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Zohdy YM, Jacob F, Agam M, Alawieh A, Bray D, Barbero JMR, Argaw SA, Maldonado J, Rodas A, Sudhakar V, Porto E, Peragallo JH, Olson JJ, Pradilla G, Garzon-Muvdi T. Volumetric Analysis of Spheno-Orbital Meningiomas: Prognostic Correlation and a Compartmentalized Approach. Neurosurgery 2024; 94:736-744. [PMID: 37931131 DOI: 10.1227/neu.0000000000002724] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/24/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Spheno-orbital meningiomas arise from the arachnoid villi cap cells at the sphenoid ridge and have the ability to spread through soft tissue extension and cranial bone invasion. Owing to their orbital hyperostosis and intraorbital soft tissue extension, they commonly present with ophthalmologic manifestations. This study aims to investigate the correlation between tumor volume with the presenting symptoms and postoperative outcomes. METHODS This retrospective study analyzed patients who underwent surgical resection of spheno-orbital meningiomas. Tumor volumes in different compartments were measured using preoperative and postoperative imaging. Linear and logistic regression analyses were used to identify correlations between tumor volumes and presenting symptoms preoperatively and postoperative outcomes. RESULTS Sixty-six patients were included in this study, of whom 86.4% had proptosis, 80.3% had decreased visual acuity (VA), 30.3% had visual field defects, and 13.6% had periorbital edema. Preoperatively, proptosis linearly correlated with intraosseous tumor volume (coefficient = 0.6, P < .001), while the decrease in baseline VA correlated with the intraorbital tumor volume (coefficient = 0.3, P = .01). The odds of periorbital edema were found to increase with an increase in intraosseous tumor volume with an adjusted odds ratio of 1.4 (95% CI, 1.1-1.7, P = .003), while the odds of visual field defects were found to increase with an increase in intraorbital tumor volume with an adjusted odds ratio of 2.7 (95% CI, 1.3-5.6, P = .01). Postoperatively, the volume of intraosseous tumor resected linearly correlated with the improvement in proptosis (coefficient = 0.7, P < .001), while the volume of intraorbital tumor resected linearly correlated with improvement in VA (coefficient = 0.5, P < .001) and with a larger effect size in patients presenting with moderate-to-severe decrease in VA preoperatively (coefficient = 0.8). CONCLUSION Underscoring the importance of each tumor compartment relative to the patient's symptomatology serves as a valuable guide in implementing a compartmentalized resection approach tailored to the surgical objectives.
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Affiliation(s)
- Youssef M Zohdy
- Department of Neurosurgery, School of Medicine, Emory University, Atlanta , Georgia , USA
| | - Fadi Jacob
- Department of Neurosurgery, School of Medicine, Emory University, Atlanta , Georgia , USA
| | - Matthew Agam
- Department of Neurosurgery, School of Medicine, Emory University, Atlanta , Georgia , USA
| | - Ali Alawieh
- Department of Neurosurgery, School of Medicine, Emory University, Atlanta , Georgia , USA
| | - David Bray
- Department of Neurosurgery, School of Medicine, Emory University, Atlanta , Georgia , USA
| | | | - Samson A Argaw
- Rollins School of Public Health, Emory University, Atlanta , Georgia , USA
| | - Justin Maldonado
- Department of Neurosurgery, School of Medicine, Emory University, Atlanta , Georgia , USA
| | - Alejandra Rodas
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Emory University, Atlanta , Georgia , USA
| | - Vivek Sudhakar
- Department of Neurosurgery, School of Medicine, Emory University, Atlanta , Georgia , USA
| | - Edoardo Porto
- Department of Neurosurgery, School of Medicine, Emory University, Atlanta , Georgia , USA
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan , Italy
| | - Jason H Peragallo
- Department of Ophthalmology, Emory University School of Medicine, Atlanta , Georgia , USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta , Georgia , USA
| | - Jeffrey J Olson
- Department of Neurosurgery, School of Medicine, Emory University, Atlanta , Georgia , USA
| | - Gustavo Pradilla
- Department of Neurosurgery, School of Medicine, Emory University, Atlanta , Georgia , USA
| | - Tomas Garzon-Muvdi
- Department of Neurosurgery, School of Medicine, Emory University, Atlanta , Georgia , USA
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Puertas M, Flores-Moreno I, Ruiz-Medrano J, Ruiz-Moreno JM. Development of Acquired Peripapillary Optic Disk Pit in Pathologic Myopia. Retina 2024; 44:e18-e19. [PMID: 37883493 DOI: 10.1097/iae.0000000000003964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/30/2023] [Indexed: 10/28/2023]
Affiliation(s)
- Mariluz Puertas
- Department of Ophthalmology, Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain
| | - Ignacio Flores-Moreno
- Department of Ophthalmology, Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain
- Clínica Suárez Leoz, Madrid, Spain
| | - Jorge Ruiz-Medrano
- Department of Ophthalmology, Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain
- Ocular Microsurgery Institute IMO, Madrid, Spain; and
| | - José M Ruiz-Moreno
- Department of Ophthalmology, Puerta de Hierro-Majadahonda University Hospital, Madrid, Spain
- Ocular Microsurgery Institute IMO, Madrid, Spain; and
- Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain
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Li J, Dan YS, Chua SQ, Wong QY, Chong RS, Ang M, Wong CW, Hoang QV. Pathologic myopia in highly myopic patients with high axial anisomyopia. Br J Ophthalmol 2024; 108:411-416. [PMID: 36690422 DOI: 10.1136/bjo-2022-322285] [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: 07/22/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE To determine prevalence of anisomyopia (axial length (AL) difference ≥2.5 mm) among high myopes ((HMs), defined by spherical equivalent of ≤6.0 diopters or AL ≥ 26.5 mm). To characterise the shorter anisomyopic eye (SAE) and evaluate if pathologic myopia (PM) in the longer anisomyopic eye (LAE) was associated with increased risk of PM in the SAE. METHODS 1168 HMs were recruited from Singapore National Eye Centre clinic for this cross-sectional study. Biometry, fundus photography and swept-source optical coherence tomography were performed. Patients with high axial anisomyopia were identified. Structural characteristics and presence of PM were described. Stepwise multivariate regression explored associations between PM in the LAE and pathology in the SAE, controlling for confounding variables. RESULTS Prevalence of anisomyopia was 15.8% (184 of 1168 patients). Anisomyopic patients (age 65.8±13.5 years) had mean AL of 30.6±2.0 mm and 26.2±2.3 mm in the LAE and SAE, respectively. 52.7% of SAEs had AL < 26.5 mm. Prevalence of myopic macular degeneration, macula-involving posterior staphyloma (PS), myopic traction maculopathy (MTM) and myopic choroidal neovascularisation (mCNV) in the SAE was 52.2%, 36.5%, 13.0% and 8.2%, respectively. Macular hole in the LAE was associated with increased risk of MTM in the SAE (OR=4.88, p=0.01). mCNV in the LAE was associated with mCNV in the SAE (OR=3.57, p=0.02). PS in the LAE was associated with PS in the SAE (OR=4.03, p<0.001). CONCLUSIONS Even when controlled for AL, PM complications in the LAE predict similar PM complications in the SAE. Patients with high axial anisometropia with PM in the LAE should be monitored carefully for complications in the SAE.
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Affiliation(s)
- Jonathan Li
- Department of Ophthalmology, Singapore National Eye Centre, Singapore
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, USA
| | | | - Si Qi Chua
- Singapore Eye Research Institute, Singapore
| | | | - Rachel S Chong
- Department of Ophthalmology, Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore
| | - Marcus Ang
- Department of Ophthalmology, Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore
| | - Chee Wai Wong
- Department of Ophthalmology, Singapore National Eye Centre, Singapore
| | - Quan V Hoang
- Department of Ophthalmology, Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Duke-NUS Medical School, Singapore
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Hanai K, Hashimoto M, Nakamura H. Tuberculum meningioma with recovery of glaucoma-like visual field defects after chiasmal decompression: a case report. BMC Ophthalmol 2024; 24:68. [PMID: 38355425 PMCID: PMC10868030 DOI: 10.1186/s12886-024-03332-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND To report a case of tuberculum meningioma with recovery of glaucoma-like visual field defects after chiasmal decompression. CASE PRESENTATION A 39-year-old woman presenting with headache was found to have bilateral arcuate retinal nerve fiber layer (RNFL) thinning on optical coherence tomography (OCT) with a corresponding arcuate scotomas consistent with glaucomatous change. However a suprasellar tumor compressing the anterior chiasm from below was found on magnetic resonance imaging of the brain. After resection of the mass, which was diagnosed as meningothelial meningioma by the pathological examination, the glaucoma-like visual field defects resolved despite the RNFL thinning on the OCT showing no improvement. CONCLUSIONS Chiasmal compression may mimic glaucoma and produce arcuate scotoma rather than temporal visual field loss. There is a possibility that the development of chiasmal compression somehow converted preperimetric glaucoma into a more advanced form accompanied by visual field defects and that the glaucoma reverted to the preperimetric state after chiasmal decompression.
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Affiliation(s)
- Kaori Hanai
- Department of Ophthalmology, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, 060-8570, Sapporo, Japan.
| | - Masato Hashimoto
- Department of Ophthalmology, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, 060-8570, Sapporo, Japan
| | - Hirohiko Nakamura
- Department of Neurosurgery, Nakamura Memorial Hospital, S-1, W-14, Chuo-ku, Sapporo, Japan
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He C, Peng K, Zhu X, Wang Z, Xiu W, Zhang G, Chen Y, Sun C, Xiao X, Liu D, Li A, Gao Y, Wang J, Shuai P, Chen Y, Yu L, Lu F. Th1 cells contribute to retinal ganglion cell loss in glaucoma in a VCAM-1-dependent manner. J Neuroinflammation 2024; 21:43. [PMID: 38317227 PMCID: PMC10840227 DOI: 10.1186/s12974-024-03035-5] [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: 09/14/2023] [Accepted: 01/31/2024] [Indexed: 02/07/2024] Open
Abstract
Glaucoma is a complex neurodegenerative disorder characterized by the progressive loss of retinal ganglion cells (RGC) and optic nerve axons, leading to irreversible visual impairment. Despite its clinical significance, the underlying mechanisms of glaucoma pathogenesis remain poorly understood. In this study, we aimed to unravel the multifaceted nature of glaucoma by investigating the interaction between T cells and retinas. By utilizing clinical samples, murine glaucoma models, and T cell transfer models, we made several key findings. Firstly, we observed that CD4+ T cells from glaucoma patients displayed enhanced activation and a bias towards T helper (Th) 1 responses, which correlated with visual impairment. Secondly, we identified the infiltration of Th1 cells into the retina, where they targeted RGC and integrated into the pro-inflammatory glial network, contributing to progressive RGC loss. Thirdly, we discovered that circulating Th1 cells upregulated vascular cell adhesion protein 1 (VCAM-1) on retinal microvessels, facilitating their entry into the neural retina. Lastly, we found that Th1 cells underwent functional reprogramming before reaching the retina, acquiring a phenotype associated with lymphocyte migration and neurodegenerative diseases. Our study provides novel insights into the role of peripheral CD4+ T cells in glaucoma pathogenesis, shedding light on the mechanisms underlying their infiltration into the retina and offering potential avenues for innovative therapeutic interventions in this sight-threatening disease.
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Affiliation(s)
- Chong He
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Kun Peng
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiong Zhu
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Prenatal Diagnosis, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zuo Wang
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Department of Clinical Laboratory, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wenbo Xiu
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Gao Zhang
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yang Chen
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Chaonan Sun
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiao Xiao
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Donghua Liu
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - An Li
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yanping Gao
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jinxia Wang
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Ping Shuai
- Health Management Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yilian Chen
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Ling Yu
- Department of Ophthalmology, Daping Hospital, Army Medical Center, Army Medical University, Chongqing, China
| | - Fang Lu
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
- Yangtze Delta Region Institute (Quzhou), University of Electronic Science and Technology of China, Quzhou, China.
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Kawamoto T, Ogasawara M, Murayama G, Matsuki-Muramoto Y, Hayashi E, Harada M, Kusaoi M, Matsushita M, Yamaji K, Tamura N. Transitions in vascular ultrasonography findings of temporal arteritis in a GCA case with progressive temporal headache and visual impairment. Mod Rheumatol Case Rep 2023; 8:112-116. [PMID: 37572090 DOI: 10.1093/mrcr/rxad046] [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: 04/17/2023] [Revised: 07/06/2023] [Accepted: 07/29/2023] [Indexed: 08/14/2023]
Abstract
The European League Against Rheumatism and the American College of Rheumatology have stated that the halo sign on vascular ultrasonography (v-US) is relevant in diagnosing giant cell arteritis (GCA) and is equivalent to temporal artery biopsy. However, there are only a few reports about transitions in v-US findings after glucocorticoid (GC) therapy. We report the transitions in the v-US findings in a case of GCA after GC therapy. The patient had rapidly progressive symptoms, and there were concerns about blindness. After GC therapy, we first observed improvement in headache and visual impairment symptoms within 1 week, followed by rapid improvement in laboratory findings within 2 weeks. Subsequently, there were improvements in v-US findings after more than 2 months. In conclusion, these findings showed a dissociation between improvements in clinical symptoms and v-US findings of the temporal artery. Additionally, this case suggests that regular examination of v-US findings is useful in evaluating GCA with evident vascular wall thickness before GC therapy.
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Affiliation(s)
- Toshio Kawamoto
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Michihiro Ogasawara
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Go Murayama
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yuko Matsuki-Muramoto
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Eri Hayashi
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Mariko Harada
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Makio Kusaoi
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Masakazu Matsushita
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Ken Yamaji
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
| | - Naoto Tamura
- Department of Internal Medicine and Rheumatology, Juntendo University School of Medicine, Tokyo, Japan
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Alemi H, Dehghani S, Forouzanfar K, Surico PL, Narimatsu A, Musayeva A, Sharifi S, Wang S, Dohlman TH, Yin J, Chen Y, Dana R. Insights into mustard gas keratopathy- characterizing corneal layer-specific changes in mice exposed to nitrogen mustard. Exp Eye Res 2023; 236:109657. [PMID: 37722586 DOI: 10.1016/j.exer.2023.109657] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 09/20/2023]
Abstract
Exposure to mustard agents, such as sulfur mustard (SM) and nitrogen mustard (NM), often results in ocular surface damage. This can lead to the emergence of various corneal disorders that are collectively referred to as mustard gas keratopathy (MGK). In this study, we aimed to develop a mouse model of MGK by using ocular NM exposure, and describe the subsequent structural changes analyzed across the different layers of the cornea. A 3 μL solution of 0.25 mg/mL or 5 mg/mL NM was applied to the center of the cornea via a 2-mm filter paper for 5 min. Mice were evaluated prior to and after exposure on days 1, 3, 7, 14, and 28 for 4 weeks using slit lamp examination with fluorescein staining. Anterior segment optical coherence tomography (AS-OCT) and in vivo confocal microscopy (IVCM) tracked changes in the epithelium, stroma, and endothelium of the cornea. Histologic evaluation was used to examine corneal cross-sections collected at the completion of follow-up. Following exposure, mice experienced central corneal epithelial erosion and thinning, accompanied by a decreased number of nerve branches in the subbasal plexus and increased activated keratocytes in the stroma in both dosages. The epithelium was recovered by day 3 in the low dose group, followed by exacerbated punctuate erosions alongside persistent corneal edema that arose and continued onward to four weeks post-exposure. The high dose group showed persistent epitheliopathy throughout the study. The endothelial cell density was reduced, more prominent in the high dose group, early after NM exposure, which persisted until the end of follow-up, along with increased polymegethism and pleomorphism. Microstructural changes in the central cornea at 4 weeks post-exposure included dysmorphic basal epithelial cells and reduced epithelial thickness, and in the limbal cornea included decreased cellular layers. We present a mouse model of MGK using NM that successfully replicates ocular injury caused by SM in humans who have been exposed to mustard gas.
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Affiliation(s)
- Hamid Alemi
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Shima Dehghani
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Katayoon Forouzanfar
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Pier Luigi Surico
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Akitomo Narimatsu
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Aytan Musayeva
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Sina Sharifi
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Shudan Wang
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Thomas H Dohlman
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Jia Yin
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Yihe Chen
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
| | - Reza Dana
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
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Attia R, Fitoussi R, Mairot K, Demortiere S, Stellman JP, Tilsley P, Audoin B, David T, Stolowy N. Risk factors associated with progression from papilloedema to optic atrophy: results from a cohort of 113 patients. BMJ Open Ophthalmol 2023; 8:e001375. [PMID: 37935563 PMCID: PMC10632874 DOI: 10.1136/bmjophth-2023-001375] [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: 06/27/2023] [Accepted: 10/15/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND The aim of this study was to assess the risk factors for atrophic progression of patients with papilloedema secondary to intracranial hypertension, using optical coherence tomography parameters. METHODS A retrospective study was conducted at Marseille University Hospitals' Ophthalmology departments between December 2015 and December 2021. All patients with papilloedema resulting from elevated intracranial hypertension at the initial presentation were included. Ophthalmological evaluations included analysing retinal nerve fibre layer (RNFL), ganglion cell layer (GCL) and total peripapillary retinal thickness (RT). RESULTS The study included 222 eyes from 113 patients. The main aetiologies of intracranial hypertension were idiopathic intracranial hypertension (49/113), intracranial tumours (33/113) and cerebral venous thrombosis (15/113). The initial RNFL and RT showed significant correlations with optic atrophy. The mean RNFL was 199.63 µm in the 'no atrophy' group and 365.28 µm in the 'atrophy' group (p<0.001). Similarly, the mean RT was 483.72 µm in the 'non-atrophy' group and 796.69 µm in the 'atrophy' group (p<0.001). The presence of peripapillary haemorrhages showed a strong correlated with optic atrophy with an OR=19.12 (p<0.001). Impaired initial visual acuity was also associated with final optic atrophy with an OR=7.76 (p=0.020). Furthermore, impaired initial GCL was a major predictor of optic atrophy (OR=18.25 (p=0.021)). CONCLUSION Our study highlights the risk factors for optic atrophy in papilloedema, aiming to facilitate the early detection of patients at a high risk of vision loss and enable more aggressive medical or surgical management.
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Affiliation(s)
- Ruben Attia
- Ophthalmology, Hospital Timone, Marseille, France
| | | | - Kevin Mairot
- Ophthalmology, Hospital Timone, Marseille, France
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9
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Kerschensteiner D. Losing, preserving, and restoring vision from neurodegeneration in the eye. Curr Biol 2023; 33:R1019-R1036. [PMID: 37816323 PMCID: PMC10575673 DOI: 10.1016/j.cub.2023.08.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
The retina is a part of the brain that sits at the back of the eye, looking out onto the world. The first neurons of the retina are the rod and cone photoreceptors, which convert changes in photon flux into electrical signals that are the basis of vision. Rods and cones are frequent targets of heritable neurodegenerative diseases that cause visual impairment, including blindness, in millions of people worldwide. This review summarizes the diverse genetic causes of inherited retinal degenerations (IRDs) and their convergence onto common pathogenic mechanisms of vision loss. Currently, there are few effective treatments for IRDs, but recent advances in disparate areas of biology and technology (e.g., genome editing, viral engineering, 3D organoids, optogenetics, semiconductor arrays) discussed here enable promising efforts to preserve and restore vision in IRD patients with implications for neurodegeneration in less approachable brain areas.
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Affiliation(s)
- Daniel Kerschensteiner
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Neuroscience, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, MO 63110, USA.
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10
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Zhioua Braham I, Haddar S, Boukari M, Mokrani M, Mili I, Zhioua R. Case Report: Complete tomographic resolution of focal choroidal excavation complicated with choroidal neovascularization after anti-VEGF treatment. F1000Res 2023; 12:1270. [PMID: 38515861 PMCID: PMC10955186 DOI: 10.12688/f1000research.141099.1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 03/23/2024] Open
Abstract
Purpose We report a case of focal choroidal excavation (FCE) that resolved after intravitreal injection of anti-vascular endothelial growth factor (VEGF) for choroidal neovascularization (CNV) and we describe its tomographic features. Case report A 43-year-old female presented with blurred vision and metamorphopsia in her left eye (LE) evolving for 10 years. The best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/32 in the LE. Fundus examination revealed the presence of a yellowish foveal lesion which corresponded to a conforming FCE associated to a pachychoroid on swept-source optical coherence tomography (OCT). The OCT-Angiography showed a foveal flow void in the choriocapillaris layer corresponding to the FCE area. Three years later, the patient complained of visual impairment, more metamorphopsia with a BCVA of 20/80 on her LE. The OCT showed intraretinal fluid with a foveal retinal pigment epithelium (RPE) detachment. The OCT-angiography confirmed the presence of CNV. Two months after one intravitreal bevacizumab injection, the OCT documented the complete resolution of macular edema, the regression of the CNV tissue and the restoration of a normal aspect of the fovea without any FCE. Her BCVA improved to 20/32 with resolution of the metamorphopsia. The OCT aspect remained stable during 3 years of follow-up. Conclusion CNV can develop in FCE and anti-VEGF therapy is a good option treatment. After treatment, FCE pattern can change et may completely resolve.
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Affiliation(s)
- Imène Zhioua Braham
- University of Tunis El Manar, faculty of medicine of Tunis, Tunis, Tunis, Tunisia
- Ophthalmology, Charles Nicolle University Hospital, Tunis, Tunis, Tunisia
| | - Selim Haddar
- University of Tunis El Manar, faculty of medicine of Tunis, Tunis, Tunis, Tunisia
- Ophthalmology, Charles Nicolle University Hospital, Tunis, Tunis, Tunisia
| | - Mejdi Boukari
- University of Tunis El Manar, faculty of medicine of Tunis, Tunis, Tunis, Tunisia
- Ophthalmology, Charles Nicolle University Hospital, Tunis, Tunis, Tunisia
| | - Manel Mokrani
- University of Tunis El Manar, faculty of medicine of Tunis, Tunis, Tunis, Tunisia
- Ophthalmology, Charles Nicolle University Hospital, Tunis, Tunis, Tunisia
| | - Ilhem Mili
- University of Tunis El Manar, faculty of medicine of Tunis, Tunis, Tunis, Tunisia
- Ophthalmology, Charles Nicolle University Hospital, Tunis, Tunis, Tunisia
| | - Raja Zhioua
- University of Tunis El Manar, faculty of medicine of Tunis, Tunis, Tunis, Tunisia
- Ophthalmology, Charles Nicolle University Hospital, Tunis, Tunis, Tunisia
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11
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Xu L, Xu H, Chen S, Jiang W, Afridi SK, Wang Y, Ren X, Zhao Y, Lai S, Qiu X, Alvin Huang YW, Cui Y, Yang H, Qiu W, Tang C. Inhibition of complement C3 signaling ameliorates locomotor and visual dysfunction in autoimmune inflammatory diseases. Mol Ther 2023; 31:2715-2733. [PMID: 37481702 PMCID: PMC10492028 DOI: 10.1016/j.ymthe.2023.07.017] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/29/2023] [Accepted: 07/19/2023] [Indexed: 07/24/2023] Open
Abstract
Neuromyelitis optica (NMO) is an autoimmune inflammatory disease of the central nervous system (CNS) characterized by transverse myelitis and optic neuritis. The pathogenic serum IgG antibody against the aquaporin-4 (AQP4) on astrocytes triggers the activation of the complement cascade, causing astrocyte injury, followed by oligodendrocyte injury, demyelination, and neuronal loss. Complement C3 is positioned as a central player that relays upstream initiation signals to activate downstream effectors, potentially stimulating and amplifying host immune and inflammatory responses. However, whether targeting the inhibition of C3 signaling could ameliorate tissue injury, locomotor defects, and visual impairments in NMO remains to be investigated. In this study, using the targeted C3 inhibitor CR2-Crry led to a significant decrease in complement deposition and demyelination in both slice cultures and focal intracerebral injection models. Moreover, the treatment downregulated the expression of inflammatory cytokines and improved motor dysfunction in a systemic NMO mouse model. Similarly, employing serotype 2/9 adeno-associated virus (AAV2/9) to induce permanent expression of CR2-Crry resulted in a reduction in visual dysfunction by attenuating NMO-like lesions. Our findings reveal the therapeutic value of inhibiting the complement C3 signaling pathway in NMO.
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Affiliation(s)
- Li Xu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630, China
| | - Huiming Xu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630, China
| | - Siqi Chen
- Department of Medical Retina and Neuro-Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong Province 510060, China
| | - Wei Jiang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630, China
| | - Shabbir Khan Afridi
- Faculty of Biological Sciences, School of Biomedical Sciences, University of Leeds, Leeds LS2 9JT, UK
| | - Yuge Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630, China
| | - Xin Ren
- Department of Medical Retina and Neuro-Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong Province 510060, China
| | - Yipeng Zhao
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630, China
| | - Shuiqing Lai
- Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy 19 of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong Province 510080, China
| | - Xiusheng Qiu
- Vaccine Research Institute, The Third Affiliated Hospital of Sun Yat-sen University, 600 21 Tianhe Road, Guangzhou, Guangdong Province 510630, China
| | - Yu-Wen Alvin Huang
- Department of Molecular Biology, Cell Biology, and Biochemistry, Brown University, 70 Ship 15 Street, Providence, RI 02903, USA
| | - Yaxiong Cui
- State Key Laboratory of Membrane Biology, Tsinghua-Peking Center for Life Sciences, IDG/McGovern Institute for Brain Research, Beijing Advanced Innovation Center for Structural Biology, School of Pharmaceutical Sciences, Tsinghua University, Beijing 100084, China
| | - Hui Yang
- Department of Medical Retina and Neuro-Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong Province 510060, China
| | - Wei Qiu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630, China.
| | - Changyong Tang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province 510630, China.
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12
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Nuijts MA, Stegeman I, Porro GL, Bennebroek CAM, van Seeters T, Proudlock FA, Schouten-van Meeteren AYN, Imhof SM. Diagnostic accuracy of retinal optical coherence tomography in children with a newly diagnosed brain tumour. Acta Ophthalmol 2023; 101:658-669. [PMID: 36924320 DOI: 10.1111/aos.15650] [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: 10/04/2022] [Revised: 01/15/2023] [Accepted: 02/09/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE To estimate the diagnostic accuracy of circumpapillary retinal nerve fibre layer (RNFL) thickness and macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness measurements to discriminate an abnormal visual function (i.e. abnormal age-based visual acuity and/or visual field defect) in children with a newly diagnosed brain tumour. METHODS This cross-sectional analysis of a prospective longitudinal nationwide cohort study was conducted at four hospitals in the Netherlands, including the national referral centre for paediatric oncology. Patients aged 0-18 years with a newly diagnosed brain tumour and reliable visual acuity and/or visual field examination and optical coherence tomography were included. Diagnostic accuracy was evaluated with sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). RESULTS Of 115 patients included in the study (67 [58.3%] male; median age 10.6 years [range, 0.2-17.8 years]), reliable RNFL thickness and GCL-IPL thickness measurements were available in 92 patients (80.0%) and 84 patients (73.0%), respectively. The sensitivity for detecting an abnormal visual function was 74.5% for average RNFL thickness and 41.7% for average GCL-IPL thickness at a specificity of 44.5% and 82.9%, respectively. The PPV and NPV were 33.0% and 82.6% for the average RNFL thickness and 57.1% and 82.2% for the average GCL-IPL thickness. CONCLUSION An abnormal visual function was discriminated correctly by using the average RNFL thickness in seven out of ten patients and by using the average GCL-IPL thickness in four out of ten patients. The relatively high NPVs signified that patients with normal average RNFL thickness and average GCL-IPL thickness measurements had a relative high certainty of a normal visual function.
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Affiliation(s)
- Myrthe A Nuijts
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Otorhinolaryngology and Head & Neck Surgery University, University Medical Centre Utrecht, Utrecht, The Netherlands
- Brain Centre, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Giorgio L Porro
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Carlien A M Bennebroek
- Department of Ophthalmology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Tom van Seeters
- Department of Radiology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | | | | | - Saskia M Imhof
- Department of Ophthalmology, University Medical Centre Utrecht, Utrecht, The Netherlands
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Xiang J, Wang X, Yu LL, Jin KJ, Yang YK. Objective Assessment of Visual Field Defects Caused by Optic Chiasm and Its Posterior Visual Pathway Injury. Fa Yi Xue Za Zhi 2023; 39:350-359. [PMID: 37859473 DOI: 10.12116/j.issn.1004-5619.2023.230309] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
OBJECTIVES To investigate the characteristics and objective assessment method of visual field defects caused by optic chiasm and its posterior visual pathway injury. METHODS Typical cases of visual field defects caused by injuries to the optic chiasm, optic tracts, optic radiations, and visual cortex were selected. Visual field examinations, visual evoked potential (VEP) and multifocal visual evolved potential (mfVEP) measurements, craniocerebral CT/MRI, and retinal optical coherence tomography (OCT) were performed, respectively, and the aforementioned visual electrophysiological and neuroimaging indicators were analyzed comprehensively. RESULTS The electrophysiological manifestations of visual field defects caused by optic chiasm injuries were bitemporal hemianopsia mfVEP abnormalities. The visual field defects caused by optic tract, optic radiation, and visual cortex injuries were all manifested homonymous hemianopsia mfVEP abnormalities contralateral to the lesion. Mild relative afferent pupil disorder (RAPD) and characteristic optic nerve atrophy were observed in hemianopsia patients with optic tract injuries, but not in patients with optic radiation or visual cortex injuries. Neuroimaging could provide morphological evidence of damages to the optic chiasm and its posterior visual pathway. CONCLUSIONS Visual field defects caused by optic chiasm, optic tract, optic radiation, and visual cortex injuries have their respective characteristics. The combined application of mfVEP and static visual field measurements, in combination with neuroimaging, can maximize the assessment of the location and degree of visual pathway damage, providing an effective scheme for the identification of such injuries.
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Affiliation(s)
- Jian Xiang
- Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing 100088, China
- Center of Cooperative Innovation for Judicial Civilization, Beijing 100088, China
| | - Xu Wang
- Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing 100088, China
- Center of Cooperative Innovation for Judicial Civilization, Beijing 100088, China
| | - Li-Li Yu
- Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing 100088, China
| | - Kang-Jia Jin
- Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing 100088, China
| | - Ying-Kai Yang
- Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing 100088, China
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14
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Kuht HJ, Thomas MG, McLean RJ, Sheth V, Proudlock FA, Gottlob I. Abnormal foveal morphology in carriers of oculocutaneous albinism. Br J Ophthalmol 2023; 107:1202-1208. [PMID: 35379600 PMCID: PMC10359511 DOI: 10.1136/bjophthalmol-2020-318192] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/18/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND/AIMS To investigate the foveal morphology in carriers of oculocutaneous albinism (OCA) using spectral domain optical coherence tomography (SD-OCT). A cross-sectional, observational study. METHODS Handheld SD-OCT (Envisu C2300) was used to acquire horizontal scans through the centre of the fovea in biological parents of patients with OCA (n=28; mean age±SD=40.43±8.07 years) and age-matched and ethnicity-matched controls (n=28; mean age±SD=38.04±10.27 years). Sequence analysis was performed for variants in known genes associated with OCA. Best-corrected visual acuity (BCVA), presence of foveal hypoplasia and grade, foveal, parafoveal and perifoveal thickness measurements of total retinal layers (TRL), inner retinal layers (IRL) and outer retinal layers (ORL) thickness were measured. RESULTS Foveal hypoplasia was identified in 32.14% of OCA carriers; grade 1 in all cases. OCA carriers demonstrated significant thicker TRL thickness (median difference: 13.46 µm, p=0.009) and IRL thickness (mean difference: 8.98 µm, p<0.001) at the central fovea compared with controls. BCVA of carriers was between -0.16 and 0.18 logMAR (mean: 0.0 logMAR). No significant differences in BCVA was noted between OCA carriers or controls (p=0.83). In the OCA carriers, we identified previously reported pathogenic variants in TYR, OCA2 and SLC45A2, novel OCA2 variants (n=3) and heterozygosity of the pathogenic TYR haplotype. CONCLUSION We have, for the first time, identified foveal abnormalities in OCA carriers. This provides clinical value, particularly in cases where limited phenotype data are available. Our findings raise the possibility that previously reported mild cases of foveal hypoplasia or isolated foveal hypoplasia could correspond to OCA carrier status.
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Affiliation(s)
- Helen J Kuht
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Mervyn G Thomas
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Rebecca J McLean
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Viral Sheth
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Frank A Proudlock
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Irene Gottlob
- Ulverscroft Eye Unit, Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
- Cooper Medical School of Rowan University, Cooper Neurological Institute, Camden, New Jersey, USA
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15
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Chuangsuwanich T, Tun TA, Braeu FA, Yeoh CHY, Chong RS, Wang X, Aung T, Hoang QV, Girard MJA. How Myopia and Glaucoma Influence the Biomechanical Susceptibility of the Optic Nerve Head. Invest Ophthalmol Vis Sci 2023; 64:12. [PMID: 37552032 PMCID: PMC10411647 DOI: 10.1167/iovs.64.11.12] [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: 04/06/2023] [Accepted: 07/06/2023] [Indexed: 08/09/2023] Open
Abstract
PURPOSE The purpose of this study was to assess optic nerve head (ONH) deformations following acute intraocular pressure (IOP) elevations and horizontal eye movements in control eyes, highly myopic (HM) eyes, HM eyes with glaucoma (HMG), and eyes with pathologic myopia (PM) alone or PM with staphyloma (PM + S). METHODS We studied 282 eyes, comprising of 99 controls (between +2.75 and -2.75 diopters), 51 HM (< -5 diopters), 35 HMG, 21 PM, and 75 PM + S eyes. For each eye, we imaged the ONH using spectral-domain optical coherence tomography (OCT) under the following conditions: (1) primary gaze, (2) 20 degrees adduction, (3) 20 degrees abduction, and (4) primary gaze with acute IOP elevation (to ∼35 mm Hg) achieved through ophthalmodynamometry. We then computed IOP- and gaze-induced ONH displacements and effective strains. Effective strains were compared across groups. RESULTS Under IOP elevation, we found that HM eyes exhibited significantly lower strains (3.9 ± 2.4%) than PM eyes (6.9 ± 5.0%, P < 0.001), HMG eyes (4.7 ± 1.8%, P = 0.04), and PM + S eyes (7.0 ± 5.2%, P < 0.001). Under adduction, we found that HM eyes exhibited significantly lower strains (4.8% ± 2.7%) than PM + S eyes (6.0 ± 3.1%, P = 0.02). We also found that eyes with higher axial length were associated with higher strains. CONCLUSIONS Our study revealed that eyes with HMG experienced significantly greater strains under IOP compared to eyes with HM. Furthermore, eyes with PM + S had the highest strains on the ONH of all groups.
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Affiliation(s)
- Thanadet Chuangsuwanich
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Tin A. Tun
- Eye-ACP, Duke-NUS Medical School, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Fabian A. Braeu
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Clarice H. Y. Yeoh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Rachel S. Chong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Xiaofei Wang
- Laboratory for Biomechanics and Mechanobiology of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, School of Engineering Medicine, Beihang University, Beijing, China
| | - Tin Aung
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Eye-ACP, Duke-NUS Medical School, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Quan V. Hoang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Eye-ACP, Duke-NUS Medical School, Singapore, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Columbia University, New York, New York, United States
| | - Michaël J. A. Girard
- Ophthalmic Engineering & Innovation Laboratory, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Eye-ACP, Duke-NUS Medical School, Singapore, Singapore
- Institute for Molecular and Clinical Ophthalmology, Basel, Switzerland
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Gilissen SRJ, Hennes M, Arckens L. Analysis of Immediate Early Gene Expression Levels to Interrogate Changes in Cortical Neuronal Activity Patterns upon Vision Loss. Methods Mol Biol 2023; 2636:55-70. [PMID: 36881295 DOI: 10.1007/978-1-0716-3012-9_4] [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: 03/08/2023]
Abstract
Mapping immediate early gene (IEG) expression levels to characterize changes in neuronal activity patterns has become a golden standard in neuroscience research. Due to straightforward detection methods such as in situ hybridization and immunohistochemistry, changes in IEG expression can be easily visualized across brain regions and in response to physiological and pathological stimulation. Based on in-house experience and existing literature, zif268 represents itself as the IEG of choice to investigate the neuronal activity dynamics induced by sensory deprivation. In the monocular enucleation mouse model of partial vision loss, zif268 in situ hybridization can be implemented to study cross-modal plasticity by charting the initial decline and subsequent rise in neuronal activity in visual cortical territory deprived of direct retinal visual input. Here, we describe a protocol for high-throughput radioactive zif268 in situ hybridization as a readout for cortical neuronal activity dynamics in response to partial vision loss in mice.
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Affiliation(s)
- Sara R J Gilissen
- Department of Biology & Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Maroussia Hennes
- Department of Biology & Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Lutgarde Arckens
- Department of Biology & Leuven Brain Institute, KU Leuven, Leuven, Belgium.
- Laboratory of Neuroplasticity and Neuroproteomics, Katholieke Universiteit Leuven, Leuven, Belgium.
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17
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Wang XB, Tang H, Cheng YJ, Shang HB, Ma JG, Xu Z, He C, Wu Z. [Clinical observation of microsurgical removal of the hemilateral tuberculum sellae meningiomas through contralateral eyebrow arch approach]. Zhonghua Yi Xue Za Zhi 2022; 102:2630-2633. [PMID: 36058690 DOI: 10.3760/cma.j.cn112137-20220208-00261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The current study aimed to investigate the clinical feasibility of microscopic resection of hemilateral tuberculum sellae meningiomas (TSM) via the contralateral eye brow arch approach. The clinical data of 34 patients with TSM who underwent microsurgery from January 2016 to June 2021 in the Neurosurgery Department of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine and the First Affiliated Hospital of Henan University were collected and reviewed. The postoperative visual acuity improvement rate was 88.5% (23/26), and the total tumor resection rate was 88.2% (30/34); the postoperative visual acuity improvement in patients with total tumor resection was better than that of patients with partial resection [90.9% (20/22) vs 3/4]. Meanwhile, the postoperative visual acuity improvement in patients with the superior optic nerve and laterl-superior optic nerve was better than that of patients with the lateral optic nerve type (12/14, 8/8 vs 3/4). Supraorbital skin numbness occurred in 3 cases after operation, and the symptoms disappeared during follow-up; 2 cases had mild disturbance of hormone level, and urine output of 2 cases increased after operation, which returned to normal level after symptomatic treatment; 1 case had subcutaneous effusion which was absorbed after treatment. There were no complications such as olfactory disturbance and intracranial infection. During follow-up for 3-60 (33±6) months, recurrence occurred in 2 cases and reoperation was performed. For the hemilateral TSM, according to the preoperative evaluation of the origin of the TSM and the side with visual impairment, the contralateral eyebrow approach is selected to fully expose the tumor base below the optic nerve. It is beneficial to fully resect the tumor under direct vision, and the symptoms of postoperative visual impairment are significantly improved, indicating that the current surgical method can be used in the clinical setting.
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Affiliation(s)
- X B Wang
- Department of Neurosurgery, the First Affiliated Hospital of Henan University, Kaifeng 475000, China
| | - H Tang
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Y J Cheng
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - H B Shang
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - J G Ma
- Department of Neurosurgery, the First Affiliated Hospital of Henan University, Kaifeng 475000, China
| | - Z Xu
- Department of Neurosurgery, the First Affiliated Hospital of Henan University, Kaifeng 475000, China
| | - C He
- Department of Neurosurgery, the First Affiliated Hospital of Henan University, Kaifeng 475000, China
| | - Zhebao Wu
- Department of Neurosurgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
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Campagna GA, Chew L, Pettenkofer M, Nicoletti E, Schwartz JD, Choi G, Fernandes AO, Terrazas D, Kohn DB, Tsui I. Findings on Optical Coherence Tomography in Malignant Infantile Osteopetrosis. Ophthalmic Surg Lasers Imaging Retina 2022; 53:398-402. [PMID: 35858232 DOI: 10.3928/23258160-20220613-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Malignant infantile osteopetrosis is a rare inherited disorder with neurological complications and a shortened life expectancy. Vision loss is typically attributed to osseous compression of the optic nerves at the level of the optic canal. Fundus imaging is reported, as well as the first optical coherence tomography and optical coherence tomography angiography in this rare condition. Imaging revealed optic nerve pallor, subfoveal ellipsoid zone disruption, and an enlarged foveal avascular zone. These results provide insight regarding other potential mechanisms of vision loss in these patients. [Ophthalmic Surg Lasers Imaging Retina 2022; 53:398-402.].
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Lin F, Chen S, Song Y, Li F, Wang W, Zhao Z, Gao X, Wang P, Jin L, Liu Y, Chen M, Liang X, Yang B, Ning G, Cheng CY, Healey PR, Park KH, Zangwill LM, Aung T, Ohno-Matsui K, Jonas JB, Weinreb RN, Zhang X. Classification of Visual Field Abnormalities in Highly Myopic Eyes without Pathologic Change. Ophthalmology 2022; 129:803-812. [PMID: 35288144 PMCID: PMC10866199 DOI: 10.1016/j.ophtha.2022.03.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 11/08/2021] [Revised: 03/01/2022] [Accepted: 03/07/2022] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To develop a classification system of visual field (VF) abnormalities in highly myopic eyes with and without glaucoma. DESIGN Secondary analysis of VF data from a longitudinal cohort study. PARTICIPANTS One thousand eight hundred ninety-three VF tests from 1302 eyes (825 individuals). METHODS All participants underwent VF testing (Humphrey 24-2 Swedish interactive threshold algorithm standard program; Carl Zeiss Meditec) and detailed ophthalmic examination. A comprehensive set of VF defect patterns was defined via observation of the 1893 VF reports, literature review, and consensus meetings. The classification system comprised 4 major types of VF patterns, including normal type, glaucoma-like defects (paracentral defect, nasal step, partial arcuate defect, arcuate defect), high myopia-related defects (enlarged blind spot, vertical step, partial peripheral rim, nonspecific defect), and combined defects (nasal step with enlarged blind spot). A subset (n = 1000) of the VFs was used to evaluate the interobserver and intraobserver agreement and weighted κ values of the classification system by 2 trained readers. The prevalence of various VF patterns and their associated factors were determined. MAIN OUTCOME MEASURES The classification of VF in highly myopic eyes and its associated risk factors. RESULTS We found that normal type, glaucoma-like defects, high myopia-related defects, and combined defects accounted for 74.1%, 10.8%, 15.0%, and 0.1% of all unique VF tests, respectively. The interobserver and intraobserver agreements were > 89%, and the corresponding κ values were 0.86 or more between readers. Both glaucoma-like and high myopia-related VF defects were associated with older age (odds ratios [ORs], 1.07 [95% confidence interval (CI), 1.04-1.10; P < 0.001] and 1.06 [95% CI, 1.04-1.10; P < 0.001]) and longer axial length (ORs, 1.65 [95% CI, 1.32-2.07; P < 0.001] and 1.37 [95% CI, 1.11-1.68; P = 0.003]). Longer axial length showed a stronger effect on the prevalence of glaucoma-like VF defects than on the prevalence of high myopia-related VF defects (P = 0.036). CONCLUSIONS We propose a new and reproducible classification system of VF abnormalities for nonpathologic high myopia. Applying a comprehensive classification system will facilitate communication and comparison of findings among studies.
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Affiliation(s)
- Fengbin Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Shida Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yunhe Song
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Zhenni Zhao
- Department of Pediatric Ophthalmology, Guangzhou Children's Hospital and Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xinbo Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Peiyuan Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Yuhong Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Meiling Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Xiaohong Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China
| | - Bin Yang
- Department of Ophthalmology, Zigong Third People's Hospital, Zigong, China
| | - Guili Ning
- Department of Ophthalmology, Guizhou Aerospace Hospital, Zunyi, China
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore; Ophthalmology & Visual Sciences Academic Clinical Program (Eye ACP), Duke-NUS Medical School, Singapore, Republic of Singapore
| | - Paul R Healey
- Centre for Vision Research & Westmead Clinical School, University of Sydney, Sydney, Australia
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA
| | - Tin Aung
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Republic of Singapore
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany; Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland.
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, CA.
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
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Lee DC, Lee SY, Jun JH. Alterations of lower- and higher-order aberrations after unilateral horizontal rectus muscle surgery in children with intermittent exotropia: A retrospective cross-sectional study. PLoS One 2022; 17:e0264037. [PMID: 35176076 PMCID: PMC8853472 DOI: 10.1371/journal.pone.0264037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 02/01/2022] [Indexed: 12/04/2022] Open
Abstract
Background This retrospective, cross-sectional study investigated changes in corneal lower- and higher-order aberrations that cause visual disturbance after lateral rectus recession and medial rectus resection in children. Methods Eighty-five eyes of 85 patients (44 boys; 8.64±2.88 years) who underwent lateral rectus recession and medial rectus resection to correct intermittent exotropia were assessed. The Galilei G4 Dual Scheimpflug Analyzer was used for wavefront analysis. Risk factors (age, sex, amount of surgery, preoperative axial length, preoperative intraocular pressure) were determined. Outcome measures included simulated and ray-tracing mode keratometry with secondary defocus, oblique, and vertical astigmatism (for lower-order aberrations) and the root mean square, 3rd-order vertical and horizontal coma, oblique and horizontal trefoil, 4th-order spherical aberration, oblique and vertical secondary astigmatism, and oblique and vertical quadrafoil (2nd‒8th sums) (for higher-order aberrations). Results Myopic with-the-rule changes in low-order aberrations and increases in simulated and ray-tracing mode keratometry during the 3 months following lateral rectus recession and medial rectus resection were attributed to muscle healing and stability changes. High-order aberrations altered in the week following surgery almost returned to normal within 3 months. Axial length, the amount of surgery, age, and sex affected astigmatism due to differences in patients’ scleral states. Conclusions Clinicians should consider changes in high-order aberrations of young individuals who underwent lateral rectus recession and medial rectus resection and may not be able to verbalize changes in vision.
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Affiliation(s)
- Dong Cheol Lee
- Department of Ophthalmology, School of Medicine, Keimyung University, Daegu, Korea
| | - Se Youp Lee
- Department of Ophthalmology, School of Medicine, Keimyung University, Daegu, Korea
| | - Jong Hwa Jun
- Department of Ophthalmology, School of Medicine, Keimyung University, Daegu, Korea
- * E-mail:
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Li X, Qin J, Cao X, Ren Z, Cui T, Bao Y. The different structure-function correlation as measured by OCT and octopus perimetry cluster analysis in intracranial tumor and glaucoma patients. Front Endocrinol (Lausanne) 2022; 13:938952. [PMID: 35966105 PMCID: PMC9363760 DOI: 10.3389/fendo.2022.938952] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND To explore the correlation between visual field (VF) defect values and retinal nerve fiber layer (RNFL) thickness for intracranial tumor and glaucoma patients. METHODS Retrospective analysis is performed for the intracranial and glaucoma patients, whose VF defect values were measured with Octopus perimeter cluster analysis, RNFL thickness, ganglion cell layer (GCL) thickness, and optic disk parameters measured with swept-source OCT. The differences between VF and RNFL (including the data of optic disc) are calculated. The correlation between VF defect values and RNFL and GCL thickness are explored. RESULTS In total 43 eyes of 29 patients with intracranial tumor and 31 eyes of 19 patients with glaucoma were enrolled. The thickness of RNFL not only for the whole (360°), but also for the four quadrants was thinner in the glaucoma group than those of the intracranial tumor group (p<0.05), and similar to the thickness of GCL without significance (p>). There is no significant difference in VF for those two groups except glaucoma having lower sLV (p<0.05). A stronger correlation for mean deviations (MD)s of VF ten clusters and RNFL thickness of OCT twelve sectors is found in the glaucoma patients, but few in the intracranial tumor patients. Logistic regression also shows the loss of RNFL or increasing of vertical CDR and cup volume tending to the diagnosis of glaucoma and the irregular VF damage is inclined to the diagnosis of intracranial tumor. CONCLUSIONS Intracranial tumor has a weak correlation between the RNFL thickness and Octopus VF MD, compared with that of glaucoma. OCT and Octopus VF might provide more helpful information for the differential diagnosis of intracranial tumor and glaucoma.
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Affiliation(s)
- Xiaochun Li
- Department of Ophthalmology, Peking University People’s Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology, Peking University International Hospital, Beijing, China
| | - Jiayin Qin
- Department of Ophthalmology, Peking University People’s Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology, Peking University International Hospital, Beijing, China
| | - Xiaoguang Cao
- Department of Ophthalmology, Peking University People’s Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Zeqin Ren
- Department of Ophthalmology, Peking University People’s Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
| | - Ting Cui
- Department of Ophthalmology, Peking University International Hospital, Beijing, China
| | - Yongzhen Bao
- Department of Ophthalmology, Peking University People’s Hospital, Eye Diseases and Optometry Institute, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, College of Optometry, Peking University Health Science Center, Beijing, China
- *Correspondence: Yongzhen Bao,
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Ye J, Liu W, Hu X, Jiang H, Xu M, Jin H, Wang M, Liu Z, Chen Q, Wu W, Tu Y. Elevated pulse pressure correlated with reduced retinal peripapillary capillary in thyroid-associated ophthalmology with visual field defect. Front Endocrinol (Lausanne) 2022; 13:941051. [PMID: 36187091 PMCID: PMC9523314 DOI: 10.3389/fendo.2022.941051] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To quantify the retinal vessel density in thyroid-associated ophthalmology (TAO) patients with visual field (VF) defect and examine its associations with mechanical and system vascular risk factors for underlying pathogenesis of VF defect in TAO. METHODS The cohort was composed of 62 TAO eyes (39 with VF defect and 23 without VF defect). The pulse pressure (PP), intraocular pressure (IOP), ophthalmic rectus muscular index (MI), superficial retinal capillary plexus (SRCP), radial peripapillary capillary (RPC) density, and other related parameters were measured. The associations among these factors and VF mean deviation (MD) were analyzed. RESULTS In TAO patients with VF defect, reduced RPC density, higher PP, and larger horizontal and vertical MI were found (all P < 0.03) when compared to TAO patients without VF defect. The RPC density was correlated with VF MD value (r = 0.242, P = 0.029), while SRCP density was not (P = 0.419). In univariable general estimating equation (GEE) analysis with RPC density as the outcome, PP and its fluctuation showed a significant association (both P < 0.04). In the final RPC model with multivariable GEE analysis, only PP (β = -0.082, P = 0.029) showed significance while PP fluctuation (P = 0.080) did not. CONCLUSIONS The elevated PP was correlated with reduced retinal peripapillary perfusion in TAO resulting in VF defect. These data suggested that the system vascular factor may be important in the pathogenesis of reduced retinal perfusion resulting in visual impairment in TAO.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Wencan Wu
- *Correspondence: Yunhai Tu, ; Wencan Wu,
| | - Yunhai Tu
- *Correspondence: Yunhai Tu, ; Wencan Wu,
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Abdelhalim I, Hamdy O, Hassan AA, Elnaby SH. Nd:YAG fourth harmonic (266-nm) generation for corneal reshaping procedure: An ex-vivo experimental study. PLoS One 2021; 16:e0260494. [PMID: 34843558 PMCID: PMC8629266 DOI: 10.1371/journal.pone.0260494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/10/2021] [Indexed: 11/18/2022] Open
Abstract
Corneal reshaping is a common medical procedure utilized for the correction of different vision disorders relying on the ablation effect of the UV pulsed lasers, especially excimer lasers (ArF) at 193 nm. This wavelength is preferred in such medical procedures since laser radiation at 193 nm exhibits an optimum absorption by corneal tissue. However, it is also significantly absorbed by the water content of the cornea resulting in an unpredictability in the clinical results, as well as the high service and operation cost of the commercial ArF excimer laser device. Consequently, other types of solid-state UV pulsed lasers have been introduced. The present work investigates the ablation effect of solid-state laser at 266 nm in order to be utilized in corneal reshaping procedures. Different number of pulses has been applied to Polymethyl Methacrylate (PMMA) and ex-vivo rabbit cornea to evaluate the ablation effect of the produced laser radiation. PMMA target experienced ellipse-like ablated areas with a conical shape in the depth. The results revealed an almost constant ablation area regardless the number of laser pulses, which indicates the stability of the produced laser beam, whereas the ablation depth increases only with increasing the number of laser pulses. Examination of the ex-vivo cornea showed a significant tissue undulation, minimal thermal damage, and relatively smooth ablation surfaces. Accordingly, the obtained 266-nm laser specifications provide promising alternative to the traditional 193-nm excimer laser in corneal reshaping procedure.
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Affiliation(s)
- Ibrahim Abdelhalim
- Engineering Applications of Lasers Dept., National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
| | - Omnia Hamdy
- Engineering Applications of Lasers Dept., National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
| | - Aziza Ahmed Hassan
- Medical Applications of Lasers Dept., National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
| | - Salah Hassab Elnaby
- Engineering Applications of Lasers Dept., National Institute of Laser Enhanced Sciences, Cairo University, Giza, Egypt
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Kim BH, Kim DI, Bae KW, Park UC. Influence of postoperative ectopic inner foveal layer on visual function after removal of idiopathic epiretinal membrane. PLoS One 2021; 16:e0259388. [PMID: 34735519 PMCID: PMC8568108 DOI: 10.1371/journal.pone.0259388] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/18/2021] [Indexed: 11/22/2022] Open
Abstract
Purpose To investigate the functional and anatomical parameters and their postoperative changes according to the ectopic inner foveal layer (EIFL) staging scheme for idiopathic epiretinal membrane (ERM). Methods In this prospective study, patients with idiopathic ERM underwent pars plana vitrectomy and ERM removal, and were followed-up for 6 months. The associations of EIFL with pre- and postoperative functional and anatomical parameters were analyzed. Results A total of 84 eyes (84 patients) were included: 39 (46.4%), 33 (39.3%), and 12 (14.3%) as EIFL stages 2, 3, and 4, respectively. At 6 months after surgery, the mean best-corrected visual acuity (BCVA) significantly improved in all EIFL stages (P ≤ 0.003); however, metamorphopsia improved only in eyes with EIFL stage 2 (P = 0.039) and 3 (P = 0.011). The aniseikonia and foveal avascular zone (FAZ) area showed no significant postoperative changes in any of the EIFL stages. Both preoperatively and during 6 months after surgery, the EIFL stage showed a significant correlation with BCVA (P ≤ 0.033), metamorphopsia (P ≤ 0.008), central macular thickness (P < 0.001), and FAZ parameters (P ≤ 0.016) at each time point, but not with aniseikonia. Significant correlations of EIFL thickness with BCVA (P = 0.028) and metamorphopsia (P = 0.006) before surgery were not persistent after surgery. Conclusion Both pre- and postoperatively, the staging of EIFL, rather than its thickness, is a simple and adequate surrogate marker for visual acuity and metamorphopsia in eyes with idiopathic ERM.
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Affiliation(s)
- Bo Hee Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Dong Ik Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Ki Woong Bae
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
| | - Un Chul Park
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
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Yamada H, Imai H, Tetsumoto A, Hayashida M, Otsuka K, Miki A, Nakamura M. The contribution of the proximity of the retinal detachment to the fovea for postoperative metamorphopsia after 27-gauge pars plana vitrectomy for the primary rhegmatogenous retinal detachment. PLoS One 2021; 16:e0258775. [PMID: 34710146 PMCID: PMC8553140 DOI: 10.1371/journal.pone.0258775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 10/05/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose To investigate clinical factors contributing to metamorphopsia after 27-gauge pars plana vitrectomy (27GPPV) for primary rhegmatogenous retinal detachment (RRD) to reveal whether the proximity of the preoperative retinal detachment to the fovea is associated with postoperative metamorphopsia. Methods We retrospectively reviewed medical records of 77 eyes of 77 patients after 27GPPV for RRD. Patients were subdivided into three groups using optical coherence tomography findings: Group A, patients with RRD outside the vascular arcade; Group B, patients whose condition was present within the vascular arcade, but without foveal detachment; and Group C, patients with foveal detachment. Results The average metamorphopsia score (°) assessed with M-charts 12 months after surgery was 0.01 ± 0.04 in Group A (24 eyes), 0.08 ± 0.18 in Group B (20 eyes), and 0.49 ± 0.48 in Group C (33 eyes) (p<0.001). Logistic regression analysis revealed that metamorphopsia at 12 months after surgery significantly correlated with the proximity of the retinal detachment to the fovea (p = 0.007). Conclusion Metamorphopsia after 27GPPV for RRD correlated with the proximity of the preoperative retinal detachment to the fovea. Attention should be paid to the possibility of postoperative metamorphopsia development when retinal detachment is present within a vascular arcade even if the fovea is not involved.
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Affiliation(s)
- Hiroko Yamada
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hisanori Imai
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
- * E-mail:
| | - Akira Tetsumoto
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mayuka Hayashida
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Keiko Otsuka
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Akiko Miki
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Makoto Nakamura
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
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Venturini G, Kokona D, Steiner BL, Bulla EG, Jovanovic J, Zinkernagel MS, Escher P. In vivo analysis of onset and progression of retinal degeneration in the Nr2e3 rd7/rd7 mouse model of enhanced S-cone sensitivity syndrome. Sci Rep 2021; 11:19032. [PMID: 34561487 PMCID: PMC8463594 DOI: 10.1038/s41598-021-98271-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 09/06/2021] [Indexed: 12/02/2022] Open
Abstract
The photoreceptor-specific nuclear receptor Nr2e3 is not expressed in Nr2e3rd7/rd7 mice, a mouse model of the recessively inherited retinal degeneration enhanced S-cone sensitivity syndrome (ESCS). We characterized in detail C57BL/6J Nr2e3rd7/rd7 mice in vivo by fundus photography, optical coherence tomography and fluorescein angiography and, post mortem, by histology and immunohistochemistry. White retinal spots and so-called 'rosettes' first appear at postnatal day (P) 12 in the dorsal retina and reach maximal expansion at P21. The highest density in 'rosettes' is observed within a region located between 100 and 350 µM from the optic nerve head. 'Rosettes' disappear between 9 to 12 months. Non-apoptotic cell death markers are detected during the slow photoreceptor degeneration, at a rate of an approximately 3% reduction of outer nuclear layer thickness per month, as observed from 7 to 31 months of age. In vivo analysis of Nr2e3rd7/rd7 Cx3cr1gfp/+ retinas identified microglial cells within 'rosettes' from P21 on. Subretinal macrophages were observed in vivo and by confocal microscopy earliest in 12-months-old Nr2e3rd7/rd7 retinas. At P21, S-opsin expression and the number of S-opsin expressing dorsal cones was increased. The dorso-ventral M-cone gradient was present in Nr2e3rd7/rd7 retinas, but M-opsin expression and M-opsin expressing cones were decreased. Retinal vasculature was normal.
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Affiliation(s)
- Giulia Venturini
- Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Despina Kokona
- Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Beatrice L Steiner
- Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Emanuele G Bulla
- Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Joel Jovanovic
- Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Martin S Zinkernagel
- Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland
- Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - Pascal Escher
- Department of Ophthalmology, Inselspital, Bern University Hospital, Bern, Switzerland.
- Department of BioMedical Research, University of Bern, Bern, Switzerland.
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Bartalena L, Kahaly GJ, Baldeschi L, Dayan CM, Eckstein A, Marcocci C, Marinò M, Vaidya B, Wiersinga WM. The 2021 European Group on Graves' orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves' orbitopathy. Eur J Endocrinol 2021; 185:G43-G67. [PMID: 34297684 DOI: 10.1530/eje-21-0479] [Citation(s) in RCA: 312] [Impact Index Per Article: 104.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/23/2021] [Indexed: 11/08/2022]
Abstract
Graves' orbitopathy (GO) is the main extrathyroidal manifestation of Graves' disease (GD). Choice of treatment should be based on the assessment of clinical activity and severity of GO. Early referral to specialized centers is fundamental for most patients with GO. Risk factors include smoking, thyroid dysfunction, high serum level of thyrotropin receptor antibodies, radioactive iodine (RAI) treatment, and hypercholesterolemia. In mild and active GO, control of risk factors, local treatments, and selenium (selenium-deficient areas) are usually sufficient; if RAI treatment is selected to manage GD, low-dose oral prednisone prophylaxis is needed, especially if risk factors coexist. For both active moderate-to-severe and sight-threatening GO, antithyroid drugs are preferred when managing Graves' hyperthyroidism. In moderate-to-severe and active GO i.v. glucocorticoids are more effective and better tolerated than oral glucocorticoids. Based on current evidence and efficacy/safety profile, costs and reimbursement, drug availability, long-term effectiveness, and patient choice after extensive counseling, a combination of i.v. methylprednisolone and mycophenolate sodium is recommended as first-line treatment. A cumulative dose of 4.5 g of i.v. methylprednisolone in 12 weekly infusions is the optimal regimen. Alternatively, higher cumulative doses not exceeding 8 g can be used as monotherapy in most severe cases and constant/inconstant diplopia. Second-line treatments for moderate-to-severe and active GO include (a) the second course of i.v. methylprednisolone (7.5 g) subsequent to careful ophthalmic and biochemical evaluation, (b) oral prednisone/prednisolone combined with either cyclosporine or azathioprine; (c) orbital radiotherapy combined with oral or i.v. glucocorticoids, (d) teprotumumab; (e) rituximab and (f) tocilizumab. Sight-threatening GO is treated with several high single doses of i.v. methylprednisolone per week and, if unresponsive, with urgent orbital decompression. Rehabilitative surgery (orbital decompression, squint, and eyelid surgery) is indicated for inactive residual GO manifestations.
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Affiliation(s)
- L Bartalena
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - G J Kahaly
- Department of Medicine I, Johannes Gutenberg-University (JGU) Medical Center, Mainz, Germany
| | - L Baldeschi
- Department of Ophthalmology, Cliniques Universitaires Saint Luc, Catholic University of Louvain, Brussels, Belgium
| | - C M Dayan
- Thyroid Research Group, Cardiff University School of Medicine, Cardiff, UK
| | - A Eckstein
- Clinic for Ophthalmology, University Clinic, Essen, Germany
| | - C Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Marinò
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - B Vaidya
- Department of Endocrinology, Royal Devon & Exeter Hospital and University of Exeter Medical School, Exeter, UK
| | - W M Wiersinga
- Amsterdam University Medical Center, Amsterdam, the Netherlands
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Robertson AO, Tadić V, Rahi JS. This is me: A qualitative investigation of young people's experience of growing up with visual impairment. PLoS One 2021; 16:e0254009. [PMID: 34234377 PMCID: PMC8263264 DOI: 10.1371/journal.pone.0254009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 06/17/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Childhood visual impairment (VI) has a profound impact on many aspects of childhood and adolescence. This is well-documented in cross-sectional and/or quantitative studies utilizing self-report instruments which compare children with and without VI. Young people's views on the experience of growing up with VI as a developmental, change-driven process remain largely unexplored. METHODS As part of our broader research programme on quality of life of visually impaired children and young people in the United Kingdom, in-depth, semi-structured interviews were conducted between March and June 2015, with a stratified sample of 17 young people with VI, aged 16-19 years. An age-sensitive, empirically-based topic guide encouraged retrospective reflections on participants' experiences of growing up with VI, including age-normative and vision-specific challenges. RESULTS Descriptions of growing up with VI largely centered on an overarching higher-order theme labelled becoming me. Four themes representing everyday activities, attitudes, preferences and perceptions in relation to i) social relationships, ii) independence and responsibilities, iii) the future, and iv) rising to challenges emerged and were used by participants in their description of three stages in which they developed a sense of self: i) laying the foundations, ii) testing the waters, and iii) this is me. Differences in manifestation of VI influenced how young people made sense of their experiences and their sense of self. CONCLUSIONS Findings are discussed in relation to normative and vision-specific changes in psychosocial development during adolescence, including the development of identity. They highlight the need for ongoing monitoring of subjective well-being in a clinical population with a unique early life course trajectory.
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Affiliation(s)
- Alexandra O. Robertson
- Population, Policy and Practice Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Valerija Tadić
- Population, Policy and Practice Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Jugnoo S. Rahi
- Population, Policy and Practice Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
- Ulverscroft Vision Research Group, London, United Kingdom
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Tilahun MM, Yibekal BT, Kerebih H, Ayele FA. Prevalence of common mental disorders and associated factors among adults with Glaucoma attending University of Gondar comprehensive specialized hospital tertiary eye care and training center, Northwest, Ethiopia 2020. PLoS One 2021; 16:e0252064. [PMID: 34015012 PMCID: PMC8136648 DOI: 10.1371/journal.pone.0252064] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/07/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study aimed to assess the prevalence of common mental disorders and associated factors among adults with glaucoma at Gondar university comprehensive specialized hospital tertiary eye care and training center. Glaucoma predisposes patients to common mental problems and leads to wasteful, costly and inefficient use of medical services and complications of the diagnoses. So, determining the level and factors associated with common mental disorders among glaucoma patient would help to improve and integrate comprehensive ophthalmic services which address common mental disorder in a follow-up visit. METHODS An institution-based cross-sectional study was conducted on 495 glaucoma patients selected by using systematic random sampling. Data were collected through face-to-face interview and chart review. Self-reported questionnaire (SRQ-20) was used to assess the presence of common mental disorders. Binary logistic regression analysis was done to identify factors associated with common mental disorders. Variables with P<0.05 were considered as factors significantly associated with common mental disorders. RESULT Four hundred sixty-eight patients were included in this study with a response rate of 94.54%. The mean age of the participant was 58 ± 14.11 years. The prevalence of common mental disorders was found to be 29.5% (95% CI 25.4-33.3). Female sex (AOR = 3.79, 95% CI: 1.66-8.62) (p-value = 0.001), average monthly income of less than 1200 birr (AOR = 6.05 95% CI: 2.26-16.22) (p-value = 0.001), poor level of social support (AOR = 17.39 95% CI: 7.79-38.82) (p-value = 0.001), moderate and high risk of alcohol use (AOR = 10.42 95%CI: 2.74-39.54) (p-value = 0.001), presence of chronic medical illness (AOR = 3.85 95% CI: 2.07-7.16) (p-value = 0.001), receiving both drug and surgical treatment (AOR = 2.50, 95%CI: 1.30-4.83) (p-value = 0.006) and presence of systemic carbonic anhydrase inhibitors use (AOR = 3.16, 95%CI: 1.65-6.06) (p-value = 0.001) were significantly associated with increased level of common mental disorders. CONCLUSION Significant numbers of glaucoma patients have CMD and found significantly associated with socio-economic, ocular and systemic clinical factors. Therefore, the integration of psychosocial care into the current treatment of patients with glaucoma would have a significant advantage to help these patients.
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Affiliation(s)
- Mikias Mered Tilahun
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar Comprehensive specialized hospital, Gondar Town, Ethiopia
| | - Betelhem Temesgen Yibekal
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar Comprehensive specialized hospital, Gondar Town, Ethiopia
| | - Habtamu Kerebih
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar Comprehensive Specialized Hospital, Gondar Town, Ethiopia
| | - Fisseha Ademassu Ayele
- Department of Ophthalmology, School of Medicine, College of Medicine and Health Science, University of Gondar Comprehensive Specialized Hospital, Gondar Town, Ethiopia
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Rohrer B, Biswal MR, Obert E, Dang Y, Su Y, Zuo X, Fogelgren B, Kondkar AA, Lobo GP, Lipschutz JH. Conditional Loss of the Exocyst Component Exoc5 in Retinal Pigment Epithelium (RPE) Results in RPE Dysfunction, Photoreceptor Cell Degeneration, and Decreased Visual Function. Int J Mol Sci 2021; 22:5083. [PMID: 34064901 PMCID: PMC8151988 DOI: 10.3390/ijms22105083] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 04/29/2021] [Accepted: 05/07/2021] [Indexed: 11/17/2022] Open
Abstract
To characterize the mechanisms by which the highly conserved exocyst trafficking complex regulates eye physiology in zebrafish and mice, we focused on Exoc5 (also known as sec10), a central exocyst component. We analyzed both exoc5 zebrafish mutants and retinal pigmented epithelium (RPE)-specific Exoc5 knockout mice. Exoc5 is present in both the non-pigmented epithelium of the ciliary body and in the RPE. In this study, we set out to establish an animal model to study the mechanisms underlying the ocular phenotype and to establish if loss of visual function is induced by postnatal RPE Exoc5-deficiency. Exoc5-/- zebrafish had smaller eyes, with decreased number of melanocytes in the RPE and shorter photoreceptor outer segments. At 3.5 days post-fertilization, loss of rod and cone opsins were observed in zebrafish exoc5 mutants. Mice with postnatal RPE-specific loss of Exoc5 showed retinal thinning associated with compromised visual function and loss of visual photoreceptor pigments. Abnormal levels of RPE65 together with a reduced c-wave amplitude indicate a dysfunctional RPE. The retinal phenotype in Exoc5-/- mice was present at 20 weeks, but was more pronounced at 27 weeks, indicating progressive disease phenotype. We previously showed that the exocyst is necessary for photoreceptor ciliogenesis and retinal development. Here, we report that exoc5 mutant zebrafish and mice with RPE-specific genetic ablation of Exoc5 develop abnormal RPE pigmentation, resulting in retinal cell dystrophy and loss of visual pigments associated with compromised vision. Together, these data suggest that exocyst-mediated signaling in the RPE is required for RPE structure and function, indirectly leading to photoreceptor degeneration.
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Affiliation(s)
- Bärbel Rohrer
- Department of Ophthalmology, Medical University of South Carolina, Charleston, SC 29425, USA; (B.R.); (E.O.)
- Ralph H. Johnson VA Medical Center, Division of Research, Charleston, SC 29401, USA
| | - Manas R. Biswal
- Department of Pharmaceutical Sciences, Taneja College of Pharmacy, University of South Florida, Tampa, FL 33612, USA;
| | - Elisabeth Obert
- Department of Ophthalmology, Medical University of South Carolina, Charleston, SC 29425, USA; (B.R.); (E.O.)
| | - Yujing Dang
- Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; (Y.D.); (Y.S.); (X.Z.); (J.H.L.)
| | - Yanhui Su
- Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; (Y.D.); (Y.S.); (X.Z.); (J.H.L.)
| | - Xiaofeng Zuo
- Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; (Y.D.); (Y.S.); (X.Z.); (J.H.L.)
| | - Ben Fogelgren
- Department of Anatomy, Biochemistry, and Physiology, University of Hawaii at Manoa, Honolulu, HI 96813, USA;
| | - Altaf A. Kondkar
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh 11411, Saudi Arabia;
| | - Glenn P. Lobo
- Department of Ophthalmology, Medical University of South Carolina, Charleston, SC 29425, USA; (B.R.); (E.O.)
- Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; (Y.D.); (Y.S.); (X.Z.); (J.H.L.)
- Department of Ophthalmology and Visual Neurosciences, Lions Research Building, 2001 6th Street SE., Room 225, University of Minnesota, Minneapolis, MN 55455, USA
| | - Joshua H. Lipschutz
- Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA; (Y.D.); (Y.S.); (X.Z.); (J.H.L.)
- Department of Medicine, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC 29425, USA
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Hetzer SM, Guilhaume-Correa F, Day D, Bedolla A, Evanson NK. Traumatic Optic Neuropathy Is Associated with Visual Impairment, Neurodegeneration, and Endoplasmic Reticulum Stress in Adolescent Mice. Cells 2021; 10:cells10050996. [PMID: 33922788 PMCID: PMC8146890 DOI: 10.3390/cells10050996] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/02/2021] [Accepted: 04/17/2021] [Indexed: 02/02/2023] Open
Abstract
Traumatic brain injury (TBI) results in a number of impairments, often including visual symptoms. In some cases, visual impairments after head trauma are mediated by traumatic injury to the optic nerve, termed traumatic optic neuropathy (TON), which has few effective options for treatment. Using a murine closed-head weight-drop model of head trauma, we previously reported in adult mice that there is relatively selective injury to the optic tract and thalamic/brainstem projections of the visual system. In the current study, we performed blunt head trauma on adolescent C57BL/6 mice and investigated visual impairment in the primary visual system, now including the retina and using behavioral and histologic methods at new time points. After injury, mice displayed evidence of decreased optomotor responses illustrated by decreased optokinetic nystagmus. There did not appear to be a significant change in circadian locomotor behavior patterns, although there was an overall decrease in locomotor behavior in mice with head injury. There was evidence of axonal degeneration of optic nerve fibers with associated retinal ganglion cell death. There was also evidence of astrogliosis and microgliosis in major central targets of optic nerve projections. Further, there was elevated expression of endoplasmic reticulum (ER) stress markers in retinas of injured mice. Visual impairment, histologic markers of gliosis and neurodegeneration, and elevated ER stress marker expression persisted for at least 30 days after injury. The current results extend our previous findings in adult mice into adolescent mice, provide direct evidence of retinal ganglion cell injury after head trauma and suggest that axonal degeneration is associated with elevated ER stress in this model of TON.
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Affiliation(s)
- Shelby M. Hetzer
- Neuroscience Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (S.M.H.); (D.D.); (A.B.)
| | - Fernanda Guilhaume-Correa
- Translational Biology, Medicine and Health, Virginia Polytechnic Institute and State University, Roanoke, VA 24016, USA;
| | - Dylan Day
- Neuroscience Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (S.M.H.); (D.D.); (A.B.)
| | - Alicia Bedolla
- Neuroscience Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (S.M.H.); (D.D.); (A.B.)
| | - Nathan K. Evanson
- Neuroscience Graduate Program, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; (S.M.H.); (D.D.); (A.B.)
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Pediatrics, University of Cincinnati, Cincinnati, OH 45229, USA
- Correspondence:
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Margolin E, Chaban Y, Jeeva-Patel T, Zaslavsky K, Yoganathan D. Visual Disturbance and Skin Rash. Am Fam Physician 2021; 103:373-374. [PMID: 33719379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Edward Margolin
- University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada
| | - Yuri Chaban
- University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada
| | - Trisha Jeeva-Patel
- University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada
| | - Kirill Zaslavsky
- University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada
| | - Deepa Yoganathan
- University of Toronto, Department of Ophthalmology and Vision Sciences, Toronto, Ontario, Canada
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Abstract
To analyse what eyecare clinicians think about which symptoms are associated with refractive, accommodative and binocular dysfunctions, and which of them should be used in a questionnaire of visual symptomatology. A Delphi method was developed, using a coordinating group and a group of experts, and the process was conducted in three rounds. In the first round we compiled a list of 34 symptoms from the scientific literature and additional 10 suggested by the experts. These symptoms were categorized by each expert to the associated visual anomalies and working distance. In the second round, the relationship between each symptom and visual dysfunctions was analysed using a numeric scale. In the third round, the appearance or absence of the 44 symptoms in a questionnaire was assessed. Symptoms most frequently assigned by the experts to visual anomalies were related to near vision. Symptoms of blurred vision, difficulty focusing from one distance to another and close one eye obtained the highest mean score for refractive, accommodative and binocular disorders respectively. The experts were in agreement for 15 symptoms and in disagreement for 5 symptoms that should appear in a questionnaire. Delphi method has been used to identify the symptoms related to visual dysfunctions according to eyecare professionals and has allowed to arrive at appropriate symptoms to be asked for in a visual symptomatology questionnaire.
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Affiliation(s)
- Mario Cantó-Cerdán
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Apartado 99, 03080, Alicante, Spain
| | - Pilar Cacho-Martínez
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Apartado 99, 03080, Alicante, Spain.
| | - Ángel García-Muñoz
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Apartado 99, 03080, Alicante, Spain
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Ortuño-Lizarán I, Sánchez-Sáez X, Lax P, Serrano GE, Beach TG, Adler CH, Cuenca N. Dopaminergic Retinal Cell Loss and Visual Dysfunction in Parkinson Disease. Ann Neurol 2020; 88:893-906. [PMID: 32881029 PMCID: PMC10005860 DOI: 10.1002/ana.25897] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [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: 03/23/2020] [Revised: 08/29/2020] [Accepted: 08/31/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Considering the demonstrated implication of the retina in Parkinson disease (PD) pathology and the importance of dopaminergic cells in this tissue, we aimed to analyze the state of the dopaminergic amacrine cells and some of their main postsynaptic neurons in the retina of PD. METHODS Using immunohistochemistry and confocal microscopy, we evaluated morphology, number, and synaptic connections of dopaminergic cells and their postsynaptic cells, AII amacrine and melanopsin-containing retinal ganglion cells, in control and PD eyes from human donors. RESULTS In PD, dopaminergic amacrine cell number was reduced between 58% and 26% in different retinal regions, involving a decline in the number of synaptic contacts with AII amacrine cells (by 60%) and melanopsin cells (by 35%). Despite losing their main synaptic input, AII cells were not reduced in number, but they showed cellular alterations compromising their adequate function: (1) a loss of mitochondria inside their lobular appendages, which may indicate an energetic failure; and (2) a loss of connexin 36, suggesting alterations in the AII coupling and in visual signal transmission from the rod pathway. INTERPRETATION The dopaminergic system impairment and the affection of the rod pathway through the AII cells may explain and be partially responsible for the reduced contrast sensitivity or electroretinographic response described in PD. Also, dopamine reduction and the loss of synaptic contacts with melanopsin cells may contribute to the melanopsin retinal ganglion cell loss previously described and to the disturbances in circadian rhythm and sleep reported in PD patients. These data support the idea that the retina reproduces brain neurodegeneration and is highly involved in PD pathology. ANN NEUROL 2020;88:893-906.
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Affiliation(s)
- Isabel Ortuño-Lizarán
- Department of Physiology, Genetics and Microbiology, University of Alicante, Alicante, Spain
| | - Xavier Sánchez-Sáez
- Department of Physiology, Genetics and Microbiology, University of Alicante, Alicante, Spain
| | - Pedro Lax
- Department of Physiology, Genetics and Microbiology, University of Alicante, Alicante, Spain
| | | | | | | | - Nicolás Cuenca
- Department of Physiology, Genetics and Microbiology, University of Alicante, Alicante, Spain
- Institute Ramón Margalef, University of Alicante, Alicante, Spain
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Yasuda M, Sato H, Hashimoto K, Osada U, Hariya T, Nakayama H, Asano T, Suzuki N, Okabe T, Yamazaki M, Uematsu M, Munakata M, Nakazawa T. Carotid artery intima-media thickness, HDL cholesterol levels, and gender associated with poor visual acuity in patients with branch retinal artery occlusion. PLoS One 2020; 15:e0240977. [PMID: 33091078 PMCID: PMC7580897 DOI: 10.1371/journal.pone.0240977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 10/06/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To investigate factors associated with poor visual acuity (VA) in branch retinal artery occlusion (BRAO). METHODS This was a retrospective cross-sectional study of 72 eyes with BRAO of 72 patients. For statistical comparison, we divided the patients into worse-VA (decimal VA < 0.5) and better-VA (decimal VA > = 0.5) groups. We examined the association of clinical findings, including blood biochemical test data and carotid artery ultrasound parameters, with poor VA. RESULTS Median age, hematocrit, hemoglobin and high-density lipoprotein (HDL) differed significantly between the groups (P = 0.018, P < 0.01, P < 0.01, and P = 0.025). There was a tendency towards higher median IMT-Bmax in the worse-VA group (worse-VA vs. better-VA: 2.70 mm vs. 1.60 mm, P = 0.152). Spearman's rank correlation test revealed that logMAR VA was significantly correlated to IMT-Bmax (rs = 0.31, P < 0.01) and IMT-Cmax (rs = 0.24, P = 0.035). Furthermore, logMAR VA was significantly correlated to HDL level (rs = -0.33, P < 0.01). Multivariate logistic regression analysis revealed that IMT-Bmax (odds ratio [OR] = 2.70, P = 0.049), HDL level (OR = 0.91, P = 0.032), and female gender (OR = 15.63, P = 0.032) were independently associated with worse VA in BRAO. CONCLUSIONS We found that increased IMT-Bmax, decreased HDL, and female sex were associated with poor VA in BRAO patients. Our findings might suggest novel risk factors for visual dysfunction in BRAO and may provide new insights into the pathomechanisms underlying BRAO.
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Affiliation(s)
- Masayuki Yasuda
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hajime Sato
- Yaotome Sato Hajime Eye Clinic, Miyagi, Japan
| | - Kazuki Hashimoto
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Urara Osada
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takehiro Hariya
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hiroko Nakayama
- Department of Ophthalmology, JR Sendai Hospital, Sendai, Miyagi, Japan
| | - Toshifumi Asano
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Noriyuki Suzuki
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Tatsu Okabe
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Ophthalmology, Tohoku Rosai Hospital, Sendai, Miyagi, Japan
| | - Mai Yamazaki
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Seiryo Eye Clinic, Miyagi, Japan
| | - Megumi Uematsu
- Department of Ophthalmology, Tohoku Rosai Hospital, Sendai, Miyagi, Japan
| | - Masanori Munakata
- Division of Hypertension & Research Center for Lifestyle-Related Disease, Tohoku Rosai Hospital, Sendai, Miyagi, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- * E-mail:
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Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has reportedly affected almost 23 million people, with more than 800 thousand deaths globally. There have been a few reports on the ocular manifestations of COVID-19 patients in China but no reports in Korea. The present study aimed to examine ocular manifestations of COVID-19 patients in Korea. METHODS COVID-19 patients admitted from March 2020 to April 2020 at Keimyung University Dongsan Hospital and Keimyung University Daegu Dongsan Hospital were reviewed retrospectively for ocular manifestations. During the period of hospitalization, ocular symptoms as well as blood test results were noted and analyzed. Patients were then divided into the first-episode and relapsed group and ocular symptoms were analyzed in the groups. RESULTS A total of 103 patients were included in this study. Among them, 71patients were in the first-episode group and 32 patients in the relapsed group. No significant differences were determined in terms of positivity of ocular symptoms between the first-episode group (12 patients, 16.9%) and the relapsed group (10 patients, 31.3%, P > 0.05). Symptoms of positive upper respiratory infection and lower creatine phosphokinase were determined to be related to positive ocular symptoms. Conjunctival congestion was noted in seven patients. In the subgroup analysis, the conjunctival congestion-positive patients exhibited higher positivity of upper respiratory infection symptoms (100%) as compared with those in the negative group (40%, P = 0.017). CONCLUSION Positive upper respiratory infection symptoms and lower creatine phosphokinase were determined to be related to ocular symptoms in COVID-19 patients. Among these patients, positive upper respiratory infection symptoms were associated with conjunctival congestion.
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Affiliation(s)
- You Hyun Lee
- Department of Ophthalmology, Keimyung University Daegu Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
| | - Yu Cheol Kim
- Department of Ophthalmology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea.
| | - Jae Pil Shin
- Department of Ophthalmology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea
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Whitwell RL, Sperandio I, Buckingham G, Chouinard PA, Goodale MA. Grip Constancy but Not Perceptual Size Constancy Survives Lesions of Early Visual Cortex. Curr Biol 2020; 30:3680-3686.e5. [PMID: 32735814 DOI: 10.1016/j.cub.2020.07.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 05/06/2020] [Revised: 06/27/2020] [Accepted: 07/08/2020] [Indexed: 01/06/2023]
Abstract
Object constancies are central constructs in theories of visual phenomenology. A powerful example is "size constancy," in which the perceived size of an object remains stable despite changes in viewing distance [1-4]. Evidence from neuropsychology [5], neuroimaging [6-11], transcranial magnetic stimulation [12, 13], single-unit and lesion studies in monkey [14-20], and computational modeling [21] suggests that re-entrant processes involving reciprocal interactions between primary visual cortex (V1) and extrastriate visual areas [22-26] play an essential role in mediating size constancy. It is seldom appreciated, however, that object constancies must also operate for the visual guidance of goal-directed action. For example, when reaching out to pick up an object, the hand's in-flight aperture scales with size of the goal object [27-30] and is refractory to the decrease in retinal-image size with increased viewing distance [31-41] (Figure 1), a phenomenon we call "grip constancy." Does grip constancy, like perceptual constancy, depend on V1 or can it be mediated by pathways that bypass it altogether? We tested these possibilities in an individual, M.C., who has bilateral lesions encompassing V1 and much of the ventral visual stream. We show that her perceptual estimates of object size co-vary with retinal-image size rather than real-world size as viewing distance varies. In contrast, M.C. shows near-normal scaling of in-flight grasp aperture to object size despite changes in viewing distance. Thus, although early visual cortex is necessary for perceptual object constancy, it is unnecessary for grip constancy, which is mediated instead by separate visual inputs to dorsal-stream visuomotor areas [42-48].
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Affiliation(s)
- Robert L Whitwell
- Department of Psychology, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - Irene Sperandio
- Department of Psychology and Cognitive Science, University of Trento, Rovereto 38068, Italy
| | - Gavin Buckingham
- Department of Sport and Health Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Philippe A Chouinard
- Department of Psychology and Counselling, La Trobe University, Bendigo 3550, Australia
| | - Melvyn A Goodale
- Brain and Mind Institute, Department of Psychology, The University of Western Ontario, London, ON N6A 5C2, Canada
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Wallace S, Mactaggart I, Banks LM, Polack S, Kuper H. Association of anxiety and depression with physical and sensory functional difficulties in adults in five population-based surveys in low and middle-income countries. PLoS One 2020; 15:e0231563. [PMID: 32589635 PMCID: PMC7319598 DOI: 10.1371/journal.pone.0231563] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/26/2020] [Indexed: 12/13/2022] Open
Abstract
Background The aim of this study was to assess the association between anxiety and depression with physical and sensory functional difficulties, among adults living in five low and middle-income countries (LMICs). Methods and findings A secondary data analysis was undertaken using population-based disability survey data from five LMICs, including two national surveys (Guatemala, Maldives) and 3 regional/district surveys (Nepal, India, Cameroon). 19,337 participants were sampled in total (range 1,617–7,604 in individual studies). Anxiety, depression, and physical and sensory functional difficulties were assessed using the Washington Group Extended Question Set on Functioning. Age-sex adjusted logistic regression analyses were undertaken to assess the association of anxiety and depression with hearing, visual or mobility functional difficulties. The findings demonstrated an increased adjusted odds of severe depression and severe anxiety among adults with mobility, hearing and visual functional difficulties in all settings (with ORs ranging from 2.0 to 14.2) except for in relation to hearing loss in India, the Maldives and Cameroon, where no clear association was found. For all settings and types of functional difficulties, there was a stronger association with severe anxiety and depression than with moderate. Both India and Cameroon had higher reported prevalences of physical and sensory functional difficulties compared with Nepal and Guatemala, and weaker associations with anxiety and depression. Conclusion People with physical and sensory functional difficulties are more likely to report experiencing depression and anxiety. This evidence supports the need for ensuring a good awareness of mental health among those working with individuals with physical and sensory functional difficulties in LMICs. This implies that these practitioners must have the skills to identify anxiety and depression. Furthermore, mental health services must be available and accessible to patients with these conditions, which will likely require further programmatic scale-up in these LMIC settings.
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Affiliation(s)
- Sarah Wallace
- Public Health Training Scheme, London Deanery, London, United Kingdom
| | - Islay Mactaggart
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Lena Morgon Banks
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sarah Polack
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Hannah Kuper
- International Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail:
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Shukla AG, De Moraes CG, Cioffi GA, Girkin CA, Weinreb RN, Zangwill LM, Liebmann JM. The Relationship Between Intraocular Pressure and Rates of Central Versus Peripheral Visual Field Progression. J Glaucoma 2020; 29:435-440. [PMID: 32251071 PMCID: PMC7272279 DOI: 10.1097/ijg.0000000000001494] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PRECIS In this longitudinal prospective cohort study of open-angle glaucoma patients, intraocular pressure (IOP) parameters (mean, fluctuation, and maximum) had a similar effect on glaucomatous progression in the central and peripheral visual field (VF) regions. PURPOSE To study the effects of IOP on rates of glaucomatous central versus peripheral VF progression. METHODS The African Descent and Glaucoma Evaluation Study (ADAGES) is a longitudinal prospective cohort study that recruited patients from 3 centers. A sample of those with established glaucoma were included in this study. The mean peripheral sensitivity (MPS) and the mean central sensitivity (MCS) were defined based upon the average total deviation of the peripheral and central (10 degrees) points of the 24-2 VF, respectively. Progression was based upon central and peripheral change from linear mixed-effects models. The relationships between VF progression and IOP mean, maximum, and fluctuation as continuous variables were also investigated. Main outcome measures were MPS and MCS progression rates. RESULTS A total of 452 eyes of 344 patients were studied. The mean number of VFs (SD) for each eye was 13.3 (6.4) over 9.1 (3.7) years. The mean baseline MD was -5.1 (3.9) dB and the mean rate of MD change was -0.26 dB/y [95% confidence interval (CI): -0.33 to -0.20, P<0.001]. Mean rates of MPS (-0.27 dB/y, 95% CI: -0.33 to -0.22, P<0.001) and MCS change (-0.26 dB/y, 95% CI: -0.31 to -0.21, P<0.001) were similar (P=0.351). Mean, fluctuation, and maximum IOP were significantly associated with MPS and MCS (all P<0.025). CONCLUSIONS The effect of IOP parameters on VF progression was statistically similar between central and peripheral VF regions.
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Affiliation(s)
- Aakriti G Shukla
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, NY
| | - C Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, NY
| | - George A Cioffi
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, NY
| | | | - Robert N Weinreb
- Department of Ophthalmology, Hamilton Glaucoma Center, University of California-San Diego, San Diego, CA
| | - Linda M Zangwill
- Department of Ophthalmology, Hamilton Glaucoma Center, University of California-San Diego, San Diego, CA
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, NY
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Iyer SSR, Jin Z, Seifert RP, Dang NH. Bilateral pseudohypopyon causing white eyes in a patient with lymphoma. Lancet 2020; 395:e74. [PMID: 32334711 DOI: 10.1016/s0140-6736(20)30610-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 02/12/2020] [Accepted: 03/06/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Siva S Radhakrishnan Iyer
- Department of Ophthalmology, University of Florida College of Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
| | - Zhongbo Jin
- Department of Pathology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Robert P Seifert
- Department of Pathology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Nam H Dang
- Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA
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Marques P, Appelman-Dijkstra NM, Gelderblom H, Kruit MC, van Furth WR, Pereira AM, Biermasz NR. Denosumab salvage therapy in a patient with a locally advanced and refractory sellar giant cell tumour of bone. Lancet Diabetes Endocrinol 2020; 8:348. [PMID: 32059785 DOI: 10.1016/s2213-8587(20)30041-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 01/16/2020] [Accepted: 01/30/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Pedro Marques
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, Netherlands
| | | | - Hans Gelderblom
- Department of Medical Oncology, Leiden University Medical Center, Leiden, Netherlands
| | - Mark C Kruit
- Department of Radiology, Leiden University Medical Center, Leiden, Netherlands
| | - Wouter R van Furth
- Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands
| | - Alberto M Pereira
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Nienke R Biermasz
- Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, Netherlands.
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Abstract
Prolonged life expectancies contribute to the increasing prevalence of age-related macular degeneration (AMD) that is already the leading cause of severe vision loss among the elderly in developed countries. In dry AMD, the disease culminates into vast retinal atrophy, whereas the wet form is characterized by retinal edema and sudden vision loss due to neovascularization originating from the choroid beneath the Bruch's membrane. There is no treatment for dry AMD and despite intravitreal injections of anti-vascular endothelial growth factor (VEGF) that suppress the neovessel formation, also wet AMD needs new therapies to prevent the disease progression and to serve patients lacking of positive response to current medicines. Knowledge on disease mechanisms is a prerequisite for the drug development, which is hindered by the multifactorial nature of AMD. Numerous distinguished publications have revealed AMD mechanisms at the cellular and molecular level and in this multi-author review, we take a bit broader look at the topic with some novel aspects.
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Affiliation(s)
- Anu Kauppinen
- Faculty of Health Sciences, School of Pharmacy, University of Eastern Finland, 1627, 70211, Kuopio, Finland.
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Choi EJ, Choi GW, Kim JH, Jang HW, Lee JH, Bae HJ, Kim YG, Lee YB, Cho HY. A Novel Eye Drop Candidate for Age-Related Macular Degeneration Treatment: Studies on its Pharmacokinetics and Distribution in Rats and Rabbits. Molecules 2020; 25:molecules25030663. [PMID: 32033125 PMCID: PMC7037153 DOI: 10.3390/molecules25030663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/03/2020] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 11/16/2022] Open
Abstract
Age-related macular degeneration (AMD) is wearing down of macula of retina, causing a blur or loss of vision in the center of the visual field. It can be categorized into dry or wet AMD. Until now, medical treatments for dry AMD have not been developed yet. The aim of this study was to evaluate pharmacokinetics (PKs) and tissue distribution of CK41016, a novel candidate for dry AMD, after intravenous (IV) or eye drop administration in rats and rabbits. In addition, a simple and sensitive bioanalytical method for CK41016 using ultra performance liquid chromatography-tandem mass spectrometer (UPLC-MS/MS) was developed. PK parameters were estimated by compartmental analysis using a WinNonlin® software version 8.1 (a Certara™ company). A PK model of CK41016 was well-described by the two-compartment model. The tissue-to-plasma partition coefficient (Kp) of CK41016 was the highest in the vitreous humor of rats and the cornea of rabbits after eye drop administration. In addition, the Caco-2 cell transporter assay confirmed that CK41016 was not an active substrate for the efflux transporter. In summary, the PKs and tissue distribution of CK41016 were successfully evaluated and investigated whether this drug was a substrate of efflux transporters.
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Affiliation(s)
- Eun-Jeong Choi
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, Korea; (E.-J.C.); (G.-W.C.); (J.H.K.); (H.-W.J.)
| | - Go-Wun Choi
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, Korea; (E.-J.C.); (G.-W.C.); (J.H.K.); (H.-W.J.)
| | - Ju Hee Kim
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, Korea; (E.-J.C.); (G.-W.C.); (J.H.K.); (H.-W.J.)
| | - Hee-Woon Jang
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, Korea; (E.-J.C.); (G.-W.C.); (J.H.K.); (H.-W.J.)
| | - Ju-Hee Lee
- Kukje Pharma R&D Center, Sanseong-ro 47, Ansan, Gyeonggi-do 15438, Korea; (J.-H.L.); (H.J.B.); (Y.G.K.)
| | - Hyun Ju Bae
- Kukje Pharma R&D Center, Sanseong-ro 47, Ansan, Gyeonggi-do 15438, Korea; (J.-H.L.); (H.J.B.); (Y.G.K.)
| | - Young Gwan Kim
- Kukje Pharma R&D Center, Sanseong-ro 47, Ansan, Gyeonggi-do 15438, Korea; (J.-H.L.); (H.J.B.); (Y.G.K.)
| | - Yong-Bok Lee
- College of Pharmacy, Chonnam National University, 77 Yongbong-ro, Buk-Gu, Gwangju 61186, Korea;
| | - Hea-Young Cho
- College of Pharmacy, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13488, Korea; (E.-J.C.); (G.-W.C.); (J.H.K.); (H.-W.J.)
- Correspondence: ; Tel.: +82-31-881-7167; Fax: +82-31-881-7219
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Yang A, Cho SY, Park H, Kim MS, Kong DS, Shin HJ, Jin DK. Clinical, Hormonal, and Neuroradiological Characteristics and Therapeutic Outcomes of Prolactinomas in Children and Adolescents at a Single Center. Front Endocrinol (Lausanne) 2020; 11:527. [PMID: 32849307 PMCID: PMC7417303 DOI: 10.3389/fendo.2020.00527] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/29/2020] [Indexed: 01/10/2023] Open
Abstract
Background/Purpose: A prolactinoma is the most common pituitary adenoma, but it is relatively rare in childhood and adolescence. There is only limited research about the clinical spectrum, treatment, and outcomes of prolactinomas in childhood and adolescence. In this single-center cohort study, we assessed the clinical, hormonal, and neuroradiological characteristics and therapeutic outcomes of children and adolescents with prolactinomas. Methods: This retrospective cohort study included 25 patients with prolactinomas diagnosed before 19 years of age, who presented at Samsung Medical Center during a 15-year period (March 2005 to August 2019). Results: The median age at diagnosis was 16.9 (range 10.1-18.5) years, and 80% of the patients were female. The common clinical manifestations at diagnosis were galactorrhea (10/20, 50%) and amenorrhea (9/20, 45%) among females and visual field defects (3/5, 60%) and headaches (2/5, 40%) among males. In our cohort, macroadenomas accounted for 56% of cases, and the rate of overall responsiveness to dopamine agonists (DAs) was 56% (10/18). Male gender, the prolactin (PRL) level at diagnosis, and the presence of panhypopituitarism were positively correlated with maximum tumor diameter (r = 0.443, P = 0.026; r = 0.710, P < 0.001; and r = 0.623, P = 0.001, respectively). After the trans-sphenoidal approach (TSA), 53% (8/15) of patients showed normalization of the PRL level. Three patients, who underwent gamma knife surgery (GKS) owing to either resistance or intolerance to DAs or recurrence after the TSA, achieved a normal PRL level accompanied with marked tumor reduction and symptom remission. Conclusions: A macroprolactinoma is more prevalent than a microprolactinoma in children and adolescents than in adults. Male gender, increased PRL levels, and the presence of panhypopituitarism at diagnosis are closely related to macroprolactinomas in children and adolescents.
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Affiliation(s)
- Aram Yang
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sung Yoon Cho
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- *Correspondence: Sung Yoon Cho
| | - Hyojung Park
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Min Sun Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Doo-Sik Kong
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyung-Jin Shin
- Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dong-Kyu Jin
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Dong-Kyu Jin
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Bennett CR, Bauer CM, Bailin ES, Merabet LB. Neuroplasticity in cerebral visual impairment (CVI): Assessing functional vision and the neurophysiological correlates of dorsal stream dysfunction. Neurosci Biobehav Rev 2020; 108:171-181. [PMID: 31655075 PMCID: PMC6949360 DOI: 10.1016/j.neubiorev.2019.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 06/16/2019] [Revised: 10/15/2019] [Accepted: 10/18/2019] [Indexed: 12/31/2022]
Abstract
Cerebral visual impairment (CVI) results from perinatal injury to visual processing structures and pathways and is the most common individual cause of pediatric visual impairment and blindness in developed countries. While there is mounting evidence demonstrating extensive neuroplastic reorganization in early onset, profound ocular blindness, how the brain reorganizes in the setting of congenital damage to cerebral (i.e. retro-geniculate) visual pathways remains comparatively poorly understood. Individuals with CVI exhibit a wide range of visual deficits and, in particular, present with impairments of higher order visual spatial processing (referred to as "dorsal stream dysfunction") as well as object recognition (associated with processing along the ventral stream). In this review, we discuss the need for ongoing work to develop novel, neuroscience-inspired approaches to investigate functional visual deficits in this population. We also outline the role played by advanced structural and functional neuroimaging in helping to elucidate the underlying neurophysiology of CVI, and highlight key differences with regard to patterns of neural reorganization previously described in ocular blindness.
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Affiliation(s)
- Christopher R Bennett
- Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, United States
| | - Corinna M Bauer
- Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, United States
| | - Emma S Bailin
- Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, United States
| | - Lotfi B Merabet
- Massachusetts Eye and Ear, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, United States.
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Mammadzada P, Corredoira PM, André H. The role of hypoxia-inducible factors in neovascular age-related macular degeneration: a gene therapy perspective. Cell Mol Life Sci 2019; 77:819-833. [PMID: 31893312 PMCID: PMC7058677 DOI: 10.1007/s00018-019-03422-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [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: 12/04/2019] [Revised: 12/04/2019] [Accepted: 12/10/2019] [Indexed: 12/19/2022]
Abstract
Understanding the mechanisms that underlie age-related macular degeneration (AMD) has led to the identification of key molecules. Hypoxia-inducible transcription factors (HIFs) have been associated with choroidal neovascularization and the progression of AMD into the neovascular clinical phenotype (nAMD). HIFs regulate the expression of multiple growth factors and cytokines involved in angiogenesis and inflammation, hallmarks of nAMD. This knowledge has propelled the development of a new group of therapeutic strategies focused on gene therapy. The present review provides an update on current gene therapies in ocular angiogenesis, particularly nAMD, from both basic and clinical perspectives.
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Affiliation(s)
- Parviz Mammadzada
- Division of Eye and Vision, Department of Clinical Neuroscience, Karolinska Institutet, St. Erik Eye Hospital, Stockholm, Sweden
| | - Pablo M Corredoira
- Division of Eye and Vision, Department of Clinical Neuroscience, Karolinska Institutet, St. Erik Eye Hospital, Stockholm, Sweden
| | - Helder André
- Division of Eye and Vision, Department of Clinical Neuroscience, Karolinska Institutet, St. Erik Eye Hospital, Stockholm, Sweden.
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Lithgow K, Batra R, Matthews T, Karavitaki N. MANAGEMENT OF ENDOCRINE DISEASE: Visual morbidity in patients with pituitary adenoma. Eur J Endocrinol 2019; 181:R185-R197. [PMID: 31416048 DOI: 10.1530/eje-19-0349] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 08/15/2019] [Indexed: 11/08/2022]
Abstract
Visual dysfunction is an important element in the morbidity encountered in patients with pituitary adenoma leading to functional impairment and compromised quality of life. It consists of many parameters (even in the absence of reported symptomatology) as a result of tumour growth in proximity to structures critical for vision (anterior visual pathway, cranial nerves within cavernous sinuses), and as an adverse consequence of therapeutic interventions. Adenoma resection leads to high rates of visual improvement and possibly continues beyond a year post surgery, but the exact timing of maximum effect requires elucidation. Retinal nerve fibre layer measurement may be a reliable, objective parameter predicting favourable visual outcomes, although its prognostic value when pathological, needs to be confirmed. For compromised vision after pituitary apoplexy, early surgical decompression remains usual practice until evidence-based guidance becomes available. The risk of radiation-induced visual toxicity is mainly influenced by total and per fraction dose of radiation and treatment modality. Careful selection of cases and of radiotherapy technique/planning are of major importance in minimising this risk. Dopamine agonists lead to visual recovery in a considerable number of prolactinoma patients. Visual morbidity should be considered a vital indicator in the metrics of quality of service/care in pituitary disease making regular, full ophthalmic examination an essential component of modern management of pituitary pathology at all time points of patient pathway. Well-designed studies minimising effects of bias and using tools and scoring systems reliably reflecting visual status will provide robust evidence on valid prognostication and patient stratification guiding clinical decision making.
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Affiliation(s)
- Kirstie Lithgow
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
- Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Ruchika Batra
- Birmingham Neuro-Ophthalmology Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Tim Matthews
- Birmingham Neuro-Ophthalmology Unit, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Niki Karavitaki
- Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
- Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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Prasad S, Dinkin M. Higher Cortical Visual Disorders. Continuum (Minneap Minn) 2019; 25:1329-1361. [PMID: 31584540 DOI: 10.1212/con.0000000000000774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW This article reviews the disorders that result from disruption of extrastriate regions of the cerebral cortex responsible for higher visual processing. For each disorder, a historical perspective is offered and relevant neuroscientific studies are reviewed. RECENT FINDINGS Careful analysis of the consequences of lesions that disrupt visual functions such as facial recognition and written language processing has improved understanding of the role of key regions in these networks. In addition, modern imaging techniques have built upon prior lesion studies to further elucidate the functions of these cortical areas. For example, functional MRI (fMRI) has identified and characterized the response properties of ventral regions that contribute to object recognition and dorsal regions that subserve motion perception and visuospatial attention. Newer network-based functional imaging studies have shed light on the mechanisms behind various causes of spontaneous visual hallucinations. SUMMARY Understanding the regions and neural networks responsible for higher-order visual function helps the practicing neurologist to diagnose and manage associated disorders of visual processing and to identify and treat responsible underlying disease.
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Abstract
PURPOSE OF REVIEW This article reviews the anatomy, symptoms, examination findings, and causes of diseases affecting the optic chiasm, optic tracts, optic radiations, and occipital lobes. RECENT FINDINGS Modern ophthalmic imaging can be used to monitor the effects of diseases of the optic chiasm and tract on the retinal ganglion cells. It can also be used to visualize transsynaptic degeneration of the anterior visual pathway in the setting of acquired retrogeniculate lesions. Visual prostheses that directly stimulate the occipital lobe are a potential strategy for rehabilitation that is in active clinical trials. SUMMARY Detecting and characterizing visual deficits due to optic chiasm and retrochiasmal disease are important for the diagnosis, localization, and monitoring of neurologic disease; identifying patient disability; and guiding rehabilitation.
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50
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Affiliation(s)
- J Ram
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - A Singh
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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