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Retinal Cases & Brief Reports Mar 2021To report a case of bilateral endogenous endophthalmitis from Streptococcus pneumoniae with devastating sequelae.
PURPOSE
To report a case of bilateral endogenous endophthalmitis from Streptococcus pneumoniae with devastating sequelae.
METHODS
Interventional case report.
RESULTS
A 56-year-old man presented with acute bilateral blurred vision and floaters with fever and hemodynamic instability. Previously, he was diagnosed with acute otitis externa and reported manually extracting several of his own teeth. He underwent a vitreous tap and intravitreal antibiotic injections. Blood and vitreous cultures were positive for S. pneumoniae. The patient later developed life-threatening medical sequelae. His final visual acuity was no light perception in the right eye and 20/25 in the left eye.
CONCLUSION
Diagnosing endogenous endophthalmitis early is essential to initiating a systemic evaluation for potentially life-threatening medical conditions, including sepsis, endocarditis, and osteomyelitis. A high degree of suspicion, expeditious treatment, and interdisciplinary collaboration are essential to maximizing patient outcomes.
Topics: Anti-Bacterial Agents; Bacteremia; Ceftazidime; Dexamethasone; Drug Therapy, Combination; Endophthalmitis; Eye Infections, Bacterial; Glucocorticoids; Humans; Male; Middle Aged; Pneumococcal Infections; Streptococcus pneumoniae; Vancomycin; Visual Acuity; Vitreous Body
PubMed: 29994996
DOI: 10.1097/ICB.0000000000000760 -
Experimental Eye Research Apr 2024Extracellular vesicles (EVs) are released as highly stable lipid bilayer particles carrying proteins, lipids, glycans and miRNAs. The contents of EVs vary based on the... (Review)
Review
Extracellular vesicles (EVs) are released as highly stable lipid bilayer particles carrying proteins, lipids, glycans and miRNAs. The contents of EVs vary based on the cellular origin, biogenesis route and the functional state of the cell suggesting certain diseased conditions. A growing body of evidence show that EVs carry important molecules implicated in the development and progression of ophthalmic diseases. EVs associated with ophthalmic diseases are mainly carried by one of the three ocular biofluids which include tears, aqueous humor and vitreous humor. This review summarizes the list of EV derived biomarkers identified thus far in ocular fluids for ophthalmic disease diagnosis. Further, the methods used for sample collection, sample volume and the sample numbers used in these studies have been highlighted. Emphasis has been given to describe the EV isolation and the characterization methods used, EV size profiled and the EV concentrations analyzed by these studies, thus providing a roadmap for future EV biomarker studies in ocular fluids.
Topics: Extracellular Vesicles; Biomarkers; MicroRNAs; Proteins; Body Fluids
PubMed: 38401855
DOI: 10.1016/j.exer.2024.109831 -
Indian Journal of Ophthalmology Apr 2022Diabetic membranes are always a challenge for a surgeon because of sticky nature and chances of iatrogenic break while removing.
BACKGROUND
Diabetic membranes are always a challenge for a surgeon because of sticky nature and chances of iatrogenic break while removing.
PURPOSE
To demonstrate a safe reverse swiss roll technique to dissect diabetic vitreous membranes.
SYNPOSIS
Approaches and techniques for membrane dissection are segmentation, delamination and en-bloc dissection using various types of instruments and illumination. With vitreous cutte, picks and scissors, surgical steps are traditionallu performed by using classic lift and shave technique. After identifying the plane, tissue is lifted and then cut, which puts the retina at risk of break because of traction and active suction. Such a threat can be reduced by placing the cutter above the membrane thereby having the membrane itseld acting as a protective cushion to the retina. Port here, unlike lift and shave technique, doesn't face the edge of membrane but is exactly 180 degree opposite and membrane curls into port because of suction. Also, hemostasis is maintained by continuous aspiration and cutting as the instrument is moved side to side, retracting from the edge.
HIGHLIGHTS
Reverse swiss roll technique is safer compared to lift and shave because of the safety cushion of the membrane between the port and the retina. There is inherently less chances of retinal break because the active suction from the port is directed away from the retina. The technique also minimises traction and localised pull on the atrophic macula.
VIDEO LINK
https://youtu.be/WNnSsP69ZLw.
Topics: Diabetes Mellitus; Humans; Retinal Perforations; Switzerland; Vitrectomy; Vitreous Body
PubMed: 35326086
DOI: 10.4103/ijo.IJO_631_22 -
PloS One 2020The aim of this study was to investigate whether and how the biological media which are in contact with silicone oil play a role in the silicone emulsification process....
The aim of this study was to investigate whether and how the biological media which are in contact with silicone oil play a role in the silicone emulsification process. Commercially available Oxane 1300 silicone oil and potential hydrophilic phases of the emulsions in the eye (porcine aqueous humor, porcine vitreous and balanced salt solution) were investigated separately and in a mixture or emulsions by means of surface tension, rheological, zeta potential measurements and microscopic investigation. The surface tension of biological media (vitreous and aqueous humor) was significantly lower than that of non-biological media, especially in the case of aqueous humor, which indicates a remarkable emulsification tendency with these phases. The biological media are able to form both oil-in-water and water-in-oil emulsions, which can be observed in the clinical practice as well. It was established that the vitreous has a more expressed emulsification ability compared with the aqueous humor because smaller and more stable droplets can form with silicon oil when the vitreous is still there. It can be concluded that the vitreous has a higher impact on emulsification than the aqueous medium, which can predict that the vitreous remaining after vitrectomy has a key role in emulsion formation in the eye with silicone oil endotamponade.
Topics: Animals; Aqueous Humor; Emulsions; Isotonic Solutions; Rheology; Silicone Oils; Surface Tension; Swine; Vitrectomy; Vitreous Body
PubMed: 32559226
DOI: 10.1371/journal.pone.0235067 -
Forensic Science International Sep 2023Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality worldwide. The patients' and injuries' heterogeneity associated with TBI, alongside...
BACKGROUND
Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality worldwide. The patients' and injuries' heterogeneity associated with TBI, alongside with its variable clinical manifestations, make it challenging to make diagnosis and predict prognosis. Therefore, the identification of reliable prognostic markers would be relevant both to support clinical decision-making and forensic evaluation of polytraumatic deaths and cases of medical malpractice. This pilot study aimed to evaluate some of the main biomarkers specific for brain damage in sTBI and mmTBI deaths in samples of vitreous humor (VH) in order to verify whether predictors of prognosis in TBI can be found in this matrix.
METHODS
VH were obtained from both eyes (right and left) of 30 cadavers (20 sTBI and 10 mmTBI) and analysed. These factors were evaluated: NSE (neuron-specific enolase), S100 calcium-binding protein (S100), glial fibrillary acidic protein (GFAP), Brain-derived neurotrophic factor (BDNF), Copeptin, Interleukin 6 (IL-6), Ferritin, Lactate dehydrogenase (LDH), C-Reactive Protein (CRP), Procalcitonin (PCT), Glucose and Neutrophil gelatinase-associated lipocalin (N-Gal).
RESULTS
Four of the analysed proteins (LDH, ferritin, S100 and NSE) proved to be particularly promising. In particular, logistic regression analysis found a good discriminatory power.
CONCLUSIONS
Given the peculiarity of the matrix and the poor standardization of the sampling, such promising results need to be furtherly investigated in serum before being implemented in the forensic practice.
Topics: Humans; Pilot Projects; Vitreous Body; S100 Calcium Binding Protein beta Subunit; Brain Injuries, Traumatic; Biomarkers; Glial Fibrillary Acidic Protein; Ferritins
PubMed: 37467521
DOI: 10.1016/j.forsciint.2023.111782 -
The Journal of International Medical... Dec 2022To evaluate the relationship between the microbiological results of the vitreous humor and those of foreign body specimens in patients with intraocular foreign body...
OBJECTIVE
To evaluate the relationship between the microbiological results of the vitreous humor and those of foreign body specimens in patients with intraocular foreign body (IOFB).
METHODS
Seventy-one patients with an IOFB were included in this descriptive prospective case series. All patients underwent immediate IOFB removal. Vitreous sampling was performed during vitrectomy. Foreign bodies were placed directly into culture media for microbiological study.
RESULTS
Thirteen (18.3%) patients developed endophthalmitis. The results of microbiological analysis of IOFB and vitreous humor specimens were negative in nine patients and positive in four. Fifty-eight (81.6%) patients with an IOFB had no evidence of endophthalmitis. Among them, seven patients showed positive microbiological results of foreign bodies with no manifestations of endophthalmitis. In five patients, a strain was observed in the culture of the IOFB specimen. Two patients had only positive smear test results of their vitreous humor specimen.
CONCLUSION
A correlation appears to be present between the microbiological results of the vitreous humor and IOFB specimens in patients with clinical findings of endophthalmitis but not in patients with a pure IOFB without clinical features of endophthalmitis. This may justify early use of intravitreal and intravenous antibiotics before the development of endophthalmitis.
Topics: Humans; Eye Injuries, Penetrating; Eye Foreign Bodies; Vitreous Body; Anti-Bacterial Agents; Endophthalmitis; Vitrectomy; Retrospective Studies
PubMed: 36562091
DOI: 10.1177/03000605221138482 -
Cells Apr 2021In this study, we compare the vitreous cytokine profile in patients with proliferative diabetic retinopathy (PDR) to that of patients without PDR. The identification of...
In this study, we compare the vitreous cytokine profile in patients with proliferative diabetic retinopathy (PDR) to that of patients without PDR. The identification of novel cytokines involved in the pathogenesis of PDR provides candidate therapeutic targets that may stand alone or work synergistically with current therapies in the management of diabetic retinopathy. Undiluted vitreous humor specimens were collected from 74 patients undergoing vitrectomy for various vitreoretinal disorders. Quantitative immunoassay was performed for a panel of 36 neuroinflammatory cytokines in each specimen and assessed to identify differences between PDR ( = 35) and non-PDR ( = 39) patients. Levels of interleukin-8 (IL-8), IL-15, IL-16, vascular endothelial growth factor (VEGF), VEGF-D, c-reactive protein (CRP), serum amyloid-A (SAA), and intracellular adhesion molecule-1 (ICAM1) were significantly increased in the vitreous of PDR patients compared to non-PDR patients ( < 0.05). We report novel increases in IL-15 and IL-16, in addition to the expected VEGF, in the human vitreous humor of patients with PDR. Additionally, we confirm the elevation of ICAM-1, VCAM-1, SAA, IL-8 and CRP in the vitreous of patients with PDR, which has previously been described.
Topics: C-Reactive Protein; Diabetic Retinopathy; Female; Fibroblast Growth Factor 2; Humans; Intercellular Adhesion Molecule-1; Interleukins; Male; Middle Aged; Vascular Cell Adhesion Molecule-1; Vascular Endothelial Growth Factor A; Vitreous Body
PubMed: 33946446
DOI: 10.3390/cells10051069 -
International Ophthalmology Clinics Jul 2022The purpose of this article is to discuss the early- and late-onset corneal complications that can occur following vitreoretinal surgery. (Review)
Review
PURPOSE:
The purpose of this article is to discuss the early- and late-onset corneal complications that can occur following vitreoretinal surgery.
METHODS:
A systematic review of the literature was conducted using PubMed and Google Scholar databases. Articles detailing the clinical findings and the associations between surgical techniques, irrigating solutions, and microsurgical instruments used for vitreoretinal surgery and postoperative corneal complications were included in this review.
RESULTS:
Vitreoretinal surgery can be associated with corneal complications such as persistent corneal epithelial defects, neurotrophic keratopathy, band keratopathy, ocular surface disruption, and endothelial cell damage. Risk factors for the development of cornea complications after posterior segment surgery include history of uncontrolled diabetes mellitus, aphakia or pseudophakia, disrupted anterior lens capsule integrity, use of irrigating solutions without appropriate buffers, use of contact viewing lenses intraoperatively, intraocular gases or silicone oil after vitrectomy, and prolonged duration of surgery.
CONCLUSIONS:
Corneal complications secondary to vitreoretinal surgery are multifactorial, but more commonly arise in diabetic patients, those with preexisting ocular comorbidities, and under certain surgical-related conditions. Special pre-, peri-, and postoperative considerations, with a focus on early identification and management of risk factors, are required to help decrease the incidence of corneal complications.
Topics: Cornea; Humans; Ophthalmologic Surgical Procedures; Retrospective Studies; Vitrectomy; Vitreoretinal Surgery; Vitreous Body
PubMed: 35752886
DOI: 10.1097/IIO.0000000000000423 -
Advances in Therapy May 2020Proliferative vitreoretinopathy (PVR), which is regulated by growth factors and cytokines, is the leading cause of failure in vitreoretinal surgery. In this study, we...
INTRODUCTION
Proliferative vitreoretinopathy (PVR), which is regulated by growth factors and cytokines, is the leading cause of failure in vitreoretinal surgery. In this study, we aimed to investigate the role of the human serum and vitreous inflammation-related factors in the development of proliferative vitreoretinopathy (PVR).
METHODS
Blood and vitreous samples were obtained from patients undergoing pars plana vitrectomy. Inflammation-related factors were detected using an immunology multiplex assay on a Luminex xMAP platform. Patients with PVR and rhegmatogenous retinal detachment (RRD) were compared with macular hole (MH) or epiretinal membrane (ERM) patients without any other ocular or systemic disease.
RESULTS
Thirty-six serum samples and 34 vitreous samples were obtained. Thirty-one different growth factors and cytokines were detected in serum samples. However, none of the circulating growth factors and cytokines were found to be different from the controls. Ten different growth factors and cytokines were measured in the vitreous samples. The concentration levels of PDGF-AA, TGF-α, VEGF, IL-6, IL-8, and TNFβ were found to have significantly increased in the vitreous of PVR patients.
CONCLUSION
Our study found that none of the circulating inflammation-related factors were changed in PVR or RRD patients, indicating the absence of a system inflammatory biomarkers to predict the development of proliferative vitreoretinopathy. As a supplement to previous research, the concentrations of PDGF-AA, TGF-α, VEGF, IL-6, IL-8, and TNFβ were significantly upregulated in the vitreous of PVR patients. These factors should be considered for preventing PVR.
Topics: Adult; Aged; Enzyme-Linked Immunosorbent Assay; Epiretinal Membrane; Female; Humans; Inflammation Mediators; Male; Middle Aged; Retinal Detachment; Retinal Perforations; Vitrectomy; Vitreoretinopathy, Proliferative; Vitreous Body
PubMed: 32274748
DOI: 10.1007/s12325-020-01325-x -
Ophthalmology Jul 2021To test whether analyzing DEPArray (Menarini Silicon Biosystems) isolated single B cells from the vitreous fluid can reveal crucial genomic and clinicopathological...
PURPOSE
To test whether analyzing DEPArray (Menarini Silicon Biosystems) isolated single B cells from the vitreous fluid can reveal crucial genomic and clinicopathological features to distinguish patients with vitreoretinal lymphoma (VRL) from those with chronic inflammation using immunoglobulin heavy chain (IGH), disease biomarker myeloid differentiation primary response 88 (MYD88) mutation, and copy number profiling.
DESIGN
A single-center, retrospective study.
PARTICIPANTS
Remnant vitreous biopsies from 7 patients with VRL and 4 patients with chronic inflammation were acquired for molecular analysis.
METHODS
Vitreous fluid samples were prefixed in PreservCyt (Hologic) and underwent cytologic analysis and immunohistochemistry examination. Single cells were isolated using the DEPArray NxT system, followed by downstream genomic analysis.
MAIN OUTCOME MEASURES
The frequencies of the dominant IGH and MYD88 mutation and the genome-wide copy number aberration (CNA) profiles of individual vitreous-isolated B cells were characterized.
RESULTS
An average of 10 to 13 vitreous B cells were used in the single-cell IGH and MYD88 analyses. Higher frequencies of dominant IGH (88.8% ± 13.2%) and MYD88 mutations (35.0% ± 31.3%) were detected in patients with VRL than in patients with chronic inflammation (65.9% ± 13.4% and 1.5% ± 2.6% for IGH and MYD88, respectively). In a cytology-proven VRL case, all 15 vitreous isolated B cells were derived from the same clone with 100% paired IGH: immunoglobulin light chain (IGK) sequences. Genome-wide copy number profiling revealed a high degree of similarity between B cells from the same patient with VRL, with extensive gains and losses at the same areas across the whole genome. In addition, 14 of 15 B cells showed a BCL2/JH t(14;18) translocation, confirming cellular malignancy with a clonal origin. Clustering analysis of the copy number profiles revealed that malignant B cells derived from different patients with VRL had no common genome-wide signatures.
CONCLUSIONS
Single B-cell genomic characterization of the IGH, MYD88 mutation, and copy number profile enables VRL diagnosis. Because our study involved only a small cohort, these meaningful proof-of-concept data now warrant further investigation in a larger patient cohort.
Topics: B-Lymphocytes; Biopsy; Cell Line; Chronic Disease; DNA Mutational Analysis; DNA, Neoplasm; Feasibility Studies; Genomics; Inflammation; Lymphoma, Large B-Cell, Diffuse; Mutation; Myeloid Differentiation Factor 88; Retina; Retinal Neoplasms; Vitreous Body
PubMed: 33221324
DOI: 10.1016/j.ophtha.2020.11.018