-
Journal of Proteome Research Jul 2023As a vision-threatening complication of diabetes mellitus (DM), proliferative diabetic retinopathy (PDR) is associated with sustained metabolic disorders. Herein, we...
As a vision-threatening complication of diabetes mellitus (DM), proliferative diabetic retinopathy (PDR) is associated with sustained metabolic disorders. Herein, we collected the vitreous cavity fluid of 49 patients with PDR and 23 control subjects without DM for metabolomics and lipidomics analyses. Multivariate statistical methods were performed to explore relationships between samples. For each group of metabolites, gene set variation analysis scores were generated, and we constructed a lipid network by using weighted gene co-expression network analysis. The association between lipid co-expression modules and metabolite set scores was investigated using the two-way orthogonal partial least squares (O2PLS) model. A total of 390 lipids and 314 metabolites were identified. Multivariate statistical analysis revealed significant vitreous metabolic and lipid differences between PDR and controls. Pathway analysis showed that 8 metabolic processes might be associated with the development of PDR, and 14 lipid species were found to be altered in PDR patients. Combining metabolomics and lipidomics, we identified fatty acid desaturase 2 (FADS2) as an important potential contributor to the pathogenesis of PDR. Collectively, this study integrates vitreous metabolomics and lipidomics to comprehensively unravel metabolic dysregulation and identifies genetic variants associated with altered lipid species in the mechanistic pathways for PDR.
Topics: Humans; Diabetic Retinopathy; Lipidomics; Vitreous Body; Metabolomics; Lipids; Diabetes Mellitus
PubMed: 37329324
DOI: 10.1021/acs.jproteome.3c00007 -
Translational Vision Science &... Feb 2023The purpose of this study was to assess the performance of ultrasonic (US) vitrectomy devices by quantifying and comparing its impact on extracted vitreous properties to...
PURPOSE
The purpose of this study was to assess the performance of ultrasonic (US) vitrectomy devices by quantifying and comparing its impact on extracted vitreous properties to conventional pneumatic blade (PB) cutters using micro-extensional rheology. US vitrectomy is a new technology that offers an alternative to PB cutters used in vitreo-retinal surgeries.
METHODS
Thirty-six porcine vitreous samples were extracted using US and PB cutters. Each sample was kept at 4°C and tested within 24 hours postmortem and 4 hours post-vitrectomy. A recently developed micro-extensional rheology technique is used to infer the relative protein fragment size of extracted vitreous by quantifying the extensional relaxation time.
RESULTS
US-extracted vitreous exhibited extensional relaxation times orders of magnitude lower than PB-extracted vitreous (0.37 ms and 27.25 ms, respectively). Relaxation time is directly correlated to the fragment size of the collagen fibers in the vitreous. The formation of beads-on-a-string droplets within the PB samples indicates the presence of larger collagen fragments. These droplets were not seen on US samples.
CONCLUSIONS
This new micro-extensional rheology technique can identify significant differences in physical properties of extracted vitreous. Long relaxation times and beads-on-a-string droplets within the PB vitreous samples indicate larger protein fragments compared to the US samples.
TRANSLATIONAL RELEVANCE
Higher fragmentation of vitreous and lower extensional relaxation times may improve retina safety due to a reduction in vitreo-retinal traction resulting from the continuous shear action and aspiration applied by ultrasonic vitrectomy technology.
Topics: Swine; Animals; Vitrectomy; Vitreous Body; Ultrasonics; Collagen; Rheology
PubMed: 36790819
DOI: 10.1167/tvst.12.2.24 -
Translational Vision Science &... May 2022To accurately evaluate pressure changes during vitrectomy in a rigid model of the vitreous chamber and to test the efficiency of the EVA phacovitrectomy system (Dutch...
PURPOSE
To accurately evaluate pressure changes during vitrectomy in a rigid model of the vitreous chamber and to test the efficiency of the EVA phacovitrectomy system (Dutch Ophthalmic Research Center) in terms of compensation of intraocular pressure variations.
METHODS
We tested 23-, 25-, and 27-gauge double-blade vitreous cutters in both vented global pressure control and automatic infusion compensation (AIC) modes in a vitreous chamber model, mimicking the real surgical procedure. Balanced salt solution and artificial vitreous, similar to the real vitreous body, were used. We tested both standard-flow (SF) and high-flow (HF) infusion systems, varying the infusion pressure between 20 and 40 mm Hg. In each experiment, flow rate was also measured.
RESULTS
Pressure drop was rapidly and efficiently compensated when 23- and 25-gauge cutters were used in AIC mode, with infusion pressures ranging between 30 and 55 mm Hg. The 27-gauge cutter was less efficient in compensating pressure variations. Pressure fluctuations related to the high-frequency motion of the cutter blade were small compared to the overall pressure variations. The use of the HF infusion system resulted in larger flow rates and lower pressure changes compared to the SF infusion system.
CONCLUSIONS
Despite the rigid material of the model, the present pressure measurements are in line with previous studies performed on porcine eye. The use of AIC mode compensates intraoperative pressure drops efficiently, with both 23- and 25-gauge cutters. The HF infusion system is more efficient than the SF infusion system.
TRANSLATIONAL RELEVANCE
The AIC infusion mode efficiently compensates intraoperative pressure drops, in both 23- and 25-gauge experimental vitrectomy. The HF infusion system resulted in larger flow rate and lower pressure changes.
Topics: Animals; Eye Diseases; Microsurgery; Swine; Tonometry, Ocular; Vitrectomy; Vitreous Body
PubMed: 35583885
DOI: 10.1167/tvst.11.5.21 -
Experimental Eye Research Aug 2023Ocular diseases and treatment related to rhegmatogenous retinal detachment (RRD) are highly correlated with retinal adhesion behavior. Therefore, this paper proposes to...
Ocular diseases and treatment related to rhegmatogenous retinal detachment (RRD) are highly correlated with retinal adhesion behavior. Therefore, this paper proposes to study the adhesion behavior of the intact retina. This can provide theoretical guidance for the treatment and research of retinal detachment (RD) related diseases. To systematically analyze this aspect, two experiments were performed on the porcine retina. The pull-off test combined with the modified JKR theory was used to study the adhesion behavior of the vitreoretinal interface, while the peeling test was used to study the adhesion behavior of the chorioretinal interface. In addition, the adhesion phase involved in the pull-off test was simulated and analyzed by building the corresponding finite element method (FEM). The experimental results of adhesion force on the vitreoretinal interface were obtained by pull-off test with five sizes of rigid punch. The experimental value of the pull-off force F tends to increase gradually with increasing punch radius in the range of 0.5-4 mm. A comparison of the experimental results with the simulation results shows that they are in a well agreement. And there is no statistical difference between the experimental and theoretical values of the pull-off force F. In addition, the values of retinal adhesion work were also obtained by pull-off test. Interestingly, there is a significant scale effect of the retinal work of adhesion. Finally, the peeling test gave a maximum peeling strength T of about 13 mN/mm and a stable peeling strength T of about 11 mN/mm between the retina and the choroid. The pull-off test well shows the process of retinal traction by the diseased vitreous at the beginning of RRD. A comparison of the experimental results with the finite element results verifies the accuracy of the simulation. The peeling test well investigated the adhesion behavior between the retina and the choroid and obtained key biomechanical data (peeling strength, etc.). The combination of the two experiments allows a more systematic study of the whole retina. This research can provide more complete material parameters for finite element modeling of retina-related diseases, and it also can provide the theoretical guidance for individualized design of retinal repair surgery.
Topics: Animals; Swine; Retinal Detachment; Vitrectomy; Retina; Retinal Diseases; Vitreous Body; Tissue Adhesions
PubMed: 37321365
DOI: 10.1016/j.exer.2023.109541 -
Graefe's Archive For Clinical and... Jul 2020To investigate osteopontin (OPN) expression in vitreous and in related idiopathic epiretinal membranes (ERMs), with respect to VEGF-A, IL8, MIP1α, IL6, and IL33, and...
PURPOSE
To investigate osteopontin (OPN) expression in vitreous and in related idiopathic epiretinal membranes (ERMs), with respect to VEGF-A, IL8, MIP1α, IL6, and IL33, and correlate OPN expression with disease staging.
METHODS
Fifteen (15) vitreous and allied ERMs were collected at the time of therapeutic vitreoretinal surgery. Additional 5 vitreous and 10 ERMs (historical collection) were used. Biochemical and molecular analysis of OPN was performed in clear vitreous, vitreal pelleted cells, and ERMs. Double-immunofluorescence analysis (OPN - GFAP and OPN - αSMA) was performed on paraffin and whole-mounted ERMs. Vitreal OPN levels were correlated to those of VEGF-A, IL8, MIP1α, IL6, and IL33.
RESULTS
High OPN levels were observed in vitreal samples, and OPN transcripts were amplified in vitreal cells and related ERMs. OPN immunoreactivity was found in ERMs, mainly in GFAP-bearing (Muller cells) and to a less extend in αSMA-expressing (myofibroblasts) cells. OPN levels were highest at early stages of ERM formation and positively correlated to VEGF-A and MIP1α.
CONCLUSIONS
High OPN levels in vitreous, OPN transcripts in vitreal cells/ERMs, OPN immunoreactivity in activated Müller cells and contractile myofibroblasts, as well as the correlation with VEGF-A and MIP1α fulfill the potential involvement of OPN in both inflammation and tissue remodeling that takes part in vitreoretinal interface disorders. The highest OPN levels at early stages of ERM formation would prospect OPN as a potential biomarker for disease severity.
Topics: Aged; Biomarkers; Enzyme-Linked Immunosorbent Assay; Epiretinal Membrane; Female; Humans; Male; Osteopontin; Vitrectomy; Vitreous Body
PubMed: 32277255
DOI: 10.1007/s00417-020-04685-w -
Nature Nanotechnology May 2022In myopia, diabetes and ageing, fibrous vitreous liquefaction and degeneration is associated with the formation of opacities inside the vitreous body that cast shadows...
In myopia, diabetes and ageing, fibrous vitreous liquefaction and degeneration is associated with the formation of opacities inside the vitreous body that cast shadows on the retina, appearing as 'floaters' to the patient. Vitreous opacities degrade contrast sensitivity function and can cause notable impairment in vision-related quality of life. Here we introduce 'nanobubble ablation' for safe destruction of vitreous opacities. Following intravitreal injection, hyaluronic acid-coated gold nanoparticles and indocyanine green, which is widely used as a dye in vitreoretinal surgery, spontaneously accumulate on collagenous vitreous opacities in the eyes of rabbits. Applying nanosecond laser pulses generates vapour nanobubbles that mechanically destroy the opacities in rabbit eyes and in patient specimens. Nanobubble ablation might offer a safe and efficient treatment to millions of patients suffering from debilitating vitreous opacities and paves the way for a highly safe use of pulsed lasers in the posterior segment of the eye.
Topics: Animals; Eye Diseases; Gold; Humans; Lasers; Metal Nanoparticles; Quality of Life; Rabbits; Vitrectomy; Vitreous Body
PubMed: 35302088
DOI: 10.1038/s41565-022-01086-4 -
Clinical & Experimental Ophthalmology Mar 2020Vitreoretinal lymphomas are rare ocular cancers, and the subset of primary central nervous system lymphomas that are based in the posterior eye. These tumours are... (Review)
Review
Vitreoretinal lymphomas are rare ocular cancers, and the subset of primary central nervous system lymphomas that are based in the posterior eye. These tumours are challenging to treat, and today management generally involves a multispecialty team coordinating a treatment protocol that may include intraocular chemotherapy, ocular irradiation, systemic chemotherapy and/or autologous stem cell transplantation. The ophthalmologist has specific responsibility for the intraocular chemotherapy, which is delivered to the eye by intravitreal injection. The most commonly injected drugs are methotrexate-an anti-metabolite-and rituximab-an anti-human B cell monoclonal antibody. A range of intraocular chemotherapy treatment schedules have been described in the medical literature, although to date there have been no randomized clinical trials of these schedules. In this article, we review the development and current status of intraocular chemotherapy for vitreoretinal lymphoma.
Topics: Antimetabolites, Antineoplastic; Antineoplastic Agents, Immunological; Eye Neoplasms; Humans; Intraocular Lymphoma; Intravitreal Injections; Methotrexate; Retinal Neoplasms; Rituximab; Vitreous Body
PubMed: 31680408
DOI: 10.1111/ceo.13668 -
European Journal of Ophthalmology Jul 2022To investigate sensitivity of diagnostic vitrectomy and vitreous biopsy for patients with vitritis of unknown aetiology.
PURPOSE
To investigate sensitivity of diagnostic vitrectomy and vitreous biopsy for patients with vitritis of unknown aetiology.
METHODS
Retrospective analysis of all vitrectomies and vitreous biopsies, performed at St Thomas' Hospital, London, UK, for vitritis between February 2001 and February 2019. Patients were identified using the VITREOR database and records were reviewed. Patients were categorised as infectious, non-infectious or masquerade based on final diagnosis. Sensitivity of both diagnostic pars plana vitrectomy (PPV) and vitreous cutter biopsy in each category was investigated. Furthermore, data on gender, age, and method of anaesthesia were also collected.
RESULTS
In our cohort, 64 patients underwent PPV with a diagnostic sensitivity of 67% (43/64) overall and 60% (18/30), 56% (9/16) and 89% (16/18) for those with infectious, masquerade and non-infectious aetiologies, respectively. In comparison, 96 patients underwent a vitreous cutter biopsy with diagnostic sensitivity of 74% (71/96) overall and 71% (55/77), 67% (4/6) and 92% (12/13) for those with infectious, masquerade and non-infectious aetiologies, respectively. No statistically significant difference in sensitivity was identified between the vitrectomy and vitreous biopsy groups for either aetiology. Patients undergoing vitrectomy were noted to be older ( = 0.02) and more likely to undergo a general anaesthetic ( < 0.01).
CONCLUSIONS
Herein we demonstrate similar diagnostic sensitivity of PPV and vitreous cutter biopsy in patients with vitritis of unknown aetiology.
Topics: Biopsy; Endophthalmitis; Humans; Orbital Diseases; Retrospective Studies; Vitrectomy; Vitreous Body
PubMed: 34459269
DOI: 10.1177/11206721211041025 -
Biomedical Materials (Bristol, England) Jun 2021Vitreoretinal surgery is an essential approach to treat proliferative diabetic vitreopathy, retinal detachment, retinal tear, ocular trauma, and macular holes. The... (Review)
Review
Vitreoretinal surgery is an essential approach to treat proliferative diabetic vitreopathy, retinal detachment, retinal tear, ocular trauma, and macular holes. The removal of the natural vitreous and the replacement with substitutes are critical steps for retina reattachment. Vitreous substitutes including silicone oil (SiO), air, sulfur hexafluoride (SF), and perfluoropropane (CF), have been widely applied in clinical practice. However, these substitutes are reported to cause complications such as emulsification, high intraocular pressure, and lens opacification. Polymeric hydrogels are a kind of material with favorable physical, mechanical properties, and adaptable biocompatibility, thus being highly expected to be ideal vitreous substitutes. Despite years of research, very few polymeric hydrogels can be applied practically in the vitreous cavity. In this review, we focus on the development of polymeric natural-based hydrogels and synthetic hydrogels. Particularly, we pay attention to recent advances in the novel stimuli-response and self-assembly supramolecular hydrogels. Characterized by easy injectability and long residence time, this kind of hydrogel becomes the potentially promising candidates for ideal vitreous substitutes. Finally, we evaluate the current challenges and provide the future directions of vitreous substitutes.
Topics: Animals; Biocompatible Materials; Humans; Hydrogels; Mice; Polymers; Vitreous Body
PubMed: 34038870
DOI: 10.1088/1748-605X/ac058e -
Diabetes Care Sep 2022To correlate inflammatory cytokines and vascular endothelial growth factor (VEGF) in vitreous and plasma with vitreous retinol binding protein 3 (RBP3), diabetic...
OBJECTIVE
To correlate inflammatory cytokines and vascular endothelial growth factor (VEGF) in vitreous and plasma with vitreous retinol binding protein 3 (RBP3), diabetic retinopathy (DR) severity, and DR worsening in a population with type 1 and type 2 diabetes.
RESEARCH DESIGN AND METHODS
RBP3, VEGF, and inflammatory cytokines were measured in plasma and vitreous samples (n = 205) from subjects of the Joslin Medalist Study and Beetham Eye Institute.
RESULTS
Higher vitreous RBP3 concentrations were associated with less severe DR (P < 0.0001) and a reduced risk of developing proliferative DR (PDR) (P < 0.0001). Higher RBP3 correlated with increased photoreceptor segment thickness and lower vitreous interleukin-12 (IL-12), tumor necrosis factor-α (TNF-α), and TNF-β (P < 0.05). PDR was associated with lower vitreous interferon-γ and IL-10 and higher VEGF, IL-6, and IL-15 (P < 0.05), but was not associated with their plasma concentrations.
CONCLUSIONS
Higher vitreous RBP3 concentrations are associated with less severe DR and slower rates of progression to PDR, supporting its potential as a biomarker and therapeutic agent for preventing DR worsening, possibly by lowering retinal VEGF and inflammatory cytokines.
Topics: Cytokines; Diabetes Mellitus, Type 2; Diabetic Retinopathy; Enzyme-Linked Immunosorbent Assay; Eye Proteins; Humans; Retinol-Binding Proteins; Vascular Endothelial Growth Factor A; Vitreous Body
PubMed: 35852358
DOI: 10.2337/dc22-0165