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Indian Journal of Ophthalmology Sep 2021We describe an objective method to measure the volume of a dermis-fat graft (DFG) implant for socket reconstruction. We reviewed the charts of 10 patients undergoing...
We describe an objective method to measure the volume of a dermis-fat graft (DFG) implant for socket reconstruction. We reviewed the charts of 10 patients undergoing dermis fat grafting as a primary or secondary implant for anophthalmic socket reconstruction between January 2018 and December 2019. The amount of the DFG required to replace the volume of an appropriate spherical implant for the operated eye was predetermined. The volume of the DFG implant was measured by the water displacement method as per the Archimedes principle. Patient demographics, complications, and the outcome were analyzed regarding cosmesis and volume replacement. All patients were satisfied with the final cosmesis. Follow-up ranged from 6 to 18 months (mean 10.7 months). Thus, we concluded that the water displacement method is a simple and easy procedure to objectively determine the amount of the autologous DFG needed to replace the volume in an anophthalmic socket.
Topics: Anophthalmos; Dermis; Eye, Artificial; Humans; Orbit; Orbital Implants
PubMed: 34427258
DOI: 10.4103/ijo.IJO_130_21 -
Klinische Monatsblatter Fur... Jan 2022Congenital microphthalmos can either occur alone (simple microphthalmos) or be associated with other ocular malformations, such as sclerocornea or cataract (complex...
INTRODUCTION
Congenital microphthalmos can either occur alone (simple microphthalmos) or be associated with other ocular malformations, such as sclerocornea or cataract (complex microphthalmos). As this is a rare condition, there are no uniform recommendations for treatment.
MATERIAL AND METHODS
Retrospective case series of 103 patients or a total of 114 eyes with congenital microphthalmos, with reporting of age, sex, visual acuity, pupil reaction, axial length, horizontal width of the palpebral fissure, type of therapy performed and complications.
RESULTS
All patients would have been able to be fitted with a prosthesis primarily. The size of the palpebral fissure depended on the underlying findings: "bilateral microphthalmos" < "microphthalmos and healthy fellow eye" < "microphthalmos and fellow anophthalmos". In order to assess visual (residual) function in an infant in the first weeks or months of life, the pupillary response is of the upmost importance in deciding on therapy, especially in unilateral disease, and as assessed with the indirect light response of the healthy eye. In about half of the cases, conservative prosthetic treatment was sufficient. After the successful initial fitting of a prosthesis, the prosthesis was enlarged according to the ocularist's instructions. If the eye length difference was so large that symmetry could not be achieved even with a double-walled prosthesis, volume filling with retrobulbar implanted self-swelling pellet expanders (osmed GmbH, Ilmenau) was offered. In almost one third of the patients, no surgical therapy or prosthetic treatment was performed. The reason for this was usually the presence of minimal visual function of the microphthalmos - ranging from light perception to hand movements.
CONCLUSIONS
In the case of visual function of the microphthalmos, surgical measures should not be indicated or only with extreme caution, since the preservation of the existing visual acuity must be regarded as having priority over the cosmetic findings. In cases of asymmetry or underdeveloped palpebral fissure, therapy can be started early in the first year of life without fear of resulting complications.
Topics: Anophthalmos; Cataract; Child; Humans; Infant; Microphthalmos; Retrospective Studies; Visual Acuity
PubMed: 35120379
DOI: 10.1055/a-1685-5002 -
European Journal of Ophthalmology Jul 2022To assess clinical and biomolecular changes of the conjunctival epithelium in anophthalmic patients wearing an ocular prosthesis.
PURPOSE
To assess clinical and biomolecular changes of the conjunctival epithelium in anophthalmic patients wearing an ocular prosthesis.
METHODS
Thirty-five unilateral anophthalmic patients were enrolled. Patients with blepharitis, lid abnormalities, and topical/systemic medication affecting the ocular surface were excluded. Symptom Assessment in Dry Eye (SANDE) questionnaire and tear function test (Schirmer Test Type I) were recorded. Conjunctival inflammation and meibomian gland dysfunction (MGD) were graded in the anophthalmic side and fellow eye. Impression cytology sampling of the upper, lower tarsal, and posterior/bulbar conjunctiva from the anophthalmic socket were collected and compared to healthy controls.
RESULTS
Patients had significantly higher SANDE ( < 0.001), Schirmer test ( = 0.004), conjunctival inflammation ( < 0.001), and MGD scores ( < 0.001) on the anophthalmic side compared to the fellow eye. Mucin 5AC, inflammatory markers (MMP-9, ICAM-1) expression ( < 0.001), and response to oxidative stress (NRF2-KEAP1 signaling pathway) ( < 0.05) were significantly upregulated in the posterior conjunctival surface in the anophthalmic socket.
CONCLUSIONS
Anophthalmic patients complained of more pronounced dry eye symptoms and presented more significant signs of inflammation and MGD on the anophthalmic side. The bulbar conjunctiva, behind the prosthesis, showed more significant hyperexpression of mucins, markers of inflammation, and increased response to oxidative stress compared to the tarsal conjunctiva. Patients wearing ocular prosthesis had signs of inflammation resembling dry eye disease.
Topics: Anophthalmos; Conjunctiva; Conjunctivitis; Dry Eye Syndromes; Eye, Artificial; Humans; Inflammation; Kelch-Like ECH-Associated Protein 1; Meibomian Glands; NF-E2-Related Factor 2; Tears
PubMed: 34617482
DOI: 10.1177/11206721211048803 -
Graefe's Archive For Clinical and... Mar 2023
Topics: Humans; Anophthalmos; Conjunctivitis; Inflammation; Eye Enucleation
PubMed: 36355084
DOI: 10.1007/s00417-022-05899-w -
Trends in Molecular Medicine Apr 2021Retinal congenital malformations known as microphthalmia, anophthalmia, and coloboma (MAC) are associated with alterations in genes encoding epigenetic proteins that... (Review)
Review
Retinal congenital malformations known as microphthalmia, anophthalmia, and coloboma (MAC) are associated with alterations in genes encoding epigenetic proteins that modify chromatin. We review newly discovered functions of such chromatin modifiers in retinal development and discuss the role of epigenetics in MAC in humans and animal models. Further, we highlight how advances in epigenomic technologies provide foundational and regenerative medicine-related insights into blinding disorders. Combining knowledge of epigenetics and pluripotent stem cells (PSCs) is a promising avenue because epigenetic factors cooperate with eye field transcription factors (EFTFs) to direct PSC fate - a foundation for congenital retinal disease modeling and cell therapy.
Topics: Animals; Anophthalmos; Blindness; Cell- and Tissue-Based Therapy; Chromatin; Coloboma; Congenital Abnormalities; Disease Models, Animal; Epigenomics; Humans; Microphthalmos; Pluripotent Stem Cells; Regenerative Medicine; Retina; Retinal Diseases; Transcription Factors
PubMed: 33573910
DOI: 10.1016/j.molmed.2021.01.001 -
Orbit (Amsterdam, Netherlands) Dec 2022To evaluate the amplitude of movement in anophthalmic sockets reconstructed with conical or spherical orbital implants with and without an external ocular prosthesis... (Observational Study)
Observational Study
PURPOSE
To evaluate the amplitude of movement in anophthalmic sockets reconstructed with conical or spherical orbital implants with and without an external ocular prosthesis (EOP), and whether the fornix depth could play a role.
METHODS
Prospective observational study involving unilateral anophthalmic sockets evaluated the amplitude of movement with conical (20 subjects) or spherical (16) non-porous orbital implants, with and without an EOP, having the contralateral eye as the control group. Standardized photographs were obtained in the four gaze directions and measurements were performed using the Image J software. The upper and lower fornix depths were measured using rulers.
RESULTS
Compared to the contralateral eye, the median movement amplitude without EOP was smaller with conical implants in supraduction (-0.88 mm, p=0.008), abduction (-2.26 mm, p<0.001) and adduction (-0.91 mm, p=0.008). Spherical implants had reduced movement only in abduction (-2.63 mm, p<0.001). Conical and spherical implants had similar amplitudes of movement in all versions, and were always smaller compared to the control. The median movement amplitude with the EOP was -3.05 mm (p=0.001) than without the EOP in abduction and -2.07 mm (p=0.020) in adduction, regardless of implant format. The fornix depth did not affect the orbital implants or EOP movement amplitude's median.
CONCLUSION
Conical and spherical implants provide similar amplitude of movement and fornix depth did not have an influence on it. The amplitude of movement was significantly limited compared to the contralateral eye and was even more reduced if the EOP was in place with conical or spherical implant formats.
Topics: Humans; Eye Enucleation; Anophthalmos; Orbital Implants; Eye, Artificial; Prospective Studies; Orbit
PubMed: 34842036
DOI: 10.1080/01676830.2021.1998914 -
Clinical & Experimental Optometry Jan 2021Loss of an eye has a negative impact on the psychological health of a person. (Observational Study)
Observational Study
CLINICAL RELEVANCE
Loss of an eye has a negative impact on the psychological health of a person.
BACKGROUND
The aims are to: (a) identify the concerns of experienced prosthetic eye wearers in representative areas of India; (b) investigate how they change over time; (c) study how some demographic characteristics influence concerns; and (d) compare prosthetic eye concerns in India versus Germany and New Zealand.
METHODS
This observational multi-centre study was conducted in the cities of Mumbai, Bengaluru and Delhi. Subjects aged from 18 to 65-years, with experience of at least two years of wearing a prosthetic eye fabricated from polymethyl methacrylate material, completed a validated questionnaire over the telephone. The questionnaire captured demographic data and general and prosthetic eye concerns at the time of eye loss and at the present time.
RESULTS
At the time of eye loss, the five main concerns of participants were: health of the remaining eye; change in appearance; comfort; colour of the prosthesis; and movement of the prosthesis. However, after at least two years these concerns were significantly reduced (pā<ā0.05). The main present-day concern was watering, crusting and discharge, which was experienced by 81.1-per cent of the participants, 55.5-per cent of them on a daily basis. Compared with other demographic groups, blue-collar workers had higher odds of being concerned about the health of the remaining eye and least odds about prosthesis motility. Homemakers had higher odds of being concerned about wearing comfort and students had higher odds of being concerned about wearing comfort, appearance and health of the remaining eye.
CONCLUSION
Initial concerns significantly reduce after two years. Watering, crusting and discharge are the most important current concerns for anophthalmic participants.
Topics: Anophthalmos; Eye, Artificial; Humans; Prosthesis Implantation; Students; Surveys and Questionnaires
PubMed: 32329114
DOI: 10.1111/cxo.13076 -
Reproductive Toxicology (Elmsford, N.Y.) Sep 2022We previously revealed that insulin-induced severe and long-lasting maternal hypoglycemia in rats caused anophthalmia and microphthalmia in fetuses; however, it remained...
We previously revealed that insulin-induced severe and long-lasting maternal hypoglycemia in rats caused anophthalmia and microphthalmia in fetuses; however, it remained unclear whether hypoglycemia-induced eye anomalies were developmental retardation or disruption, and when and how they developed. Hence, we induced hypoglycemia in pregnant Sprague-Dawley rats by injecting insulin from Days 6 to 11 of pregnancy and performed periodical histopathological examination of fetal eyes from embryonic days (E)10 to 20. On E10, optic vesicle had developed normally both in the control and insulin-treated group; however, on E11, optic cup (OC) had developed in the control group but not in the insulin-treated group. On E12, neural retina (NR), retinal pigmented epithelium (RPE), lens, and presumptive cornea had been observed in the control group. In contrast, lens pit and OC with remaining space between RPE and NR had developed in the insulin-treated group. From E13 to E15, developmental disruption characterized by defects, hypoplasia, and degeneration in the retina, lens, and cornea was observed in the insulin-treated group, resulting in anophthalmia or microphthalmia on E20. Moreover, the expression of MITF and chx10, which are essential for early eye development by expressing in the presumptive retina and lens and regulating each other's expression level, was ectopic and suppressed on E11. In conclusion, insulin-induced maternal hypoglycemia caused developmental disruption, but not simple developmental retardation of fetal eyes, and its trigger might be a failure of presumptive retina and lens to interact on E11.
Topics: Animals; Anophthalmos; Eye; Female; Fetus; Hypoglycemia; Insulin; Microphthalmos; Pregnancy; Rats; Rats, Sprague-Dawley; Retinal Pigment Epithelium
PubMed: 35738499
DOI: 10.1016/j.reprotox.2022.06.008 -
American Journal of Medical Genetics.... Jan 2021
Topics: Acyltransferases; Anophthalmos; Focal Dermal Hypoplasia; Humans; Membrane Proteins; Microphthalmos
PubMed: 33219742
DOI: 10.1002/ajmg.a.61984 -
The Science of the Total Environment Jun 2023The increased water scarcity, depletion of freshwater resources, and rising environmental awareness are stressing for the development of sustainable wastewater treatment... (Review)
Review
The increased water scarcity, depletion of freshwater resources, and rising environmental awareness are stressing for the development of sustainable wastewater treatment processes. Microalgae-based wastewater treatment has resulted in a paradigm shift in our approach toward nutrient removal and simultaneous resource recovery from wastewater. Wastewater treatment and the generation of biofuels and bioproducts from microalgae can be coupled to promote the circular economy synergistically. A microalgal biorefinery transforms microalgal biomass into biofuels, bioactive chemicals, and biomaterials. The large-scale cultivation of microalgae is essential for the commercialization and industrialization of microalgae biorefinery. However, the inherent complexity of microalgal cultivation parameters regarding physiological and illumination parameters renders it challenging to facilitate a smooth and cost-effective operation. Artificial intelligence (AI)/machine learning algorithms (MLA) offer innovative strategies for assessing, predicting, and regulating uncertainties in algal wastewater treatment and biorefinery. The current study presents a critical review of the most promising AI/MLAs that demonstrate a potential to be applied in microalgal technologies. The most commonly used MLAs include artificial neural networks, support vector machine, genetic algorithms, decision tree, and random forest algorithms. Recent developments in AI have made it possible to combine cutting-edge techniques from AI research fields with microalgae for accurate analysis of large datasets. MLAs have been extensively studied for their potential in microalgae detection and classification. However, the ML application in microalgal industries, such as optimizing microalgae cultivation for increased biomass productivity, is still in its infancy. Incorporating smart AI/ML-enabled Internet of Things (IoT) based technologies can help the microalgal industries to operate effectively with minimum resources. Future research directions are also highlighted, and some of the challenges and perspectives of AI/ML are outlined. As the world is entering the digitalized industrial era, this review provides an insightful discussion about intelligent microalgal wastewater treatment and biorefinery for researchers in the field of microalgae.
Topics: Microalgae; Artificial Intelligence; Biofuels; Machine Learning; Biotechnology; Biomass; Water Purification
PubMed: 36907394
DOI: 10.1016/j.scitotenv.2023.162797