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Gouliopoulos N, Oikonomou D, Karygianni F, Rouvas A, Kympouropoulos S, Moschos MM. The association of symptomatic vitreous floaters with depression and anxiety. Int Ophthalmol 2024; 44:218. [PMID: 38713290 DOI: 10.1007/s10792-024-03006-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/19/2023] [Indexed: 05/08/2024]
Abstract
PURPOSE To evaluate the levels of anxiety and depression in patients with symptomatic vitreous floaters and to determine the possible correlations of psychological implications with the symptoms duration and possible improvement, the degree of posterior vitreous detachment, and the discomfort severity. METHODS Ninety patients complaining for floaters and fifty-seven age- and gender-matched healthy-control subjects were recruited. Every participant underwent a complete ophthalmological examination, including funduscopy and optical coherence tomography scans, while clinical and demographic data were also gathered. The Patient Health Questionnaire-9 (PHQ-9), the Zung Depression Inventory-Self-Rating Depression Scale (Zung SDS), and the Hospital Anxiety and Depression Scale (HADS) were completed by everyone. RESULTS Between the studied groups, no significant differences were detected regarding the clinical and demographic data (p > 0.05). The patients with floaters had significantly higher scores of PHQ-9, Zung SDS, HADS Anxiety, and HADS Depression (p < 0.001). After adjustment for several confounders, PHQ-9 (p = 0.041), Zung SDS (p = 0.003), and HADS Anxiety (p = 0.036) values remained significantly impaired. Among the patients, PHQ-9 and Zung SDS scores were significantly elevated in the patients with floaters duration less than 4 weeks (p < 0.05). Finally, anxiety and depression were significantly correlated with the symptoms duration and intensity, with the floater-associated discomfort, and with the stage of posterior vitreous detachment. CONCLUSION Vitreous floaters have a negative impact on patients' psychological status, by the terms of enhanced depressive and anxiety levels. To the best of our knowledge, our study is the first in the literature to elaborate the aforementioned association, by assessing three different questionnaires simultaneously.
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Affiliation(s)
- Nikolaos Gouliopoulos
- 2nd Department of Ophthalmology, Medical School of National and Kapodistrian University of Athens, 'Attikon' University General Hospital, 1 Rimini Str, 12462, Haidari, Athens, Greece.
| | - Dimitra Oikonomou
- 2nd Department of Ophthalmology, Medical School of National and Kapodistrian University of Athens, 'Attikon' University General Hospital, 1 Rimini Str, 12462, Haidari, Athens, Greece
| | - Foteini Karygianni
- 2nd Department of Ophthalmology, Medical School of National and Kapodistrian University of Athens, 'Attikon' University General Hospital, 1 Rimini Str, 12462, Haidari, Athens, Greece
| | - Alexandros Rouvas
- 2nd Department of Ophthalmology, Medical School of National and Kapodistrian University of Athens, 'Attikon' University General Hospital, 1 Rimini Str, 12462, Haidari, Athens, Greece
| | - Stylianos Kympouropoulos
- 2nd Department of Psychiatry, Medical School of National and Kapodistrian University of Athens, 'Attikon' University General Hospital, Haidari, Athens, Greece
| | - Marilita M Moschos
- 1st Department of Ophthalmology, Medical School of National and Kapodistrian University of Athens, 'G. Gennimatas' General Hospital, Holargos, Athens, Greece
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Hammer M, Muuss M, Schickhardt S, Scheuerle A, Khoramnia R, Łabuz G, Uhl P, Auffarth GU. Forward Light Scattering of the Vitreous Gel After Enzymatic Aging: An In Vitro Model to Study Vitreous Opacification. Invest Ophthalmol Vis Sci 2024; 65:36. [PMID: 38551585 PMCID: PMC10981431 DOI: 10.1167/iovs.65.3.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/04/2024] [Indexed: 04/01/2024] Open
Abstract
Purpose Symptomatic vitreous opacifications, so-called floaters, are difficult to objectively assess majorly limiting the possibility of in vitro studies. Forward light scattering was found previously to be increased in eyes with symptomatic floaters. Using an objective setup to measure forward light scattering, we studied the effects of enzymatically digesting the components of the vitreous body on straylight to develop an in vitro model of vitreous opacifications. Methods Fifty-seven porcine vitreous bodies were digested using hyaluronidase, collagenase, trypsin, and bromelain, as well as using a combination of hyaluronidase + collagenase and hyaluronidase + bromelain. A modified C-Quant setup was used to objectively assess forward light scattering. Results Depletion of hyaluronic acid majorly increased vitreous straylight (mean increase 34.4 deg2/sr; P = 0.01), whereas primarily digesting the vitreous gel with collagenase or trypsin did not significantly affect straylight. When collagenase or bromelain is applied in hyaluronic acid depleted vitreous gels, the increase in forward light scattering is reversed partially. Conclusions The age-related loss of hyaluronic acid primarily drives the increase in vitreous gel straylight induced by conglomerates of collagen. This process can be reversed partially by digesting collagen. This in vitro model allows the objective quantification and statistical comparison of straylight burden caused by vitreous opacities and, thus, can serve as a first testing ground for pharmacological therapies, as demonstrated with bromelain.
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Affiliation(s)
- Maximilian Hammer
- University Eye Clinic Heidelberg, Heidelberg, Germany
- The David J Apple Laboratory for Vision Research, Heidelberg, Germany
| | - Marcel Muuss
- University Eye Clinic Heidelberg, Heidelberg, Germany
- The David J Apple Laboratory for Vision Research, Heidelberg, Germany
| | - Sonja Schickhardt
- The David J Apple Laboratory for Vision Research, Heidelberg, Germany
| | | | | | - Grzegorz Łabuz
- University Eye Clinic Heidelberg, Heidelberg, Germany
- The David J Apple Laboratory for Vision Research, Heidelberg, Germany
| | - Philipp Uhl
- Institute for Pharmacy and Molecular Biotechnology, Heidelberg, Germany
| | - Gerd Uwe Auffarth
- University Eye Clinic Heidelberg, Heidelberg, Germany
- The David J Apple Laboratory for Vision Research, Heidelberg, Germany
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Valentín-Bravo FJ. Vitreous opacities: A common but poorly understood phenomenon. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2024; 99:47-48. [PMID: 37944643 DOI: 10.1016/j.oftale.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/26/2023] [Indexed: 11/12/2023]
Affiliation(s)
- F J Valentín-Bravo
- The Retina Clinic London, London, United Kingdom; Hospital Germans Trias i Pujol, Barcelona, Spain.
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Hangshuai Z, Yanhua J, Yao Z, Guangjin Z, Hongyan W, Fanlian C. Efficacy and safety of early YAG laser vitreolysis for symptomatic vitreous floaters: the study protocol for a randomized clinical trial. Trials 2024; 25:48. [PMID: 38218919 PMCID: PMC10787457 DOI: 10.1186/s13063-024-07924-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/10/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Vitreous floaters are a common ocular condition that affects individuals of all ages. Although vitreous floaters are typically benign, they can significantly impair visual acuity and quality of life. Laser vitreolysis, which uses an Nd: YAG laser to vaporize collagenous vitreous opacities, is increasingly being used as a treatment option. However, there is currently a lack of evidence regarding its efficacy and the appropriate timing of its application. This study aims to evaluate the efficacy and safety of early intervention with YAG laser vitreolysis in treating symptomatic vitreous floaters. METHODS The present study is a randomized, controlled, double-blind clinical trial. A total of 70 participants with symptomatic floaters for 1 month were prospectively recruited. These participants will be randomly assigned to two groups, with 35 individuals in each group: the early treatment group and the delayed treatment group. Participants assigned to the early treatment group will undergo YAG laser vitreolysis immediately, followed by a sham laser treatment 3 months later. On the other hand, participants assigned to the delayed treatment group will receive a sham laser treatment and then undergo YAG laser vitreolysis 3 months later. The follow-up time points will be 1, 3, 6, and 12 months from randomization. Primary outcomes will be participants' self-reported improvement in visual disturbance on a scale of 1 to 10 and their scores on the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Secondary outcomes will be an objective evaluation of the effectiveness of the treatment in reducing vitreous floaters through OCT and fundus photography and tracking any adverse events related to the eyes or overall health. DISCUSSION This clinical trial aims to evaluate the effectiveness of YAG laser vitreolysis in treating symptomatic vitreous floaters and assess the safety of performing early intervention with YAG laser vitreolysis. TRIAL REGISTRATION ClinicalTrials.gov NCT05800353 . Registered on 10 March 2023.
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Affiliation(s)
- Zhou Hangshuai
- Department of Ophthalmology, Dongyang People's Hospital, No. 60 Wu Ning West Road, Dongyang, Zhejiang, China.
| | - Jin Yanhua
- Department of Ophthalmology, Dongyang People's Hospital, No. 60 Wu Ning West Road, Dongyang, Zhejiang, China
| | - Zhou Yao
- Department of Ophthalmology, Dongyang People's Hospital, No. 60 Wu Ning West Road, Dongyang, Zhejiang, China
| | - Zhao Guangjin
- Department of Ophthalmology, Dongyang People's Hospital, No. 60 Wu Ning West Road, Dongyang, Zhejiang, China
| | - Wu Hongyan
- Department of Ophthalmology, Dongyang People's Hospital, No. 60 Wu Ning West Road, Dongyang, Zhejiang, China
| | - Chen Fanlian
- Department of Ophthalmology, Dongyang People's Hospital, No. 60 Wu Ning West Road, Dongyang, Zhejiang, China
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Wu G, Zhao W, Wong A, Lee DA. Patients with floaters: Answers from virtual assistants and large language models. Digit Health 2024; 10:20552076241229933. [PMID: 38362238 PMCID: PMC10868475 DOI: 10.1177/20552076241229933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 02/17/2024] Open
Abstract
Objectives "Floaters," a common complaint among patients of all ages, was used as a query term because it affects 30% of all people searching for eye care. The American Academy of Ophthalmology website's "floaters" section was used as a source for questions and answers (www.aao.org). Floaters is a visual obstruction that moves with the movement of the eye. They can be associated with retinal detachment, which can lead to vision loss. With the advent of large language model (LLM) chatbots ChatGPT, Bard versus virtual assistants (VA), Google Assistant, and Alexa, we analyzed their responses to "floaters." Methods Using AAO.org, "Public & Patients," and its related subsection, "EyeHealth A-Z": Floaters and Flashes link, we asked four questions: (1) What are floaters? (2) What are flashes? (3) Flashes and Migraines? (4) Floaters and Flashes Treatment? to ChatGPT, Bard, Google Assistant, and Alexa. The American Academy of Ophthalmology (AAO) keywords were identified if they were highlighted. The "Flesch-Kincaid Grade Level" formula approved by the U.S. Department of Education, was used to evaluate the reading comprehension level for the responses. Results Of the chatbots and virtual assistants, Google Assistant is the only one that uses the term "ophthalmologist." There is no mention of the urgency or emergency nature of floaters. AAO.org shows a lower reading level vs the LLMs and VA (p = .11). The reading comprehension levels of ChatGPT, Bard, Google Assistant, and Alexa are higher (12.3, 9.7, 13.1, 8.1 grade) vs the AAO.org (7.3 grade). There is a higher word count for LLMs vs VA (p < .0286). Conclusion Currently, ChatGPT, Bard, Google Assistant, and Alexa are similar. Factual information is present but all miss the urgency of the diagnosis of a retinal detachment. Translational relevance: Both the LLM and virtual assistants are free and our patients will use them to obtain "floaters" information. There may be errors of omission with ChatGPT and a lack of urgency to seek a physician's care.
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Affiliation(s)
- Gloria Wu
- Department of Ophthalmology, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Weichen Zhao
- University of California, Davis, Davis, California, USA
| | - Adrial Wong
- University of California, Davis, Davis, California, USA
| | - David A Lee
- University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas, USA
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Lin T, Shi C, Wu B, Pazo EE, Shen L. Vision degrading myodesopsia assessed with optos ultra-widefield scanning laser ophthalmoscope. BMC Ophthalmol 2023; 23:425. [PMID: 37864149 PMCID: PMC10588225 DOI: 10.1186/s12886-023-03166-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/09/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND To investigate the diagnostic sensitivity of Optos imaging for vision degrading myodesopsia (VDM). METHODS A total of 420 eyes from 345 patients with VDM were collected in this cross-sectional study. All eyes were classified as having posterior vitreous detachment (PVD) or not having PVD. The sensitivity of Optos imaging for the visibility of vitreous floaters was evaluated. The associated factors with the visibility of vitreous floaters on Optos images were analyzed in univariate and multivariate logistic regression analyses. RESULTS The mean age of all patients was 56.19 ± 13.89 years old, and 66.67% of patients were female. The vitreous floaters were visible on the ultrasound B scan in all eyes, but only in 47.62% of Optos images (55.29% in eyes with PVD and 15% in eyes without PVD). In the multiple binary logistic regression analysis, age (OR = 1.094, 95%CI = 1.063-1.125, P < 0.001), spherical equivalent (OR = 0.869, 95%CI = 0.791-0.955, P = 0.004) and the distance of the floaters from the retina (OR = 1.191, 95%CI = 1.059-1.339, P = 0.003) were significantly correlated with the visibility of vitreous floaters on Optos images. On Optos images, 25.71% of VDM eyes presented additional retinal abnormalities. CONCLUSIONS Optos imaging has a low sensitivity for vitreous floaters, particularly in eyes without PVD. On Optos imaging, floaters were more visible in older patients, eyes with greater myopia, and floaters that were further from the retina.
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Affiliation(s)
- Tiezhu Lin
- Ophthalmology Department, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang Province, China
- He Eye Specialist Hospital, Shenyang, Liaoning, China
| | - Cheng Shi
- He Eye Specialist Hospital, Shenyang, Liaoning, China
- Dalian Medical University, Dalian, Liaoning Province, China
| | - Bing Wu
- He Eye Specialist Hospital, Shenyang, Liaoning, China
- Dalian Medical University, Dalian, Liaoning Province, China
| | | | - Lijun Shen
- Ophthalmology Department, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang Province, China.
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Xu J, Mo Y. Mendelian randomization study confirms causal relationship between myopia and vitreous disorders. BMC Med Genomics 2023; 16:238. [PMID: 37814298 PMCID: PMC10561500 DOI: 10.1186/s12920-023-01673-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 09/27/2023] [Indexed: 10/11/2023] Open
Abstract
PURPOSE This study aims to investigate the potential bidirectional causal relationship between myopia and vitreous disorders from a genetic perspective, as vitreous disorders have been found to be closely associated with myopia development. METHODS To achieve this, a two-sample Mendelian randomization (MR) design was employed. The study utilized pooled statistics from independent genome-wide association studies. Myopia was chosen as the exposure factor, while five different vitreous disorders were considered as outcomes. The primary analytical method was the inverse variance weighting (IVW) method, supplemented by sensitivity analysis. RESULTS The study yielded significant findings indicating a positive association between myopia and vitreous disorders. The genetic prediction of myopia consistently demonstrated a positive correlation with vitreous disorders, as evidenced by IVW (odds ratio [OR] = 18.387; P < 0.01), MR Egger (OR = 2784.954; P < 0.01), weighted median (OR = 30.284; P < 0.01), and weighted mode (OR = 57.381; P < 0.01). All sensitivity analyses further validated these associations. Furthermore, a significant association was observed between myopia and other unspecified vitreous body disorders (IVW: OR = 57.729; P < 0.01). CONCLUSION Studies mainly conducted in European populations have confirmed that myopia, extending beyond early high myopia, plays a crucial role in influencing vitreous disorders and that there is a unidirectional causal relationship between myopia and vitreous disorders. Additionally, a causal relationship was identified between myopia and other unspecified vitreous disordes. These findings introduce fresh perspectives for the clinical management of unspecified vitreous disorders and contribute to the understanding of the effect of myopia on vitreous disorders. Myopia prevention and treatment will aid in slowing down the process of vitreous liquefaction and subsequently decrease the incidence of malignant eye conditions.
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Affiliation(s)
- Jiayu Xu
- Chengdu University of TCM, Sichuan, China
| | - Ya Mo
- Chengdu University of TCM, Sichuan, China.
- Hospital of Chengdu University of TCM, Sichuan, China.
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Jiang S, Golding J, Choudhry N. Practical applications of vitreous imaging for the treatment of vitreous opacities with YAG vitreolysis. Int Ophthalmol 2023; 43:3587-3594. [PMID: 37402010 DOI: 10.1007/s10792-023-02765-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 06/08/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE To demonstrate the methodology and efficacy of using scanning laser ophthalmoscopy (SLO) and dynamic optical coherence tomography (OCT) to identify and treat symptomatic vitreous floaters using yttrium-aluminum garnet laser vitreolysis (YLV). METHODS This is a case series highlighted from a cross sectional retrospective study conducted at the Vitreous Retina Macula Specialists of Toronto. Forty eyes from thirty-five patients were treated with YLV between November 2018 and December 2020 for symptomatic floaters and imaged with SLO and dynamic OCT. Patients were re-treated with YLV if they reported ongoing significant vision symptoms during follow-up which correlated to visible opacities on exam and or imaging. Three cases will be highlighted to present the practical applications of SLO and dynamic OCT imaging for YLV treatment. RESULTS Forty treated eyes were enrolled in this study, with twenty-six eyes (65%) requiring at least one repeat YLV treatment following the first treatment due to ongoing symptomatic floaters. Following the first YLV, there was a significant improvement in overall mean best corrected visual acuity compared to before treatment (0.11 ± 0.20 LogMAR units vs. 0.14 ± 0.20 LogMAR units, p = 0.02 (paired t test)). Case 1 demonstrates a dense, solitary vitreous opacity that has been localized with dynamic OCT imaging to track its movements and retinal shadowing with the patient's eye movements. Case 2 shows the utility of adjusting the fixation target to monitor the movement of vitreous opacities in real-time. Case 3 exhibits an association between decreased symptom burden and vitreous opacity density after YLV. CONCLUSION Image-guided YLV facilitates the localization and confirmation of vitreous opacities. SLO and dynamic OCT of the vitreous can provide a real-time evaluation of floater size, movement, and morphology, to help clinicians target treatment and monitoring of symptomatic floaters.
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Affiliation(s)
- Shangjun Jiang
- Section of Ophthalmology, Department of Surgery, Cumming School of Medicine, 1403 29 St NW, Calgary, AB, T2N 2T9, Canada.
| | - John Golding
- Vitreous Retina Macula Specialists of Toronto, 3280 Bloor Street West, Suite 310, Etobicoke, ON, M8X 2X3, Canada
| | - Netan Choudhry
- Vitreous Retina Macula Specialists of Toronto, 3280 Bloor Street West, Suite 310, Etobicoke, ON, M8X 2X3, Canada.
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Sharma A, Wu L, Bloom S, Stanga P, Khaqan HA, Garcia-Aguirre G, Cheung JY, Rezaei KA. RWC Update: Intruding Scleral Buckle; Vitrectomy for Floaters; Group-Type Congenital Pigmented Nevi of the RPE. Ophthalmic Surg Lasers Imaging Retina 2023; 54:500-503. [PMID: 37708226 DOI: 10.3928/23258160-20230817-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
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10
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Lam AKC, Lai HC, Sung YK, Lam WH, Tiu CM. Performance of neuroretinal rim thickness measurement by Cirrus high-definition optical coherence tomography in myopic eyes. Sci Rep 2023; 13:12714. [PMID: 37543611 PMCID: PMC10404224 DOI: 10.1038/s41598-023-39701-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/29/2023] [Indexed: 08/07/2023] Open
Abstract
Neuroretinal rim (NRR) measurement can aid the diagnosis of glaucoma. A few studies reported that Cirrus optical coherence tomography (OCT) had NRR segmentation errors. The current study investigated segmentation success of NRR in myopic eyes using the Cirrus built-in software and to determine the number of acquisitions required to identify NRR thinning. Right eye of 87 healthy adult myopes had an optic disc scanned using Cirrus HD-OCT for five successive acquisitions. A masked examiner evaluated 36 radial line images of each scan to screen for segmentation errors using the built-in software at the Bruch's membrane opening (BMO) and/or internal limiting membrane (ILM). Participants with three accurate NRR acquisitions had their average NRR thickness determined. This result was compared with average of the two acquisitions and the first acquisition. Among 435 OCT scans of the optic disc (87 eyes × 5 acquisitions), 129 (29.7%) scans had segmentation errors that occurred mainly at the ILM. The inferior-temporal and superior meridians had slightly more segmentation errors than other meridians, independent of axial length, amount of myopia, or presence of peripapillary atrophy. Sixty-five eyes (74.7%) had at least three accurate NRR measurements. The three acquisitions had high reliability in NRR thickness in the four quadrants (intraclass correlation coefficient > 0.990, coefficient of variation < 3.9%). NRR difference between the first acquisition and the average of three acquisitions was small (mean difference 2 ± 13 μm, 95% limits of agreement within ± 30 μm) among the four quadrants. Segmentation errors in NRR measurements appeared regardless of axial length, amount of myopia, or presence of peripapillary atrophy. Cirrus segmentation lines should be manually inspected when measuring NRR thickness.
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Affiliation(s)
- Andrew K C Lam
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
- School of Optometry, Centre for Myopia Research, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Shatin, Hong Kong SAR, China.
- Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
| | - H C Lai
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Y K Sung
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - W H Lam
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - C M Tiu
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Ngo WK, Keshet Y, Salcedo-Ledesma A, Walia J, Ledesma-Gil G, Spaide RF. THE WAY PATIENTS SEE FLOATERS: Widefield Dynamic Scanning Laser Ophthalmoscopy Imaging of Vitreous Abnormalities. Retina 2023; 43:1240-1245. [PMID: 36977315 DOI: 10.1097/iae.0000000000003786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
PURPOSE To investigate the use of dynamic widefield scanning laser ophthalmoscopy (SLO) and B-scan ultrasonography in imaging vitreous abnormalities in patients with complaints of floaters. METHODS Twenty-one patients underwent both dynamic SLO and B-scan ultrasonography to image their vitreous abnormalities. After reviewing these videos, patients graded each imaging technique on a scale of 1 to 10, based on how closely it represented their visual perception of floaters. RESULTS The mean age of the patients (12 women and nine men) was 47.7 ± 18.5 years. The patients graded a median score of nine for SLO imaging (mean = 8.43) compared with a median score of 5 (mean = 4.95) for ultrasound ( P = 0.001). Widefield SLO imaging demonstrated three-dimensional interconnectivity within the condensations of the formed vitreous that exhibited translational and rotational movements with eye saccades. CONCLUSION Floaters are a common complaint, but it is difficult to know whether imaging findings of the vitreous correlate to what patients perceive. Widefield SLO seems to image vitreous abnormalities related to how patients perceive their own floaters better than B-scan ultrasonography. Despite the term "floaters", the vitreous abnormalities in the videos seemed to be manifestations of a complex three-dimensional degeneration of the vitreous framework.
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Affiliation(s)
- Wei Kiong Ngo
- Vitreous Retina Macula Consultants of New York, New York, New York
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Boneva SK, Nguyen JH, Gui W, Hoerig C, Mamou J, Ketterling JA, Chong LP, Sebag J. RECURRENT FLOATERS AFTER LIMITED VITRECTOMY FOR VISION DEGRADING MYODESOPSIA. Retina 2023; 43:1114-1121. [PMID: 36940362 PMCID: PMC10293082 DOI: 10.1097/iae.0000000000003781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
PURPOSE Limited vitrectomy improves vision degrading myodesopsia, but the incidence of recurrent floaters postoperatively is not known. We studied patients with recurrent central floaters using ultrasonography and contrast sensitivity (CS) testing to characterize this subgroup and identify the clinical profile of patients at risk of recurrent floaters. METHODS A total of 286 eyes (203 patients, 60.6 ± 12.9 years) undergoing limited vitrectomy for vision degrading myodesopsia were studied retrospectively. Sutureless 25G vitrectomy was performed without intentional surgical posterior vitreous detachment (PVD) induction. CS (Freiburg Acuity Contrast test: Weber index, %W) and vitreous echodensity (quantitative ultrasonography) were assessed prospectively. RESULTS No eyes (0/179) with preoperative PVD experienced new floaters. Recurrent central floaters occurred in 14/99 eyes (14.1%) without complete preoperative PVD (mean follow-up = 39 months vs. 31 months in 85 eyes without recurrent floaters). Ultrasonography identified new-onset PVD in all 14 (100%) recurrent cases. Young (younger than 52 years; 71.4%), myopic (≥-3D; 85.7%), phakic (100%) men (92.9%) predominated. Reoperation was elected by 11 patients, who had partial PVD preoperatively in 5/11 (45.5%). At study entry, CS was degraded (3.55 ± 1.79 %W) but improved postoperatively by 45.6% (1.93 ± 0.86 %W, P = 0.033), while vitreous echodensity reduced by 86.6% ( P = 0.016). New-onset PVD postoperatively degraded CS anew, by 49.4% (3.28 ± 0.96 %W; P = 0.009) in patients electing reoperation. Repeat vitrectomy normalized CS to 2.00 ± 0.74%W ( P = 0.018). CONCLUSION Recurrent floaters after limited vitrectomy for vision degrading myodesopsia are caused by new-onset PVD, with younger age, male sex, myopia, and phakic status as risk factors. Inducing surgical PVD at the primary operation should be considered in these select patients to mitigate recurrent floaters.
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Affiliation(s)
- Stefaniya K. Boneva
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
- Doheny Eye Institute, UCLA, Pasadena, CA, USA
- Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Germany
| | - Justin H. Nguyen
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
| | - Wei Gui
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
| | - Cameron Hoerig
- Department of Radiology, Weill-Cornell Medicine, New York, NY, USA
| | - Jonathan Mamou
- Department of Radiology, Weill-Cornell Medicine, New York, NY, USA
| | | | - Lawrence P. Chong
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - J. Sebag
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
- Doheny Eye Institute, UCLA, Pasadena, CA, USA
- Department of Ophthalmology, David Geffen School of Medicine, UCLA, Los Angeles, CA
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13
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Zu H, Zhang K, Zhang H, Qian X. An Inverse Method to Determine Mechanical Parameters of Porcine Vitreous Bodies Based on the Indentation Test. Bioengineering (Basel) 2023; 10:646. [PMID: 37370577 DOI: 10.3390/bioengineering10060646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
The vitreous body keeps the lens and retina in place and protects these tissues from physical insults. Existing studies have reported that the mechanical properties of vitreous body varied after liquefaction, suggesting mechanical properties could be effective parameters to identify vitreous liquefaction process. Thus, in this work, we aimed to propose a method to determine the mechanical properties of vitreous bodies. Fresh porcine eyes were divided into three groups, including the untreated group, the 24 h liquefaction group and the 48 h liquefaction group, which was injected collagenase and then kept for 24 h or 48 h. The indentation tests were carried out on the vitreous body in its natural location while the posterior segment of the eye was fixed in the container. A finite element model of a specimen undertaking indentation was constructed to simulate the indentation test with surface tension of vitreous body considered. Using the inverse method, the mechanical parameters of the vitreous body and the surface tension coefficient were determined. For the same parameter, values were highest in the untreated group, followed by the 24 h liquefaction group and the lowest in the 48 h liquefaction group. For C10 in the neo-Hookean model, the significant differences were found between the untreated group and liquefaction groups. This work quantified vitreous body mechanical properties successfully using inverse method, which provides a new method for identifying vitreous liquefactions related studies.
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Affiliation(s)
- Haicheng Zu
- School of Biomedical Engineering, Capital Medical University, Beijing 100069, China
| | - Kunya Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing 100069, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing 100069, China
| | - Haixia Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing 100069, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing 100069, China
| | - Xiuqing Qian
- School of Biomedical Engineering, Capital Medical University, Beijing 100069, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing 100069, China
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Stanga PE, Valentin Bravo FJ, Reinstein UI, Stanga SFE, Marshall J, Archer TJ, Reinstein DZ. New Terminology and Methodology for the Assessment of the Vitreous, Its Floaters and Opacities, and Their Effect on Vision: Standardized and Kinetic Anatomical and Functional Testing of Vitreous Floaters and Opacities (SK VFO Test). Ophthalmic Surg Lasers Imaging Retina 2023; 54:306-315. [PMID: 37184989 DOI: 10.3928/23258160-20230412-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To introduce VFO and SK VFO Test: new, more representative terminology for symptoms of vitreous floaters/opacities (VFO) and new standardized kinetic (SK) anatomical-functional assessment. MATERIALS AND METHODS Eight eyes underwent before-after limited vitrectomy (LV): best-corrected visual acuity, low-luminance visual acuity, Minnesota Low Vision Reading Chart near visual acuity in logMAR, contrast sensitivity function (CV1000E), and straylight measurements (SM) (HDA/LDA/C-Quant). SK infrared confocal scanning laser ophthalmoscopy (SK IRcSLO) and swept-source widefield optical coherence tomography (SS-WF-OCT) identified VFO and posterior vitreous detachment (PVD). SK IRcSLO was performed with gaze directed towards the extreme superior, inferior, and lateral directions. RESULTS Anatomical-functional results after LV improved in 7 eyes (87.5%): objective scatter index (27.34%), disturbance index (47.97%) and C-Quant Log units (2.26%). Pre-LV SK IRcSLO and SS-WFOCT imaging identified dynamic well-defined VFO and PVD status (100%). A residual asymptomatic anterior cortical vitreous-induced shadowing ripple effect was detected post-LV. CONCLUSIONS This is the first objective-standardized test accounting for VFO kinesis and intermittent effect. There is potential for personalizing treatment and establishing best candidates for laser or surgery. [Ophthalmic Surg Lasers Imaging Retina 2023;54:306-315.].
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15
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Jonas JB, Spaide RF, Ostrin LA, Logan NS, Flitcroft I, Panda-Jonas S. IMI-Nonpathological Human Ocular Tissue Changes With Axial Myopia. Invest Ophthalmol Vis Sci 2023; 64:5. [PMID: 37126358 PMCID: PMC10153585 DOI: 10.1167/iovs.64.6.5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Purpose To describe nonpathological myopia-related characteristics of the human eye. Methods Based on histomorphometric and clinical studies, qualitative and quantitative findings associated with myopic axial elongation are presented. Results In axial myopia, the eye changes from a spherical shape to a prolate ellipsoid, photoreceptor, and retinal pigment epithelium cell density and total retinal thickness decrease, most marked in the retroequatorial region, followed by the equator. The choroid and sclera are thin, most markedly at the posterior pole and least markedly at the ora serrata. The sclera undergoes alterations in fibroblast activity, changes in extracellular matrix content, and remodeling. Bruch's membrane (BM) thickness is unrelated to axial length, although the BM volume increases. In moderate myopia, the BM opening shifts, usually toward the fovea, leading to the BM overhanging into the nasal intrapapillary compartment. Subsequently, the BM is absent in the temporal region (such as parapapillary gamma zone), the optic disc takes on a vertically oval shape, the fovea-optic disc distance elongates without macular BM elongation, the angle kappa reduces, and the papillomacular retinal vessels and nerve fibers straighten and stretch. In high myopia, the BM opening and the optic disc enlarge, the lamina cribrosa, the peripapillary scleral flange (such as parapapillary delta zone) and the peripapillary choroidal border tissue lengthen and thin, and a circular gamma and delta zone develop. Conclusions A thorough characterization of ocular changes in nonpathological myopia are of importance to better understand the mechanisms of myopic axial elongation, pathological structural changes, and psychophysical sequelae of myopia on visual function.
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Affiliation(s)
- Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
| | - Richard F Spaide
- Vitreous, Retina, Macula Consultants of New York, New York, New York, United States
| | - Lisa A Ostrin
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Nicola S Logan
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Ian Flitcroft
- Centre for Eye Research, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
- Department of Ophthalmology, Children's Health Ireland at Temple Street Hospital, Dublin, Ireland
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16
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Jin C, Park GS, Kim KN, Song MY, Hwang YH. Comparison of posterior vitreous detachment-related and glaucomatous optic disc hemorrhage. Sci Rep 2023; 13:5011. [PMID: 36973533 PMCID: PMC10042820 DOI: 10.1038/s41598-023-32327-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/25/2023] [Indexed: 03/29/2023] Open
Abstract
This study compared the characteristics of posterior vitreous detachment (PVD)-related and glaucomatous optic disc hemorrhage (DH). Fundus photographs of eyes with PVD-related DH (PVD group) and glaucomatous DH (glaucoma group) were reviewed. The shape, type, layer, location (clock-hour sector), and DH/disc area (DH/DA) ratio of DH were investigated. In the PVD group, DH presented as a flame (60.9%), splinter (34.8%), and dot or blot (4.3%) shape. However, most of the glaucomatous DH revealed a splinter shape (92.3%), followed by a flame shape (7.7%, p < 0.001). In the PVD group, the most common type of DH was cup margin type (52.2%), whereas, in the glaucoma group it was disc rim type (53.8%, p = 0.003). Both PVD-related and glaucomatous DH were most commonly observed in the 7 o'clock sector. In the PVD group, DH was also found in the 2 and 5 o'clock sectors (p = 0.010). Mean DH/DA ratio in PVD group (0.15 ± 0.19) was greater than in glaucoma group (0.04 ± 0.04, p < 0.001). PVD-related DH showed a higher frequency of flame shape, cup margin type, nasal location, and greater area compared to the glaucomatous DH.
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Affiliation(s)
- Cho Jin
- Department of Ophthalmology, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Gi Seok Park
- Department of Ophthalmology, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Kyung Nam Kim
- Department of Ophthalmology, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Mi Yeon Song
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Hoon Hwang
- Department of Ophthalmology, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea.
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Luo RH, Tram NK, Parekh AM, Puri R, Reilly MA, Swindle-Reilly KE. The Roles of Vitreous Biomechanics in Ocular Disease, Biomolecule Transport, and Pharmacokinetics. Curr Eye Res 2023; 48:195-207. [PMID: 35179421 DOI: 10.1080/02713683.2022.2033271] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE The biomechanical properties of the vitreous humor and replication of these properties to develop substitutes for the vitreous humor have rapidly become topics of interest over the last two decades. In particular, the behavior of the vitreous humor as a viscoelastic tissue has been investigated to identify its role in a variety of processes related to biotransport, aging, and age-related pathologies of the vitreoretinal interface. METHODS A thorough search and review of peer-reviewed publications discussing the biomechanical properties of the vitreous humor in both human and animal specimens was conducted. Findings on the effects of biomechanics on vitreoretinal pathologies and vitreous biotransport were analyzed and discussed. RESULTS The pig and rabbit vitreous have been found to be most mechanically similar to the human vitreous. Age-related liquefaction of the vitreous creates two mechanically unique phases, with an overall effect of softening the vitreous. However, the techniques used to acquire this mechanical data are limited by the in vitro testing methods used, and the vitreous humor has been hypothesized to behave differently in vivo due in part to its swelling properties. The impact of liquefaction and subsequent detachment of the vitreous humor from the posterior retinal surface is implicated in a variety of tractional pathologies of the retina and macula. Liquefaction also causes significant changes in the biotransport properties of the eye, allowing for significantly faster movement of molecules compared to the healthy vitreous. Recent developments in computational and ex vivo models of the vitreous humor have helped with understanding its behavior and developing materials capable of replacing it. CONCLUSIONS A better understanding of the biomechanical properties of the vitreous humor and how these relate to its structure will potentially aid in improving clinical metrics for vitreous liquefaction, design of biomimetic vitreous substitutes, and predicting pharmacokinetics for intravitreal drug delivery.
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Affiliation(s)
- Richard H Luo
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Nguyen K Tram
- Center for Regenerative Medicine, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Ankur M Parekh
- William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, USA
| | - Raima Puri
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA
| | - Matthew A Reilly
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA.,Department of Ophthalmology and Visual Sciences, The Ohio State University, Columbus, OH, USA
| | - Katelyn E Swindle-Reilly
- Department of Biomedical Engineering, The Ohio State University, Columbus, OH, USA.,William G. Lowrie Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, USA.,Department of Ophthalmology and Visual Sciences, The Ohio State University, Columbus, OH, USA
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18
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Marquez MA, Nadelson A, Magraner M, Haddock LJ, Fortun JA. Dynamic Infrared Imaging of Vitreous Floaters. Clin Ophthalmol 2023; 17:1169-1177. [PMID: 37089579 PMCID: PMC10120865 DOI: 10.2147/opth.s399684] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/10/2023] [Indexed: 04/25/2023] Open
Abstract
Background and Objective To evaluate the use of dynamic infrared (IR) imaging as a tool for the objective evaluation of symptomatic vitreous floaters and to correlate it with the patient symptomatology. Study Design/Materials and Methods Retrospective study that examined 66 eyes of 44 patients with symptomatic and asymptomatic vitreous opacities. Patients were imaged using the Heidelberg Spectralis dynamic infrared (IR) image in video mode to record the vitreous movements and shadow artifacts within 30 degrees of the center of the macula. Patients were also asked how symptomatic their vitreous floaters were from absent to severe. After reviewing IR videos and OCT, a grading system was created to evaluate the floaters and a masked reader was asked to evaluate the videos and OCT based on the grading system created. Results A total of 66 eyes were identified and examined with the IR videos, 50 were symptomatic, and 16 were asymptomatic. After masked review and analysis of the IR videos, there were 4 characteristics that correlated with the patient's symptoms: size, location, movement, and density of obscuration of the OCT B Scan by the vitreous opacity. A table with grading of these characteristics was created to analyze how symptomatic patients were. A masked grader was asked to grade the videos and OCT using the grading system created. A positive correlation was found between the masked grader and the symptoms of patients. (0.70039; p < 0.00001). Conclusion Dynamic IR video capture of vitreous opacities is a new imaging technique that can qualitatively assess vitreous opacities in a way that correlates to a patient's symptoms. This imaging modality can provide a qualitative assessment of the patient's severity of symptoms based on the location, density, and movement of the visualized vitreous opacities in the imaged video.
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Affiliation(s)
- Marilyn A Marquez
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Allie Nadelson
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Maria Magraner
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Luis J Haddock
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jorge A Fortun
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
- Correspondence: Jorge A Fortun, Email
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19
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Spontaneous remission of vision degrading myodesopsia of posterior vitreous detachment type. Graefes Arch Clin Exp Ophthalmol 2022; 261:1571-1577. [PMID: 36565330 DOI: 10.1007/s00417-022-05948-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/21/2022] [Accepted: 12/13/2022] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The study aims to observe the spontaneous remission of posterior vitreous detachment (PVD)-type vision degrading myodesopsia (VDM) during long-term follow-up. METHODS We retrospectively reviewed VDM patients with PVD type that refused any treatment. The ratio and time of significant spontaneous remission of floater symptoms occurring were described. The associated factors with significant remission of floater symptoms were analyzed in the univariate and multivariate logistic regression analyses. RESULTS In total, 179 patients with VDM were assessed. The mean age of all patients was 60.56 ± 0.47 years old, and the mean duration of follow-up was 23.89 ± 6.63 months. Of the patients, 40.78% have significant improvement in their floater symptoms after mean 16.55 ± 10.63-month follow-up. Myopia (OR = 0.280, 95% CI = 0.084-0.932, P = 0.038), the number of floaters > 3 (OR = 0.343, 95% CI = 0.172-0.683, P = 0.002), and floaters with string-like pattern (OR = 0.370, 95% CI = 0.166-0.824, P = 0.015) and blocky pattern (OR = 0.299, 95% CI = 0.090-0.993, P = 0.049) were negatively correlated with the significant spontaneous remission of VDM symptoms in the multiple binary logistic regression analysis. CONCLUSIONS Approximately 40% of VDM patients with PVD may experience significant spontaneous remission during long-term follow-up. Patients that are non-myopic and with fewer floaters are more likely to feel relief from VDM symptoms. Floaters with string-like or blocky patterns are less likely to undergo spontaneous remission.
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20
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Nguyen JH, Yee KMP, Nguyen-Cuu J, Mamou J, Sebag J. Vitrectomy Improves Contrast Sensitivity in Multifocal Pseudophakia With Vision Degrading Myodesopsia. Am J Ophthalmol 2022; 244:196-204. [PMID: 35562070 DOI: 10.1016/j.ajo.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE Multifocal intraocular lenses (MFIOL) are associated with degradation in contrast sensitivity function (CSF); yet the contribution of vitreous is not known, nor is the benefit of vitrectomy. DESIGN Prospective, nonrandomized clinical study. METHODS A total of 180 eyes of 180 patients (55 MFIOL, 60 monofocal intraocular lenses [MIOL], 65 phakic) with symptomatic vitreous opacities were enrolled. Vitreous structure was assessed with quantitative ultrasonography (QUS). Vision was evaluated with visual acuity and CSF measurements. RESULTS Vitreous echodensity was the same in all lens cohorts, yet CSF was worse in MFIOL eyes (P < .001). In 86 patients who elected vitrectomy, there was 68% greater vitreous echodensity and 31% worse CSF than in observation controls (P < .0001 for each). Preoperatively, CSF was 25% worse in MFIOL than in MIOL (P = .014). Postoperatively, vitreous echodensity decreased by 55%, 51%, and 52%, whereas CSF improved by 37% 48% in and 43% in MFIOL, MIOL, and phakic eyes, respectively (P < .0001 for each). NEI Visual Function Questionnaire analyses showed improved visual well-being. CONCLUSIONS Patients with vision degrading myodesopsia who elected vitrectomy had greater vitreous echodensity and worse CSF than controls, but no other differences in age, sex, or myopia. MFIOL eyes had worse CSF than MIOL and phakic eyes, very possibly due to combined effects of the MFIOL and vitreous opacification. Limited vitrectomy reduced vitreous echodensity and improved CSF in all eyes. All patients with CSF-degrading vitreous opacities benefited from limited vitrectomy, including those with MFIOL. As MFIOL eyes had 37% improvement in CSF, patients with MFIOL and vision degrading myodesopsia merit consideration of vitrectomy.
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Affiliation(s)
- Justin H Nguyen
- From the VMR Institute for Vitreous Macula Retina (J.H.N., K.M.P.Y., J.N.-C., J.S.), Huntington Beach, California, USA
| | - Kenneth M P Yee
- From the VMR Institute for Vitreous Macula Retina (J.H.N., K.M.P.Y., J.N.-C., J.S.), Huntington Beach, California, USA
| | - Jeannie Nguyen-Cuu
- From the VMR Institute for Vitreous Macula Retina (J.H.N., K.M.P.Y., J.N.-C., J.S.), Huntington Beach, California, USA; DeBusk College of Osteopathic Medicine at LMU-Knoxville, Knoxville (J.N.-C.), Tennessee, USA
| | - Jonathan Mamou
- Department of Radiology (J.M.), Weill Cornell Medicine, New York, New York, USA
| | - J Sebag
- From the VMR Institute for Vitreous Macula Retina (J.H.N., K.M.P.Y., J.N.-C., J.S.), Huntington Beach, California, USA; Doheny Eye Institute/UCLA (J.S.), Pasadena, California, USA; Department of Ophthalmology (J.S.), Stein Eye Institute, Geffen School of Medicine, UCLA, Los Angeles, California.
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21
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Krásný J, Šach J. LASER VITREOLYSIS IN PATIENTS WITH SYMPTOMATIC VITREOUS FLOATERS. CESKA A SLOVENSKA OFTALMOLOGIE : CASOPIS CESKE OFTALMOLOGICKE SPOLECNOSTI A SLOVENSKE OFTALMOLOGICKE SPOLECNOSTI 2022; 79:59-67. [PMID: 37072253 DOI: 10.31348/2022/28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
AIMS To examine the effectiveness and safety of Nd:YAG laser vitreolysis in patients with symptomatic vitreous floaters. MATERIAL AND METHODS This was a single-centre study of adult patients with symptomatic vitreous floaters who underwent laser vitreolysis. Patients treated between 1/2020 and 10/2021 were included. Intraocular pressure was measured by non-contact tonometry before and one month after treatment. Colour fundus photography, slit lamp examination in mydriasis, best corrected visual acuity, optical coherence tomography, and ultrasound examinations were performed before treatment. The patients completed a questionnaire to subjectively rank the degree of impairment associated with the floaters before and between 1 and 2 months after treatment. RESULTS 89 eyes from 84 patients were included in the study, with a slight predominance of women (53%). A Weiss ring was present in 46%, and other types of vitreous opacity were found in 54%. Before treatment, 69% evaluated floaters as very troublesome (i.e., a value of 4 or 5 on a 1-5 scale). After treatment, 42% indicated subjective improvement (9% viewed the treatment as a complete success and 33% as a significant success). In 33% of eyes there was a partial improvement, i.e., some floaters could still be seen, and in 17% there was no improvement; 8% of patients were dissatisfied with the treatment results. There was no statistically significant difference in improvement between the group with Weiss rings and the group with other types of floaters. The procedure itself and the subsequent observation period were without complications, i.e., no cases of intraocular pressure elevation, cataract formation or retinal complications. Intraocular pressure did not significantly change from the pre-procedure value (p = 0.29). Average best corrected visual acuity after treatment was 0.97, thus it did not differ significantly from the pre-treatment values (p = 0.82). CONCLUSION Nd:YAG laser vitreolysis subjectively improved floater-related symptoms in treated eyes. The lack of an objective measurement of treatment success is a limiting factor. Laser vitreolysis is more suitable for solitary than diffuse vitreous opacities.
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22
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Design of a Functional Eye Dressing for Treatment of the Vitreous Floater. J Pers Med 2022; 12:jpm12101659. [PMID: 36294798 PMCID: PMC9604789 DOI: 10.3390/jpm12101659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/20/2022] [Accepted: 10/03/2022] [Indexed: 11/25/2022] Open
Abstract
With the rapid development of display technology, related diseases of the human eye are also increasing day by day. Eye floaters are one of the diseases that affect humans. Herein, we present a functional ophthalmic dressing that can permeate the skin tissues of the eyes through oxygen and hydrogen to improve the symptoms of floaters. In clinical tests, the symptoms of sensory floaters improved in 28 patients, and the recovery rates of mild, moderate, and severe floaters were about 70%, 66.7%, and 83.3%, respectively.
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23
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Zhang S, Yang K, Wang B. Efficacy Evaluation of the VFQ-25 Scale in Patients with Different Degrees of Vitreous Opacity After Nd : YAG Laser Ablation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:5075447. [PMID: 36212958 PMCID: PMC9534634 DOI: 10.1155/2022/5075447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/14/2022] [Accepted: 09/17/2022] [Indexed: 11/17/2022]
Abstract
Objective To evaluate the effect of the VFQ-25 scale on the efficacy of Nd : YAG laser ablation in patients with different severity of vitreous opacities. Methods From January 2020 to March 2021, data of patients who presented to our department and were diagnosed with vitreous opacity were collected, and the severity of vitreous opacity was divided into four grades: I, II, III, and IV. Preoperative visual acuity, intraocular pressure, dilated fundus, B ultrasound, and other examinations were performed, and the patients were scored using the VFQ-25 scale. All patients underwent Nd : YAG laser ablation and were followed for 6 months. The VFQ-25 scale was again used postoperatively to score the patient's efficacy. The general information and clinical characteristics of the patients we collected. The Spearman's test was used to evaluate the correlation between VFQ-25 score and Nd : YAG laser efficacy in patients. Results A total of 80 patients (95 eyes) were included in this study. Vitreous opacities were grade I in 56 eyes (58.9%), grade II in 22 eyes (23.2%), grade III in 10 eyes (10.5%), and grade IV in 7 eyes (7.4%). Compared with preoperative scores, patients with vitreous opacity had significantly higher postoperative scores in terms of overall health (36.54 ± 17.06 vs 33.52 ± 16.74), overall visual acuity (60.39 ± 14.24 vs 57.56 ± 13.13), color vision (88.94 ± 12.56 vs 86.38 ± 12.37), and peripheral visual acuity (74.06 ± 18.38 vs 72.20 ± 18.79) items (all P < 0.001). The overall response rates of vitreous opacities I, II, III, and IV were 100%, 90.9%, 80.0%, and 71.4%, respectively. There was a significant correlation between the postoperative VFQ-25 total score, and the therapeutic effect of laser ablation for grade I vitreous opacities, with a correlation coefficient r of 0.417 (P=0.001). The correlation coefficient r between the total score of postoperative VFQ-25 and the treatment effect of grade II vitreous opacity was 0.622 (P=0.002). However, the correlation between the postoperative efficacy of grade III and IV patients and the VFQ-25 score was not significant. Conclusion In patients with different degrees of vitreous opacity undergoing Nd : YAG laser vitreous ablation, the overall health, overall visual acuity, color vision, and peripheral visual acuity were improved after surgery, and the VFQ-25 score was significantly correlated with the postoperative efficacy, which is worthy of clinical use.
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Affiliation(s)
- Siwei Zhang
- Department of Ophthalmology, Hefei Bright Eye Hospital, Hefei 230001, Anhui, China
| | - Kang Yang
- Department of Ophthalmology, Fuyang Women and Children's Hospital, Fuyang 236000, Anhui, China
| | - Bin Wang
- Department of Ophthalmology, Hefei Bright Eye Hospital, Hefei 230001, Anhui, China
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24
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Visualization and Grading of Vitreous Floaters Using Dynamic Ultra-Widefield Infrared Confocal Scanning Laser Ophthalmoscopy: A Pilot Study. J Clin Med 2022; 11:jcm11195502. [PMID: 36233369 PMCID: PMC9571201 DOI: 10.3390/jcm11195502] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose: To describe the appearance of vitreous opacities using dynamic ultra-widefield infrared confocal scanning laser ophthalmoscopy (IRcSLO). Design: Retrospective case series. Methods: Eyes of patients complaining of myodesopsia were analyzed using dynamic ultra-widefield IRcSLO imaging (Nidek Mirante, Nidek Co., Ltd., Gamagori, Japan), and classified according to a vitreous opacity severity scale. Results: Thirty eyes of 21 patients were included in this study. The average age was 56 years. Symptom duration ranged from 1 to more than 365 days. The most common cause of vitreous floaters was posterior vitreous detachment (63.3%), followed by vitreous syneresis (23.3%), asteroid hyalosis (10%) and vitreous hemorrhage (3.3%). Opacities were classified as Grade 1 in three eyes (10%), Grade 2 in 10 eyes (33.3%), Grade 3 in 11 eyes (36.6%), Grade 4 in two eyes (6.6%) and Grade 5 in four eyes (13.3%). Patients with Grade 1 opacities were younger than patients with opacities Grade 2 or greater. A visible Weiss ring could be identified in 0% of eyes with Grade 1 opacities, 40% of eyes with Grade 2 opacities, 100% of eyes with Grade 3 opacities, and 100% of eyes with Grade 4 opacities. In patients with Grade 5 opacities, a Weiss ring could not be identified. Conclusion: Dynamic ultra-widefield IRcSLO imaging is a useful tool to evaluate patients with vitreous floaters. It allows for accurate visualization of the number, density, and behavior of the shadows that vitreous opacities project over a very wide area of the retina, which has a positive correlation with patient perception of floaters.
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Ripa M, Motta L, Florit T, Sahyoun JY, Matello V, Parolini B. The Role of Widefield and Ultra Widefield Optical Coherence Tomography in the Diagnosis and Management of Vitreoretinal Diseases. Diagnostics (Basel) 2022; 12:diagnostics12092247. [PMID: 36140648 PMCID: PMC9497586 DOI: 10.3390/diagnostics12092247] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background: This study reports on the advantages of wide-field (WF)- and ultra-widefield (UWF)- optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) in managing different vitreoretinal diseases in a real-life setting using the new WF—Swept Source (SS)—OCT Xephilio S1 (Canon, Tokyo, Japan). Methods: We conducted an observational retrospective case series study involving 1472 eyes that underwent retinal scans with Canon Xephilio® OCT-S1 between 1 March 2021 and 1 December 2021 at Eyecare Clinic (Brescia, Italy). All patients underwent routine ophthalmologic examinations along with WF and UWF color fundus retinography with Clarus 500™ (Carl Zeiss Meditec, Inc., Dublin, CA, USA) and Xephilio® OCT-S1. WF SS-OCT, UWF-OCT, WF-OCTA, and UWF-OCTA were taken by using Xephilio® OCT-S1. Results: We analyzed 122 peripheral retinal lesions, 144 retinal detachment, 329 high myopic eyes, 37 pediatric cases, 60 vascular retinopathies, 15 choroidal lesions, and 90 eyes as follow-up post vitreoretinal surgery. The OCT-S1 was the only reliable and diagnostic exam for peripheral lesions, pediatric and high myopic cases, and significantly influenced the management in 10% of cases and the postoperative follow-up. Conclusions: WF and UWF OCT and OCTA imaging may help in the management of several vitreoretinal diseases, becoming an indispensable tool for the high-quality management of patients.
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Affiliation(s)
- Matteo Ripa
- Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Ophthalmology Unit, Catholic University “Sacro Cuore”, 00168 Rome, Italy
| | - Lorenzo Motta
- Department of Ophthalmology, William Harvey Hospital, East Kent Hospitals University NHS Foundation Trust, Ashford TN24 0LZ, UK
- Correspondence:
| | - Teresa Florit
- Department of Ophthalmology, Eyecare Clinic, 25124 Brescia, Italy
| | - Jean-Yves Sahyoun
- Department of Ophthalmology, Université de Montréal, Montreal, QC H3T 1J4, Canada
- Department of Ophthalmology, Centre Hospitalier de l’Université de Montréal (CHUM), Montreal, QC H2X 3E4, Canada
| | - Veronika Matello
- Department of Ophthalmology, Eyecare Clinic, 25124 Brescia, Italy
| | - Barbara Parolini
- Department of Ophthalmology, Eyecare Clinic, 25124 Brescia, Italy
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Goh WN, Mustapha M, Zakaria SZS, Bastion MLC. The effectiveness of laser vitreolysis for vitreous floaters in posterior vitreous detachment. Indian J Ophthalmol 2022; 70:3026-3032. [PMID: 35918966 DOI: 10.4103/ijo.ijo_3198_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose To determine the effectiveness of laser vitreolysis in terms of contrast sensitivity function (CSF) and vision-related quality of life (VRQol) for symptomatic floaters due to posterior vitreous detachment (PVD). Materials This is an interventional study that involved 57 eyes of 45 patients with symptomatic floaters for more than 3 months. Patients underwent one to three sessions of vitreolysis via Neodymiun-doped Yttrium Aluminum Garnet (Nd:YAG) laser. We examined the CSF using the computer programs Freiburg Acuity and Contrast Test (FrACT) and VRQoL survey using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) before, and 1 month after, vitreolysis. Results Twelve patients had both eyes lasered and 33 patients had one eye lasered. The mean CSF improved from 3.20 ± 0.85%W to 2.64 ± 0.63%W 1 month after vitreolysis. Each use of the laser showed a significant mean difference in CSF (%W) as analyzed by paired t-test before and after the first laser (0.29 ± 0.49%W [P ≤ 0.001]); after the first and second laser (0.35 ± 0.53%W [P = 0.01]); and after second and third laser (0.21 ± 0.31%W [P = 0.02]). There was improvement in the median of four subscales in NEI VFQ-25 scores post treatment: general vision (z = -3.30, P = 0.001), near activity (z = 3.396, P = 0.001, distance activity (z = -2.788, P = 0.005), and mental health (z = -2.219, P = 0.026). The mean scores increased to 79.55 ± 9.45 from the baseline 75.06 ± 9.69 (P ≤ 0.001). No adverse events were recorded 1 month after the laser treatments. Conclusion Vitreolysis by Nd:YAG laser improved the CFS and VRQoL in symptomatic PVD patients.
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Affiliation(s)
- Wan Ni Goh
- Department of Ophthalmology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
| | - Mushawiahti Mustapha
- Department of Ophthalmology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
| | - Syed Z S Zakaria
- Department of Paediatrics, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mae-Lynn C Bastion
- Department of Ophthalmology, Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur, Malaysia
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Complications of Treatment for Symptomatic Vitreous Floaters: A Review. Int Ophthalmol Clin 2022; 62:131-155. [PMID: 35752891 DOI: 10.1097/iio.0000000000000433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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The Weiss Ring, a Major Confounding Factor For Measurements of Peripapillary Retinal Nerve Fiber Layer Thickness: Short title: The Impact of the Weiss Ring On RNFL Thickness Measurements. Am J Ophthalmol 2022; 238:134-140. [PMID: 35038416 DOI: 10.1016/j.ajo.2022.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/30/2021] [Accepted: 01/01/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To identify how the Weiss ring affects the measurement of mean and sectoral peripapillary retinal nerve fiber layer (pRNFL) thicknesses. DESIGN Retrospective, cross-sectional study. METHODS Subjects were divided into two groups: controls (control group) and subjects in which a Weiss ring was visible on optical coherence tomography fundus images (WR group). Mean and sectoral pRNFL thicknesses were compared between the two groups. RESULTS A total of 205 eyes were enrolled: 131 eyes in the control group and 74 eyes in the WR group. The mean pRNFL thicknesses of the control group and WR group were 97.2 ± 6.7 µm and 94.6 ± 10.8 µm, respectively (P = .042). In sectoral thickness, the inferior sector of the WR group was 112.1 ± 23.2 µm, which was significantly thinner than that of the control group (125.5 ± 13.3 µm; P < .001). The Weiss ring was located in 10 eyes (13.5%) in the superior sector, 7 eyes (9.5%) in the temporal sector, 40 eyes (54.1%) in the inferior sector, and 17 eyes (23.0%) in the nasal sector. In analyses of reproducibility, the coefficient of variation and intraclass coefficient of the inferior sector measurement were 10.90% and 0.409, respectively, indicating low reliability of the measurement. CONCLUSIONS Eyes with a Weiss ring showed thinner mean and inferior pRNFL thicknesses than normal controls, which would be a measurement error caused by the Weiss ring. This could be a major confounding factor for analyses of pRNFL changes, especially in glaucoma patients.
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Sauvage F, Nguyen VP, Li Y, Harizaj A, Sebag J, Roels D, Van Havere V, Peynshaert K, Xiong R, Fraire JC, Tassignon MJ, Remaut K, Paulus YM, Braeckmans K, De Smedt SC. Laser-induced nanobubbles safely ablate vitreous opacities in vivo. NATURE NANOTECHNOLOGY 2022; 17:552-559. [PMID: 35302088 DOI: 10.1038/s41565-022-01086-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
In myopia, diabetes and ageing, fibrous vitreous liquefaction and degeneration is associated with the formation of opacities inside the vitreous body that cast shadows on the retina, appearing as 'floaters' to the patient. Vitreous opacities degrade contrast sensitivity function and can cause notable impairment in vision-related quality of life. Here we introduce 'nanobubble ablation' for safe destruction of vitreous opacities. Following intravitreal injection, hyaluronic acid-coated gold nanoparticles and indocyanine green, which is widely used as a dye in vitreoretinal surgery, spontaneously accumulate on collagenous vitreous opacities in the eyes of rabbits. Applying nanosecond laser pulses generates vapour nanobubbles that mechanically destroy the opacities in rabbit eyes and in patient specimens. Nanobubble ablation might offer a safe and efficient treatment to millions of patients suffering from debilitating vitreous opacities and paves the way for a highly safe use of pulsed lasers in the posterior segment of the eye.
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Affiliation(s)
- Félix Sauvage
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Van Phuc Nguyen
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- NTT-Hitech Institutes, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Yanxiu Li
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Aranit Harizaj
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - J Sebag
- VMR Institute for Vitreous Macula Retina, Huntington Beach, CA, USA
- Doheny Eye Institute/UCLA, Los Angeles, CA, USA
| | - Dimitri Roels
- Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium
| | - Viktor Van Havere
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Karen Peynshaert
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Ranhua Xiong
- Joint Laboratory of Advanced Biomedical Materials, International Innovation Center for Forest Chemicals and Materials, College of Chemical Engineering, Nanjing Forestry University, Nanjing, China
| | - Juan C Fraire
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Marie-José Tassignon
- Department of Ophthalmology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Katrien Remaut
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Yannis M Paulus
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA.
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA.
| | - Kevin Braeckmans
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
| | - Stefaan C De Smedt
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.
- Joint Laboratory of Advanced Biomedical Materials, International Innovation Center for Forest Chemicals and Materials, College of Chemical Engineering, Nanjing Forestry University, Nanjing, China.
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Harmer SW, Luff AJ, Gini G. Optical Scattering from Vitreous Floaters. Bioelectromagnetics 2021; 43:90-105. [PMID: 34969150 PMCID: PMC9303562 DOI: 10.1002/bem.22386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 12/07/2021] [Accepted: 12/18/2021] [Indexed: 11/18/2022]
Abstract
Vitreous “floaters” are a common entoptic phenomenon that can result in significant reduction in quality of life in a proportion of sufferers. The authors use a computational mathematical model based on Fourier optics and reflection and transmission coefficients calculated for a planar type II collagen opacity suspended in aqueous to show that floaters are perceived by the patient through interference effects that result in significant variations in intensity on the retina when viewing a constant brightness surface. The model also predicts that backscattered intensity from floaters is ten thousand to one million times lower than the variations in intensity produced on the retina, which demonstrates that the visible effects of floaters for the patient can be highly significant, whereas clinical observation of the vitreous may be entirely unremarkable. Importantly, the results also demonstrate that floaters do not need to be opaque to cause symptoms, with only small differences in refractive index between the floater material and the surrounding vitreous needed to produce significant optical effects. The model predicts that pupil size is an important factor in determining the severity of symptoms from floaters, with constricted pupils giving much greater effect than dilated pupils. Finally, the authors’ model predicts that floaters degrade contrast sensitivity function, with greatest degradation occurring in the 5–40 cycles per degree spatial frequency range and that the effects of shadowing caused by floaters are very strongly correlated to the predicted degradation of contrast sensitivity function. Bioelectromagnetics. 43:90–105, 2022. © 2021 The Authors. Bioelectromagnetics published by Wiley Periodicals LLC on behalf of Bioelectromagnetics Society.
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Affiliation(s)
- Stuart W Harmer
- Department of Engineering, Computing and Design, University of Chichester, Chichester, UK
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The Efficacy and Safety of YAG Laser Vitreolysis for Symptomatic Vitreous Floaters of Complete PVD or Non-PVD. Ophthalmol Ther 2021; 11:201-214. [PMID: 34778916 PMCID: PMC8770727 DOI: 10.1007/s40123-021-00422-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/01/2021] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION To evaluate and compare the efficacy and safety of YAG laser vitreolysis in treating symptomatic vitreous floaters of complete posterior vitreous detachment (PVD) and non-PVD. METHODS In this prospective cohort study, 51 eyes with symptomatic floaters were treated with YAG laser vitreolysis. Participants were divided into complete PVD and non-PVD groups. Objective visual quality measures including the Strehl ratio (SR), internal spherical aberration (SA), internal comatic aberration (CA), internal high-order aberration (HOA), area ratio of modulation transfer function (MTFa) and Vitreous Floaters Symptom Questionnaire (VFSQ-13) scores were used to compare the efficacy of YAG laser vitreolysis treatment between two groups. RESULTS The mean age of all patients was 56.80 ± 10.82 years old. In total, 36 of 51 (70.59%; 95% CI 58.10-83.10) patients reported their symptoms as significant or complete improvement after YAG laser vitreolysis treatment. Post-treatment MTFa, internal SA and internal HOA were significantly better compared to baseline (26.19 ± 14.73 vs. 29.19 ± 17.98, p = 0.013; 0.05 ± 0.05 vs. 0.04 ± 0.04, p = 0.031 and 0.23 ± 0.22 vs. 0.16 ± 0.07, p = 0.044; respectively) in all eyes. Twenty-nine of 51 (56.86%) eyes had floaters of non-PVD type. Significant or complete subjective improvements in the PVD group and non-PVD group were 72.73% and 68.97% (p = 0.344), respectively. CONCLUSIONS Improved subjective and objective visual quality in participants with symptomatic floaters following YAG laser vitreolysis was found in both groups. The efficacy of YAG laser vitreolysis was comparable in floaters of complete PVD and non-PVD types.
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Ankamah E, Green-Gomez M, Roche W, Ng E, Welge-Lüßen U, Kaercher T, Barbur J, Nolan JM. Impact of symptomatic vitreous degeneration on photopic and mesopic contrast thresholds. Clin Exp Optom 2021; 105:609-616. [PMID: 34751082 DOI: 10.1080/08164622.2021.1981116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CLINICAL RELEVANCE Contrast thresholds under photopic and mesopic luminance conditions are compromised in subjects with vitreous degeneration. A plausible explanation is needed for the visual discomfort expressed by patients suffering from symptomatic vitreous degeneration. BACKGROUND The current study investigates the effect of symptomatic vitreous degeneration on photopic and mesopic contrast at high spatial frequencies. METHODS An age-matched sample of 115 subjects, comprising 30 subjects with symptomatic vitreous floaters (cases) and 85 healthy subjects (controls), was included in this study. Visual acuity and flicker thresholds were measured for all participants. Photopic and mesopic functional contrast thresholds at 10 cycles per degree were measured for all participants to assess the effect of floaters on contrast. Further, to determine the effect of posterior vitreous detachment on contrast, the sample was divided into three groups: cases with posterior vitreous detachment (n = 12); cases without posterior vitreous detachment (n = 18); and controls (n = 85), and their contrast thresholds were compared. RESULTS Photopic and mesopic contrast thresholds were lower by 37.4% and 27.5%, respectively, when the cases were compared with the controls (p = 0.028 and p < 0.001 for photopic and mesopic contrast thresholds, respectively). Photopic contrast was lower by 64.0% in cases with posterior vitreous detachment compared with controls (p = 0.001). Compared with controls, mesopic contrast was lower in cases with posterior vitreous detachment and in cases without posterior vitreous detachment by 30.3% and 25.6%, respectively (p = 0.014 and p = 0.017 for cases with and without posterior vitreous detachment, respectively). CONCLUSION : Subjects with vitreous degeneration have diminished photopic and mesopic contrast thresholds compared with controls. This finding highlights the negative impact of vitreous degeneration on the quality of vision.
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Affiliation(s)
- Emmanuel Ankamah
- Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Co, Waterford, Ireland
| | - Marina Green-Gomez
- Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Co, Waterford, Ireland
| | - Warren Roche
- Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Co, Waterford, Ireland
| | - Eugene Ng
- Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Co, Waterford, Ireland.,Institute of Eye Surgery, UPMC Whitfield Hospital, Co, Waterford, Ireland
| | | | | | - John Barbur
- Applied Vision Research Centre, School of Health Sciences, University of London, London, UK
| | - John M Nolan
- Nutrition Research Centre Ireland, School of Health Science, Waterford Institute of Technology, Co, Waterford, Ireland
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Zong Y, Gao QY, Hui YN. Vitreous function and intervention of it with vitrectomy and other modalities. Int J Ophthalmol 2021; 14:1610-1618. [PMID: 34667740 DOI: 10.18240/ijo.2021.10.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 05/14/2021] [Indexed: 12/11/2022] Open
Abstract
The vitreous body, the largest intraocular component, plays a key role in eye development, refraction, cell barrier function, oxygen metabolism and the pathogenesis of assorted diseases. Age, refraction and systemic diseases can cause vitreous metabolic abnormalities. With the continuous development of vitrectomy techniques and equipment, vitreous injections and vitrectomies have increased over the recent decades. However, the normal oxygen tension gradient in the vitreous helps to protect the lens and anterior chamber angle from oxidative stress damage, whereas the increased vitreous oxygen tension around lens and the trabecular meshwork after vitrectomy may lead to postoperative nuclear cataract and a high incidence of open angle glaucoma. As a conventional procedure, scleral buckling holds several advantages over vitrectomy in selected cases. This review raises concerns regarding the function of the vitreous, and encourages conducting vitreous interventions prudently.
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Affiliation(s)
- Yao Zong
- Department of Ophthalmology, the Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Qian-Ying Gao
- Vesber Vitreous Institute, Guangzhou 510000, Guangdong Province, China
| | - Yan-Nian Hui
- Department of Ophthalmology, Eye Institute of PLA, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China
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Ankamah E, Green-Gomez M, Roche W, Ng E, Welge-Lüßen U, Kaercher T, Nolan JM. Dietary Intervention With a Targeted Micronutrient Formulation Reduces the Visual Discomfort Associated With Vitreous Degeneration. Transl Vis Sci Technol 2021; 10:19. [PMID: 34647961 PMCID: PMC8525826 DOI: 10.1167/tvst.10.12.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the impact of supplementation with a targeted micronutrient formulation on the visual discomfort associated with vitreous degeneration. Methods In this clinical trial, 61 patients with symptomatic vitreous floaters were randomized to consume daily, the active supplement consisting of 125 mg L-lysine, 40 mg vitamin C, 26.3 mg Vitis vinifera extract, 5 mg zinc, and 100 mg Citrus aurantium or placebo for 6 months. Change in visual discomfort from floaters, assessed with the Floater Disturbance Questionnaire, was the primary outcome measure. Secondary outcome measures included best-corrected visual acuity, letter contrast sensitivity, photopic functional contrast sensitivity with positive and negative contrast polarity, and quantitative vitreous opacity areas. Results After supplementation, the active group reported a significant decrease in their visual discomfort from floaters (P < 0.001), whereas the placebo group had no significant change in their visual discomfort (P = 0.416). At 6 months, there was a significant decrease in vitreous opacity areas in the active group (P < 0.001) and an insignificant increase in vitreous opacity areas in the placebo group (P = 0.081). Also, there was a significant improvement in photopic functional contrast sensitivity with positive contrast polarity in the active group after supplementation (P = 0.047). Conclusions The findings of this study indicate improvements in vision-related quality of life and visual function of patients suffering from vitreous floaters after supplementation with a formulation of antioxidative and antiglycation micronutrients. Notably, these improvements were confirmed by the decrease in vitreous opacity areas in the active group. Translational Relevance This targeted dietary intervention should be considered to support patients with symptomatic vitreous degeneration.
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Affiliation(s)
- Emmanuel Ankamah
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| | - Marina Green-Gomez
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| | - Warren Roche
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
| | - Eugene Ng
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland.,Institute of Eye Surgery, UPMC Whitfield, Buttlerstown, County Waterford, Ireland
| | | | | | - John M Nolan
- Nutrition Research Centre Ireland, School of Health Science, Carriganore House, Waterford Institute of Technology, West Campus, Waterford, Ireland
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Shaimova VA, Nosul YV, Kuchkildina SK, Kulikov AN, Maltsev DS, Shaimov TB, Shaimov RB, Golovneva ES, Kravchenko TG, Kholopova AY, Ermilov VV, Berdnikov RB. [Retrolental amyloidosis of the vitreous body (case study)]. Vestn Oftalmol 2021; 137:98-103. [PMID: 34410063 DOI: 10.17116/oftalma202113704198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Accumulations of pathological amyloid protein in the vitreous can be a pathognomonic morphological sign of systemic amyloidosis, which is characterized by deposition of insoluble fibrillar protein aggregates (amyloid) in various organs and tissues. The article describes a clinical case of a female 65-year-old patient with bilateral vitreous floaters and histologically confirmed vitreous amyloidosis on the right eye. The patient had undergone YAG laser vitreolysis of the right eye 3 years ago on the Ultra Q Reflex system («Ellex», Australia) to treat an atypical Weiss ring. Diagnosis of vitreous amyloidosis was confirmed using the following equipment: video slit lamp SL9900 («CSO», Italy), optical coherence tomography system Solix («Optovue», USA), B-scan Plus («Accutome», USA), microscope CX41RF («Olympus Corporation», Japan). Due to significant visual deterioration in the right eye, the patient underwent vitrectomy. Microscopic examination of the surgical sample showed the presence of amyloid deposits revealed by the brick-red specific staining with congo red dye and apple-green birefringence of the stained areas in polarized light.
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Affiliation(s)
- V A Shaimova
- S.M. Kirov Military Medical Academy, Saint Petersburg, Russia.,Multidisciplinary Center of Laser Medicine, Chelyabinsk, Russia.,Center Zreniya LLC, Chelyabinsk, Russia
| | - Yu V Nosul
- Center Zreniya LLC, Chelyabinsk, Russia.,Municipal Clinical Hospital No. 6, Chelyabinsk, Russia
| | | | - A N Kulikov
- S.M. Kirov Military Medical Academy, Saint Petersburg, Russia
| | - D S Maltsev
- S.M. Kirov Military Medical Academy, Saint Petersburg, Russia
| | | | - R B Shaimov
- Center Zreniya LLC, Chelyabinsk, Russia.,Municipal Clinical Hospital No. 6, Chelyabinsk, Russia
| | - E S Golovneva
- Multidisciplinary Center of Laser Medicine, Chelyabinsk, Russia.,South Ural State Medical University, Chelyabinsk, Russia
| | - T G Kravchenko
- Multidisciplinary Center of Laser Medicine, Chelyabinsk, Russia
| | - A Yu Kholopova
- Chelyabinsk Regional Pathoanatomical Bureau, Chelyabinsk, Russia
| | - V V Ermilov
- Volgograd State Medical University, Volgograd, Russia
| | - R B Berdnikov
- Ural State Medical University, Ekaterinburg, Russia.,Ural Scientific Research Institute of Phthisiopulmonology - branch of National Research Medical Center of Phthisiopulmonology and Infectious Diseases, Ekaterinburg, Russia
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Matyushchenko AG, Budzinskaya MV, Petrachkov DV. [Modern understanding of structural and biochemical characteristics of the vitreous in eyes with normal and increased axial length]. Vestn Oftalmol 2021; 137:110-115. [PMID: 34410065 DOI: 10.17116/oftalma2021137041110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The review highlights the features of molecular, morphological and anatomical organization of the vitreous body in normal human eyes and in eyes with elongated anterior-posterior axis. The molecular structure of the vitreous consists of various types of collagen, glycosaminoglycans, glycoproteins and proteoglycans. The lowest concentration of collagen fibrils is in the central vitreous, so the structural changes of vitreous gel associated with attenuation of the vitreous body happen there much earlier and to a greater degree. Increased aggregation of collagen fibrils with age casuses an increase of liquid fractions of the vitreous with a concomitant decrease in gel volume. Similar processes occur earlier in eyes with axial myopia. Destructive processes in myopia increase progressively with axial elongation. As a result of vitreous collapse, vitreoretinal adhesion weakens and posterior vitreous detachment occurs.
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Barras A, Sauvage F, de Hoon I, Braeckmans K, Hua D, Buvat G, Fraire JC, Lethien C, Sebag J, Harrington M, Abderrahmani A, Boukherroub R, De Smedt S, Szunerits S. Carbon quantum dots as a dual platform for the inhibition and light-based destruction of collagen fibers: implications for the treatment of eye floaters. NANOSCALE HORIZONS 2021; 6:449-461. [PMID: 33903870 DOI: 10.1039/d1nh00157d] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Common in myopia and aging, vitreous opacities arise from clumped collagen fibers within the vitreous body that cast shadows on the retina, appearing as 'floaters' to the patient. Vitreous opacities degrade contrast sensitivity function and can cause significant impairment in vision-related quality-of-life, representing an unmet and underestimated medical need. One therapeutic approach could be the use of versatile light-responsive nanostructures which (i) interfere with the formation of collagen fibers and/or (ii) destroy aggregates of vitreous collagen upon pulsed-laser irradiation at low fluences. In this work, the potential of positively and negatively charged carbon quantum dots (CQDs) to interfere with the aggregation of type I collagen is investigated. We demonstrate that fibrillation of collagen I is prevented most strongly by positively charged CQDs (CQDs-2) and that pulsed-laser illumination allowed to destroy type I collagen aggregates and vitreous opacities (as obtained from patients after vitrectomy) treated with CQDs-2.
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Affiliation(s)
- Alexandre Barras
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France.
| | - Félix Sauvage
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Inès de Hoon
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France. and Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Kevin Braeckmans
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Dawei Hua
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Gaëtan Buvat
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France.
| | - Juan C Fraire
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Christophe Lethien
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France.
| | - J Sebag
- VMR Institute for Vitreous Macula Retina, Huntington Beach, California 92647, USA and Doheny Eye Institute/UCLA, Los Angeles, California 90033, USA
| | | | - Amar Abderrahmani
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France.
| | - Rabah Boukherroub
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France.
| | - Stefaan De Smedt
- Laboratory of General Biochemistry and Physical Pharmacy, Faculty of Pharmaceutical Sciences, Ghent University, 9000 Ghent, Belgium.
| | - Sabine Szunerits
- Univ. Lille, CNRS, Centrale Lille, Univ. Polytechnique Hauts-de-France, UMR 8520 - IEMN, F-59000 Lille, France.
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Ramovecchi P, Salati C, Zeppieri M. Spontaneous posterior vitreous detachment: A glance at the current literature. World J Exp Med 2021; 11:30-36. [PMID: 34141604 PMCID: PMC8188834 DOI: 10.5493/wjem.v11.i3.30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/14/2021] [Accepted: 05/21/2021] [Indexed: 02/06/2023] Open
Abstract
Spontaneous posterior vitreous detachment (PVD) is a common age-related condition in which prevalence tends to increase with age. Acute PVD can cause the onset of symptoms that include visual disturbances, myodesopsia and photopsia. The goal of this short review was to provide a quick glance at the important factors related to PVD based on current literature in this field, which includes incidence, symptoms, diagnosis, risk factors, and education for patients with acute symptoms, and treatments. The take home message is that an ophthalmic examination at the onset of symptoms is of utmost importance, considering that irreversible sight-threatening complications can be prevented if diagnosed and treated promptly.
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Affiliation(s)
- Paola Ramovecchi
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
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Dong N, Cai Q, Li Z, Xu L, Wu H, Lin Z, Qiu B, Li C, Lin Z. Convenient hyaluronidase biosensors based on the target-trigger enhancing of the permeability of a membrane using an electronic balance as a readout. Analyst 2021; 146:3299-3304. [PMID: 33999089 DOI: 10.1039/d1an00257k] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The change in hyaluronidase (HAase) is related to specific changes in the structure of vitreous, and it is necessary to develop simple but sensitive methods for HAase detection. In this work, a thin film fabricated from a hyaluronic acid (HA)-polyethyleneimine (PEI) hydrogel has been covered on a mixed cellulose microporous membrane (MCEM) to form a HA-PEI-MCEM firstly and it was then applied in a filtration system. The permeability of the filter membrane greatly affects the amount of water passing through within a certain time and the water can be collected and quantitatively measured with a simple electronic balance easily. The low permeability of the HA-PEI-MCEM allows a small amount of water to be drained. But after the addition of HAase, which can hydrolyze HA in the hydrogel, the permeability of the membrane increased. Therefore, the amount of water passing through the HA-PEI-MCEM composite membrane increased accordingly. The composite of the membrane, and the reaction conditions after the addition of HAase were optimized. Under the optimized conditions, the amount of water collected within 5 min showed a linear relationship with the HAase concentration in a range of 1.0-36 U mL-1 with a limit of detection of 0.35 U mL-1.The proposed method has been applied to detect HAase in vitreous samples with satisfactory results.
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Affiliation(s)
- Nuo Dong
- Eye Institute & Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China. and Department of Ophthalmology, Affiliated People's Hospital & Zhenjiang Kangfu Eye Hospital, Jiangsu University, Zhenjiang, Jiangsu, China and Fujian Provincial Key Laboratory of Ocular Surface and Corneal Disease, Xiamen, Fujian, China
| | - Qing Cai
- Eye Institute & Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China.
| | - Zhixin Li
- Ministry of Education Key Laboratory for Analytical Science of Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection for Food Safety, College of Chemistry, Fuzhou University, Fuzhou, Fujian, China.
| | - Liangzhen Xu
- Eye Institute & Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China.
| | - Huping Wu
- Eye Institute & Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China. and Fujian Provincial Key Laboratory of Ocular Surface and Corneal Disease, Xiamen, Fujian, China
| | - Zhirong Lin
- Eye Institute & Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China. and Fujian Provincial Key Laboratory of Ocular Surface and Corneal Disease, Xiamen, Fujian, China
| | - Bin Qiu
- Ministry of Education Key Laboratory for Analytical Science of Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection for Food Safety, College of Chemistry, Fuzhou University, Fuzhou, Fujian, China.
| | - Cheng Li
- Eye Institute & Affiliated Xiamen Eye Center, School of Medicine, Xiamen University, Xiamen, Fujian, China.
| | - Zhenyu Lin
- Ministry of Education Key Laboratory for Analytical Science of Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection for Food Safety, College of Chemistry, Fuzhou University, Fuzhou, Fujian, China.
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Sebag J. Vitrectomy for Vision Degrading Myodesopsia. Ophthalmol Retina 2021; 5:1-3. [PMID: 33413791 DOI: 10.1016/j.oret.2020.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/18/2020] [Accepted: 08/21/2020] [Indexed: 11/16/2022]
Affiliation(s)
- J Sebag
- Doheny Eye Institute/UCLA, Los Angeles, California; Department of Ophthalmology, Geffen School of Medicine, UCLA, Los Angeles, California; VMR Institute for Vitreous Macula Retina, Huntington Beach, California.
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García BG, Orduna Magán C, Alvarez-Peregrina C, Villa-Collar C, Sánchez-Tena MÁ. Nd:YAG laser vitreolysis and health-related quality of life in patients with symptomatic vitreous floaters. Eur J Ophthalmol 2021; 32:11206721211008036. [PMID: 33827286 DOI: 10.1177/11206721211008036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The treatment of floaters has consisted primarily of monitoring. The therapeutic approach is based on surgical removal or Nd:YAG laser treatment. The objective of this study was the assessment of the quality of life in patients treated with Nd:YAG laser for floaters. METHODS Single-center pretest-posttest design in a cohort of subjects treated with Nd-YAG laser with Ultra Q-Reflex technology. Health-related quality of life of the patients was measured before and after the intervention with the Visual Function Questionnaires VFQ-25 and VFQ-39. Anxiety level was measured with the State-Trait Anxiety Inventory. Visual acuity, contrast sensitivity, and safety parameters were also considered. RESULTS Thirty-four patients were included in the study. For the VFQ-25 baseline, the median was 73.05, interquartile range (19.25) versus a final median value of 93.76 (8.73) with p < 0.01. The baseline median for the extended version VFQ-39 was 74.60 (19.01) versus the final median of 95.01 (6.50) with p < 0.001. Regarding the anxiety, according to the STAI questionnaire, there were statistically significant differences between the baseline and the final conditions, with a baseline median of 38 (11) versus a final median of 18 (19); p < 0.001. When the analyses differentiated between patients with and without myopia, there were statistically significant differences for VFQ-25 and VFQ-39. CONCLUSIONS This study shows an improvement in the health-related quality of life and a significant decrease in anxiety for patients that have undergone Nd: YAG Ultra-Q Reflex laser vitreolysis for floaters vaporization. The effect found is higher in myopic patients.
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Affiliation(s)
| | | | - Cristina Alvarez-Peregrina
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odon, Madrid, Spain
| | - César Villa-Collar
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odon, Madrid, Spain
| | - Miguel Ángel Sánchez-Tena
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odon, Madrid, Spain
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Vitreous Structure and Visual Function in Myopic Vitreopathy Causing Vision-Degrading Myodesopsia. Am J Ophthalmol 2021; 224:246-253. [PMID: 32950508 DOI: 10.1016/j.ajo.2020.09.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/29/2020] [Accepted: 09/10/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE Myopic vitreopathy features precocious fibrous vitreous liquefaction and early posterior vitreous detachment (PVD). It is unclear whether visual function is affected by myopic vitreopathy and PVD. This study assessed the relationships among axial length, structural vitreous density, PVD, and visual function. DESIGN Retrospective case-control study. METHODS Ultrasonography measurements were made of axial length, logMAR VA, contrast sensitivity function (CSF [Freiburg acuity contrast test]), and quantitative B-scan ultrasonography. RESULTS Seventy-nine subjects (45 men and 34 women; mean age: 49 ± 14 years) were analyzed. Axial lengths ranged from 22 to 29.2 mm (mean: 24.9 ± 1.8 mm; myopic eyes: 26.35 ± 1.35 mm; and nonmyopic eyes: 23.45 ± 0.75 mm; P < .001). With increasing axial length there was greater vitreous echodensity (R: 0.573; P < .01) and degradation in CSF (R: 0.611; P < .01). Subgroup analyses found that myopic eyes (>- 3 diopters) had 37% more vitreous echodensity than nonmyopic eyes (762 ± 198 arbitrary units [AU] vs. 557 ± 171 AU, respectively; P < .001) and that CSF was 53% worse in myopic eyes (3.30 ± 1.24 Weber index [%W]) than in nonmyopic eyes (2.16 ± .59 %W; P < .001). Myopic eyes with PVD had 33% greater vitreous echodensity (815 ± 217 AU; P < .001) and 62% degradation in CSF (3.63 ± 2.99 %W) compared to nonmyopic eyes with PVD (613 ± 159 AU; 2.24 ± 0.69 %W; P < .001, each). Limited vitrectomy was performed in 11 of 40 cases (27.5%), normalizing vitreous echodensity and CSF in each case. CONCLUSIONS Axial myopia is associated with increased fibrous vitreous liquefaction and echodensity, as well as profound degradation of CSF. PVD in myopic eyes is associated with even more structural and functional abnormalities, normalized by limited vitrectomy. These findings may explain some common complaints of myopic patients with respect to vision and quality of life.
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Ruminski D, Sebag J, Toledo RD, Jiménez-Villar A, Nowak JK, Manzanera S, Artal P, Grulkowski I. Volumetric Optical Imaging and Quantitative Analysis of Age-Related Changes in Anterior Human Vitreous. Invest Ophthalmol Vis Sci 2021; 62:31. [PMID: 33929483 PMCID: PMC8088225 DOI: 10.1167/iovs.62.4.31] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose The purpose of this study was to characterize age-related changes in anterior human vitreous with 3-D swept source optical coherence tomography (SS-OCT) and evaluate associations with axial length (AL) and contrast sensitivity function (CSF). Methods There were 49 phakic eyes in 49 patients (40.0 ± 19.3 years) had 3-D volumetric scanning of the lens and retrolental vitreous with SS-OCT at 1050 nm. OCT-derived indices of vitreous optical density (VOD), vitreous opacification ratio (VOR), and lens optical density (LOD) were correlated with AL and double-pass assessment of retinal point spread function (Objective Scatter Index [OSI]). CSF was measured using an adaptive-optics visual simulator (area under log-log contrast sensitivity function [AULCSF]). Results Vitreous SS-OCT detected gel vitreous, liquefied lacunae, Berger's space, retrolental laminae, and fibrous opacifications. VOD, VOR, and LOD showed high reproducibility (intraclass correlation coefficients 0.968, 0.975, and 0.998, respectively). VOD was highly correlated with VOR (Pearson's R = 0.96, P < 0.000001). VOD, VOR, and LOD correlated with age (R = 0.48, 0.58, and 0.85, P < 0.001 for each). VOR and LOD correlated with OSI (R = 0.36, P = 0.0094, and R = 0.36, P = 0.0096, respectively). VOR correlated negatively with AULCSF (R = −0.53, P < 0.00009), which was related to OSI. Myopic eyes had higher OSI than nonmyopic eyes (P = 0.0121), consistent with correlation between OSI and AL (R = 0.37, P = 0.0091). Multivariable regression confirmed these findings. Conclusions SS-OCT visualized microstructural features of anterior human vitreous, where opacification is associated with increased light scattering and CSF degradation. SS-OCT enables high-resolution optical evaluation of vitreous opacities.
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Affiliation(s)
- Daniel Ruminski
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Torun, Poland
| | - J Sebag
- VMR Institute for Vitreous Macula Retina, Huntington Beach, California, United States
| | - Raúl Duarte Toledo
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo, Murcia, Spain
| | - Alfonso Jiménez-Villar
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Torun, Poland
| | - Jan K Nowak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Silvestre Manzanera
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo, Murcia, Spain
| | - Pablo Artal
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo, Murcia, Spain
| | - Ireneusz Grulkowski
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Torun, Poland
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Levin M, Cohen N. The effects of aging on the mechanical properties of the vitreous. J Biomech 2021; 119:110310. [PMID: 33721627 DOI: 10.1016/j.jbiomech.2021.110310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 01/22/2021] [Accepted: 02/03/2021] [Indexed: 12/14/2022]
Abstract
The vitreous body is a viscoelastic gel-like network that fills the space between the lens and the retina in the eye. With aging, the vitreous undergoes a liquefaction process in which liquid pockets form in the gel network, thereby motivating the detachment of the vitreous from the retina in a process known as posterior vitreous detachment (PVD). The PVD process may lead to the formation of floaters and even result in partial or complete loss of vision. Experiments show that the liquefaction and the PVD processes alter the mechanical properties of the vitreous. In this work, we propose a microscopically motivated model that characterizes the changes in the mechanical properties of the vitreous due to aging. To this end, we distinguish between four vitreous states: a homogeneous vitreous, a liquefied vitreous, a vitreous that undergoes partial PVD, and a vitreous with full PVD. The model predicts the time-dependent and the steady-state response of the vitreous in each of the four states. The proposed framework is validated through a comparison with various experimental findings and captures the softening of the vitreous due to aging. We illustrate the importance of the age at which the PVD process begins and of the rate of the detachment process. In addition, we introduce a quantifiable parameter that describes the stage of PVD in the eye. Lastly, we employ our model to investigate the possibility of restoring the mechanical properties of a vitreous that has undergone PVD through the addition of reinforcing fibers to the gel. This work provides insight into the consequences of the age-related changes in the microstructure of the eye and serves as a motivation for new therapeutic measures.
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Affiliation(s)
- Michal Levin
- Department of Materials Science and Engineering, Technion - Israel Institute of Technology, Haifa 3200003, Israel
| | - Noy Cohen
- Department of Materials Science and Engineering, Technion - Israel Institute of Technology, Haifa 3200003, Israel.
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Kalavar M, Hubschman S, Hudson J, Kuriyan AE, Sridhar J. Evaluation of Available Online Information Regarding Treatment for Vitreous Floaters. Semin Ophthalmol 2021; 36:58-63. [PMID: 33599190 DOI: 10.1080/08820538.2021.1887898] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To assess the quality, content, and readability of information available online on vitreous floater information. DESIGN Cross-sectional study. PARTICIPANTS Not applicable. METHODS Websites were generated using a Google search of "vitreous floaters treatment" and "[State]" and were analyzed using a standardized checklist of 22 questions. Readability was assessed using the Flesch Reading Ease score. Websites met qualification criteria if they represented U.S.-based institutions, if they provided clinical care and addressed vitreous floater treatment on their website. RESULTS Of the 1,065 websites screened, 456 were included. Of these, 406 (89%) were private institutions, 24 (5.3%) were academic, and 26 (5.7%) were a combination of private and academic. The average readability score correlated to a 10th-12th grade reading level. Vitreous floater treatment was discussed on 283 (62.1%) websites and 63 (21.8%) websites discussed potential side effects. Google rank was inversely correlated with the depth of explanation (r = -0.114, p = .016). Observation was the main treatment recommended (55.8%, n = 158), followed by laser treatment (27.6%, n = 78), no specific treatment recommendation (11.3%, n = 32), and vitrectomy (5.3%, n = 15). Centers with vitreoretinal surgeons were 16.43 times more likely to recommend vitrectomy than those without vitreoretinal surgeons (p < .001). CONCLUSIONS Online information about vitreous floater treatment is variable, and the material is at a higher than recommended reading level for health information. While treatment was discussed by nearly two thirds of websites, less than a quarter mentioned possible complications, and treatment recommendations varied significantly depending on physician training.
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Affiliation(s)
- Meghana Kalavar
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Sasha Hubschman
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Julia Hudson
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ajay E Kuriyan
- Mid Atlantic Retina, Retina Service of Wills Eye Hospital, Philadelphia, PA
| | - Jayanth Sridhar
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
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Return to the Operating Room after Vitrectomy for Vitreous Opacities. ACTA ACUST UNITED AC 2021; 5:4-8. [DOI: 10.1016/j.oret.2020.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 11/22/2022]
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López-Contreras AK, Martínez-Ruiz MG, Olvera-Montaño C, Robles-Rivera RR, Arévalo-Simental DE, Castellanos-González JA, Hernández-Chávez A, Huerta-Olvera SG, Cardona-Muñoz EG, Rodríguez-Carrizalez AD. Importance of the Use of Oxidative Stress Biomarkers and Inflammatory Profile in Aqueous and Vitreous Humor in Diabetic Retinopathy. Antioxidants (Basel) 2020; 9:antiox9090891. [PMID: 32962301 PMCID: PMC7555116 DOI: 10.3390/antiox9090891] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 12/23/2022] Open
Abstract
Diabetic retinopathy is one of the leading causes of visual impairment and morbidity worldwide, being the number one cause of blindness in people between 27 and 75 years old. It is estimated that ~191 million people will be diagnosed with this microvascular complication by 2030. Its pathogenesis is due to alterations in the retinal microvasculature as a result of a high concentration of glucose in the blood for a long time which generates numerous molecular changes like oxidative stress. Therefore, this narrative review aims to approach various biomarkers associated with the development of diabetic retinopathy. Focusing on the molecules showing promise as detection tools, among them we consider markers of oxidative stress (TAC, LPO, MDA, 4-HNE, SOD, GPx, and catalase), inflammation (IL-6, IL-1ß, IL-8, IL-10, IL-17A, TNF-α, and MMPs), apoptosis (NF-kB, cyt-c, and caspases), and recently those that have to do with epigenetic modifications, their measurement in different biological matrices obtained from the eye, including importance, obtaining process, handling, and storage of these matrices in order to have the ability to detect the disease in its early stages.
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Affiliation(s)
- Ana Karen López-Contreras
- Department of Physiology, Health Sciences University Center, Institute of Clinical and Experimental Therapeutics, University of Guadalajara, Guadalajara, Jalisco 44340, Mexico; (A.K.L.-C.); (M.G.M.-R.); (C.O.-M.); (R.R.R.-R.); (D.E.A.-S.); (J.A.C.-G.); (A.H.-C.); (E.G.C.-M.)
| | - María Guadalupe Martínez-Ruiz
- Department of Physiology, Health Sciences University Center, Institute of Clinical and Experimental Therapeutics, University of Guadalajara, Guadalajara, Jalisco 44340, Mexico; (A.K.L.-C.); (M.G.M.-R.); (C.O.-M.); (R.R.R.-R.); (D.E.A.-S.); (J.A.C.-G.); (A.H.-C.); (E.G.C.-M.)
| | - Cecilia Olvera-Montaño
- Department of Physiology, Health Sciences University Center, Institute of Clinical and Experimental Therapeutics, University of Guadalajara, Guadalajara, Jalisco 44340, Mexico; (A.K.L.-C.); (M.G.M.-R.); (C.O.-M.); (R.R.R.-R.); (D.E.A.-S.); (J.A.C.-G.); (A.H.-C.); (E.G.C.-M.)
| | - Ricardo Raúl Robles-Rivera
- Department of Physiology, Health Sciences University Center, Institute of Clinical and Experimental Therapeutics, University of Guadalajara, Guadalajara, Jalisco 44340, Mexico; (A.K.L.-C.); (M.G.M.-R.); (C.O.-M.); (R.R.R.-R.); (D.E.A.-S.); (J.A.C.-G.); (A.H.-C.); (E.G.C.-M.)
| | - Diana Esperanza Arévalo-Simental
- Department of Physiology, Health Sciences University Center, Institute of Clinical and Experimental Therapeutics, University of Guadalajara, Guadalajara, Jalisco 44340, Mexico; (A.K.L.-C.); (M.G.M.-R.); (C.O.-M.); (R.R.R.-R.); (D.E.A.-S.); (J.A.C.-G.); (A.H.-C.); (E.G.C.-M.)
- Department of Ophthalmology, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Guadalajara, Jalisco 44280, Mexico
| | - José Alberto Castellanos-González
- Department of Physiology, Health Sciences University Center, Institute of Clinical and Experimental Therapeutics, University of Guadalajara, Guadalajara, Jalisco 44340, Mexico; (A.K.L.-C.); (M.G.M.-R.); (C.O.-M.); (R.R.R.-R.); (D.E.A.-S.); (J.A.C.-G.); (A.H.-C.); (E.G.C.-M.)
- Department of Ophthalmology, Specialties Hospital of the National Occidental Medical Center, Mexican Institute of Social Security, Guadalajara, Jalisco 44329, Mexico
| | - Abel Hernández-Chávez
- Department of Physiology, Health Sciences University Center, Institute of Clinical and Experimental Therapeutics, University of Guadalajara, Guadalajara, Jalisco 44340, Mexico; (A.K.L.-C.); (M.G.M.-R.); (C.O.-M.); (R.R.R.-R.); (D.E.A.-S.); (J.A.C.-G.); (A.H.-C.); (E.G.C.-M.)
| | - Selene Guadalupe Huerta-Olvera
- Medical and Life Sciences Department, La Ciénega University Center, University of Guadalajara, Ocotlán, Jalisco 47810, Mexico;
| | - Ernesto German Cardona-Muñoz
- Department of Physiology, Health Sciences University Center, Institute of Clinical and Experimental Therapeutics, University of Guadalajara, Guadalajara, Jalisco 44340, Mexico; (A.K.L.-C.); (M.G.M.-R.); (C.O.-M.); (R.R.R.-R.); (D.E.A.-S.); (J.A.C.-G.); (A.H.-C.); (E.G.C.-M.)
| | - Adolfo Daniel Rodríguez-Carrizalez
- Department of Physiology, Health Sciences University Center, Institute of Clinical and Experimental Therapeutics, University of Guadalajara, Guadalajara, Jalisco 44340, Mexico; (A.K.L.-C.); (M.G.M.-R.); (C.O.-M.); (R.R.R.-R.); (D.E.A.-S.); (J.A.C.-G.); (A.H.-C.); (E.G.C.-M.)
- Correspondence:
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Lommatzsch A. [The Management of Vitreous Opacities]. Klin Monbl Augenheilkd 2020; 237:e3-e14. [PMID: 32777831 DOI: 10.1055/a-1211-0325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The management of symptomatic vitreous opacities is often complicated in daily practice. The technically significantly improved surgical possibilities lead to an increased number of surgical interventions. The Nd:YAG laser vitreolysis is increasingly becoming a therapeutic option. Unfortunately, there are no comparative randomized studies on vitrectomy, Nd:YAG laser vitreolysis and a wait-and-see approach to spontaneous progress. This article gives an overview of this problem.
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Preclinical challenges for developing long acting intravitreal medicines. Eur J Pharm Biopharm 2020; 153:130-149. [DOI: 10.1016/j.ejpb.2020.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/01/2020] [Accepted: 05/08/2020] [Indexed: 02/07/2023]
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Lommatzsch A. Das Management von Glaskörpertrübungen. AUGENHEILKUNDE UP2DATE 2020. [DOI: 10.1055/a-1017-0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ZusammenfassungDas Management von symptomatischen Glaskörpertrübungen stellt sich in der täglichen Praxis oft als kompliziert dar. Die Nd:YAG-Laser-Vitreolyse rückt als weitere therapeutische Option immer mehr in den Fokus. Vergleichende randomisierte Studien zur Vitrektomie, Nd:YAG-Laser-Vitreolyse und einer abwartenden Vorgehensweise zum Spontanverlauf gibt es leider nicht. Dieser Beitrag versucht, zu dieser Problematik einen Überblick zu geben.
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