1
|
Karaca I, Uludag G, Matsumiya W, Regenold J, Or C, Mobasserian A, Halim MS, Zaidi M, Lajevardi S, Dongchau A, Ghoraba H, Nguyen QD. Six-month outcomes of infliximab and tocilizumab therapy in non-infectious retinal vasculitis. Eye (Lond) 2023; 37:2197-2203. [PMID: 36443499 PMCID: PMC10366079 DOI: 10.1038/s41433-022-02315-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 09/03/2022] [Accepted: 11/11/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To evaluate the efficacy of infliximab (IFX, 5-10 mg/kg) (Group 1) and tocilizumab (TCZ, 4-8 mg/kg) (Group 2) infusions in non-infectious retinal vasculitis (RV) using Angiographic Scoring for the Uveitis Working Group fluorescein angiography (FA) scoring system. METHODS Records of 14 patients (24 eyes) in Group 1 and 8 patients (11 eyes) in Group 2 were retrospectively evaluated to assess visual acuity (VA), anterior chamber cell and flare, vitreous haze, central subfield thickness (CST), and FA scoring at baseline and 6 months of follow-up. The measurements were employed to grade in each group. RESULTS In Group 1 and 2, respectively, there was no underlying disease in 9 (60%) and 3 (42.9%) patients. Three (42.9%) patients in Group 2 had juvenile idiopathic arthritis (JIA) as the most common identified cause. Mean improvement in VA (log MAR) and CST were 0.04 ± 0.14 and 40.3 ± 78.5 µm in Group 1; 0.04 ± 0.09 and 47.3 ± 82.3 µm in Group 2, respectively. Mean FA scores were significantly reduced from 12.4 ± 5.2 and 11.6 ± 4.4 at baseline to 6.4 ± 5.0 and 5.8 ± 3.9 at 6-month in Group 1 and 2, respectively. In Group 2, 9 eyes of 6 patients (75%) had the history of IFX use prior to TCZ initiation. There was no significant safety concern requiring treatment discontinuation during the follow-up in either group. CONCLUSION IFX and TCZ infusions showed statistically significant improvement of non-infectious RV as shown by ASUWOG FA Scoring System. TCZ, as well as IFX, appeared to be effective treatment options for non-infectious RV.
Collapse
Affiliation(s)
- Irmak Karaca
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Gunay Uludag
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Wataru Matsumiya
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Jonathan Regenold
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Christopher Or
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Azadeh Mobasserian
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Muhammad Sohail Halim
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Moosa Zaidi
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Sherin Lajevardi
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Ami Dongchau
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Hashem Ghoraba
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | - Quan Dong Nguyen
- Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA, USA.
| |
Collapse
|
2
|
Mautone L, Birtel J, Atiskova Y, Druchkiv V, Stübiger N, Spitzer MS, Dulz S. X-Linked Retinoschisis Masquerading Uveitis. J Clin Med 2023; 12:jcm12113729. [PMID: 37297924 DOI: 10.3390/jcm12113729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/21/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
X-linked retinoschisis (XLRS) shows features also seen in patients with uveitis and is recognized as an uveitis masquerade syndrome. This retrospective study aimed to describe characteristics of XLRS patients with an initial uveitis diagnosis and to contrast these to patients with an initial XLRS diagnosis. Patients referred to a uveitis clinic, which turned out to have XLRS (n = 4), and patients referred to a clinic for inherited retinal diseases (n = 18) were included. All patients underwent comprehensive ophthalmic examinations, including retinal imaging with fundus photography, ultra-widefield fundus imaging, and optical coherence tomography (OCT). In patients with an initial diagnosis of uveitis, a macular cystoid schisis was always interpreted as an inflammatory macular edema; vitreous hemorrhages were commonly interpreted as intraocular inflammation. Patients with an initial diagnosis of XLRS rarely (2/18; p = 0.02) showed vitreous hemorrhages. No additional demographic, anamnestic, and anatomical differences were found. An increased awareness of XLRS as a uveitis masquerade syndrome may facilitate early diagnosis and may prevent unnecessary therapies.
Collapse
Affiliation(s)
- Luca Mautone
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Johannes Birtel
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Yevgeniya Atiskova
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Vasyl Druchkiv
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Nicole Stübiger
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Martin S Spitzer
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Simon Dulz
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| |
Collapse
|
3
|
Endothelial Toll-like receptor 4 is required for microglia activation in the murine retina after systemic lipopolysaccharide exposure. J Neuroinflammation 2023; 20:25. [PMID: 36739425 PMCID: PMC9899393 DOI: 10.1186/s12974-023-02712-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/30/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Clustering of microglia around the vasculature has been reported in the retina and the brain after systemic administration of lipopolysaccharides (LPS) in mice. LPS acts via activation of Toll-like receptor 4 (TRL4), which is expressed in several cell types including microglia, monocytes and vascular endothelial cells. The purpose of this study was to investigate the effect of systemic LPS in the pigmented mouse retina and the involvement of endothelial TLR4 in LPS-induced retinal microglia activation. METHODS C57BL/6J, conditional knockout mice that lack Tlr4 expression selectively on endothelial cells (TekCre-posTlr4loxP/loxP) and TekCre-negTlr4loxP/loxP mice were used. The mice were injected with 1 mg/kg LPS via the tail vein once per day for a total of 4 days. Prior to initiation of LPS injections and approximately 5 h after the last injection, in vivo imaging using fluorescein angiography and spectral-domain optical coherence tomography was performed. Immunohistochemistry, flow cytometry, electroretinography and transmission electron microscopy were utilized to investigate the role of endothelial TLR4 in LPS-induced microglia activation and retinal function. RESULTS Activation of microglia, infiltration of monocyte-derived macrophages, impaired ribbon synapse organization and retinal dysfunction were observed after the LPS exposure in C57BL/6J and TekCre-negTlr4loxP/loxP mice. None of these effects were observed in the retinas of conditional Tlr4 knockout mice after the LPS challenge. CONCLUSIONS The findings of the present study suggest that systemic LPS exposure can have detrimental effects in the healthy retina and that TLR4 expressed on endothelial cells is essential for retinal microglia activation and retinal dysfunction upon systemic LPS challenge. This important finding provides new insights into the role of microglia-endothelial cell interaction in inflammatory retinal disease.
Collapse
|
4
|
Testi I, Vermeirsch S, Pavesio C. Acute posterior multifocal placoid pigment epitheliopathy (APMPPE). J Ophthalmic Inflamm Infect 2021; 11:31. [PMID: 34524577 PMCID: PMC8443720 DOI: 10.1186/s12348-021-00263-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 08/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is a rare inflammatory eye disease, affecting the inner choroid and the outer retina. Recent advances in multimodal imaging have been important in the understanding of the pathophysiology of the disease, allowing a better characterization of the morphology of this condition. Methods Narrative review. Results In this review, a comprehensive overview of clinical features, imaging findings, treatment management, and long-term outcomes of patients with APMPPE will be provided. Conclusions Although APMPPE was originally believed to be a self-limited condition with a good prognosis, the disease can be recurrent and result in significant loss of vision function. Fundus imaging plays an important role in the diagnosis and management of the disease, allowing to evaluate response to treatment and onset of complications.
Collapse
Affiliation(s)
- Ilaria Testi
- Department of Uveitis, Moorfields Eye Hospital, National Health Service Foundation Trust, 162 City Rd, Old Street, London, EC1V 2PD, UK
| | - Sandra Vermeirsch
- Department of Uveitis, Moorfields Eye Hospital, National Health Service Foundation Trust, 162 City Rd, Old Street, London, EC1V 2PD, UK
| | - Carlos Pavesio
- Department of Uveitis, Moorfields Eye Hospital, National Health Service Foundation Trust, 162 City Rd, Old Street, London, EC1V 2PD, UK.
| |
Collapse
|
5
|
Wintergerst MWM, Liu X, Terheyden JH, Pohlmann D, Li JQ, Montesano G, Ometto G, Holz FG, Crabb DP, Pleyer U, Heinz C, Denniston AK, Finger RP. Structural Endpoints and Outcome Measures in Uveitis. Ophthalmologica 2021; 244:465-479. [PMID: 34062542 DOI: 10.1159/000517521] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/20/2021] [Indexed: 11/19/2022]
Abstract
Most uveitis entities are rare diseases but, taken together, are responsible for 5-10% of worldwide visual impairment which largely affects persons of working age. As with many rare diseases, there is a lack of high-level evidence regarding its clinical management, partly due to a dearth of reliable and objective quantitative endpoints for clinical trials. This review provides an overview of available structural outcome measures for uveitis disease activity and damage in an anatomical order from the anterior to the posterior segment of the eye. While there is a multitude of available structural outcome measures, not all might qualify as endpoints for clinical uveitis trials, and thorough testing of applicability is warranted. Furthermore, a consensus on endpoint definition, standardization, and "core outcomes" is required. As stipulated by regulatory agencies, endpoints should be precisely defined, clinically important, internally consistent, reliable, responsive to treatment, and relevant for the respective subtype of uveitis. Out of all modalities used for assessment of the reviewed structural outcome measures, optical coherence tomography, color fundus photography, fundus autofluorescence, and fluorescein/indocyanine green angiography represent current "core modalities" for reliable and objective quantification of uveitis outcome measures, based on their practical availability and the evidence provided so far.
Collapse
Affiliation(s)
| | - Xiaoxuan Liu
- Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Academic Unit of Ophthalmology, Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Health Data Research UK, London, United Kingdom
| | - Jan H Terheyden
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Dominika Pohlmann
- Berlin Institute of Health, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jeany Q Li
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Giovanni Montesano
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, United Kingdom
| | - Giovanni Ometto
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, United Kingdom
| | - Frank G Holz
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - David P Crabb
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, United Kingdom
| | - Uwe Pleyer
- Berlin Institute of Health, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carsten Heinz
- Department of Ophthalmology, St. Franziskus-Hospital Münster, Münster, Germany
- Department of Ophthalmology, University Duisburg-Essen, Essen, Germany
| | - Alastair K Denniston
- Department of Ophthalmology, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
- Academic Unit of Ophthalmology, Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
- Health Data Research UK, London, United Kingdom
- NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Robert P Finger
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| |
Collapse
|
6
|
Tripathy K, Ying H, Maldonado Cerda A, Filipowicz A, Kaya M, Seymen Z, Anesi SD, Chang PY, Foster CS. Widefield Fundus Fluorescein Angiography Features of Uveitis Associated with Juvenile Idiopathic Arthritis. Ocul Immunol Inflamm 2020; 30:829-838. [PMID: 33264037 DOI: 10.1080/09273948.2020.1834586] [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: 10/22/2022]
Abstract
PURPOSE To evaluate the wide-field fundus fluorescein angiography (WFA) characteristics of uveitis associated with juvenile idiopathic arthritis (JIA-uveitis). METHODS Retrospective review of records. WFA with Spectralis (Heidelberg) of JIA-uveitis patients were analyzed using the scoring system by Angiography Scoring for Uveitis Nomenclature. RESULTS Thirty-seven eyes of 20 patients were studied. A total score of at least 1 was noted in 27 eyes (72.97%). WFA features included optic disc hyperfluorescence (51.35%), macular leakage (27.03%), retinal vascular staining/leakage at posterior pole (27.03%) and peripheral retina (64.86%), capillary leakage at the posterior pole (37.84%), and peripheral retina (59.46%). A decision to change the management plan was made in 8 of 9 patients with bilateral quiet anterior chambers after WFA results. CONCLUSION More than 70% of JIA-uveitis eyes showed some WFA-evidence of posterior segment inflammation, which changed the course of therapy for a major proportion of patients with no clinically active anterior chamber inflammation.
Collapse
Affiliation(s)
- Koushik Tripathy
- Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.,The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA
| | - Howard Ying
- Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.,The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA
| | - Anapatricia Maldonado Cerda
- Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.,The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA
| | - Artur Filipowicz
- Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.,The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA
| | - Mahmut Kaya
- Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.,The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA
| | - Zeynep Seymen
- Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.,The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA
| | - Stephen D Anesi
- Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.,The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA
| | - Peter Y Chang
- Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.,The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA
| | - Charles Stephen Foster
- Massachusetts Eye Research and Surgery Institution, Waltham, Massachusetts, USA.,The Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA.,Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
7
|
Tanaka R, Kaburaki T, Yoshida A, Takamoto M, Miyaji T, Yamaguchi T. Fluorescein Angiography Scoring System Using Ultra-Wide-Field Fluorescein Angiography Versus Standard Fluorescein Angiography in Patients with Sarcoid Uveitis. Ocul Immunol Inflamm 2020; 29:1398-1402. [PMID: 32162984 DOI: 10.1080/09273948.2020.1737141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To compare standard fluorescein angiography (FA) and ultra-wide-field (UWF) FA in evaluating sarcoid uveitis activity using the scoring system adopted by the Angiography Scoring for Uveitis Working Group (ASUWG).Methods: Standard and UWF FA images of 36 eyes with sarcoid uveitis were acquired on the same day. Three graders independently graded 72 FA images using the ASUWG scoring system. We evaluated inter-observer variability using the intra-class correlation coefficient (ICC) and compared scores of each angiographic sign.Results: The ICC was 0.77 for standard FA and 0.87 for UWF FA, with respective total scores of 12.0 and 14.6. UWF FA had higher scores than standard FA for optic disc hyperfluorescence, posterior retinal vascular staining and/or leakage, and peripheral capillary leakage.Conclusions: The scores for UWF FA had a higher ICC than those for standard FA in evaluating sarcoid uveitis. Peripheral capillary leakage scores were particularly high for UWF FA.
Collapse
Affiliation(s)
- Rie Tanaka
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Toshikatsu Kaburaki
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan.,Department of Ophthalmology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Atsushi Yoshida
- Department of Ophthalmology, The Cancer Institute Hospital Of JFCR, Tokyo, Japan
| | - Mitsuko Takamoto
- Department of Ophthalmology, The University of Tokyo Hospital, Tokyo, Japan
| | - Tempei Miyaji
- Department of Clinical Trial Data Management, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Department of Clinical Trial Data Management, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| |
Collapse
|
8
|
Meira J, Marques ML, Falcão-Reis F, Rebelo Gomes E, Carneiro Â. Immediate Reactions to Fluorescein and Indocyanine Green in Retinal Angiography: Review of Literature and Proposal for Patient's Evaluation. Clin Ophthalmol 2020; 14:171-178. [PMID: 32021082 PMCID: PMC6980835 DOI: 10.2147/opth.s234858] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 12/19/2019] [Indexed: 02/02/2023] Open
Abstract
Introduction Contrast rapid sequence angiography with fluorescein or indocyanine green (ICG) is a diagnostic procedure commonly used in ophthalmology. Adverse reactions to fluorescein and ICG are rare and may be classified as toxic, of hypersensitivity and non-specific. The evaluation and management of a patient with an adverse reaction is a challenge for the majority of ophthalmologists, as is the assessment of risk factors that may contraindicate the procedure. Purpose We aim to review the concepts underlying adverse reactions to fluorescein and ICG, especially those of hypersensitivity, and present a proposal or the evaluation of the patients in need to perform retinal angiography and for the treatment of immediate reactions to fluorescein and ICG. Methods The available literature was examined using PubMed-Medline, and using the MeSH terms "fluorescein", "Indocyanine green", "ophthalmic dyes", "retinal angiography", "adverse reactions", and "allergic reaction". Conclusion This review may help ophthalmologists to identify patients with higher risk of a hypersensitivity reaction and give them tools to recognize patients with suspected hypersensitivity that may benefit from an allergy study.
Collapse
Affiliation(s)
- Jorge Meira
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal
| | - Maria Luís Marques
- Department of Allergy and Clinical Immunology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Fernando Falcão-Reis
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Eva Rebelo Gomes
- Department of Allergy and Clinical Immunology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ângela Carneiro
- Department of Ophthalmology, Centro Hospitalar Universitário São João, Porto, Portugal.,Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| |
Collapse
|
9
|
Accorinti M, Okada AA, Smith JR, Gilardi M. Epidemiology of Macular Edema in Uveitis. Ocul Immunol Inflamm 2019; 27:169-180. [DOI: 10.1080/09273948.2019.1576910] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Massimo Accorinti
- Department of Ophthalmology, Sapienza University of Rome, Rome, Italy
| | - Annabelle A. Okada
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
| | - Justine R. Smith
- Flinders University College of Medicine & Public Health, Adelaide, Australia
| | | |
Collapse
|
10
|
Agarwal A, Aggarwal K, Gupta V, Agrawal R, Nguyen QD. Advances in imaging and molecular diagnostics of ocular tuberculosis and selected observations from the Collaborative Ocular Tuberculosis Study (COTS). EXPERT REVIEW OF OPHTHALMOLOGY 2018. [DOI: 10.1080/17469899.2018.1555472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Aniruddha Agarwal
- Advanced Eye Center, Post Graduate Institute of Medicine and Research (PGIMER), Chandigarh, India
| | - Kanika Aggarwal
- Advanced Eye Center, Post Graduate Institute of Medicine and Research (PGIMER), Chandigarh, India
| | - Vishali Gupta
- Advanced Eye Center, Post Graduate Institute of Medicine and Research (PGIMER), Chandigarh, India
| | - Rupesh Agrawal
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore
- Singapore Eye Research Institute and Singapore National Eye Centre, Singapore, Singapore
- Moorfields Eye Hospital, NHS Foundation Trust, London, UK
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Quan Dong Nguyen
- Byers Eye Institute, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, USA
| |
Collapse
|
11
|
Han KN, Kim HK. Imaging techniques for minimally invasive thoracic surgery-Korea University Guro Hospital experiences. J Thorac Dis 2018; 10:S731-S738. [PMID: 29732194 DOI: 10.21037/jtd.2018.03.114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In this paper, we described our clinical experiences with respect to image-guided thoracic surgery, including procedures involving percutaneous injection of fluorescent dye, radiotracers, and hook wires, guided by preoperative computed tomography (CT); and transbronchial injection of fluorescent dye by using electromagnetic navigational bronchoscope technology. Our recent experience with the intravenous systemic injection of fluorescent dye for the intraoperative detection of pulmonary lesions and intersegmental planes are also described in this review.
Collapse
Affiliation(s)
- Kook Nam Han
- Departments of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hyun Koo Kim
- Departments of Thoracic and Cardiovascular Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| |
Collapse
|
12
|
Recent Advances in Ocular Imaging in Management of Uveitis and Related Intraocular Inflammations. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.yaoo.2017.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
13
|
Massy R, Herbort CP. Contribution of Dual Fluorescein and Indocyanine Green Angiography to the Appraisal of Presumed Tuberculous Chorioretinitis in a Non-endemic Area. J Ophthalmic Vis Res 2017; 12:30-38. [PMID: 28299004 PMCID: PMC5340061 DOI: 10.4103/2008-322x.200157] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 11/19/2016] [Indexed: 11/04/2022] Open
Abstract
PURPOSE To assess the respective involvement of retina versus choroid in presumed ocular tuberculosis (POT) in a non-endemic area using dual fluorescein (FA) and indocyanine green angiography (ICGA). METHODS We retrospectively analyzed cases diagnosed with POT at the Centre for Ophthalmic Specialized Care, Lausanne, Switzerland. Angiography signs were quantified using an established dual FA and ICGA scoring system for uveitis. RESULTS Out of 1739 uveitis patients visited from 1995 to 2014, 53 (3%) were diagnosed with POT; of whom 28 patients (54 eyes) had sufficient data available to be included in this study. Of 54 affected eyes, 39 showed predominant choroidal involvement, 14 showed predominant retinal involvement and one had equal retinal and choroidal scores. Mean angiographic score was 6.97 ± 5.08 for the retina versus 13.48 ± 7.06 for the choroid (P < 0.0001). For patients with sufficient angiographic follow-up after combined anti-tuberculous and inflammation suppressive therapy, mean FA and ICGA scores decreased from 6.97 ± 5.08 to 3.63 ± 3.14 (P = 0.004), and 13.48 ± 7.06 to 7.47 ± 5.58 (P < 0.0001), respectively. CONCLUSION These results represent the first report of the respective contributions of retinal and choroidal involvement in POT. Choroidal involvement was more common, for which ICGA is the preferred examination. In cases of compatible uveitis with positive results of an interferon-gamma release assay, particularly in a region that is non-endemic for TB, dual FA and ICGA should be performed to help establish the diagnosis of ocular tuberculosis and improve follow-up.
Collapse
Affiliation(s)
- Raphael Massy
- Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland; Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialized Care (COS), Teaching Centre Clinic Montchoisi, Lausanne, Switzerland
| | - Carl P Herbort
- Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland; Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialized Care (COS), Teaching Centre Clinic Montchoisi, Lausanne, Switzerland
| |
Collapse
|
14
|
Hitier M, Cracowski JL, Hamou C, Righini C, Bettega G. Indocyanine green fluorescence angiography for free flap monitoring: A pilot study. J Craniomaxillofac Surg 2016; 44:1833-1841. [PMID: 27745767 DOI: 10.1016/j.jcms.2016.09.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 07/22/2016] [Accepted: 09/02/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE We evaluated the feasibility and the tolerance of repeated fluorescent indocyanine green angiography in free flap monitoring, and determined the intraoperative predictive values of flap vitality. BACKGROUND The free flap failure rate has been significantly reduced, but free flap loss still occurs and remains a costly disaster. Repeated clinical examinations are commonly used for flap monitoring, but they can be unreliable because of their subjectivity. Laser-induced fluorescence of indocyanine green is a new method for assessing tissue perfusion. METHODS 20 patients undergoing microsurgical reconstruction were monitored by indocyanine green fluorescence angiography, intraoperatively, and during 4 days after surgery, with 18 injections. Monitoring was made by clinical examination, and then compared to angiographic findings. RESULTS The vascular complication rate was 15% (3/20) with 2 cases of venous thrombosis and one case of partial necrosis of the flap skin paddle. Both cases of venous thrombosis were salvaged by secondary surgery. There was no total flap loss. ICG angiography allowed detecting each intra and postoperative complication, earlier than clinical examination. The mean per-operative intensity of fluorescence was significantly lower in flaps with vascular complications (23.8 GL/ms; p = 0.008). The postoperative slope (p = 0.02) and amplitude (p = 0.03) of the fluorescent signal were both significantly lower than for uncomplicated flaps, before surgical revision. These 2 parameters came back to normal values after secondary surgery. There was no adverse effect of ICG despite the repeated injections. CONCLUSION ICG angiography is a feasible and safe technique for the detection of free flap vascular complications.
Collapse
Affiliation(s)
- Marine Hitier
- Plastic and Maxillofacial Surgery Department, Hôpital A Michallon, BP217, 38043 Grenoble Cedex, France
| | - Jean-Luc Cracowski
- Centre d'investigation clinique, Hôpital A Michallon, BP217, 38043 Grenoble Cedex, France
| | - Cynthia Hamou
- Plastic and Maxillofacial Surgery Department, Hôpital A Michallon, BP217, 38043 Grenoble Cedex, France
| | - Christian Righini
- ENT Department, Hôpital A Michallon, BP217, 38043 Grenoble Cedex, France; INSERM-UJF U823 Team 5, Institut Albert Bonniot, 38706 Grenoble Cedex, France
| | - Georges Bettega
- INSERM-UJF U823 Team 5, Institut Albert Bonniot, 38706 Grenoble Cedex, France; Maxillofacial Surgery Department, Centre hospitalier Annecy Genevois, 1 avenue de l'hôpital, 74370 Epagny Metz-Tessy, France.
| |
Collapse
|
15
|
Kim M, Kwon HJ, Choi EY, Kim SS, Koh HJ, Lee SC. Correlation between Fluorescein Angiographic Findings and Visual Acuity in Behçet Retinal Vasculitis. Yonsei Med J 2015; 56:1087-96. [PMID: 26069134 PMCID: PMC4479839 DOI: 10.3349/ymj.2015.56.4.1087] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To identify significant fluorescein angiographic (FA) characteristics associated with visual acuity (VA) in Behçet retinal vasculitis. MATERIALS AND METHODS Retrospective review of 86 eyes of 48 patients (age: 35.6±10.2 years) with Behçet retinal vasculitis were performed. VA and FA findings as well as correlation between them were assessed. RESULTS The mean initial VA of eyes with posterior pole-involved vasculitis (63 eyes; 73.3%) was significantly worse than that of those with peripheral vasculitis (23 eye; 26.7%) (logarithm of the minimum angle of resolution VA: 0.554±0.572 vs. 0.078±0.148; p<0.0001). Subgroup analysis revealed a more severe and diffuse pattern of vascular leakage in posterior pole-involved vasculitis compared to peripheral vasculitis (p<0.0001). Retinal vascular leakage (β=0.345; p<0.0001), optic disc hyperfluorescence (β=0.147; p=0.032), and macular leakage (β=0.107; p=0.047) were significantly associated with worse initial VA. During the follow up (mean: 33.3±17.9 months), the change of leakage showed no significant correlation with change of VA in posterior pole-involved vasculitis (τ=0.199, p=0.092). CONCLUSION Posterior pole involvement, the degree of retinal vascular leakage, optic disc hyperfluorescence, and macular leakage are significantly associated with VA in Behçet retinal vasculitis.
Collapse
Affiliation(s)
- Min Kim
- Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Jung Kwon
- Institute of Vision Research, Department of Ophthalmology, Severance Eye and ENT Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Young Choi
- Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Soo Kim
- Institute of Vision Research, Department of Ophthalmology, Severance Eye and ENT Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyoung Jun Koh
- Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Chul Lee
- Institute of Vision Research, Department of Ophthalmology, Severance Eye and ENT Hospital, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|
16
|
Magnetic resonance imaging of uveitis. Neuroradiology 2015; 57:825-32. [DOI: 10.1007/s00234-015-1531-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 04/06/2015] [Indexed: 10/23/2022]
|
17
|
Yolcu Ü, Ilhan A, Altun S, Gundogan FÇ. Fluorescein-related jaundınce or skın dıscoloratıon? Am J Emerg Med 2015; 33:455. [DOI: 10.1016/j.ajem.2014.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 10/11/2014] [Indexed: 10/24/2022] Open
|
18
|
Gupta V, Al-Dhibi HA, Arevalo JF. Retinal imaging in uveitis. Saudi J Ophthalmol 2014; 28:95-103. [PMID: 24843301 DOI: 10.1016/j.sjopt.2014.02.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 02/24/2014] [Indexed: 11/25/2022] Open
Abstract
Ancillary investigations are the backbone of uveitis workup for posterior segment inflammations. They help in establishing the differential diagnosis and making certain diagnosis by ruling out certain pathologies and are a useful aid in monitoring response to therapy during follow-up. These investigations include fundus photography including ultra wide field angiography, fundus autofluorescence imaging, fluorescein angiography, optical coherence tomography and multimodal imaging. This review aims to be an overview describing the role of these retinal investigations for posterior uveitis.
Collapse
Affiliation(s)
- Vishali Gupta
- Vitreoretinal and Uveitis Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Hassan A Al-Dhibi
- Vitreoretinal and Uveitis Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - J Fernando Arevalo
- Vitreoretinal and Uveitis Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia ; Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
19
|
|
20
|
|
21
|
Abstract
Ancillary investigations are the backbone of uveitis work-up both for anterior and posterior segment diseases. They help in making the diagnosis, ruling out certain differential diagnosis and monitoring inflammation during the follow-up. This review aims to be an overview describing the role of commonly used investigations for uveitis.
Collapse
Affiliation(s)
- Vishali Gupta
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | |
Collapse
|
22
|
Tobis S, Knopf JK, Silvers C, Messing E, Yao J, Rashid H, Wu G, Golijanin D. Robot-Assisted and Laparoscopic Partial Nephrectomy with Near Infrared Fluorescence Imaging. J Endourol 2012; 26:797-802. [DOI: 10.1089/end.2011.0604] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Scott Tobis
- Department of Urology at the University of Rochester Medical Center, Rochester, New York
| | - Joy K. Knopf
- Department of Urology at the University of Rochester Medical Center, Rochester, New York
| | - Christopher Silvers
- Department of Urology at the University of Rochester Medical Center, Rochester, New York
| | - Edward Messing
- Department of Urology at the University of Rochester Medical Center, Rochester, New York
| | - Jorge Yao
- Department of Pathology at the University of Rochester Medical Center, Rochester, New York
| | - Hani Rashid
- Department of Urology at the University of Rochester Medical Center, Rochester, New York
| | - Guan Wu
- Department of Urology at the University of Rochester Medical Center, Rochester, New York
| | - Dragan Golijanin
- Department of Urology at the University of Rochester Medical Center, Rochester, New York
| |
Collapse
|
23
|
Tobis S, Knopf JK, Silvers CR, Marshall J, Cardin A, Wood RW, Reeder JE, Erturk E, Madeb R, Yao J, Singer EA, Rashid H, Wu G, Messing E, Golijanin D. Near infrared fluorescence imaging after intravenous indocyanine green: initial clinical experience with open partial nephrectomy for renal cortical tumors. Urology 2012; 79:958-64. [PMID: 22336035 DOI: 10.1016/j.urology.2011.10.016] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 10/07/2011] [Accepted: 10/11/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the safety of near infrared fluorescence (NIRF) of intravenously injected indocyanine green (ICG) during open partial nephrectomy, and to demonstrate the feasibility of this technology to identify the renal vasculature and distinguish renal cortical tumors from normal parenchyma. METHODS Patients undergoing open partial nephrectomy provided written informed consent for inclusion in this institutional review board-approved study. Perirenal fat was removed to allow visualization of the renal parenchyma and lesions to be excised. The patients received intravenous injections of ICG, and NIRF imaging was performed using the SPY system. Intraoperative NIRF video images were evaluated for differentiation of tumor from normal parenchyma and for renal vasculature identification. RESULTS A total of 15 patients underwent 16 open partial nephrectomies. The mean cold ischemia time was 26.6 minutes (range 20-33). All 14 malignant lesions were afluorescent or hypofluorescent compared with the surrounding normal renal parenchyma. NIRF imaging of intravenously injected ICG clearly identified the renal hilar vessels and guided selective arterial clamping in 3 patients. No adverse reactions to ICG were noted, and all surgical margins were negative on final pathologic examination. CONCLUSION The intravenous use of ICG combined with NIRF is safe during open renal surgery. This technology allows the surgeon to distinguish renal cortical tumors from normal tissue and highlights the renal vasculature, with the potential to maximize oncologic control and nephron sparing during open partial nephrectomy. Additional study is needed to determine whether this imaging technique will help improve the outcomes during open partial nephrectomy.
Collapse
Affiliation(s)
- Scott Tobis
- Department of Urology, University of Rochester Medical Center, Rochester, New York 14642, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Adl MA, LeHoang P, Bodaghi B. Use of fluorescein angiography in the diagnosis and management of uveitis. Int Ophthalmol Clin 2012; 52:1-12. [PMID: 22954925 DOI: 10.1097/iio.0b013e3182662e49] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
25
|
Tobis S, Knopf J, Silvers C, Yao J, Rashid H, Wu G, Golijanin D. Near infrared fluorescence imaging with robotic assisted laparoscopic partial nephrectomy: initial clinical experience for renal cortical tumors. J Urol 2011; 186:47-52. [PMID: 21571337 DOI: 10.1016/j.juro.2011.02.2701] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Indexed: 01/20/2023]
Abstract
PURPOSE We evaluated the utility of near infrared fluorescence of intravenously injected indocyanine green in performing robotic assisted laparoscopic partial nephrectomy. In addition, we evaluated the initial performance of a novel near infrared fluorescence imaging system integrated into the da Vinci® Si Surgical System during robotic assisted laparoscopic nephrectomy. MATERIALS AND METHODS Fluorescence imaging for the da Vinci Si Surgical System was used for all cases. Indocyanine green was injected before near infrared imaging. Immediate imaging assessed the renal vasculature while delayed imaging differentiated renal cortical tumors from normal parenchyma. The intraoperative performance of near infrared fluorescence of intravenous indocyanine green was evaluated for tumor appearance relative to surrounding renal parenchyma as well as identification of the renal vasculature. RESULTS A total of 11 patients underwent robotic assisted laparoscopic nephrectomy with 2 converted to robotic assisted laparoscopic radical nephrectomy. Indocyanine green injections were repeated up to a total of 5 times depending on the goal of visualization. Of the 11 patients 10 demonstrated malignancy on final pathology. Of the malignant tumors 7 were hypofluorescent and 3 were isofluorescent compared to the surrounding renal parenchyma. Near infrared fluorescence imaging delineated the vascular anatomy in all cases. All surgical margins were negative on final pathology. CONCLUSIONS Intraoperative imaging of indocyanine green with near infrared fluorescence is a safe and effective method to accurately identify the renal vasculature and to differentiate renal tumors from surrounding normal parenchyma. The capacity for multimodal imaging within the surgical console further facilitates this imaging. Further study is needed to determine if this technique will help improve outcomes of robotic assisted laparoscopic nephrectomy.
Collapse
Affiliation(s)
- Scott Tobis
- Departments of Urology and Pathology, University of Rochester Medical Center, Rochester, New York, USA
| | | | | | | | | | | | | |
Collapse
|
26
|
Arosio D, Manzoni L, Araldi EMV, Caprini A, Monferini E, Scolastico C. Functionalized cyclic RGD peptidomimetics: conjugable ligands for αvβ3 receptor imaging. Bioconjug Chem 2009; 20:1611-7. [PMID: 21141806 DOI: 10.1021/bc900155j] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The α(v)β(3) integrin is an adhesion molecule involved in physiological and pathological angiogenesis as well as in tumor invasion and metastasis, and therefore, there is a strong interest in developing novel agents interacting with this molecule. We report the synthesis and characterization of fluorescent α(v)β(3) integrin probes and their use to visualize integrin α(v)β(3) expression on human normal and cancer cells. The fluorescent probes we describe here may be of use for noninvasive imaging of α(V)β(3) integrin expression also in vivo.
Collapse
Affiliation(s)
- Daniela Arosio
- CNR-Istituto di Scienze e Tecnologie Molecolari (ISTM), Milan, Italy.
| | | | | | | | | | | |
Collapse
|
27
|
Abstract
Sarcoid affecting the skin, eye, or liver can be symptomatic of or cause significant morbidity. When disease is sever, alternative therapies may be needed.
Collapse
Affiliation(s)
- Anthony S Rose
- Division of Pulmonary and Critical Care Medicine, Indiana University, Richard L. Roudebush VA Medical Center, 1481 W. 10th Street, Indianapolis, IN 46202, USA
| | | | | |
Collapse
|
28
|
Tugal-Tutkun I, Herbort CP, Khairallah M. Scoring of dual fluorescein and ICG inflammatory angiographic signs for the grading of posterior segment inflammation (dual fluorescein and ICG angiographic scoring system for uveitis). Int Ophthalmol 2008; 30:539-52. [DOI: 10.1007/s10792-008-9263-x] [Citation(s) in RCA: 114] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2008] [Accepted: 08/21/2008] [Indexed: 11/24/2022]
|
29
|
Hama Y, Urano Y, Koyama Y, Bernardo M, Choyke PL, Kobayashi H. A comparison of the emission efficiency of four common green fluorescence dyes after internalization into cancer cells. Bioconjug Chem 2007; 17:1426-31. [PMID: 17105220 PMCID: PMC2556176 DOI: 10.1021/bc0601626] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In vivo optical imaging to enhance the detection of cancer during endoscopy or surgery requires a targeted fluorescent probe with high emission efficiency and high signal-to-background ratio. One strategy to accurately detect cancers is to have the fluorophore internalize within the cancer cells permitting nonbound fluorophores to be washed away or absorbed. The choice of fluorophores for this task must be carefully considered. For depth of penetration, near-infrared probes are ordinarily preferred but suffer from relatively low quantum efficiency. Although green fluorescent protein has been widely used to image tumors on internal organs in mice, green fluorescent probes are better suited for imaging the superficial tissues because of the short penetration distance of green light in tissue and the highly efficient production of signal. While the fluorescence properties of green fluorophores are well-known in vitro, less attention has been paid to their fluorescence once they are internalized within cells. In this study, the emission efficiency after cellular internalization of four common green fluorophores conjugated to avidin (Av-fluorescein, Av-Oregon green, Av-BODIPY-FL, and Av-rhodamine green) were compared after each conjugate was incubated with SHIN3 ovarian cancer cells. Using the lectin binding receptor system, the avidin-fluorophore conjugates were endocytosed, and their fluorescence was evaluated with fluorescence microscopy and flow cytometry. While fluorescein demonstrated the highest signal outside the cell, among the four fluorophores, internalized Av-rhodamine green emitted the most light from SHIN3 ovarian cancer cells both in vitro and in vivo. The internalized Av-rhodamine green complex appeared to localize to the endoplasmic vesicles. Thus, among the four common green fluorescent dyes, rhodamine green is the brightest green fluorescence probe after cellular internalization. This information could have implications for the design of tumor-targeted fluorescent probes that rely on cellular internalization for cancer detection.
Collapse
Affiliation(s)
- Yukihiro Hama
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland 20892-1002, USA
| | - Yasuteru Urano
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yoshinori Koyama
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland 20892-1002, USA
| | | | - Peter L. Choyke
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland 20892-1002, USA
| | - Hisataka Kobayashi
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, NIH, Bethesda, Maryland 20892-1002, USA
- Correspondence to: Hisataka Kobayashi, MD, PhD, Molecular Imaging Program, Center for Cancer for Cancer Research, National Cancer, Institute, NIH, Bethesda, Maryland 20892-1088, USA, Phone: 301-435-4086; Fax: 301-402-3191, E-mail:
| |
Collapse
|
30
|
Hafezi-Moghadam A, Noda K, Almulki L, Iliaki EF, Poulaki V, Thomas KL, Nakazawa T, Hisatomi T, Miller JW, Gragoudas ES. VLA-4 blockade suppresses endotoxin-induced uveitis: in vivo evidence for functional integrin up-regulation. FASEB J 2007; 21:464-74. [PMID: 17202250 DOI: 10.1096/fj.06-6390com] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Leukocyte adhesion to the vascular wall is a critical early step in the pathogenesis of inflammatory diseases and is mediated in part by the leukocyte integrin, VLA-4, which binds to endothelial vascular cell adhesion molecule (VCAM) -1. Here, we investigate VLA-4's role in endotoxin-induced uveitis (EIU). At various time points (6-48 h) after EIU induction, the severity of the inflammation was evaluated by quantifying cell and protein content in the aqueous fluid, firm leukocyte adhesion in the retinal vessels, and the number of extravasated leukocytes into the vitreous. Functional activation of VLA-4 in vivo was investigated in our previously introduced autoperfused micro flow chamber assay. Firm adhesion of EIU leukocytes to immobilized VCAM-1 under physiological blood flow conditions was significantly increased compared with normal controls (P<0.05), suggesting an important role for VLA-4 in EIU. VLA-4 blockade in vivo significantly suppressed all uveitis-related inflammatory parameters studied, decreasing the clinical score by 45% (P<0.01), protein content in the aqueous fluid by 21% (P<0.01), retinal leukostasis by 68% (P<0.01), and leukocyte accumulation in the vitreous by 75% (P<0.01). Our data provide novel evidence for functional up-regulation of VLA-4 during EIU and suggest VLA-4 blockade as a promising therapeutic strategy for treatment of acute inflammatory eye diseases.
Collapse
Affiliation(s)
- A Hafezi-Moghadam
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Hama Y, Urano Y, Koyama Y, Kamiya M, Bernardo M, Paik RS, Krishna MC, Choyke PL, Kobayashi H. In vivo spectral fluorescence imaging of submillimeter peritoneal cancer implants using a lectin-targeted optical agent. Neoplasia 2006; 8:607-12. [PMID: 16867223 PMCID: PMC1601930 DOI: 10.1593/neo.06268] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Intraperitoneal metastases commonly recur after surgery because small tumor foci escape detection within the complex anatomy of the peritoneal cavity and mesentery. Accurate localization of peritoneal implants during surgery could improve the resection of ovarian cancer and other malignancies, but few practical techniques to enhance detectability are currently available. Here, we describe a targeted molecular imaging method that employs fluorescently labeled avidin to detect submillimeter peritoneal implants of ovarian cancer in mice. After binding to surface lectins on the tumor, fluorescein-conjugated avidin enabled the spectral fluorescence imaging of disseminated peritoneal implants. High spatial resolution and high tumor-to-background ratio allowed the visualization of implants as small as 0.3 mm (with 100% sensitivity and specificity; n = 150) and the identification of even smaller lesions ex vivo. These results suggest that targeted molecular imaging with a fluorescence-labeled lectin-ligand system is a promising technique for the detection of disseminated submillimeter foci of cancer.
Collapse
Affiliation(s)
- Yukihiro Hama
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1088, USA
| | - Yasuteru Urano
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yoshinori Koyama
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1088, USA
| | - Mako Kamiya
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Marcelino Bernardo
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1088, USA
| | - Ronald S. Paik
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1088, USA
| | - Murali C. Krishna
- Radiation Biology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1002, USA
| | - Peter L. Choyke
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1088, USA
| | - Hisataka Kobayashi
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892-1088, USA
| |
Collapse
|