency department due to functional decline, anasarca, and dyspnea after receiving an HLA-directed vaccine in combination with pembrolizumab. Extensive workup revealed that his symptoms were secondary to SCLS. Ophthalmology was consulted due bilateral choroidal detachments seen on magnetic resonance imaging. B-scan ultrasound and ultrasound biomicroscopy revealed large, non-appositional choroidal effusions with anterior rotation of the ciliary body. Given minimal response to oral steroid therapy, sub-Tenon's triamcinolone acetonide, atropine, and intraocular pressure-lowering eyedrops were initiated with a good response. Conclusions and Importance Choroidal effusions and secondary angle closure can be rare complications of SCLS in the setting of ICIs. Clinicians must be aware of the potentials side effects of ICI therapy, as these medications become more commonly used.
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Key Words
- AACG, Acute angle closure glaucoma
- AC, Anterior chamber
- CSC, Central serous chorioretinopathy
- Choroidal effusion
- HLA, Human Leukocyte Antigen
- ICI, Immune checkpoint inhibitors
- IFN, Interferon
- IL, Interleukin
- IOP, Intraocular pressure
- Idiopathic systemic capillary leak syndrome
- Immune checkpoint inhibitor
- LPI, Laser peripheral iridotomy
- MRI, Magnetic resonance imaging
- OCT, Optical coherence tomography
- PCIOL, Posterior chamber intraocular lens
- PD-1, Programmed cell death protein 1
- SCLS, Systemic capillary leak syndrome
- SCS, Squamous cell carcinoma
- Secondary angle closure
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Dhodapkar RM, Spadaro JZ, Adelman RA. A case of extrafoveal focal choroidal excavation. Am J Ophthalmol Case Rep 2022; 27:101682. [PMID: 35990800 PMCID: PMC9385540 DOI: 10.1016/j.ajoc.2022.101682] [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: 05/05/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To describe an extrafoveal presentation of focal choroidal excavation and corresponding imaging findings. Methods Retrospective case report. Patients Single patient with diagnosis of extrafoveal focal choroidal excavation. Results A 28-year-old man was referred for evaluation of a suspicious lesion in his right posterior fundus. Functional examination demonstrated best-corrected visual acuity of 20/40 in the right eye and 20/20 in the left eye. Ophthalmoscopy exam and fundus photography revealed a yellowish lesion superior to the fovea of the right eye. The lesion was hyperfluorescent on fundus autofluorescence imaging and late phase fluorescein angiography demonstrated staining of the lesion without leakage. Optical coherence tomography (OCT) of the lesion was consistent with focal choroidal excavation. Five months after presentation, the patient's vision, exam, and imaging remained stable. Discussion Focal choroidal excavation is a recently recognized clinical entity that is often incidentally found, and presents asymptomatic or with mildly decreased visual acuity in the affected eye. It has characteristic findings on optical coherence tomography (OCT) that can be used to distinguish it from other retinal lesions that may appear similar on ophthalmoscopy. We present the case of an uncommon extrafoveal presentation of FCE at a relatively young age, which may represent either a congenital abnormality or the sequelae of an unidentified chronic process. While most FCE remain stable, patients are often followed for lesion progression and the possibility of choroidal vascular pathology which might necessitate intervention.
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Affiliation(s)
| | - Jane Zhu Spadaro
- Department of Ophthalmology and Visual Science, Yale University, New Haven, CT, USA
| | - Ron A Adelman
- Department of Ophthalmology and Visual Science, Yale University, New Haven, CT, USA
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Altınel MG, Uslu H. Comparison of choroidal structural changes between children born preterm without retinopathy of prematurity and age-matched children born at full term. Photodiagnosis Photodyn Ther 2021; 37:102626. [PMID: 34785405 DOI: 10.1016/j.pdpdt.2021.102626] [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: 05/13/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022]
Abstract
AIM To evaluate the effect of prematurity on choroidal structure in children born preterm with no history of retinopathy of prematurity (ROP) by comparing them with age-matched healthy children born at full term. METHODS Enhanced depth imaging optical coherence tomography (EDI-OCT) scans of children aged 5 to 9 years with a history of prematurity but no history of ROP, and age-matched full-term healthy children were evaluated, retrospectively. Choroidal thicknesses (CTs) were measured at subfoveal (SFCT), 1000 µm temporal and nasal from the fovea (T1, N1), and 2000 µm temporal and nasal (T2, N2) from the fovea. The EDI-OCT images were binarized to stromal (SA) and luminal areas (LA) using the ImageJ software. The choroidal vascularity index (CVI) was calculated by dividing LA by the total choroidal area (TCA). RESULTS Twenty-nine eyes of 15 preterm children and 41 eyes of 26 full-term children were included. Demographic characteristics including axial length (AL), eye side, age, and the sex of the children in the groups were similar (p>0.05). There was no statistically significant difference in the mean CVI, SFCT, N1, and T1 values between the groups (p>0.05); however, the mean T2 and N2 values were significantly higher in the full-term group than in the preterm group (p<0.05). There was a significant positive correlation between the birth week and the T1 (p<0.05) CONCLUSION: : Prematurity can affect CT even with no history of ROP. The decreases in CTs were significant at 2000 µm nasal and temporal from the fovea. The impairment of temporal choroidal region was more evident than nasal choroidal region. The mean CVI values were similar between the groups.
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Key Words
- AL, Axial length
- ANS, Autonomic nervous system
- Abbrevation: ROP, Retinopathy of prematurity
- BCVA, Best corrected visual acuity
- CRYO-ROP, The Cryotherapy for Retinopathy of Prematurity study
- CT, Choroidal thickness
- CVI, Choroidal vascularity index
- ChVD, Choriocapillaris vessel density
- Choroidal thickness
- Choroidal vascularity index
- D, Diopter
- EDI-OCT, Enhanced depth imaging- OCT
- LA, Luminal area
- N1, Choroidal thickness at 1000 µm nasal to the center of the fovea
- N2, Choroidal thickness at 2000 µm nasal to the center of the fovea
- O2, Oxygen
- OCT, Optical coherence tomography
- OCTA, OCT angiography
- Prematurity
- Q, Quality score
- RGB, Red green blue
- ROI, Region of interest
- RPE, Retinal pigment epithelium
- SFCT, Subfoveal choroidal thickness
- SS-OCT, Swept-source OCT
- T1, Choroidal thickness at 1000 µm temporal to the center of the fovea
- T2, Choroidal thickness at 2000 µm temporal to the center of the fovea
- TCA, Total choroidal area
- VEGF, Vascular endothelial growth factor
- srROP, spontaneously regressed ROP
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Affiliation(s)
- Meltem Guzin Altınel
- Saglik Bilimleri University Fatih Sultan Mehmet Training and Research Hospital, Department of Ophthalmology, 34752 Istanbul, Turkey..
| | - Hasim Uslu
- Hisar Intercontinental Hospital, Department of Ophthalmology, 34768 Istanbul, Turkey.
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Peverill WT, Incani A, Worthley SG, Singbal Y, Garrahy PJ, McCann AB, Cox SV, Moore PT, Lim RYY, Fetahovic T, Connors GW, Hall C, Sieg C, Camuglia AC. The Cone Flare Crush Modified-T (CFCT) stenting technique for coronary artery bifurcation lesions. Int J Cardiol Heart Vasc 2020; 30:100643. [PMID: 33015315 DOI: 10.1016/j.ijcha.2020.100643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/30/2020] [Accepted: 09/13/2020] [Indexed: 12/13/2022]
Abstract
Background The present study is a prospective observational single arm clinical investigation, with parallel bench test interrogation, aimed at investigating the technical feasibility, safety and clinical outcomes with the cone flare crush modified-T (CFCT) bifurcation stenting technique. Bifurcation percutaneous coronary intervention (PCI) remains an area of ongoing procedural evolution. More widely applicable and reproducible techniques are required. Methods From April 2018 until March 2019, 20 consecutive patients underwent bifurcation PCI using the CFCT technique with a Pt-Cr everolimus drug-eluting stent with a bioresorbable polymer. Exercise stress echocardiography was performed at 12-month follow-up. The primary outcome was a composite of cardiac related mortality, myocardial infarction, target lesion/vessel revascularization and stroke. Safety secondary endpoints included bleeding, all-cause mortality and stent thrombosis. Results All patients underwent a successful CFCT bifurcation procedure with no complications to 30-day follow-up. One patient met the primary endpoint requiring target lesion revascularization at 9 months for stable angina. There were no other primary or secondary outcome events in the cohort. There were no strokes, deaths, stent thrombosis or myocardial infarction during the follow-up period. The mean CCS score improved from 2.25 to 0.25 (p < 0.0001). Optical coherence tomography (OCT) and bench test findings indicated optimal side branch ostial coverage and minimal redundant strut material crowding the neo-carina. Conclusions The CFCT technique appears to be a safe, efficacious and feasible strategy for managing coronary artery bifurcation disease. Expanded and randomized datasets with longer term follow-up are required to further explore confirm this feasibility data. (ANZCTR ID: ACTRN12618001145291).
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Key Words
- ACS, Acute coronary syndrome
- ACT, Activated clotting time
- AHA, American Heart Association
- ARC, Academic Research Consortium
- BARC, British Academic Research Consortium
- CABG, Coronary artery bypass grafting
- CCS, Canadian Cardiovascular Society
- CFCT, Cone Flare Crush Modified-T
- CFI, Cone Flare Inflation
- DAPT, Dual antiplatelet therapy
- DES, Drug Eluting Stent
- DMV, Distal main vessel
- DSE, Dobutamine stress echocardiography
- Drug Eluting Stent (DES)
- ESE, Exercise stress echocardiography
- ISKB, Intermediary simultaneous kissing balloon
- ISR, In stent restenosis
- LAD, Left anterior descending artery
- LCx, Left circumflex artery
- LMCA, Left main coronary artery
- MACCE, Major adverse cardiac and cerebrovascular event
- MI, Myocardial infarct
- MRA, Mechanical rotational atherectomy
- MV, Main Vessel
- NSTEMI, Non-ST elevation Myocardial Infarction
- NYHA, New York heart association
- OCT, Optical coherence tomography
- PCI, Percutaneous Coronary Intervention
- PMV, Proximal main vessel
- POT, Proximal Optimisation Technique
- PUKBI, Penultimate kissing balloon inflation
- Percutaneous Coronary Intervention (PCI)
- QCA, Quantitative Coronary Angiography
- RBP, Rated Burst Pressure
- SB, Side Branch
- SEM, Standard Error of the mean
- ST, Stent thrombosis
- STEMI, ST elevation Myocardial Infarction
- SYNTAX, Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery
- Stenting technique (STEC)
- TLR, Target Lesion Revascularisation
- TVR, Target Vessel Revascularisation
- UAP, Unstable angina pectoris
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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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Kikuchi T, Shimizu T. Thickness-wise growth technique for human articular chondrocytes to fabricate three-dimensional cartilage grafts. Regen Ther 2020; 14:119-127. [PMID: 32055650 PMCID: PMC7005340 DOI: 10.1016/j.reth.2019.12.001] [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: 09/02/2019] [Revised: 11/02/2019] [Accepted: 12/03/2019] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Cutting the cost of manufacturing is important for extending the use of tissue-engineered therapeutic products. The present study aimed to develop a simple method for fabrication of cartilaginous tissues for regenerative therapy, utilizing the phenomenon where human articular chondrocytes grow thickness-wise and spontaneously form three-dimensionally thick tissues. METHODS Normal human articular chondrocytes (NHACs) were cultured with varying concentrations of transforming growth factor beta 1 (TGF-β1) and/or fibroblast growth factor-2 (FGF-2) to optimize the culture condition for thickness-wise growth of chondrocytes. Next, the tissues grown in the optimal condition were subjected to re-differentiation culture in attached and detached states to assess differentiation capacity by evaluating secreted factors, histological analysis, and a gene expression assay. RESULTS NHACs grew thickness-wise efficiently in the presence of 1 ng/mL TGF-β1 and 10 ng/mL FGF-2. After two weeks of culture, NHACs grew with 11-fold higher thickness and 16-fold higher cell number compared to cells which were neither treated with TGF-β1 nor with FGF-2. These thickness-wise-grown chondrocytes could be re-differentiated by a differentiation medium according to the increase in melanoma inhibitory activity (MIA) and positive safranin-O staining. Interestingly, the cartilaginous gene expression was considerably different between the attached and detached conditions even in the same culture medium, indicating the necessity of detachment and shrinkage to achieve further differentiation. CONCLUSIONS Spontaneous thickness-wise growth might provide a simple tissue-engineering method for manufacturing cartilaginous 3D tissues.
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Affiliation(s)
| | - Tatsuya Shimizu
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University (TWIns), 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan
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Rodrigues EB, Urias MG, Penha FM, Badaró E, Novais E, Meirelles R, Farah ME. Diabetes induces changes in neuroretina before retinal vessels: a spectral-domain optical coherence tomography study. Int J Retina Vitreous 2015; 1:4. [PMID: 27847597 PMCID: PMC5066512 DOI: 10.1186/s40942-015-0001-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 01/16/2015] [Indexed: 12/26/2022] Open
Abstract
Purpose To investigate retinal changes prior to vascular signs in patients with type 2 diabetes without diabetic retinopathy or with mild non proliferative diabetic retinopathy. Methods A cross-sectional study was performed in three groups: patients without diabetes, patients with type 2 diabetes without diabetic retinopathy, and patients with diabetes with mild diabetic retinopathy. Analysis of retinal layers was performed objectively with the Cirrus Review Software 6.0 (Carl Zeiss Meditec, Dublin, CA, USA). Macular cube scans were analyzed with regard to: the ganglion cell layer + inner plexiform layer analysis, retinal nerve fiber layer thickness, central subfoveal retinal thickness and average macular thickness. Results In total, 102 patients were included in this study, of which 28 (27.4%) were classified into control group, 46 (45.0%) classified as diabetic patients with no diabetic retinopathy and 28 (27.4%) classified as mild diabetic retinopathy. Quantitative analysis with the Cirrus software showed that the mean ganglion cell layer and mean retinal nerve fiber layer were thinner in diabetes without diabetic retinopathy group when compared to controls. ANOVA with Bonferroni post test indicated a statistically significant reduction in average retinal thickness in mild diabetic retinopathy group (P = 0.032) compared to control and reduction in ganglion cell layer in diabetes with no diabetic retinopathy (P = 0.039) and mild diabetic retinopathy (P = 0.003). Also indicated reduction in retinal nerve fiber layer in diabetic without diabetic retinopathy and eyes with mild diabetic retinopathy (P < 0.001), compared to controls. Conclusions Our study found reduction in thickness of ganglion cell layer and retinal nerve fiber layer in patients with diabetes without diabetic retinopathy, which suggests neuroretinal changes before vascular signs of diabetic retinopathy.
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Affiliation(s)
- Eduardo Büchele Rodrigues
- Department of Ophthalmology, Federal University of São Paulo, R. Botucatu 820, 04023-062 SP São Paulo, Brazil
| | - Müller Gonçalves Urias
- Department of Ophthalmology, Federal University of São Paulo, R. Botucatu 820, 04023-062 SP São Paulo, Brazil
| | - Fernando Marcondes Penha
- Department of Ophthalmology, Federal University of São Paulo, R. Botucatu 820, 04023-062 SP São Paulo, Brazil
| | - Emmerson Badaró
- Department of Ophthalmology, Federal University of São Paulo, R. Botucatu 820, 04023-062 SP São Paulo, Brazil
| | - Eduardo Novais
- Department of Ophthalmology, Federal University of São Paulo, R. Botucatu 820, 04023-062 SP São Paulo, Brazil
| | - Rodrigo Meirelles
- Department of Ophthalmology, Federal University of São Paulo, R. Botucatu 820, 04023-062 SP São Paulo, Brazil
| | - Michel Eid Farah
- Department of Ophthalmology, Federal University of São Paulo, R. Botucatu 820, 04023-062 SP São Paulo, Brazil
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