1
|
Liu S, Yan Z, Huang Z, Yang H, Li J. Smart Nanocarriers for the Treatment of Retinal Diseases. ACS Appl Bio Mater 2024; 7:2070-2085. [PMID: 38489843 DOI: 10.1021/acsabm.3c01289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Retinal diseases, such as age-related macular degeneration, diabetic retinopathy, and retinoblastoma, stand as the leading causes of irreversible vision impairment and blindness worldwide. Effectively administering drugs for retinal diseases poses a formidable challenge due to the presence of complex ocular barriers and elimination mechanisms. Over time, various approaches have been developed to fabricate drug delivery systems for improving retinal therapy including virus vectors, lipid nanoparticles, and polymers. However, conventional nanocarriers encounter issues related to the controllability, efficiency, and safety in the retina. Therefore, the development of smart nanocarriers for effective or more invasive long-term treatment remains a desirable goal. Recently, approaches have surfaced for the intelligent design of nanocarriers, leveraging specific responses to external or internal triggers and enabling multiple functions for retinal therapy such as topical administration, prolonged drug release, and site-specific drug delivery. This Review provides an overview of prevalent retinal pathologies and related pharmacotherapies to enhance the understanding of retinal diseases. It also surveys recent developments and strategies employed in the intelligent design of nanocarriers for retinal disease. Finally, the challenges of smart nanocarriers in potential clinical retinal therapeutic applications are discussed to inspire the next generation of smart nanocarriers.
Collapse
Affiliation(s)
- Shuya Liu
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection Technology for Food Safety, College of Chemistry, Fuzhou University, Fuzhou 350116, P. R. China
| | - Zhike Yan
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection Technology for Food Safety, College of Chemistry, Fuzhou University, Fuzhou 350116, P. R. China
| | - Zixiang Huang
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection Technology for Food Safety, College of Chemistry, Fuzhou University, Fuzhou 350116, P. R. China
| | - Huanghao Yang
- MOE Key Laboratory for Analytical Science of Food Safety and Biology, Fujian Provincial Key Laboratory of Analysis and Detection Technology for Food Safety, College of Chemistry, Fuzhou University, Fuzhou 350116, P. R. China
| | - Jingying Li
- College of Biological Science and Engineering, Fuzhou University, Fuzhou 350116, P. R. China
| |
Collapse
|
2
|
Hoem G, Pastore A, Bratland E, Christoffersen T, Stornaiuolo M, Douzgou S. Severe isolated exudative vitreoretinopathy caused by biallelic FZD4 variants. Clin Genet 2024. [PMID: 38361102 DOI: 10.1111/cge.14499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/16/2024] [Accepted: 01/30/2024] [Indexed: 02/17/2024]
Abstract
Familial exudative vitreoretinopathy (FEVR) is linked to disruption of the Norrin/Frizzled-4 signaling pathway, which plays an important role in retinal angiogenesis. Severe or complete knock-down of proteins in the pathway also causes syndromic forms of the condition. Both heterozygous and biallelic pathogenic variants in the FZD4 gene, encoding the pathway's key protein frizzled-4, are known to cause FEVR. However, it is not clear what effect different FZD4 variants have, and whether extraocular features should be expected in those with biallelic pathogenic FZD4 variants. Biallelic FZD4 variants were found in a young boy with isolated, severe FEVR. His parents were heterozygous for one variant each and reported normal vision. In-vitro studies of the two variants, demonstrated that it was the combination of the two which led to severe inhibition of the Norrin/Frizzled-4 pathway. Our observations demonstrate that biallelic FZD4-variants are associated with a severe form of FEVR, which does not necessarily include extraocular features. In addition, variants causing severe FEVR in combination, may have no or minimal effect in heterozygous parents as non-penetrance is also a major feature in dominant FZD4-FEVR disease. This underscores the importance of genetic testing of individuals and families with FEVR.
Collapse
Affiliation(s)
- Gry Hoem
- Department of Medical Genetics, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Arianna Pastore
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Eirik Bratland
- Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Terje Christoffersen
- Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Ophthalmology, University Hospital of North Norway, Tromsø, Norway
| | | | - Sofia Douzgou
- Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
3
|
Mujat M, Sampani K, Patel AH, Zambrano R, Sun JK, Wollstein G, Ferguson RD, Schuman JS, Iftimia N. Motion Contrast, Phase Gradient, and Simultaneous OCT Images Assist in the Interpretation of Dark-Field Images in Eyes with Retinal Pathology. Diagnostics (Basel) 2024; 14:184. [PMID: 38248061 PMCID: PMC10814023 DOI: 10.3390/diagnostics14020184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024] Open
Abstract
The cellular-level visualization of retinal microstructures such as blood vessel wall components, not available with other imaging modalities, is provided with unprecedented details by dark-field imaging configurations; however, the interpretation of such images alone is sometimes difficult since multiple structural disturbances may be present in the same time. Particularly in eyes with retinal pathology, microstructures may appear in high-resolution retinal images with a wide range of sizes, sharpnesses, and brightnesses. In this paper we show that motion contrast and phase gradient imaging modalities, as well as the simultaneous acquisition of depth-resolved optical coherence tomography (OCT) images, provide additional insight to help understand the retinal neural and vascular structures seen in dark-field images and may enable improved diagnostic and treatment plans.
Collapse
Affiliation(s)
- Mircea Mujat
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (A.H.P.); (R.D.F.); (N.I.)
| | - Konstantina Sampani
- Beetham Eye Institute, Joslin Diabetes Center, Boston, MA 02115, USA; (K.S.); (J.K.S.)
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Ankit H. Patel
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (A.H.P.); (R.D.F.); (N.I.)
| | - Ronald Zambrano
- Department of Ophthalmology, New York University School of Medicine, New York, NY 10017, USA; (R.Z.); (G.W.)
| | - Jennifer K. Sun
- Beetham Eye Institute, Joslin Diabetes Center, Boston, MA 02115, USA; (K.S.); (J.K.S.)
- Department of Ophthalmology, Harvard Medical School, Boston, MA 02115, USA
| | - Gadi Wollstein
- Department of Ophthalmology, New York University School of Medicine, New York, NY 10017, USA; (R.Z.); (G.W.)
| | - R. Daniel Ferguson
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (A.H.P.); (R.D.F.); (N.I.)
| | | | - Nicusor Iftimia
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (A.H.P.); (R.D.F.); (N.I.)
| |
Collapse
|
4
|
Vought R, Vought V, Szirth B, Bhagat N. Utility of Optical Coherence Tomography-Fundus Photography Combined Imaging for Vision-Threatening Posterior Retinal Disease Screening. J Diabetes Sci Technol 2024; 18:240-241. [PMID: 37932951 PMCID: PMC10899836 DOI: 10.1177/19322968231207091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Affiliation(s)
- Rita Vought
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Victoria Vought
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Bernard Szirth
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Neelakshi Bhagat
- Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, NJ, USA
| |
Collapse
|
5
|
Bea-Mascato B, Valverde D. Genotype-phenotype associations in Alström syndrome: a systematic review and meta-analysis. J Med Genet 2023; 61:18-26. [PMID: 37321834 PMCID: PMC10803979 DOI: 10.1136/jmg-2023-109175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/29/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Alström syndrome (ALMS; #203800) is an ultrarare monogenic recessive disease. This syndrome is associated with variants in the ALMS1 gene, which encodes a centrosome-associated protein involved in the regulation of several ciliary and extraciliary processes, such as centrosome cohesion, apoptosis, cell cycle control and receptor trafficking. The type of variant associated with ALMS is mostly complete loss-of-function variants (97%) and they are mainly located in exons 8, 10 and 16 of the gene. Other studies in the literature have tried to establish a genotype-phenotype correlation in this syndrome with limited success. The difficulty in recruiting a large cohort in rare diseases is the main barrier to conducting this type of study. METHODS In this study we collected all cases of ALMS published to date. We created a database of patients who had a genetic diagnosis and an individualised clinical history. Lastly, we attempted to establish a genotype-phenotype correlation using the truncation site of the patient's longest allele as a grouping criteria. RESULTS We collected a total of 357 patients, of whom 227 had complete clinical information, complete genetic diagnosis and meta-information on sex and age. We have seen that there are five variants with high frequency, with p.(Arg2722Ter) being the most common variant, with 28 alleles. No gender differences in disease progression were detected. Finally, truncating variants in exon 10 seem to be correlated with a higher prevalence of liver disorders in patients with ALMS. CONCLUSION Pathogenic variants in exon 10 of the ALMS1 gene were associated with a higher prevalence of liver disease. However, the location of the variant in the ALMS1 gene does not have a major impact on the phenotype developed by the patient.
Collapse
Affiliation(s)
- Brais Bea-Mascato
- CINBIO, Universidad de Vigo, 36310 Vigo, Spain
- Grupo de Investigación en Enfermedades Raras y Medicina Pediátrica, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Diana Valverde
- CINBIO, Universidad de Vigo, 36310 Vigo, Spain
- Grupo de Investigación en Enfermedades Raras y Medicina Pediátrica, Instituto de Investigación Sanitaria Galicia Sur (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| |
Collapse
|
6
|
Yoon J, Han J, Ko J, Choi S, Park JI, Hwang JS, Han JM, Hwang DDJ. Developing and Evaluating an AI-Based Computer-Aided Diagnosis System for Retinal Disease: Diagnostic Study for Central Serous Chorioretinopathy. J Med Internet Res 2023; 25:e48142. [PMID: 38019564 PMCID: PMC10719821 DOI: 10.2196/48142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 10/29/2023] [Accepted: 11/05/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Although previous research has made substantial progress in developing high-performance artificial intelligence (AI)-based computer-aided diagnosis (AI-CAD) systems in various medical domains, little attention has been paid to developing and evaluating AI-CAD system in ophthalmology, particularly for diagnosing retinal diseases using optical coherence tomography (OCT) images. OBJECTIVE This diagnostic study aimed to determine the usefulness of a proposed AI-CAD system in assisting ophthalmologists with the diagnosis of central serous chorioretinopathy (CSC), which is known to be difficult to diagnose, using OCT images. METHODS For the training and evaluation of the proposed deep learning model, 1693 OCT images were collected and annotated. The data set included 929 and 764 cases of acute and chronic CSC, respectively. In total, 66 ophthalmologists (2 groups: 36 retina and 30 nonretina specialists) participated in the observer performance test. To evaluate the deep learning algorithm used in the proposed AI-CAD system, the training, validation, and test sets were split in an 8:1:1 ratio. Further, 100 randomly sampled OCT images from the test set were used for the observer performance test, and the participants were instructed to select a CSC subtype for each of these images. Each image was provided under different conditions: (1) without AI assistance, (2) with AI assistance with a probability score, and (3) with AI assistance with a probability score and visual evidence heatmap. The sensitivity, specificity, and area under the receiver operating characteristic curve were used to measure the diagnostic performance of the model and ophthalmologists. RESULTS The proposed system achieved a high detection performance (99% of the area under the curve) for CSC, outperforming the 66 ophthalmologists who participated in the observer performance test. In both groups, ophthalmologists with the support of AI assistance with a probability score and visual evidence heatmap achieved the highest mean diagnostic performance compared with that of those subjected to other conditions (without AI assistance or with AI assistance with a probability score). Nonretina specialists achieved expert-level diagnostic performance with the support of the proposed AI-CAD system. CONCLUSIONS Our proposed AI-CAD system improved the diagnosis of CSC by ophthalmologists, which may support decision-making regarding retinal disease detection and alleviate the workload of ophthalmologists.
Collapse
Affiliation(s)
- Jeewoo Yoon
- Department of Applied Artificial Intelligence, Sungkyunkwan University, Seoul, Republic of Korea
- Raondata, Seoul, Republic of Korea
| | - Jinyoung Han
- Department of Applied Artificial Intelligence, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Human-Artificial Intelligence Interaction, Sungkyunkwan University, Seoul, Republic of Korea
| | - Junseo Ko
- Department of Applied Artificial Intelligence, Sungkyunkwan University, Seoul, Republic of Korea
- Raondata, Seoul, Republic of Korea
| | - Seong Choi
- Department of Applied Artificial Intelligence, Sungkyunkwan University, Seoul, Republic of Korea
- Raondata, Seoul, Republic of Korea
| | - Ji In Park
- Department of Medicine, Kangwon National University School of Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | | | - Jeong Mo Han
- Seoul Bombit Eye Clinic, Sejong, Republic of Korea
| | - Daniel Duck-Jin Hwang
- Department of Ophthalmology, Hangil Eye Hospital, Incheon, Republic of Korea
- Lux Mind, Incheon, Republic of Korea
| |
Collapse
|
7
|
Mujat M, Sampani K, Patel AH, Sun JK, Iftimia N. Cellular-Level Analysis of Retinal Blood Vessel Walls Based on Phase Gradient Images. Diagnostics (Basel) 2023; 13:3399. [PMID: 37998535 PMCID: PMC10670340 DOI: 10.3390/diagnostics13223399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/02/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
Diseases such as diabetes affect the retinal vasculature and the health of the neural retina, leading to vision problems. We describe here an imaging method and analysis procedure that enables characterization of the retinal vessel walls with cellular-level resolution, potentially providing markers for eye diseases. Adaptive optics scanning laser ophthalmoscopy is used with a modified detection scheme to include four simultaneous offset aperture channels. The magnitude of the phase gradient derived from these offset images is used to visualize the structural characteristics of the vessels. The average standard deviation image provides motion contrast and enables segmentation of the vessel lumen. Segmentation of blood vessel walls provides quantitative measures of geometrical characteristics of the vessel walls, including vessel and lumen diameters, wall thickness, and wall-to-lumen ratio. Retinal diseases may affect the structural integrity of the vessel walls, their elasticity, their permeability, and their geometrical characteristics. The ability to measure these changes is valuable for understanding the vascular effects of retinal diseases, monitoring disease progression, and drug testing. In addition, loss of structural integrity of the blood vessel wall may result in microaneurysms, a hallmark lesion of diabetic retinopathy, which may rupture or leak and further create vision impairment. Early identification of such structural abnormalities may open new treatment avenues for disease management and vision preservation. Functional testing of retinal circuitry through high-resolution measurement of vasodilation as a response to controlled light stimulation of the retina (neurovascular coupling) is another application of our method and can provide an unbiased evaluation of one's vision and enable early detection of retinal diseases and monitoring treatment results.
Collapse
Affiliation(s)
- Mircea Mujat
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (A.H.P.); (N.I.)
| | - Konstantina Sampani
- Beetham Eye Institute, Joslin Diabetes Center, Boston, MA 02115, USA; (K.S.); (J.K.S.)
- Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Ankit H. Patel
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (A.H.P.); (N.I.)
| | - Jennifer K. Sun
- Beetham Eye Institute, Joslin Diabetes Center, Boston, MA 02115, USA; (K.S.); (J.K.S.)
- Department of Ophthalmology, Harvard Medical School, Boston, MA 02115, USA
| | - Nicusor Iftimia
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (A.H.P.); (N.I.)
| |
Collapse
|
8
|
Zong Y, Xiao S, Lei D, Li H. Discoveries in Retina Physiology and Disease Biology Using Single-Cell RNA Sequencing. FRONT BIOSCI-LANDMRK 2023; 28:247. [PMID: 37919055 DOI: 10.31083/j.fbl2810247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/04/2023] [Accepted: 04/17/2023] [Indexed: 11/04/2023]
Abstract
The retina, a component of the central nervous system, is composed of six distinct neuronal types and various types of glial cells. A technique for single-cell transcriptome analysis called single-cell RNA sequencing (scRNA-seq) can be employed to study the complicated dynamics of several types of retinal cells. It meticulously examines how various cell types express their genes, shedding light on all biological processes. scRNA-seq is an alternative to regular RNA-seq, which cannot identify cellular heterogeneity. Understanding retinal diseases requires research on retinal cell heterogeneity. The identification of novel cell subpopulations can provide information about disease occurrence and progression as well as the specific biological functions of particular cells. We currently have a better understanding of the interactions among the brain, the retina, and its visual pathways thanks to the use of scRNA-seq to examine retinal development and disease pathogenesis. Additionally, this technology offers fresh perspectives on the sensitivity and molecular basis of cell subtypes linked to retinal diseases. Thanks to scRNA-seq technology, we now have a better understanding of the most recent developments and difficulties in retinal development and disorders. We believe that scRNA-seq is an important tool for developing cutting-edge treatments for retinal diseases. This paper presents a systematic review of the history of sRNA-seq technology development and provides an overview of the unique subtypes of retinal cells and the specific gene markers this technology identifies.
Collapse
Affiliation(s)
- Yuanjuan Zong
- Department of Ophthalmology, Chongqing Hospital of Traditional Chinese Medicine, 400021 Chongqing, China
| | - Shengyan Xiao
- Department of Ophthalmology, Chongqing Hospital of Traditional Chinese Medicine, 400021 Chongqing, China
| | - Daoxi Lei
- Department of Ophthalmology, Chongqing Hospital of Traditional Chinese Medicine, 400021 Chongqing, China
| | - Huili Li
- Department of Ophthalmology, Chongqing Hospital of Traditional Chinese Medicine, 400021 Chongqing, China
| |
Collapse
|
9
|
Vishwakarma S, Borkar DS, LaPrise A, Mbagwu M, Leng T. Vitreoretinal Specialist Use of Ancillary Testing: An IRIS ® Registry Analysis. Clin Ophthalmol 2023; 17:3077-3085. [PMID: 37873056 PMCID: PMC10590590 DOI: 10.2147/opth.s433338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/11/2023] [Indexed: 10/25/2023] Open
Abstract
Purpose To investigate patterns of ancillary imaging testing among vitreoretinal specialists for patients with vitreoretinal disease in the United States (US). Methods Optical coherence tomography (OCT), color fundus photography (CFP), and fluorescein angiography (FA), ordered by vitreoretinal specialists and documented within the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) between 01 January 2018 and 31 December 2020, were retrospectively assessed. Trends in imaging modality choice were analyzed by payer type, geographic region, and practice type. Sub-analyses were conducted according to categorization of vitreoretinal specialists into those treating a high versus low volume of patients with neovascular age-related macular degeneration (nAMD). Results OCT was the most common imaging modality used, followed by CFP and FA. Following normalization, the highest volume of OCT procedures performed were identified among Medicare Advantage and Medicare Fee-for-Service beneficiaries, within the South of the US, and at medium and large practices. Minimal differences were observed for CFP and FA volume across payer types and regions. Across practice types, the largest volume of CFP and FA procedures were identified in small and private equity owned practices, respectively. Vitreoretinal specialists with a high nAMD volume more frequently performed OCT than those with a low nAMD volume. Conclusion Vitreoretinal specialists demonstrated a strong preference for OCT, with real-world associations according to payer type, geographic location, and practice type. Volume of nAMD patients seen impacted the likelihood of specialists ordering OCTs.
Collapse
Affiliation(s)
| | - Durga S Borkar
- Ophthalmology Department, Duke University Eye Center, Duke University School of Medicine, Durham, NC, USA
| | - Andrew LaPrise
- Quantitative Sciences Department, Verana Health, San Francisco, CA, USA
| | - Michael Mbagwu
- Quantitative Sciences Department, Verana Health, San Francisco, CA, USA
| | - Theodore Leng
- Ophthalmology Department, Byers Eye Institute at Stanford, Stanford University School of Medicine, Palo Alto, CA, USA
| |
Collapse
|
10
|
Zampatti S, Peconi C, Calvino G, Ferese R, Gambardella S, Cascella R, Sebastiani J, Falsini B, Cusumano A, Giardina E. A Splicing Variant in RDH8 Is Associated with Autosomal Recessive Stargardt Macular Dystrophy. Genes (Basel) 2023; 14:1659. [PMID: 37628710 PMCID: PMC10454646 DOI: 10.3390/genes14081659] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 08/27/2023] Open
Abstract
Stargardt macular dystrophy is a genetic disorder, but in many cases, the causative gene remains unrevealed. Through a combined approach (whole-exome sequencing and phenotype/family-driven filtering algorithm) and a multilevel validation (international database searching, prediction scores calculation, splicing analysis assay, segregation analyses), a biallelic mutation in the RDH8 gene was identified to be responsible for Stargardt macular dystrophy in a consanguineous Italian family. This paper is a report on the first family in which a biallelic deleterious mutation in RDH8 is detected. The disease phenotype is consistent with the expected phenotype hypothesized in previous studies on murine models. The application of the combined approach to genetic data and the multilevel validation allowed the identification of a splicing mutation in a gene that has never been reported before in human disorders.
Collapse
Affiliation(s)
- Stefania Zampatti
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.Z.)
| | - Cristina Peconi
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.Z.)
| | - Giulia Calvino
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.Z.)
| | | | - Stefano Gambardella
- Neuromed IRCSS, 86077 Pozzilli, Italy
- Department of Biomolecular Sciences, University of Urbino “Carlo Bo”, 61029 Urbino, Italy
| | - Raffaella Cascella
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.Z.)
- Department of Biomedical Sciences, Catholic University Our Lady of Good Counsel, 1000 Tirana, Albania
| | | | - Benedetto Falsini
- Macula & Genoma Foundation, 00133 Rome, Italy; (J.S.)
- Department of Ophthalmology, Policlinico A. Gemelli, IRCCS/Catholic University, 00133 Rome, Italy
- Macula & Genoma Foundation USA, New York, NY 10017, USA
| | - Andrea Cusumano
- Macula & Genoma Foundation, 00133 Rome, Italy; (J.S.)
- Macula & Genoma Foundation USA, New York, NY 10017, USA
- Department of Ophthalmology, Tor Vergata University, 00133 Rome, Italy
| | - Emiliano Giardina
- Genomic Medicine Laboratory UILDM, IRCCS Santa Lucia Foundation, 00179 Rome, Italy; (S.Z.)
- Department of Biomedicine and Prevention, Tor Vergata University, 00133 Rome, Italy
| |
Collapse
|
11
|
Hang A, Feldman S, Amin AP, Ochoa JAR, Park SS. Intravitreal Anti-Vascular Endothelial Growth Factor Therapies for Retinal Disorders. Pharmaceuticals (Basel) 2023; 16:1140. [PMID: 37631054 PMCID: PMC10458692 DOI: 10.3390/ph16081140] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 08/06/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Vascular endothelial growth factors (VEGFs) are key mediator of retinal and choroidal neovascularization as well as retinal vascular leakage leading to macular edema. As such, VEGF plays an important role in mediating visually significant complications associated with common retinal disorders such as diabetic retinopathy, retinal vein occlusion, and age-related macular degeneration. Various drugs that inhibit vascular endothelial growth factors (anti-VEGF therapies) have been developed to minimize vision loss associated with these disorders. These drugs are injected into the vitreous cavity in a clinic setting at regular intervals. This article provides an overview of the various anti-VEGF drugs used in ophthalmology and the common retinal conditions that benefit from this therapy.
Collapse
Affiliation(s)
- Abraham Hang
- Department of Ophthalmology & Vision Science, Ernest E. Tschannen Eye Institute, University of California Davis Eye Center, 4860 Y Street, Sacramento, CA 95817, USA; (A.H.); (S.F.)
| | - Samuel Feldman
- Department of Ophthalmology & Vision Science, Ernest E. Tschannen Eye Institute, University of California Davis Eye Center, 4860 Y Street, Sacramento, CA 95817, USA; (A.H.); (S.F.)
| | - Aana P. Amin
- School of Medicine, University of California Davis, Sacramento, CA 95817, USA; (A.P.A.); (J.A.R.O.)
| | - Jorge A. Rivas Ochoa
- School of Medicine, University of California Davis, Sacramento, CA 95817, USA; (A.P.A.); (J.A.R.O.)
| | - Susanna S. Park
- Department of Ophthalmology & Vision Science, Ernest E. Tschannen Eye Institute, University of California Davis Eye Center, 4860 Y Street, Sacramento, CA 95817, USA; (A.H.); (S.F.)
| |
Collapse
|
12
|
Dutta P, Sathi KA, Hossain MA, Dewan MAA. Conv-ViT: A Convolution and Vision Transformer-Based Hybrid Feature Extraction Method for Retinal Disease Detection. J Imaging 2023; 9:140. [PMID: 37504817 PMCID: PMC10381782 DOI: 10.3390/jimaging9070140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023] Open
Abstract
The current advancement towards retinal disease detection mainly focused on distinct feature extraction using either a convolutional neural network (CNN) or a transformer-based end-to-end deep learning (DL) model. The individual end-to-end DL models are capable of only processing texture or shape-based information for performing detection tasks. However, extraction of only texture- or shape-based features does not provide the model robustness needed to classify different types of retinal diseases. Therefore, concerning these two features, this paper developed a fusion model called 'Conv-ViT' to detect retinal diseases from foveal cut optical coherence tomography (OCT) images. The transfer learning-based CNN models, such as Inception-V3 and ResNet-50, are utilized to process texture information by calculating the correlation of the nearby pixel. Additionally, the vision transformer model is fused to process shape-based features by determining the correlation between long-distance pixels. The hybridization of these three models results in shape-based texture feature learning during the classification of retinal diseases into its four classes, including choroidal neovascularization (CNV), diabetic macular edema (DME), DRUSEN, and NORMAL. The weighted average classification accuracy, precision, recall, and F1 score of the model are found to be approximately 94%. The results indicate that the fusion of both texture and shape features assisted the proposed Conv-ViT model to outperform the state-of-the-art retinal disease classification models.
Collapse
Affiliation(s)
- Pramit Dutta
- Department of Electronics and Telecommunication Engineering, Chittagong University of Engineering & Technology, Chattogram 4349, Bangladesh
| | - Khaleda Akther Sathi
- Department of Electronics and Telecommunication Engineering, Chittagong University of Engineering & Technology, Chattogram 4349, Bangladesh
| | - Md Azad Hossain
- Department of Electronics and Telecommunication Engineering, Chittagong University of Engineering & Technology, Chattogram 4349, Bangladesh
| | - M Ali Akber Dewan
- School of Computing and Information Systems, Faculty of Science and Technology, Athabasca University, Athabasca, AB T9S 3A3, Canada
| |
Collapse
|
13
|
Mujat M, Akula JD, Fulton AB, Ferguson RD, Iftimia N. Non-Rigid Registration for High-Resolution Retinal Imaging. Diagnostics (Basel) 2023; 13:2285. [PMID: 37443679 PMCID: PMC10341150 DOI: 10.3390/diagnostics13132285] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
Adaptive optics provides improved resolution in ophthalmic imaging when retinal microstructures need to be identified, counted, and mapped. In general, multiple images are averaged to improve the signal-to-noise ratio or analyzed for temporal dynamics. Image registration by cross-correlation is straightforward for small patches; however, larger images require more sophisticated registration techniques. Strip-based registration has been used successfully for photoreceptor mosaic alignment in small patches; however, if the deformations along strips are not simple displacements, averaging can degrade the final image. We have applied a non-rigid registration technique that improves the quality of processed images for mapping cones over large image patches. In this approach, correction of local deformations compensates for local image stretching, compressing, bending, and twisting due to a number of causes. The main result of this procedure is improved definition of retinal microstructures that can be better identified and segmented. Derived metrics such as cone density, wall-to-lumen ratio, and quantification of structural modification of blood vessel walls have diagnostic value in many retinal diseases, including diabetic retinopathy and age-related macular degeneration, and their improved evaluations may facilitate early diagnostics of retinal diseases.
Collapse
Affiliation(s)
- Mircea Mujat
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (R.D.F.); (N.I.)
| | - James D. Akula
- Department of Ophthalmology, Boston Children’s Hospital, Boston, MA 02115, USA; (J.D.A.); (A.B.F.)
- Department of Ophthalmology, Harvard Medical School, Boston, MA 02115, USA
| | - Anne B. Fulton
- Department of Ophthalmology, Boston Children’s Hospital, Boston, MA 02115, USA; (J.D.A.); (A.B.F.)
- Department of Ophthalmology, Harvard Medical School, Boston, MA 02115, USA
| | - R. Daniel Ferguson
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (R.D.F.); (N.I.)
| | - Nicusor Iftimia
- Physical Sciences, Inc., 20 New England Business Center, Andover, MA 01810, USA; (R.D.F.); (N.I.)
| |
Collapse
|
14
|
Abstract
Alteration of the outer retina leads to various diseases such as age-related macular degeneration or retinitis pigmentosa characterized by decreased visual acuity and ultimately blindness. Despite intensive research in the field of retinal disorders, there is currently no curative treatment. Several therapeutic approaches such as cell-based replacement and gene therapies are currently in development. In the context of cell-based therapies, different cell sources such as embryonic stem cells, induced pluripotent stem cells, or multipotent stem cells can be used for transplantation. In the vast majority of human clinical trials, retinal pigment epithelial cells and photoreceptors are the cell types considered for replacement cell therapies. In this review, we summarize the progress made in stem cell therapies ranging from the pre-clinical studies to clinical trials for retinal disease.
Collapse
Affiliation(s)
- Audrey Voisin
- Laboratoire de Neurosciences Expérimentales et Cliniques, Université de Poitiers, INSERM 1084; Department of Ophthalmology, CHU Poitiers, Poitiers, France
| | - Amaury Pénaguin
- Laboratoire de Neurosciences Expérimentales et Cliniques, Université de Poitiers, INSERM 1084, Poitiers; Laboratoires Thea, Clermont-Ferrand, France
| | - Afsaneh Gaillard
- Laboratoire de Neurosciences Expérimentales et Cliniques, Université de Poitiers, INSERM 1084, Poitiers, France
| | - Nicolas Leveziel
- Laboratoire de Neurosciences Expérimentales et Cliniques, Université de Poitiers, INSERM 1084; Department of Ophthalmology, CHU Poitiers, Poitiers, France
| |
Collapse
|
15
|
Zedan MJM, Zulkifley MA, Ibrahim AA, Moubark AM, Kamari NAM, Abdani SR. Automated Glaucoma Screening and Diagnosis Based on Retinal Fundus Images Using Deep Learning Approaches: A Comprehensive Review. Diagnostics (Basel) 2023; 13:2180. [PMID: 37443574 DOI: 10.3390/diagnostics13132180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 07/15/2023] Open
Abstract
Glaucoma is a chronic eye disease that may lead to permanent vision loss if it is not diagnosed and treated at an early stage. The disease originates from an irregular behavior in the drainage flow of the eye that eventually leads to an increase in intraocular pressure, which in the severe stage of the disease deteriorates the optic nerve head and leads to vision loss. Medical follow-ups to observe the retinal area are needed periodically by ophthalmologists, who require an extensive degree of skill and experience to interpret the results appropriately. To improve on this issue, algorithms based on deep learning techniques have been designed to screen and diagnose glaucoma based on retinal fundus image input and to analyze images of the optic nerve and retinal structures. Therefore, the objective of this paper is to provide a systematic analysis of 52 state-of-the-art relevant studies on the screening and diagnosis of glaucoma, which include a particular dataset used in the development of the algorithms, performance metrics, and modalities employed in each article. Furthermore, this review analyzes and evaluates the used methods and compares their strengths and weaknesses in an organized manner. It also explored a wide range of diagnostic procedures, such as image pre-processing, localization, classification, and segmentation. In conclusion, automated glaucoma diagnosis has shown considerable promise when deep learning algorithms are applied. Such algorithms could increase the accuracy and efficiency of glaucoma diagnosis in a better and faster manner.
Collapse
Affiliation(s)
- Mohammad J M Zedan
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
- Computer and Information Engineering Department, College of Electronics Engineering, Ninevah University, Mosul 41002, Iraq
| | - Mohd Asyraf Zulkifley
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Ahmad Asrul Ibrahim
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Asraf Mohamed Moubark
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Nor Azwan Mohamed Kamari
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi 43600, Selangor, Malaysia
| | - Siti Raihanah Abdani
- School of Computing Sciences, College of Computing, Informatics and Media, Universiti Teknologi MARA, Shah Alam 40450, Selangor, Malaysia
| |
Collapse
|
16
|
Wu KY, Mina M, Sahyoun JY, Kalevar A, Tran SD. Retinal Prostheses: Engineering and Clinical Perspectives for Vision Restoration. Sensors (Basel) 2023; 23:5782. [PMID: 37447632 PMCID: PMC10347280 DOI: 10.3390/s23135782] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/04/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023]
Abstract
A retinal prosthesis, also known as a bionic eye, is a device that can be implanted to partially restore vision in patients with retinal diseases that have resulted in the loss of photoreceptors (e.g., age-related macular degeneration and retinitis pigmentosa). Recently, there have been major breakthroughs in retinal prosthesis technology, with the creation of numerous types of implants, including epiretinal, subretinal, and suprachoroidal sensors. These devices can stimulate the remaining cells in the retina with electric signals to create a visual sensation. A literature review of the pre-clinical and clinical studies published between 2017 and 2023 is conducted. This narrative review delves into the retinal anatomy, physiology, pathology, and principles underlying electronic retinal prostheses. Engineering aspects are explored, including electrode-retina alignment, electrode size and material, charge density, resolution limits, spatial selectivity, and bidirectional closed-loop systems. This article also discusses clinical aspects, focusing on safety, adverse events, visual function, outcomes, and the importance of rehabilitation programs. Moreover, there is ongoing debate over whether implantable retinal devices still offer a promising approach for the treatment of retinal diseases, considering the recent emergence of cell-based and gene-based therapies as well as optogenetics. This review compares retinal prostheses with these alternative therapies, providing a balanced perspective on their advantages and limitations. The recent advancements in retinal prosthesis technology are also outlined, emphasizing progress in engineering and the outlook of retinal prostheses. While acknowledging the challenges and complexities of the technology, this article highlights the significant potential of retinal prostheses for vision restoration in individuals with retinal diseases and calls for continued research and development to refine and enhance their performance, ultimately improving patient outcomes and quality of life.
Collapse
Affiliation(s)
- Kevin Y. Wu
- Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada; (K.Y.W.)
| | - Mina Mina
- Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Jean-Yves Sahyoun
- Faculty of Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Ananda Kalevar
- Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada; (K.Y.W.)
| | - Simon D. Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC H3A 1G1, Canada
| |
Collapse
|
17
|
Afanasyeva TA, Athanasiou D, Perdigao PR, Whiting KR, Duijkers L, Astuti GD, Bennett J, Garanto A, van der Spuy J, Roepman R, Cheetham ME, Collin RW. CRISPR-Cas9 correction of a nonsense mutation in LCA5 rescues lebercilin expression and localization in human retinal organoids. Mol Ther Methods Clin Dev 2023; 29:522-531. [PMID: 37305852 PMCID: PMC10250556 DOI: 10.1016/j.omtm.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 05/12/2023] [Indexed: 06/13/2023]
Abstract
Mutations in the lebercilin-encoding gene LCA5 cause one of the most severe forms of Leber congenital amaurosis, an early-onset retinal disease that results in severe visual impairment. Here, we report on the generation of a patient-specific cellular model to study LCA5-associated retinal disease. CRISPR-Cas9 technology was used to correct a homozygous nonsense variant in LCA5 (c.835C>T; p.Q279∗) in patient-derived induced pluripotent stem cells (iPSCs). The absence of off-target editing in gene-corrected (isogenic) control iPSCs was demonstrated by whole-genome sequencing. We differentiated the patient, gene-corrected, and unrelated control iPSCs into three-dimensional retina-like cells, so-called retinal organoids. We observed opsin and rhodopsin mislocalization to the outer nuclear layer in patient-derived but not in the gene-corrected or unrelated control organoids. We also confirmed the rescue of lebercilin expression and localization along the ciliary axoneme within the gene-corrected organoids. Here, we show the potential of combining precise single-nucleotide gene editing with the iPSC-derived retinal organoid system for the generation of a cellular model of early-onset retinal disease.
Collapse
Affiliation(s)
- Tess A.V. Afanasyeva
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GD Nijmegen, the Netherlands
| | | | | | - Kae R. Whiting
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Lonneke Duijkers
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Galuh D.N. Astuti
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | - Jean Bennett
- Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia PA 19104, USA
| | - Alejandro Garanto
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
- Department of Paediatrics, Amalia Children’s Hospital, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | | | - Ronald Roepman
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
| | | | - Rob W.J. Collin
- Department of Human Genetics, Radboud University Medical Center, 6525 GA Nijmegen, the Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GD Nijmegen, the Netherlands
| |
Collapse
|
18
|
Shan H, Liu W, Li Y, Pang K. The Autoimmune Rheumatic Disease Related Dry Eye and Its Association with Retinopathy. Biomolecules 2023; 13:724. [PMID: 37238594 PMCID: PMC10216215 DOI: 10.3390/biom13050724] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
Dry eye disease is a chronic disease of the ocular surface characterized by abnormal tear film composition, tear film instability, and ocular surface inflammation, affecting 5% to 50% of the population worldwide. Autoimmune rheumatic diseases (ARDs) are systemic disorders with multi-organ involvement, including the eye, and play a significant role in dry eye. To date, most studies have focused on Sjögren's syndrome (one of the ARDs) since it manifests as two of the most common symptoms-dry eyes and a dry mouth-and attracts physicians to explore the relationship between dry eye and ARDs. Many patients complained of dry eye related symptoms before they were diagnosed with ARDs, and ocular surface malaise is a sensitive indicator of the severity of ARDs. In addition, ARD related dry eye is also associated with some retinal diseases directly or indirectly, which are described in this review. This review also summarizes the incidence, epidemiological characteristics, pathogenesis, and accompanying ocular lesions of ARD's related dry eye, emphasizing the potential role of dry eye in recognition and monitoring among ARDs patients.
Collapse
Affiliation(s)
| | | | | | - Kunpeng Pang
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan 250012, China
| |
Collapse
|
19
|
Wu KY, Joly-Chevrier M, Akbar D, Tran SD. Overcoming Treatment Challenges in Posterior Segment Diseases with Biodegradable Nano-Based Drug Delivery Systems. Pharmaceutics 2023; 15:pharmaceutics15041094. [PMID: 37111579 PMCID: PMC10142934 DOI: 10.3390/pharmaceutics15041094] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
Posterior segment eye diseases present a challenge in treatment due to the complex structures in the eye that serve as robust static and dynamic barriers, limiting the penetration, residence time, and bioavailability of topical and intraocular medications. This hinders effective treatment and requires frequent dosing, such as the regular use of eye drops or visits to the ophthalmologist for intravitreal injections, to manage the disease. Moreover, the drugs must be biodegradable to minimize toxicity and adverse reactions, as well as small enough to not affect the visual axis. The development of biodegradable nano-based drug delivery systems (DDSs) can be the solution to these challenges. First, they can stay in ocular tissues for longer periods of time, reducing the frequency of drug administration. Second, they can pass through ocular barriers, offering higher bioavailability to targeted tissues that are otherwise inaccessible. Third, they can be made up of polymers that are biodegradable and nanosized. Hence, therapeutic innovations in biodegradable nanosized DDS have been widely explored for ophthalmic drug delivery applications. In this review, we will present a concise overview of DDSs utilized in the treatment of ocular diseases. We will then examine the current therapeutic challenges faced in the management of posterior segment diseases and explore how various types of biodegradable nanocarriers can enhance our therapeutic arsenal. A literature review of the pre-clinical and clinical studies published between 2017 and 2023 was conducted. Through the advances in biodegradable materials, combined with a better understanding of ocular pharmacology, the nano-based DDSs have rapidly evolved, showing great promise to overcome challenges currently encountered by clinicians.
Collapse
Affiliation(s)
- Kevin Y Wu
- Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada
| | | | - Dania Akbar
- Department of Human Biology, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Simon D Tran
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC H3A 1G1, Canada
| |
Collapse
|
20
|
Xu T, Molday L, Molday R. Retinal-phospholipid Schiff-base conjugates and their interaction with ABCA4, the ABC transporter associated with Stargardt Disease. J Biol Chem 2023; 299:104614. [PMID: 36931393 PMCID: PMC10127136 DOI: 10.1016/j.jbc.2023.104614] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023] Open
Abstract
N-retinylidene-phosphatidylethanolamine (N-Ret-PE), the Schiff-base conjugate formed through the reversible reaction of retinal (Vitamin A-aldehyde) and phosphatidylethanolamine, plays a crucial role in the visual cycle and visual pigment photoregeneration. However, N-Ret-PE can react with another molecule of retinal to form toxic di-retinoids if not removed from photoreceptors through its transport across photoreceptor membranes by the ATP-binding-cassette transporter ABCA4. Loss-of-function mutations in ABCA4 are known to cause Stargardt disease (STGD1), an inherited retinal degenerative disease associated with the accumulation of fluorescent di-retinoids and severe loss in vision. A larger assessment of retinal-phospholipid Schiff-base conjugates in photoreceptors is needed, along with further investigation of ABCA4 residues important for N-Ret-PE binding. In this study we show that N-Ret-PE formation is dependent on pH and phospholipid content. When retinal is added to liposomes or photoreceptor membranes, 40-60% is converted to N-Ret-PE at physiological pH. Phosphatidylserine and taurine also react with retinal to form N-retinylidene-phosphatidylserine (N-Ret-PS) and N-retinylidene-taurine, respectively, but at significantly lower levels. N-Ret-PS is not a substrate for ABCA4 and reacts poorly with retinal to form di-retinoids. Additionally, amino acid residues within the binding pocket of ABCA4 that contribute to its interaction with N-Ret-PE were identified and characterized using site-directed mutagenesis together with functional and binding assays. Substitution of arginine residues and hydrophobic residues with alanine or residues implicated in STGD1 significantly reduced or in some cases eliminated substrate-activated ATPase activity and substrate binding. Collectively, this study provides important insight into conditions which affect retinal-phospholipid Schiff-base formation and mechanisms underlying the pathogenesis of STGD1.
Collapse
Affiliation(s)
- Tongzhou Xu
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, B.C. V6T 1Z3 Canada
| | - LaurieL Molday
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, B.C. V6T 1Z3 Canada
| | - RobertS Molday
- Department of Biochemistry and Molecular Biology, University of British Columbia, Vancouver, B.C. V6T 1Z3 Canada.
| |
Collapse
|
21
|
Di Paolo M, Corsi F, Maggi M, Nardi L, Bisti S, Piano I, Gargini C. Efficacy of Hydroponically Cultivated Saffron in the Preservation of Retinal Pigment Epithelium. Molecules 2023; 28:molecules28041699. [PMID: 36838685 PMCID: PMC9962550 DOI: 10.3390/molecules28041699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/06/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
Saffron treatment is a broad-spectrum therapy used for several retinal diseases, and its effectiveness depends on a particular molecular composition (REPRON® saffron). Its production requires specific crops and procedures that, together with low yields, make this spice expensive. To reduce costs, the use of hydroponic crops is gradually increasing. In this study, we tested the protective properties of a hydroponic saffron (sH) batch in models of retinal pigmented epithelium (RPE) degeneration. ARPE-19 cells were pretreated with 40 µg/mL saffron and exposed to different types of damage: excess light and retinol (LE + RET) or oxidative stress (H2O2). After analyzing the composition of all saffron types with spectroscopy, we performed cell viability and immunofluorescence analysis for both protocols. We compared the sH results with those of a validated batch of saffron REPRON® (sR) and those of a saffron non-REPRON® (sNR) batch. sH and sR, which we found had the same chemical composition, were more effective than sNR in increasing cell survival and attenuating the morphological changes related to apoptosis. In conclusion, hydroponic culturing is a suitable strategy to produce high-quality saffron to reduce costs and increase the accessibility of this promising treatment for retinal degeneration.
Collapse
Affiliation(s)
- Mattia Di Paolo
- Department of Ophthalmology and Visual Sciences, University of Louisville, Kentucky, KY 40202, USA
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy
- National Institute of Biostructure and Biosystem (INBB), V. le Medaglie D’Oro 305, 00136 Roma, Italy
| | - Francesca Corsi
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy
| | - Maria Maggi
- Hortus Novus srl, via Campo Sportivo 2, 67050 Canistro, Italy
- Department of Physical and Chemical Sciences, University of L’Aquila, 67100 Coppito, Italy
| | - Luca Nardi
- ENEA, Italian National Agency for New Technologies, Energy and Sustainable Economic Development, Biotechnology and Agro-Industry Division, Casaccia Research Center, 00123 Rome, Italy
| | - Silvia Bisti
- National Institute of Biostructure and Biosystem (INBB), V. le Medaglie D’Oro 305, 00136 Roma, Italy
| | - Ilaria Piano
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy
- National Institute of Biostructure and Biosystem (INBB), V. le Medaglie D’Oro 305, 00136 Roma, Italy
- Correspondence:
| | - Claudia Gargini
- Department of Pharmacy, University of Pisa, 56126 Pisa, Italy
- National Institute of Biostructure and Biosystem (INBB), V. le Medaglie D’Oro 305, 00136 Roma, Italy
| |
Collapse
|
22
|
Biasella F, Plössl K, Baird PN, Weber BHF. The extracellular microenvironment in immune dysregulation and inflammation in retinal disorders. Front Immunol 2023; 14:1147037. [PMID: 36936905 PMCID: PMC10014728 DOI: 10.3389/fimmu.2023.1147037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/15/2023] [Indexed: 03/05/2023] Open
Abstract
Inherited retinal dystrophies (IRDs) as well as genetically complex retinal phenotypes represent a heterogenous group of ocular diseases, both on account of their phenotypic and genotypic characteristics. Therefore, overlaps in clinical features often complicate or even impede their correct clinical diagnosis. Deciphering the molecular basis of retinal diseases has not only aided in their disease classification but also helped in our understanding of how different molecular pathologies may share common pathomechanisms. In particular, these relate to dysregulation of two key processes that contribute to cellular integrity, namely extracellular matrix (ECM) homeostasis and inflammation. Pathological changes in the ECM of Bruch's membrane have been described in both monogenic IRDs, such as Sorsby fundus dystrophy (SFD) and Doyne honeycomb retinal dystrophy (DHRD), as well as in the genetically complex age-related macular degeneration (AMD) or diabetic retinopathy (DR). Additionally, complement system dysfunction and distorted immune regulation may also represent a common connection between some IRDs and complex retinal degenerations. Through highlighting such overlaps in molecular pathology, this review aims to illuminate how inflammatory processes and ECM homeostasis are linked in the healthy retina and how their interplay may be disturbed in aging as well as in disease.
Collapse
Affiliation(s)
- Fabiola Biasella
- Institute of Human Genetics, University of Regensburg, Regensburg, Germany
| | - Karolina Plössl
- Institute of Human Genetics, University of Regensburg, Regensburg, Germany
| | - Paul N. Baird
- Institute of Human Genetics, University of Regensburg, Regensburg, Germany
- Department of Surgery, Ophthalmology, University of Melbourne, Melbourne, VIC, Australia
- *Correspondence: Paul N. Baird, ; Bernhard H. F. Weber,
| | - Bernhard H. F. Weber
- Institute of Human Genetics, University of Regensburg, Regensburg, Germany
- Institute of Clinical Human Genetics, University Hospital Regensburg, Regensburg, Germany
- *Correspondence: Paul N. Baird, ; Bernhard H. F. Weber,
| |
Collapse
|
23
|
Huh CYL, Leinonen H, Nakayama T, Tomasello JR, Zhang J, Zeitoun J, Peach JP, Halabi M, Kiser JZ, Palczewski K, Kiser PD, Gandhi SP. Retinoid therapy restores eye-specific cortical responses in adult mice with retinal degeneration. Curr Biol 2022; 32:4538-4546.e5. [PMID: 36152631 PMCID: PMC10083103 DOI: 10.1016/j.cub.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 06/28/2022] [Accepted: 09/04/2022] [Indexed: 11/18/2022]
Abstract
Despite the recent emergence of multiple cellular and molecular strategies to restore vision in retinal disorders, it remains unclear to what extent central visual circuits can recover when retinal defects are corrected in adulthood. We addressed this question in an Lrat-/- mouse model of Leber congenital amaurosis (LCA) in which retinal light sensitivity and optomotor responses are partially restored by 9-cis-retinyl acetate administration in adulthood. Following treatment, two-photon calcium imaging revealed increases in the number and response amplitude of visually responsive neurons in the primary visual cortex (V1). In particular, retinoid treatment enhanced responses from the ipsilateral eye, restoring the normal balance of eye-specific responses in V1. Additionally, the treatment rescued the modulation of cortical responses by arousal. These findings illustrate the significant plasticity of the adult central visual system and underscore the therapeutic potential of retinoid administration for adults with retinal diseases.
Collapse
Affiliation(s)
- Carey Y L Huh
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA 92697, USA
| | - Henri Leinonen
- Gavin Herbert Eye Institute, Department of Ophthalmology, Center for Translational Vision Research, University of California, Irvine, Irvine, CA 92697, USA; School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio 70211, Finland
| | - Taylor Nakayama
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA 92697, USA
| | - Julia R Tomasello
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA 92697, USA
| | - Jianye Zhang
- Gavin Herbert Eye Institute, Department of Ophthalmology, Center for Translational Vision Research, University of California, Irvine, Irvine, CA 92697, USA
| | - Jack Zeitoun
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA 92697, USA
| | - John P Peach
- Whiting School of Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Maximilian Halabi
- Gavin Herbert Eye Institute, Department of Ophthalmology, Center for Translational Vision Research, University of California, Irvine, Irvine, CA 92697, USA; Department of Physiology & Biophysics, University of California, Irvine, Irvine, CA 92697, USA
| | - Jianying Z Kiser
- Gavin Herbert Eye Institute, Department of Ophthalmology, Center for Translational Vision Research, University of California, Irvine, Irvine, CA 92697, USA
| | - Krzysztof Palczewski
- Gavin Herbert Eye Institute, Department of Ophthalmology, Center for Translational Vision Research, University of California, Irvine, Irvine, CA 92697, USA; Department of Physiology & Biophysics, University of California, Irvine, Irvine, CA 92697, USA; Department of Chemistry, University of California, Irvine, Irvine, CA 92697, USA
| | - Philip D Kiser
- Gavin Herbert Eye Institute, Department of Ophthalmology, Center for Translational Vision Research, University of California, Irvine, Irvine, CA 92697, USA; Department of Physiology & Biophysics, University of California, Irvine, Irvine, CA 92697, USA; Research Service, VA Long Beach Healthcare System, Long Beach, CA 90822, USA; Department of Clinical Pharmacy Practice, University of California, Irvine, Irvine, CA 92697, USA
| | - Sunil P Gandhi
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA 92697, USA; Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA 92697, USA.
| |
Collapse
|
24
|
Moran AL, Fehilly JD, Floss Jones D, Collery R, Kennedy BN. Regulation of the rhythmic diversity of daily photoreceptor outer segment phagocytosis in vivo. FASEB J 2022; 36:e22556. [PMID: 36165194 PMCID: PMC9828801 DOI: 10.1096/fj.202200990rr] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 01/12/2023]
Abstract
Outer segment phagocytosis (OSP) is a highly-regulated, biological process wherein photoreceptor outer segment (OS) tips are cyclically phagocytosed by the adjacent retinal pigment epithelium (RPE) cells. Often an overlooked retinal process, rhythmic OSP ensures the maintenance of healthy photoreceptors and vision. Daily, the photoreceptors renew OS at their base and the most distal, and likely oldest, OS tips, are phagocytosed by the RPE, preventing the accumulation of photo-oxidative compounds by breaking down phagocytosed OS tips and recycling useful components to the photoreceptors. Light changes often coincide with an escalation of OSP and within hours the phagosomes formed in each RPE cell are resolved. In the last two decades, individual molecular regulators were elucidated. Some of the molecular machinery used by RPE cells for OSP is highly similar to mechanisms used by other phagocytic cells for the clearance of apoptotic cells. Consequently, in the RPE, many molecular regulators of retinal phagocytosis have been elucidated. However, there is still a knowledge gap regarding the key regulators of physiological OSP in vivo between endogenous photoreceptors and the RPE. Understanding the regulation of OSP is of significant clinical interest as age-related macular degeneration (AMD) and inherited retinal diseases (IRD) are linked with altered OSP. Here, we review the in vivo timing of OSP peaks in selected species and focus on the reported in vivo environmental and molecular regulators of OSP.
Collapse
Affiliation(s)
- Ailis L. Moran
- UCD School of Biomolecular and Biomedical ScienceUniversity College DublinDublinIreland,UCD Conway InstituteUniversity College DublinDublinIreland
| | - John D. Fehilly
- UCD School of Biomolecular and Biomedical ScienceUniversity College DublinDublinIreland,UCD Conway InstituteUniversity College DublinDublinIreland
| | - Daniel Floss Jones
- UCD School of Biomolecular and Biomedical ScienceUniversity College DublinDublinIreland,UCD Conway InstituteUniversity College DublinDublinIreland
| | - Ross Collery
- Department of Cell Biology, Neurobiology and AnatomyMedical College of WisconsinMilwaukeeWisconsinUSA,Department of Ophthalmology and Visual SciencesMedical College of Wisconsin Eye InstituteMilwaukeeWisconsinUSA
| | - Breandán N. Kennedy
- UCD School of Biomolecular and Biomedical ScienceUniversity College DublinDublinIreland,UCD Conway InstituteUniversity College DublinDublinIreland
| |
Collapse
|
25
|
Mustafi D, Bharathan SP, Calderon R, Nagiel A. HUMAN CELLULAR MODELS FOR RETINAL DISEASE: From Induced Pluripotent Stem Cells to Organoids. Retina 2022; 42:1829-1835. [PMID: 35858274 PMCID: PMC10119785 DOI: 10.1097/iae.0000000000003571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 07/10/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To provide a concise review of induced pluripotent stem cells (iPSCs) and retinal organoids as models for human retinal diseases and their role in gene discovery and treatment of inherited retinal diseases (IRDs). METHODS A PubMed literature review was performed for models of human retinal disease, including animal models and human pluripotent stem cell-derived models. RESULTS There is a growing body of research on retinal disease using human pluripotent stem cells. This is a significant change from just a decade ago when most research was performed on animal models. The advent of induced pluripotent stem cells has permitted not only the generation of two-dimensional human cell cultures such as RPE but also more recently the generation of three-dimensional retinal organoids that better reflect the multicellular laminar architecture of the human retina. CONCLUSION Modern stem cell techniques are improving our ability to model human retinal disease in vitro, especially with the use of patient-derived induced pluripotent stem cells. In the future, a personalized approach may be used in which the individual's unique genotype can be modeled in two-dimensional culture or three-dimensional organoids and then rescued with an optimized therapy before treating the patient.
Collapse
Affiliation(s)
- Debarshi Mustafi
- Department of Ophthalmology, Karalis Johnson Retina Center, University of Washington, Seattle, Washington
- Department of Ophthalmology, Seattle Children's Hospital, Seattle, Washington
- Brotman Baty Institute for Precision Medicine, Seattle, Washington
| | - Sumitha P Bharathan
- The Vision Center, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, California
- The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California
| | - Rosanna Calderon
- The Vision Center, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, California
- The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California
- Department of Development, Stem Cells and Regenerative Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; and
| | - Aaron Nagiel
- The Vision Center, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, California
- The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, California
- Department of Ophthalmology, Roski Eye Institute, Keck School of Medicine, University of Southern California, Los Angeles, California
| |
Collapse
|
26
|
Viggiano P, Grassi MO, Boscia G, Pignataro M, Petruzzella G, Borrelli E, Molfetta T, Alessio G, Boscia F. Short-Term Morphofunctional Changes in Previously Treated Neovascular AMD Eyes Switched to Brolucizumab. J Clin Med 2022; 11. [PMID: 36233385 DOI: 10.3390/jcm11195517] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 12/02/2022] Open
Abstract
The purpose of the study is to explore the morphofunctional fluctuations in eyes treated for neovascular AMD (nAMD) when treatment is switched from aflibercept or ranibizumab to brolucizumab. A total of 31 eyes of 31 patients with nAMD with type 1 macular neovascularization (MNV) were included. All patients were imaged using spectral domain optical coherence tomography (SD-OCT). The OCT acquisition was performed at the following visits: (i) “T1 visit” corresponding to the last follow-up examination in which an intravitreal injection of aflibercept or ranibizumab was performed before switching to brolucizumab because of the lack of improvement and (ii) “T2 visit” corresponding to the examination performed 1 month after T1, the latter visit corresponding to the day when a switch to brolucizumab injection was performed, (iii) and 1 month after the latter injection “(T3)”. The main outcome measures were: (1) central macular thickness (CMT), (2) choroidal vascularity index (CVI), (3) subfoveal choroidal thickness (CT), and best-corrected visual acuity (BCVA). Functional outcome showed significant differences at each time. Mean ± SD BCVA was 0.43 ± 0.12 LogMAR at T1 and 0.56 ± 0.16 LogMAR at T2 (p = 0.038). A significant improvement in BCVA was displayed at T3 (0.34 ± 0.21 LogMAR) as compared with T2 (p = 0.019). CMT analysis showed fluctuations three times. In detail, T2 displayed a thicker CMT in comparison with T1, although not statistically significant (p = 0.12). Contrariwise, T3 showed a thinner CMT in comparison with T2 (p = 0.002). Analyzing CVI among the three different times, the luminal choroidal area (LCA) and total choroidal area (TCA) showed significantly different values before and after switching to brolucizumab. T2 showed a significant reduction in both vessel lumen and total area compared with T1 (p = 0.032 and p = 0.046, respectively). Moreover, T3 showed a greater value of both LCA and TCA in comparison with T2 (p = 0.008 and p = 0.01, respectively). CT did not show significant differences at each time (p > 0.05). Our results reported early experiences on morphofunctional fluctuations in patients with nAMD who switched to brolucizumab. The anatomical impact of brolucizumab administration appears to result in choroidal vascular enlargement, accompanied by the resolution of subretinal fluid (SRF) and intraretinal fluid (IRF).
Collapse
|
27
|
Charng J, Alam K, Swartz G, Kugelman J, Alonso-Caneiro D, Mackey DA, Chen FK. Deep learning: applications in retinal and optic nerve diseases. Clin Exp Optom 2022:1-10. [PMID: 35999058 DOI: 10.1080/08164622.2022.2111201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Deep learning (DL) represents a paradigm-shifting, burgeoning field of research with emerging clinical applications in optometry. Unlike traditional programming, which relies on human-set specific rules, DL works by exposing the algorithm to a large amount of annotated data and allowing the software to develop its own set of rules (i.e. learn) by adjusting the parameters inside the model (network) during a training process in order to complete the task on its own. One major limitation of traditional programming is that, with complex tasks, it may require an extensive set of rules to accurately complete the assignment. Additionally, traditional programming can be susceptible to human bias from programmer experience. With the dramatic increase in the amount and the complexity of clinical data, DL has been utilised to automate data analysis and thus to assist clinicians in patient management. This review will present the latest advances in DL, for managing posterior eye diseases as well as DL-based solutions for patients with vision loss.
Collapse
Affiliation(s)
- Jason Charng
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Australia.,Department of Optometry, School of Allied Health, University of Western Australia, Perth, Australia
| | - Khyber Alam
- Department of Optometry, School of Allied Health, University of Western Australia, Perth, Australia
| | - Gavin Swartz
- Department of Optometry, School of Allied Health, University of Western Australia, Perth, Australia
| | - Jason Kugelman
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - David Alonso-Caneiro
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Australia.,School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - David A Mackey
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Fred K Chen
- Centre of Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia.,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.,Department of Ophthalmology, Royal Perth Hospital, Western Australia, Perth, Australia
| |
Collapse
|
28
|
Xue Y, Lin B, Chen JT, Tang WC, Browne AW, Seiler MJ. The Prospects for Retinal Organoids in Treatment of Retinal Diseases. Asia Pac J Ophthalmol (Phila) 2022; 11:314-327. [PMID: 36041146 PMCID: PMC9966053 DOI: 10.1097/apo.0000000000000538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 04/22/2022] [Indexed: 12/28/2022] Open
Abstract
Retinal degeneration (RD) is a significant cause of incurable blindness worldwide. Photoreceptors and retinal pigmented epithelium are irreversibly damaged in advanced RD. Functional replacement of photoreceptors and/or retinal pigmented epithelium cells is a promising approach to restoring vision. This paper reviews the current status and explores future prospects of the transplantation therapy provided by pluripotent stem cell-derived retinal organoids (ROs). This review summarizes the status of rodent RD disease models and discusses RO culture and analytical tools to evaluate RO quality and function. Finally, we review and discuss the studies in which RO-derived cells or sheets were transplanted. In conclusion, methods to derive ROs from pluripotent stem cells have significantly improved and become more efficient in recent years. Meanwhile, more novel technologies are applied to characterize and validate RO quality. However, opportunity remains to optimize tissue differentiation protocols and achieve better RO reproducibility. In order to screen high-quality ROs for downstream applications, approaches such as noninvasive and label-free imaging and electrophysiological functional testing are promising and worth further investigation. Lastly, transplanted RO-derived tissues have allowed improvements in visual function in several RD models, showing promises for clinical applications in the future.
Collapse
Affiliation(s)
- Yuntian Xue
- Biomedical Engineering, University of California, Irvine, CA
- Stem Cell Research Center, University of California, Irvine, CA
| | - Bin Lin
- Stem Cell Research Center, University of California, Irvine, CA
| | - Jacqueline T. Chen
- Stem Cell Research Center, University of California, Irvine, CA
- Gavin Herbert Eye Institute Ophthalmology, University of California, Irvine, CA
| | - William C. Tang
- Biomedical Engineering, University of California, Irvine, CA
| | - Andrew W. Browne
- Biomedical Engineering, University of California, Irvine, CA
- Gavin Herbert Eye Institute Ophthalmology, University of California, Irvine, CA
- Institute for Clinical and Translational Science, University of California, Irvine, CA
| | - Magdalene J. Seiler
- Stem Cell Research Center, University of California, Irvine, CA
- Gavin Herbert Eye Institute Ophthalmology, University of California, Irvine, CA
- Department of Physical Medicine and Rehabilitation, University of California, Irvine, CA
- Department of Anatomy and Neurobiology, University of California, Irvine, CA
| |
Collapse
|
29
|
Ai Z, Huang X, Feng J, Wang H, Tao Y, Zeng F, Lu Y. FN-OCT: Disease Detection Algorithm for Retinal Optical Coherence Tomography Based on a Fusion Network. Front Neuroinform 2022; 16:876927. [PMID: 35784186 PMCID: PMC9243322 DOI: 10.3389/fninf.2022.876927] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/04/2022] [Indexed: 01/31/2023] Open
Abstract
Optical coherence tomography (OCT) is a new type of tomography that has experienced rapid development and potential in recent years. It is playing an increasingly important role in retinopathy diagnoses. At present, due to the uneven distributions of medical resources in various regions, the uneven proficiency levels of doctors in grassroots and remote areas, and the development needs of rare disease diagnosis and precision medicine, artificial intelligence technology based on deep learning can provide fast, accurate, and effective solutions for the recognition and diagnosis of retinal OCT images. To prevent vision damage and blindness caused by the delayed discovery of retinopathy, a fusion network (FN)-based retinal OCT classification algorithm (FN-OCT) is proposed in this paper to improve upon the adaptability and accuracy of traditional classification algorithms. The InceptionV3, Inception-ResNet, and Xception deep learning algorithms are used as base classifiers, a convolutional block attention mechanism (CBAM) is added after each base classifier, and three different fusion strategies are used to merge the prediction results of the base classifiers to output the final prediction results (choroidal neovascularization (CNV), diabetic macular oedema (DME), drusen, normal). The results show that in a classification problem involving the UCSD common retinal OCT dataset (108,312 OCT images from 4,686 patients), compared with that of the InceptionV3 network model, the prediction accuracy of FN-OCT is improved by 5.3% (accuracy = 98.7%, area under the curve (AUC) = 99.1%). The predictive accuracy and AUC achieved on an external dataset for the classification of retinal OCT diseases are 92 and 94.5%, respectively, and gradient-weighted class activation mapping (Grad-CAM) is used as a visualization tool to verify the effectiveness of the proposed FNs. This finding indicates that the developed fusion algorithm can significantly improve the performance of classifiers while providing a powerful tool and theoretical support for assisting with the diagnosis of retinal OCT.
Collapse
Affiliation(s)
- Zhuang Ai
- Department of Research and Development, Sinopharm Genomics Technology Co., Ltd., Jiangsu, China
| | - Xuan Huang
- Department of Ophthalmology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
- Medical Research Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jing Feng
- Department of Ophthalmology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Hui Wang
- Department of Ophthalmology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yong Tao
- Department of Ophthalmology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Fanxin Zeng
- Department of Clinical Research Center, Dazhou Central Hospital, Sichuan, China
| | - Yaping Lu
- Department of Research and Development, Sinopharm Genomics Technology Co., Ltd., Jiangsu, China
| |
Collapse
|
30
|
Saleh N, Abdel Wahed M, Salaheldin AM. Computer-aided diagnosis system for retinal disorder classification using optical coherence tomography images. BIOMED ENG-BIOMED TE 2022; 67:283-294. [PMID: 35585773 DOI: 10.1515/bmt-2021-0330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 05/03/2022] [Indexed: 11/15/2022]
Abstract
The incidence of vision impairment is rapidly increasing. Diagnosis and classifying retinal abnormalities in ophthalmological applications is a significant challenge. Using Optical Coherence Tomography (OCT), the study aims to develop a computer aided diagnosis system for detecting and classifying retinal disorders. Choroidal neovascularization, diabetic macular edema, drusen, and normal cases are the investigated groups. Both deep learning and machine learning are combined to build the system. The SqueezeNet neural network was modified to extract features. The Support Vector Machine (SVM), K-Nearest Neighbor (K-NN), Decision Tree (DT), and Ensemble Model (EM) algorithms were used for disorder classification. The Bayesian optimization technique was also used to determine the best hyperparameters for each model. The model' performance was evaluated through nine criteria using 12,000 OCT images. The results have demonstrated accuracies of 97.39, 97.47, 96.98, and 95.25% for the SVM, K-NN, DT, and EM, respectively. When results are compared to relevant studies in terms of accuracy and tested samples, they show superior performance. As a result, a novel computer-aided diagnosis system for detecting and classifying retinal diseases has been developed, reducing human error while also saving time.
Collapse
Affiliation(s)
- Neven Saleh
- Systems and Biomedical Engineering Department, Higher Institute of Engineering in El-Shorouk city, Shorouk Academy, Cairo, Egypt
| | - Manal Abdel Wahed
- Systems and Biomedical Engineering Department, Faculty of Engineering, Cairo University, Giza, Egypt
| | - Ahmed M Salaheldin
- Systems and Biomedical Engineering Department, Higher Institute of Engineering in El-Shorouk city, Shorouk Academy, Cairo, Egypt
| |
Collapse
|
31
|
Gastaldello A, Giampieri F, Quiles JL, Navarro-Hortal MD, Aparicio S, García Villena E, Tutusaus Pifarre K, De Giuseppe R, Grosso G, Cianciosi D, Forbes-Hernández TY, Nabavi SM, Battino M. Adherence to the Mediterranean-Style Eating Pattern and Macular Degeneration: A Systematic Review of Observational Studies. Nutrients 2022; 14:nu14102028. [PMID: 35631175 PMCID: PMC9144566 DOI: 10.3390/nu14102028] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/01/2022] [Accepted: 05/10/2022] [Indexed: 02/01/2023] Open
Abstract
Age-related macular degeneration (AMD) is a serious degenerative disease affecting the eyes, and is the main cause of severe vision loss among people >55 years of age in developed countries. Its onset and progression have been associated with several genetic and lifestyle factors, with diet appearing to play a pivotal role in the latter. In particular, dietary eating patterns rich in plant foods have been shown to lower the risk of developing the disease, and to decrease the odds of progressing to more advanced stages in individuals already burdened with early AMD. We systematically reviewed the literature to analyse the relationship between the adherence to a Mediterranean diet, a mainly plant-based dietary pattern, and the onset/progression of AMD. Eight human observational studies were analysed. Despite some differences, they consistently indicate that higher adherence to a Mediterranean eating pattern lowers the odds of developing AMD and decreases the risk of progression to more advanced stages of the disease, establishing the way for preventative measures emphasizing dietary patterns rich in plant-foods.
Collapse
Affiliation(s)
- Annalisa Gastaldello
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
| | - Francesca Giampieri
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah 80200, Saudi Arabia
- Correspondence: (F.G.); (M.B.)
| | - José L. Quiles
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
- Department of Physiology, Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Centre, University of Granada, 18100 Granada, Spain; (M.D.N.-H.); (T.Y.F.-H.)
| | - María D. Navarro-Hortal
- Department of Physiology, Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Centre, University of Granada, 18100 Granada, Spain; (M.D.N.-H.); (T.Y.F.-H.)
| | - Silvia Aparicio
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
- Faculdade de Ciências Sociais e Humanas, Universidade Internacional do Cuanza Bairro Kaluanda, Cuito EN 250, Bié, Angola
| | - Eduardo García Villena
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
- Department de Salud, Universidad Internacional Iberoamericana Campeche, Campeche 24560, Mexico
| | - Kilian Tutusaus Pifarre
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
- Department de Salud, Universidad Internacional Iberoamericana Campeche, Campeche 24560, Mexico
| | - Rachele De Giuseppe
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95124 Catania, Italy;
| | - Danila Cianciosi
- Department of Clinical Sciences, Polytechnic University of Marche, 60131 Ancona, Italy;
| | - Tamara Y. Forbes-Hernández
- Department of Physiology, Institute of Nutrition and Food Technology “José Mataix”, Biomedical Research Centre, University of Granada, 18100 Granada, Spain; (M.D.N.-H.); (T.Y.F.-H.)
| | - Seyed M. Nabavi
- Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran 1435916471, Iran;
| | - Maurizio Battino
- Research Group on Foods, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, 39011 Santander, Spain; (A.G.); (J.L.Q.); (S.A.); (E.G.V.); (K.T.P.)
- Department of Clinical Sciences, Polytechnic University of Marche, 60131 Ancona, Italy;
- International Joint Research Laboratory of Intelligent Agriculture and Agri-Products Processing, Jiangsu University, Zhenjiang 212013, China
- Correspondence: (F.G.); (M.B.)
| |
Collapse
|
32
|
Marmoy OR, Moinuddin M, Thompson DA. An alternative electroretinography protocol for children: a study of diagnostic agreement and accuracy relative to ISCEV standard electroretinograms. Acta Ophthalmol 2022; 100:322-330. [PMID: 34126657 DOI: 10.1111/aos.14938] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/27/2021] [Accepted: 05/20/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the diagnostic accuracy and agreement between a paediatric electroretinography protocol used at Great Ormond Street Hospital (GOSH-ERG) and the 'gold standard' international protocol (ISCEV-ERG) in health and disease. METHODS Patient databases between 2010 and 2020 were screened to identify children with an ISCEV-ERG recorded within four years of a GOSH-ERG. Electroretinogram (ERG) component peak times and amplitudes were re-measured, and data were analysed in terms of absolute abnormality and proportional deviation from respective reference ranges. Abnormality was defined by the retinal system affected and by individual ERG a- and b-wave component analysis. RESULTS A total of 59 patients were included: 38 patients had retinal disease defined by an abnormal ISCEV-ERG and 21 had normal ISCEV-ERGs. When absolute abnormality was defined by combined retinal systems, the GOSH-ERG showed an excellent overall sensitivity of 95% (accuracy 86%). Individual retinal systems showed good-excellent sensitivity (67%-100%) and specificity (68%-97%). Electroretinogram (ERG) component sensitivities ranged between 60% and 97% and specificities between 79% and 97% dependent upon the protocol step. The proportional relationship appeared mostly linear between protocols. Electroretinogram (ERG) morphology was comparable for both protocols in a range of retinal diseases including those with pathognomonic ERGs. CONCLUSION We demonstrate the high diagnostic accuracy of a paediatric ERG protocol (GOSH-ERG) relative to ISCEV standard ERGs. The close proportional deviation and similar waveform morphology indicate ERGs from each protocol are similarly affected in disease. This encourages the use of the GOSH-ERG protocol in the screening, diagnosis and monitoring of retinal disease in children who are unable to comply with the rigorous ISCEV-ERG protocol.
Collapse
Affiliation(s)
- Oliver R. Marmoy
- Tony Kriss Visual Electrophysiology Unit Great Ormond Street Hospital for Children London UK
- UCL‐GOS Institute of Child Health London UK
- Manchester Metropolitan University Manchester UK
| | - Mohammed Moinuddin
- UCL‐GOS Institute of Child Health London UK
- Faculty of Health Social Care & Medicine Edge Hill University Ormskirk UK
| | - Dorothy A. Thompson
- Tony Kriss Visual Electrophysiology Unit Great Ormond Street Hospital for Children London UK
- UCL‐GOS Institute of Child Health London UK
| |
Collapse
|
33
|
Cicerone AP, Dailey W, Sun M, Santos A, Jeong D, Jones L, Koustas K, Drekh M, Schmitz K, Haque N, Felisky JA, Guzman AE, Mellert K, Trese MT, Capone A, Drenser KA, Mitton KP. A Survey of Multigenic Protein-Altering Variant Frequency in Familial Exudative Vitreo-Retinopathy (FEVR) Patients by Targeted Sequencing of Seven FEVR-Linked Genes. Genes (Basel) 2022; 13:495. [PMID: 35328049 PMCID: PMC8953269 DOI: 10.3390/genes13030495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 02/06/2023] Open
Abstract
While Inherited Retinal Diseases (IRDs) are typically considered rare diseases, Familial Exudative Vitreo-Retinopathy (FEVR) and Norrie Disease (ND) are more rare than retinitis pigmentosa. We wanted to determine if multigenic protein-altering variants are common in FEVR subjects within a set of FEVR-related genes. The potential occurrence of protein-altering variants in two different genes has been documented in a very small percentage of patients, but potential multigenic contributions to FEVR remain unclear. Genes involved in these orphan pediatric retinal diseases are not universally included in available IRD targeted-sequencing panels, and cost is also a factor limiting multigenic-sequence-based testing for these rare conditions. To provide an accurate solution at lower cost, we developed a targeted-sequencing protocol that includes seven genes involved in Familial Exudative Vitreo-Retinopathy (FEVR) and Norrie disease. Seventy-six DNA samples from persons refered to clinic with possible FEVR and some close relatives were sequenced using a novel Oakland-ERI orphan pediatric retinal disease panel (version 2) providing 900 times average read coverage. The seven genes involved in FEVR/ND were: NDP (ChrX), CTNNB1 (Chr3); TSPAN12 (Chr7); KIF11 (Chr10), FZD4 (Chr11), LRP5 (Chr11), ZNF408 (Chr11). A total of 33 variants were found that alter protein sequence, with the following relative distribution: LRP5 13/33 (40%), FZD4 9/33 (27%), ZNF408 6/33 (18%), (KIF11 3/33 (9%), NDP 1/33 (3%), CTNNB1 1/33 (3%). Most protein-altering variants, 85%, were found in three genes: FZD4, LRP5, and ZNF408. Four previously known pathogenic variants were detected in five families and two unrelated individuals. Two novel, likely pathogenic variants were detected in one family (FZD4: Cys450ter), and a likely pathogenic frame shift termination variant was detected in one unrelated individual (LRP5: Ala919CysfsTer67). The average number of genes with protein-altering variants was greater in subjects with confirmed FEVR (1.46, n = 30) compared to subjects confirmed unaffected by FEVR (0.95, n = 20), (p = 0.009). Thirty-four percent of persons sequenced had digenic and trigenic protein-altering variants within this set of FEVR genes, which was much greater than expected in the general population (3.6%), as derived from GnomAD data. While the potential contributions to FEVR are not known for most of the variants in a multigenic context, the high multigenic frequency suggests that potential multigenic contributions to FEVR severity warrant future investigation. The targeted-sequencing format developed will support such exploration by reducing the testing cost to $250 (US) for seven genes and facilitating greater access to genetic testing for families with this very rare inherited retinal disease.
Collapse
Affiliation(s)
- Amanda Petrelli Cicerone
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
| | - Wendy Dailey
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
| | - Michael Sun
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
- Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
| | - Andrew Santos
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
- Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
| | - Daeun Jeong
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
- Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
| | - Lance Jones
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
- Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
| | - Konstaninos Koustas
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
- Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
| | - Mary Drekh
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
- Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
| | - Keaton Schmitz
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
- Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
| | - Naomi Haque
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
- Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
| | - Jennifer A. Felisky
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
| | - Alvaro E. Guzman
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
| | - Kendra Mellert
- Associated Retinal Consultants LLC, Royal Oak, MI 48073, USA; (K.M.); (M.T.T.); (A.C.)
| | - Michael T. Trese
- Associated Retinal Consultants LLC, Royal Oak, MI 48073, USA; (K.M.); (M.T.T.); (A.C.)
| | - Antonio Capone
- Associated Retinal Consultants LLC, Royal Oak, MI 48073, USA; (K.M.); (M.T.T.); (A.C.)
| | - Kimberly A. Drenser
- Associated Retinal Consultants LLC, Royal Oak, MI 48073, USA; (K.M.); (M.T.T.); (A.C.)
| | - Kenneth P. Mitton
- Eye Research Institute, Rochester, MI 48309, USA; (A.P.C.); (W.D.); (M.S.); (A.S.); (D.J.); (L.J.); (K.K.); (M.D.); (K.S.); (N.H.); (J.A.F.); (A.E.G.)
- Oakland University William Beaumont School of Medicine, Rochester, MI 48309, USA
| |
Collapse
|
34
|
Patel M, Holmes HR, Yannuzzi N, Kuriyan AE, Sridhar J. Patient Understanding of Nonapproved Stem Cell Therapies for Retinal Disease. Ophthalmol Retina 2022; 6:254-255. [PMID: 34740816 PMCID: PMC8901474 DOI: 10.1016/j.oret.2021.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 10/19/2022]
Abstract
This prospective survey study demonstrates a lack of retina clinic patient knowledge about appropriate stem cell therapy applications for retinal disease.
Collapse
Affiliation(s)
- Marissa Patel
- University of Miami Miller School of Medicine. 900 NW 17 Street. Miami, FL 33136
| | - Hailey-Robles Holmes
- University of Miami Miller School of Medicine. 900 NW 17 Street. Miami, FL 33136
| | - Nicolas Yannuzzi
- University of Miami Miller School of Medicine. 900 NW 17 Street. Miami, FL 33136
| | - Ajay E. Kuriyan
- Bascom Palmer Eye Institute at the University of Miami Miller School of Medicine. 900 NW 17 Street. Miami, FL 33136. 2Mid Atlantic Retina, Retina Service for Wills Eye Hospital, 840 Walnut St., Philadelphia, PA, 19107
| | - Jayanth Sridhar
- University of Miami Miller School of Medicine, Miami, Florida.
| |
Collapse
|
35
|
Thagaard MS, Vergmann AS, Grauslund J. Topical treatment of diabetic retinopathy: a systematic review. Acta Ophthalmol 2022; 100:136-147. [PMID: 34096180 DOI: 10.1111/aos.14912] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 03/16/2021] [Accepted: 05/01/2021] [Indexed: 12/20/2022]
Abstract
Diabetic retinopathy (DR) is the most common microvascular complication in diabetes and may cause severe visual impairment. Until late stages of DR, treatment options are limited. The aim of the present review was to investigate whether changes of DR might be influenced by topical treatment with eye drops. This systematic review included both randomized and non-randomized human clinical studies on the subject. A systematic search of PubMed Medline, Embase and Scopus databases yielded 710 studies. No inclusion criteria regarding classification of DR were defined. Reference lists as well as first authors were screened for the inclusion of additional studies. Potential bias of the randomized studies was assessed using the Cochrane Risk of Bias tool. Nineteen studies suitable for inclusion were identified. Seven studies were randomized trials. These examined 11 different pharmacological groups of drugs in DR. A favourable effect of corticosteroid eye drops in diabetic macular oedema (DMO) was reported in four studies, and another study reported a positive trend. Eye drops with non-steroidal anti-inflammatory drugs were also reported to have a favourable effect in DMO, but not in non-center involving DMO. Application of neuroprotective agents was found effective in patients with pre-existing neurodegeneration in three studies. The remaining studies of DMO and DR were heterogeneous in both designs and results. Studies on treatment of DR with topical eye drops vary with regards to patient population, interventional drugs, study design, and outcome measures. Treatment of DR with eye drops was found effective in the aforementioned cases, but there is still a need for further investigations of long-term, randomized controlled trials in any of the reported pharmacological group.
Collapse
Affiliation(s)
- Mikkel S. Thagaard
- Department of Ophthalmology Odense University Hospital Odense Denmark
- Department of Ophthalmology Hospital Sønderjylland Sønderborg Denmark
| | - Anna S. Vergmann
- Research Unit of Ophthalmology Department of Clinical Research Faculty of Health Sciences University of Southern Denmark Odense Denmark
| | - Jakob Grauslund
- Department of Ophthalmology Odense University Hospital Odense Denmark
- Research Unit of Ophthalmology Department of Clinical Research Faculty of Health Sciences University of Southern Denmark Odense Denmark
- Steno Diabetes Center Odense Odense Denmark
| |
Collapse
|
36
|
Chiang MC, Chern E. Current Development, Obstacle and Futural Direction of Induced Pluripotent Stem Cell and Mesenchymal Stem Cell Treatment in Degenerative Retinal Disease. Int J Mol Sci 2022; 23:ijms23052529. [PMID: 35269671 PMCID: PMC8910526 DOI: 10.3390/ijms23052529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/20/2022] [Accepted: 02/23/2022] [Indexed: 11/26/2022] Open
Abstract
Degenerative retinal disease is one of the major causes of vision loss around the world. The past several decades have witnessed emerging development of stem cell treatment for retinal disease. Nevertheless, sourcing stem cells remains controversial due to ethical concerns and their rarity. Furthermore, induced pluripotent stem cells (iPSCs) and mesenchymal stem cells (MSCs) are both isolated from patients’ mature tissues; thus, issues such as avoiding moral controversy and adverse events related to immunosuppression and obtaining a large number of cells have opened a new era in regenerative medicine. This review focuses on the current application and development, clinical trials, and latest research of stem cell therapy, as well as its limitations and future directions.
Collapse
|
37
|
Abstract
Misdiagnosis of retinal disease is a common problem in primary care that can lead to irreversible vision loss and false-positive referrals, resulting in inappropriate use of health services. Clinical decision support systems describe tools that leverage information technology to provide timely recommendations that assist clinicians in the decisions they make about the care of a patient. They, therefore, have the potential to reduce the rate of misdiagnosis by promoting evidence-based medicine and more effective and efficient healthcare. This narrative review aims to support primary care practitioners in better understanding the current and emerging capacity of clinical decision support systems in eye care. Different types of clinical decision support systems are discussed, using current examples and evidence from the available literature to demonstrate how they may improve diagnostic effectiveness and aid the management of retinal disease. Comments are made on the future directions of clinical decision support in primary eye care and the potential applications of artificial intelligence.
Collapse
Affiliation(s)
- Sharon Ho
- Centre for Eye Health, The University of New South Wales, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Michael Kalloniatis
- Centre for Eye Health, The University of New South Wales, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| | - Angelica Ly
- Centre for Eye Health, The University of New South Wales, Sydney, Australia.,School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
| |
Collapse
|
38
|
Britten‐Jones AC, O'Hare F, Edwards TL, Ayton LN. Victorian evolution of inherited retinal diseases natural history registry (VENTURE study): Rationale, methodology and initial participant characteristics. Clin Exp Ophthalmol 2022; 50:768-780. [PMID: 35621151 PMCID: PMC9796389 DOI: 10.1111/ceo.14110] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/28/2022] [Accepted: 05/15/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Emerging treatments are being developed for inherited retinal diseases, requiring a clear understanding of natural progression and a database of potential participants for clinical trials. This article describes the rationale, study design and methodology of the Victorian Evolution of inherited retinal diseases NaTUral history REgistry (VENTURE), including data from the first 150 participants enrolled. METHODS VENTURE collects retrospective and prospective data from people with inherited retinal diseases. Following registration, participants are asked to attend a baseline examination using a standardised protocol to confirm their inherited retinal disease diagnosis. Examination procedures include (i) retinal function, using visual acuity and perimetry; (ii) retinal structure, using multimodal imaging and (iii) patient-reported outcomes. Participants' molecular diagnoses are obtained from their clinical records or through targeted-panel genetic testing by an independent laboratory. Phenotype and genotype data are used to enrol participants into disease-specific longitudinal cohort sub-studies. RESULTS From 7 July 2020 to 30 December 2021, VENTURE enrolled 150 registrants (138 families) and most (63%) have a rod-cone dystrophy phenotype. From 93 participants who have received a probable molecular diagnosis, the most common affected genes are RPGR (13% of all registrants), USH2A (10%), CYP4V2 (7%), ABCA4 (5%), and CHM (5%). Most participants have early to moderate vision impairment, with over half (55%) having visual acuities of better than 6/60 (20/200) at registration. CONCLUSIONS The VENTURE study will complement existing patient registries and help drive inherited retinal disease research in Australia, facilitating access to research opportunities for individuals with inherited retinal diseases.
Collapse
Affiliation(s)
- Alexis Ceecee Britten‐Jones
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Centre for Eye Research AustraliaRoyal Victorian Eye and Ear HospitalMelbourneAustralia
| | - Fleur O'Hare
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Centre for Eye Research AustraliaRoyal Victorian Eye and Ear HospitalMelbourneAustralia
| | - Thomas L. Edwards
- Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Centre for Eye Research AustraliaRoyal Victorian Eye and Ear HospitalMelbourneAustralia
| | - Lauren N. Ayton
- Department of Optometry and Vision Sciences, Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Department of Surgery (Ophthalmology), Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleAustralia,Centre for Eye Research AustraliaRoyal Victorian Eye and Ear HospitalMelbourneAustralia
| | | |
Collapse
|
39
|
Zhang HJ, Liu XB, Chen XM, Kong QH, Liu YS, So KF, Chen JS, Xu Y, Mi XS, Tang SB. Lutein delays photoreceptor degeneration in a mouse model of retinitis pigmentosa. Neural Regen Res 2021; 17:1596-1603. [PMID: 34916446 PMCID: PMC8771084 DOI: 10.4103/1673-5374.330622] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Retinitis pigmentosa is a retinal disease characterized by photoreceptor degeneration. There is currently no effective treatment for retinitis pigmentosa. Although a mixture of lutein and other antioxidant agents has shown promising effects in protecting the retina from degeneration, the role of lutein alone remains unclear. In this study, we administered intragastric lutein to Pde6brd10 model mice, which display degeneration of retinal photoreceptors, on postnatal days 17 (P17) to P25, when rod apoptosis reaches peak. Lutein at the optimal protective dose of 200 mg/kg promoted the survival of photoreceptors compared with vehicle control. Lutein increased rhodopsin expression in rod cells and opsin expression in cone cells, in line with an increased survival rate of photoreceptors. Functionally, lutein improved visual behavior, visual acuity, and retinal electroretinogram responses in Pde6brd10 mice. Mechanistically, lutein reduced the expression of glial fibrillary acidic protein in Müller glial cells. The results of this study confirm the ability of lutein to postpone photoreceptor degeneration by reducing reactive gliosis of Müller cells in the retina and exerting anti-inflammatory effects. This study was approved by the Laboratory Animal Ethics Committee of Jinan University (approval No. LACUC-20181217-02) on December 17, 2018.
Collapse
Affiliation(s)
- Hui-Jun Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University; Department of Ophthalmology, Guangzhou Panyu Central Hospital, Guangzhou, Guangdong Province, China
| | - Xiao-Bin Liu
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, Guangdong Province, China
| | - Xiong-Min Chen
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, Guangdong Province, China
| | - Qi-Hang Kong
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
| | - Yu-Sang Liu
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, Guangdong Province, China
| | - Kwok-Fai So
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, Guangdong Province; Aier Academician Station, Changsha, Hunan Province; Key Laboratory of CNS Regeneration (Jinan University), Ministry of Education, Guangzhou, Guangdong Province; Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
| | - Jian-Su Chen
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province; Laboratory of Retinal Cell Biology, Aier Eye Institute; Aier Academician Station, Changsha, Hunan Province, China
| | - Ying Xu
- Guangdong-Hong Kong-Macau Institute of CNS Regeneration, Jinan University, Guangzhou, Guangdong Province; Aier Academician Station, Changsha, Hunan Province; Key Laboratory of CNS Regeneration (Jinan University), Ministry of Education, Guangzhou, Guangdong Province; Co-Innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
| | - Xue-Song Mi
- Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province; Aier Academician Station, Changsha, Hunan Province, China
| | - Shi-Bo Tang
- Laboratory of Retinal Cell Biology, Aier Eye Institute; Aier Academician Station, Changsha, Hunan Province, China
| |
Collapse
|
40
|
Sangroongruangsri S, Chaikledkaew U, Hanusaha P, Ratanapakorn T, Ruamviboonsuk P. Cost-Utility Analysis of Drug Treatments in Patients with Polypoidal Choroidal Vasculopathy in Thailand. Clinicoecon Outcomes Res 2021; 13:917-926. [PMID: 34795492 PMCID: PMC8594557 DOI: 10.2147/ceor.s340570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/03/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this study was to estimate the cost-utility and budget impact of pharmacological treatments for the eye with polypoidal choroidal vasculopathy (PCV) in Thailand. METHODS A Markov model-based cost-utility analysis (CUA) and budget impact analysis were conducted. The lifetime cost and outcomes of PCV treatments were estimated. We discounted costs and outcomes at 3% per annum. Parameters were estimated using data from published literatures, local cost and utility data, and epidemiology data among Thai patients. Univariate and probabilistic sensitivity analyses were performed to account for parameter uncertainty. RESULTS Intravitreal bevacizumab (IVB) resulted in the lowest lifetime cost, followed by IVB plus verteporfin photodynamic therapy (IVB+vPDT) and intravitreal aflibercept (IVA). The combination of IVB or intravitreal ranibizumab (IVR) and verteporfin photodynamic therapy (IVB+vPDT or IVR+vPDT) yielded the highest quality-adjusted life-years (QALY). When compared with IVB from a societal perspective, the incremental cost-effectiveness ratio for patients with PCV receiving IVB+vPDT, IVR+vPDT, IVA were 10,304; 54,135; and 82,738 the United States dollar (USD) per QALY gained, respectively. At the Thai societal willingness to pay threshold of 4884 USD, IVB had the highest probability of being cost-effective (99%) followed by IVB+vPDT (1%). IVB+vPDT could be a cost-effective strategy and required a budget of 12.61 million USD over five fiscal years when the price of verteporfin reduced by approximately 45%. CONCLUSION None of the drug treatments for PCV was cost-effective in the Thai context. The decreased price of verteporfin is required to support the inclusion of IVB+vPDT in the Thai National List of Essential Medicines for the treatment of PCV.
Collapse
Affiliation(s)
- Sermsiri Sangroongruangsri
- Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Usa Chaikledkaew
- Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand
| | - Prut Hanusaha
- Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tanapat Ratanapakorn
- Department of Ophthalmology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Paisan Ruamviboonsuk
- Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| |
Collapse
|
41
|
Szarka G, Balogh M, Tengölics ÁJ, Ganczer A, Völgyi B, Kovács-Öller T. The role of gap junctions in cell death and neuromodulation in the retina. Neural Regen Res 2021; 16:1911-1920. [PMID: 33642359 PMCID: PMC8343308 DOI: 10.4103/1673-5374.308069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/14/2020] [Accepted: 01/11/2021] [Indexed: 12/26/2022] Open
Abstract
Vision altering diseases, such as glaucoma, diabetic retinopathy, age-related macular degeneration, myopia, retinal vascular disease, traumatic brain injuries and others cripple many lives and are projected to continue to cause anguish in the foreseeable future. Gap junctions serve as an emerging target for neuromodulation and possible regeneration as they directly connect healthy and/or diseased cells, thereby playing a crucial role in pathophysiology. Since they are permeable for macromolecules, able to cross the cellular barriers, they show duality in illness as a cause and as a therapeutic target. In this review, we take recent advancements in gap junction neuromodulation (pharmacological blockade, gene therapy, electrical and light stimulation) into account, to show the gap junction's role in neuronal cell death and the possible routes of rescuing neuronal and glial cells in the retina succeeding illness or injury.
Collapse
Affiliation(s)
- Gergely Szarka
- János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Retinal Electrical Synapses Research Group, National Brain Research Program (NAP 2.0), Hungarian Academy of Sciences, Budapest, Hungary
- Department of Experimental Zoology and Neurobiology, University of Pécs, Pécs, Hungary
| | - Márton Balogh
- János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Retinal Electrical Synapses Research Group, National Brain Research Program (NAP 2.0), Hungarian Academy of Sciences, Budapest, Hungary
- Department of Experimental Zoology and Neurobiology, University of Pécs, Pécs, Hungary
| | - Ádám J. Tengölics
- János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Retinal Electrical Synapses Research Group, National Brain Research Program (NAP 2.0), Hungarian Academy of Sciences, Budapest, Hungary
- Department of Experimental Zoology and Neurobiology, University of Pécs, Pécs, Hungary
| | - Alma Ganczer
- János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Retinal Electrical Synapses Research Group, National Brain Research Program (NAP 2.0), Hungarian Academy of Sciences, Budapest, Hungary
- Department of Experimental Zoology and Neurobiology, University of Pécs, Pécs, Hungary
| | - Béla Völgyi
- János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Retinal Electrical Synapses Research Group, National Brain Research Program (NAP 2.0), Hungarian Academy of Sciences, Budapest, Hungary
- Department of Experimental Zoology and Neurobiology, University of Pécs, Pécs, Hungary
- Medical School, University of Pécs, Pécs, Hungary
| | - Tamás Kovács-Öller
- János Szentágothai Research Centre, University of Pécs, Pécs, Hungary
- Retinal Electrical Synapses Research Group, National Brain Research Program (NAP 2.0), Hungarian Academy of Sciences, Budapest, Hungary
- Medical School, University of Pécs, Pécs, Hungary
| |
Collapse
|
42
|
Abstract
Our sense of sight relies on photoreceptors, which transduce photons into the nervous system's electrochemical interpretation of the visual world. These precious photoreceptors can be disrupted by disease, injury, and aging. Once photoreceptors start to die, but before blindness occurs, the remaining retinal circuitry can withstand, mask, or exacerbate the photoreceptor deficit and potentially be receptive to newfound therapies for vision restoration. To maximize the retina's receptivity to therapy, one must understand the conditions that influence the state of the remaining retina. In this review, we provide an overview of the retina's structure and function in health and disease. We analyze a collection of observations on photoreceptor disruption and generate a predictive model to identify parameters that influence the retina's response. Finally, we speculate on whether the retina, with its remarkable capacity to function over light levels spanning nine orders of magnitude, uses these same adaptational mechanisms to withstand and perhaps mask photoreceptor loss.
Collapse
Affiliation(s)
- Joo Yeun Lee
- Department of Ophthalmology, University of California, San Francisco, California 94143, USA; , , ,
| | - Rachel A Care
- Department of Ophthalmology, University of California, San Francisco, California 94143, USA; , , ,
| | - Luca Della Santina
- Department of Ophthalmology, University of California, San Francisco, California 94143, USA; , , ,
- Bakar Computational Health Sciences Institute, University of California, San Francisco, California 94143, USA
| | - Felice A Dunn
- Department of Ophthalmology, University of California, San Francisco, California 94143, USA; , , ,
| |
Collapse
|
43
|
Finger RP, Daien V, Talks JS, Mitchell P, Wong TY, Sakamoto T, Eldem BM, Lövestam‐Adrian M, Korobelnik J. A novel tool to assess the quality of RWE to guide the management of retinal disease. Acta Ophthalmol 2021; 99:604-610. [PMID: 33369881 DOI: 10.1111/aos.14698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 12/27/2022]
Abstract
Despite the growing importance of real-world evidence (RWE) for guiding clinical decisions in retinal disease, there is currently no widely used guidance available for assessing the quality and relevance of RWE studies in ophthalmology. This paper summarizes the development of a user-friendly tool that facilitates assessment of the quality of available RWE for neovascular age-related macular degeneration (nAMD), diabetic macular oedema (DME) and retinal vein occlusion (RVO). A literature search was conducted to identify tools developed to assess the quality of RWE, in order to identify the most appropriate framework on which to base this tool. The Good Research for Comparative Effectiveness (GRACE) guidelines was chosen for this purpose as it is designed to assess the quality of observational studies and has been extensively validated, including demonstration of strong sensitivity and specificity. The GRACE guidelines were adapted to develop a straightforward tabular tool that allows simple assessment and comparison of the quality of published evidence in retinal disease for researchers and physicians alike, and includes guidance on treatment details, outcome measures, study population, and controlling for bias. The newly developed tool provides a simple method to support assessment of the strength of evidence and certainty of conclusions drawn from RWE in retinal disease, to ensure clinical decision-making is influenced by the highest quality evidence.
Collapse
Affiliation(s)
| | - Vincent Daien
- Department of Ophthalmology Gui De Chauliac Hospital Montpellier France
- The Save Sight Institute Sydney Medical School The University of Sydney Sydney NSW Australia
| | - James S. Talks
- Department of Ophthalmology Royal Victoria Infirmary Newcastle upon Tyne UK
| | - Paul Mitchell
- Center for Vision Research Westmead Institute for Medical Research University of Sydney Sydney NSW Australia
| | - Tien Y. Wong
- Singapore Eye Research Institute Singapore National Eye Center Singapore Singapore
- Duke‐NUS Medical School Singapore Singapore
| | - Taiji Sakamoto
- Department of Ophthalmology Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima and J‐CREST Japan
| | - Bora M. Eldem
- Faculty of Medicine, Ophthalmology Department Hacettepe University Ankara Turkey
| | | | | |
Collapse
|
44
|
Sun C, Zhou J, Meng X. Primary cilia in retinal pigment epithelium development and diseases. J Cell Mol Med 2021; 25:9084-9088. [PMID: 34448530 PMCID: PMC8500982 DOI: 10.1111/jcmm.16882] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 12/11/2022] Open
Abstract
Retinal pigment epithelium (RPE) is a highly polarized epithelial monolayer lying between the photoreceptor layer and the Bruch membrane. It is essential for vision through participating in many critical activities, including phagocytosis of photoreceptor outer segments, recycling the visual cycle‐related compounds, forming a barrier to control the transport of nutrients, ions, and water, and the removal of waste. Primary cilia are conservatively present in almost all the vertebrate cells and acts as a sensory organelle to control tissue development and homeostasis maintenance. Numerous studies reveal that abnormalities in RPE lead to various retinal diseases, such as age‐related macular degeneration and diabetic macular oedema, but the mechanism of primary cilia in these physiological and pathological activities remains to be elucidated. Herein, we summarize the functions of primary cilia in the RPE development and the mutations of ciliary genes identified in RPE‐related diseases. By highlighting the significance of primary cilia in regulating the physiological and pathological processes of RPE, we aim to provide novel insights for the treatment of RPE‐related retinal diseases.
Collapse
Affiliation(s)
- Chunjiao Sun
- College of Life Sciences, Shandong Provincial Key Laboratory of Animal Resistance Biology, Institute of Biomedical Sciences, Shandong Normal University, Jinan, China
| | - Jun Zhou
- College of Life Sciences, Shandong Provincial Key Laboratory of Animal Resistance Biology, Institute of Biomedical Sciences, Shandong Normal University, Jinan, China
| | - Xiaoqian Meng
- College of Life Sciences, Shandong Provincial Key Laboratory of Animal Resistance Biology, Institute of Biomedical Sciences, Shandong Normal University, Jinan, China
| |
Collapse
|
45
|
Shinozaki Y, Akanuma SI, Mori Y, Kubo Y, Hosoya KI. Comprehensive Evidence of Carrier-Mediated Distribution of Amantadine to the Retina across the Blood-Retinal Barrier in Rats. Pharmaceutics 2021; 13:1339. [PMID: 34575415 DOI: 10.3390/pharmaceutics13091339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/16/2021] [Accepted: 08/24/2021] [Indexed: 11/20/2022] Open
Abstract
Amantadine, a drug used for the blockage of NMDA receptors, is well-known to exhibit neuroprotective effects. Accordingly, assessment of amantadine transport at retinal barriers could result in the application of amantadine for retinal diseases such as glaucoma. The objective of this study was to elucidate the retinal distribution of amantadine across the inner and outer blood–retinal barrier (BRB). In vivo blood-to-retina [3H]amantadine transport was investigated by using the rat retinal uptake index method, which was significantly reduced by unlabeled amantadine. This result indicated the involvement of carrier-mediated processes in the retinal distribution of amantadine. In addition, in vitro model cells of the inner and outer BRB (TR-iBRB2 and RPE-J cells) exhibited saturable kinetics (Km in TR-iBRB2 cells, 79.4 µM; Km in RPE-J cells, 90.5 and 9830 µM). The inhibition of [3H]amantadine uptake by cationic drugs/compounds indicated a minor contribution of transport systems that accept cationic drugs (e.g., verapamil), as well as solute carrier (SLC) organic cation transporters. Collectively, these outcomes suggest that carrier-mediated transport systems, which differ from reported transporters and mechanisms, play a crucial role in the retinal distribution of amantadine across the inner/outer BRB.
Collapse
|
46
|
Rossino MG, Amato R, Amadio M, Rosini M, Basagni F, Cammalleri M, Dal Monte M, Casini G. A Nature-Inspired Nrf2 Activator Protects Retinal Explants from Oxidative Stress and Neurodegeneration. Antioxidants (Basel) 2021; 10:1296. [PMID: 34439544 PMCID: PMC8389314 DOI: 10.3390/antiox10081296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 01/02/2023] Open
Abstract
Oxidative stress (OS) plays a key role in retinal dysfunctions and acts as a major trigger of inflammatory and neurodegenerative processes in several retinal diseases. To prevent OS-induced retinal damage, approaches based on the use of natural compounds are actively investigated. Recently, structural features from curcumin and diallyl sulfide have been combined in a nature-inspired hybrid (NIH1), which has been described to activate transcription nuclear factor erythroid-2-related factor-2 (Nrf2), the master regulator of the antioxidant response, in different cell lines. We tested the antioxidant properties of NIH1 in mouse retinal explants. NIH1 increased Nrf2 nuclear translocation, Nrf2 expression, and both antioxidant enzyme expression and protein levels after 24 h or six days of incubation. Possible toxic effects of NIH1 were excluded since it did not alter the expression of apoptotic or gliotic markers. In OS-treated retinal explants, NIH1 strengthened the antioxidant response inducing a massive and persistent expression of antioxidant enzymes up to six days of incubation. These effects resulted in prevention of the accumulation of reactive oxygen species, of apoptotic cell death, and of gliotic reactivity. Together, these data indicate that a strategy based on NIH1 to counteract OS could be effective for the treatment of retinal diseases.
Collapse
Affiliation(s)
- Maria Grazia Rossino
- Department of Biology, University of Pisa, 56126 Pisa, Italy; (M.G.R.); (R.A.); (M.C.)
| | - Rosario Amato
- Department of Biology, University of Pisa, 56126 Pisa, Italy; (M.G.R.); (R.A.); (M.C.)
| | - Marialaura Amadio
- Section of Pharmacology, Department of Drug Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Michela Rosini
- Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy; (M.R.); (F.B.)
| | - Filippo Basagni
- Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy; (M.R.); (F.B.)
| | - Maurizio Cammalleri
- Department of Biology, University of Pisa, 56126 Pisa, Italy; (M.G.R.); (R.A.); (M.C.)
- Interdepartmental Research Center Nutrafood “Nutraceuticals and Food for Health”, University of Pisa, 56124 Pisa, Italy
| | - Massimo Dal Monte
- Department of Biology, University of Pisa, 56126 Pisa, Italy; (M.G.R.); (R.A.); (M.C.)
- Interdepartmental Research Center Nutrafood “Nutraceuticals and Food for Health”, University of Pisa, 56124 Pisa, Italy
| | - Giovanni Casini
- Department of Biology, University of Pisa, 56126 Pisa, Italy; (M.G.R.); (R.A.); (M.C.)
- Interdepartmental Research Center Nutrafood “Nutraceuticals and Food for Health”, University of Pisa, 56124 Pisa, Italy
| |
Collapse
|
47
|
Beirne K, Freeman TJ, Rozanowska M, Votruba M. Red Light Irradiation In Vivo Upregulates DJ-1 in the Retinal Ganglion Cell Layer and Protects against Axotomy-Related Dendritic Pruning. Int J Mol Sci 2021; 22:8380. [PMID: 34445085 DOI: 10.3390/ijms22168380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 12/26/2022] Open
Abstract
Retinal ganglion cells (RGCs) undergo dendritic pruning in a variety of neurodegenerative diseases, including glaucoma and autosomal dominant optic atrophy (ADOA). Axotomising RGCs by severing the optic nerve generates an acute model of RGC dendropathy, which can be utilized to assess the therapeutic potential of treatments for RGC degeneration. Photobiomodulation (PBM) with red light provided neuroprotection to RGCs when administered ex vivo to wild-type retinal explants. In the current study, we used aged (13–15-month-old) wild-type and heterozygous B6;C3-Opa1Q285STOP (Opa1+/−) mice, a model of ADOA exhibiting RGC dendropathy. These mice were pre-treated with 4 J/cm2 of 670 nm light for five consecutive days before the eyes were enucleated and the retinas flat-mounted into explant cultures for 0-, 8- or 16-h ex vivo. RGCs were imaged by confocal microscopy, and their dendritic architecture was quantified by Sholl analysis. In vivo 670 nm light pretreatment inhibited the RGC dendropathy observed in untreated wild-type retinas over 16 h ex vivo and inhibited dendropathy in ON-center RGCs in wild-type but not Opa1+/− retinas. Immunohistochemistry revealed that aged Opa1+/− RGCs exhibited increased nitrosative damage alongside significantly lower activation of NF-κB and upregulation of DJ-1. PBM restored NF-κB activation in Opa1+/− RGCs and enhanced DJ-1 expression in both genotypes, indicating a potential molecular mechanism priming the retina to resist future oxidative insult. These data support the potential of PBM as a treatment for diseases involving RGC degeneration.
Collapse
|
48
|
Ying P, Huang C, Wang Y, Guo X, Cao Y, Zhang Y, Fu S, Chen L, Yi G, Fu M. Single-Cell RNA Sequencing of Retina:New Looks for Gene Marker and Old Diseases. Front Mol Biosci 2021; 8:699906. [PMID: 34395530 PMCID: PMC8362665 DOI: 10.3389/fmolb.2021.699906] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 07/01/2021] [Indexed: 01/20/2023] Open
Abstract
The retina is composed of 11 types of cells, including neurons, glial cells and vascular bed cells. It contains five types of neurons, each with specific physiological, morphological, and molecular definitions. Currently, single-cell RNA sequencing (sRNA-seq) is emerging as one of the most powerful tools to reveal the complexity of the retina. The continuous discovery of retina-related gene targets plays an important role in helping us understand the nature of diseases. The revelation of new cell subpopulations can focus the occurrence and development of diseases on specific biological activities of specific cells. In addition, sRNA-seq performs high-throughput sequencing analysis of epigenetics, transcriptome and genome at the single-cell level, with the advantages of high-throughput and high-resolution. In this paper, we systematically review the development history of sRNA-seq technology, and summarize the new subtypes of retinal cells and some specific gene markers discovered by this technology. The progress in the diagnosis of retinal related diseases is also discussed.
Collapse
Affiliation(s)
- Peixi Ying
- The Second Clinical School, Southern Medical University, Guangzhou, China
| | - Chang Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yan Wang
- Department of Ophthalmology, South China Hospital, Health Science Center, Shenzhen University, Shenzhen, China
| | - Xi Guo
- Medical College of Rehabiliation, Southern Medical University, Guangzhou, China
| | - Yuchen Cao
- The Second Clinical School, Southern Medical University, Guangzhou, China
| | - Yuxi Zhang
- The Second Clinical School, Southern Medical University, Guangzhou, China
| | - Sheng Fu
- The University of South China, Hengyang, China
| | - Lin Chen
- Department of Anesthesiology, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Guoguo Yi
- Department of Ophthalmology, the Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Min Fu
- Department of Ophthalmology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| |
Collapse
|
49
|
Abu-Yaghi NE, AlNawaiseh AM, Khourshid IM, AlRawashdeh TJ, Rawashdeh MMA, Zghoul AM, Shafagoj AN, Alomairi YA, Muhsen SM, AlRyalat SS. Central macular thickness in patients with sickle cell disease and no signs of retinopathy: a cross-sectional study of Jordanian patients. J Int Med Res 2021; 49:300060520977387. [PMID: 33827305 PMCID: PMC8040581 DOI: 10.1177/0300060520977387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To measure central macular thickness in Jordanian patients with sickle cell disease who did not have retinopathy and compare the findings with age- and sex-matched controls using spectral domain optical coherence tomography (SDOCT). METHODS In this cross-sectional study, participants underwent visual acuity testing, slit-lamp bio-microscopy, dilated ophthalmoscopy, and SDOCT imaging to measure central macular thickness. Macular quadrant measurements and thickness difference indexes (TDIs) were compared between groups. RESULTS Twenty eyes with sickle cell disease and 20 control eyes were enrolled. The median visual acuity in both groups was 20/20. The mean macular thickness was significantly lower in eyes with sickle cell disease than in matched controls (mean difference, 22.15 ± 6.44 µm). Peripheral quadrants were all significantly thinner in eyes with sickle cell disease, especially in superior and temporal quadrants. TDIs were lower in eyes with sickle cell disease than in control eyes. CONCLUSIONS Eyes with sickle cell disease that had no clinical evidence of retinopathy exhibited significantly lower central macular thickness in all quadrants, compared with eyes in age- and sex-matched controls. SDOCT is a non-invasive imaging modality that can detect preclinical changes in eyes with sickle cell disease and can be used to screen and monitor the disease process.
Collapse
Affiliation(s)
- Nakhleh E Abu-Yaghi
- Special Surgery Department/Ophthalmology Division, School of Medicine, University of Jordan, Amman, Jordan
| | | | | | | | | | - Ayat M Zghoul
- School of Medicine, University of Jordan, Amman, Jordan
| | | | | | - Sana' M Muhsen
- Special Surgery Department/Ophthalmology Division, School of Medicine, University of Jordan, Amman, Jordan
| | - SaifAldeen S AlRyalat
- Special Surgery Department/Ophthalmology Division, School of Medicine, University of Jordan, Amman, Jordan
| |
Collapse
|
50
|
Fasler K, Gunzinger JM, Barthelmes D, Zweifel SA. Routine Clinical Practice Treatment Outcomes of Eplerenone in Acute and Chronic Central Serous Chorioretinopathy. Front Pharmacol 2021; 12:675295. [PMID: 34040534 PMCID: PMC8141746 DOI: 10.3389/fphar.2021.675295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/21/2021] [Indexed: 12/05/2022] Open
Abstract
Purpose: To evaluate efficacy of eplerenone therapy vs. observation on resolution of subretinal fluid (SRF) in patients with acute and chronic central serous chorioretinopathy (CSCR) in routine clinical practice. Methods: Retrospective comparative case series of eyes diagnosed with CSCR treated with eplerenone or observation. Primary outcome measure was maximum height of SRF at 12 months. Secondary outcome was percentage of eyes with complete resolution of SRF, percentage of eyes with reduction of SRF ≥50%, and best corrected visual acuity (VA) at 12 months. Separate analysis was conducted for eyes with acute and chronic CSCR. Results: Sixty-eight eyes of 60 patients (82% male) were included. Eleven of the 38 eyes with acute CSCR, and seven of the 30 eyes with chronic CSCR, received eplerenone. Subretinal fluid decreased from baseline to 12 months in acute (287 ± 221 to 31 ± 63 µm) and chronic (148 ± 134 to 40 ± 42 µm) CSCR. Kaplan-Meier curves were similar for treated and observed eyes and COX regression analysis did not show a significant difference in SRF resolution in treated vs. observed eyes (p = 0.6 for acute, p = 0.2 for chronic CSCR). Conclusion: This routine clinical practice outcome study did not show evidence of efficacy of eplerenone on resolution of SRF in acute nor chronic CSCR.
Collapse
Affiliation(s)
- Katrin Fasler
- Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Jeanne M Gunzinger
- Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | - Daniel Barthelmes
- Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland.,Save Sight Institute, The University of Sydney, Sydney, NSW, Australia
| | - Sandrine A Zweifel
- Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| |
Collapse
|