-
Journal of Translational Medicine May 2024Diabetic retinopathy (DR) is the leading cause of blinding eye disease among working adults and is primarily attributed to the excessive proliferation of microvessels,...
BACKGROUND
Diabetic retinopathy (DR) is the leading cause of blinding eye disease among working adults and is primarily attributed to the excessive proliferation of microvessels, which leads to vitreous hemorrhage and retinal traction, thereby significantly impairing patient vision. NSUN2-mediated RNA mC methylation is implicated in various diseases, and in this investigation, we focused on elucidating the impact of NSUN2 on the regulation of the expression of the downstream gene MUC1, specifically through RNA mC methylation, on the progression of DR.
METHOD
Utilizing Microarray analysis, we examined patient vitreous fluid to pinpoint potential therapeutic targets for DR. Differential expression of NSUN2 was validated through qRT-PCR, Western blot, and immunofluorescence in human tissue, animal tissue, and cell model of DR. The relationship between NSUN2 and DR was explored in vitro and in vivo through gene knockdown and overexpression. Various techniques, such as MeRIP-qPCR and dot blot, were applied to reveal the downstream targets and mechanism of action of NSUN2.
RESULTS
The levels of both NSUN2 and RNA mC methylation were significantly elevated in the DR model. Knockdown of NSUN2 mitigated DR lesion formation both in vitro and in vivo. Mechanistically, NSUN2 promoted MUC1 expression by binding to the RNA mC reader ALYREF. Knockdown of ALYREF resulted in DR lesion alterations similar to those observed with NSUN2 knockdown. Moreover, MUC1 overexpression successfully reversed a series of DR alterations induced by NSUN2 silencing.
CONCLUSIONS
NSUN2 regulates the expression of MUC1 through ALYREF-mediated RNA mC methylation, thereby regulating the progression of DR and providing a new option for the treatment of DR in the future.
Topics: Animals; Humans; Male; Diabetic Retinopathy; Disease Progression; Gene Expression Regulation; Gene Knockdown Techniques; Methylation; Methyltransferases; Mice, Inbred C57BL; Mucin-1; RNA Methylation
PubMed: 38764010
DOI: 10.1186/s12967-024-05287-4 -
Cureus Apr 2024The ventricular migration of vitreous silicone oil (SiO) is rare and can easily be mistaken for intraventricular hemorrhage or a ruptured colloid cyst. We report here...
The ventricular migration of vitreous silicone oil (SiO) is rare and can easily be mistaken for intraventricular hemorrhage or a ruptured colloid cyst. We report here the case of an adult male who was misdiagnosed with a ruptured colloid cyst and was subsequently found to have ventricular migration of vitreous SiO. A 57-year-old male presented unresponsive following a respiratory arrest and underwent a head computed tomography (CT) scan that demonstrated multiple ovoid hyperdensities in the ventricular system, which was concerning for a ruptured colloid cyst. He was transferred to our institution for neurosurgical evaluation. Magnetic resonance imaging (MRI) was performed and demonstrated widespread abnormal diffusion restriction throughout the cortex and basal ganglia, consistent with anoxic brain injury secondary to hypoxic respiratory arrest. The MRI also demonstrated an abnormal signal in areas corresponding with the previously identified intraventricular lesions, which did not layer posteriorly. Given that the MRI sequence signals of the lesions in the ventricular system matched perfectly with the signals of the somewhat deflated SiO within the globe, these multiple ovoid lesions on imaging were most consistent with the migration of SiO from the vitreous body of the right globe into the ventricular system. This case demonstrates a diagnostic error that can occur in emergent settings because of the broad differential diagnosis for cerebral ventricular hyperdensities. A ruptured colloid cyst was considered the reason for transfer, with the anticipation of neurosurgical intervention, but further imaging demonstrated that this was an incidental finding in this patient who presented in extremis. Awareness of this rare clinical condition can prevent overutilization of resources and unnecessary interventions.
PubMed: 38738078
DOI: 10.7759/cureus.58043 -
Journal of Cutaneous and Aesthetic... 2024A 25-year-old aesthetician was operating Q-switch pulse (SPECTRA) cosmetic laser machine of 1,064 nm wavelength, for the purpose of skin bleaching. The probe suddenly...
A 25-year-old aesthetician was operating Q-switch pulse (SPECTRA) cosmetic laser machine of 1,064 nm wavelength, for the purpose of skin bleaching. The probe suddenly slipped over the plastic sheet that had been placed to avoid COVID-19 exposure after which she complained of sudden loss of vision. She was diagnosed as having vitreous hemorrhage in her right eye and was treated conservatively for one month. She then complained of central scotoma and was diagnosed to have developed a full-thickness macular hole, for which she was advised vitrectomy surgery. The purpose of this case report is to emphasize the importance of taking precautions during the COVID-19 era and while doing that making sure how to handle the machines so as not to inflict any accidental injury to the operating physician. Macular Holes following skin bleaching with Nd:YAG laser occurring in operating aesthetician is rare as compared to that occurring in the patients.
PubMed: 38736866
DOI: 10.4103/JCAS.JCAS_74_21 -
POCUS Journal 2024In acute care environments, accurately assessing complications of intracranial pathology can be challenging. Ocular complications in acute intracranial disease are not...
In acute care environments, accurately assessing complications of intracranial pathology can be challenging. Ocular complications in acute intracranial disease are not consistently evaluated despite their high morbidity. We report on a case of monocular diplopia in a 63-year-old man with subacute traumatic brain injury with localized subarachnoid hemorrhage. Ocular point of care ultrasound (POCUS) identified features of vitreous hemorrhage in one globe, leading to a diagnosis of Terson syndrome and a timely referral to ophthalmology. This finding was made on the medical floor days after the initial presentation during rehabilitation when ophthalmoscopy was not possible, and vitreous hemorrhage had not been identified on presentation. Terson syndrome is a seldom discussed but important complication of intracranial hemorrhage generally associated with poor patient outcomes. Ocular POCUS can provide a useful alternative in assessing ocular complications of acute intracranial disease on the medical floor, particularly when the practicalities of performing ophthalmoscopy are challenged.
PubMed: 38681167
DOI: 10.24908/pocus.v9i1.16660 -
Medicine Apr 2024"Internet + Nursing" refers to medical institutions using Internet technologies and big data to provide nursing services to discharged patients or those with severe... (Observational Study)
Observational Study
"Internet + Nursing" refers to medical institutions using Internet technologies and big data to provide nursing services to discharged patients or those with severe illnesses unable to visit hospitals, through online applications and offline care provision. This study aimed to explore the influence of "Internet + Nursing" on the psychological status and quality of life of patients with thyroid eye disease. Sixty-eight patients with thyroid eye disease from January 2021 to December 2022 were divided into a research group (n = 34, joined the platform) and control group (n = 34, not joined the platform) based on their voluntary participation in our hospital's "Internet + Nursing Platform." The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores of the research group were lower than those of the control group (P < .05). The short form-36 health survey (SF-36) scores in various dimensions were higher in the research group compared to the control group (P < .05). The incidence rates of retinal detachment, vitreous hemorrhage, diabetic retinopathy, and iris neovascularization were lower in the research group compared to the control group (P < .05). After nursing, exophthalmos, blink frequency, and eyelid height of the research group were lower than those of the control group, while tear film breakup time was higher than that of the control group (P < .05). The visual acuity of the research group was higher than that of the control group (P < .05). After nursing, the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25) scores in various dimensions were significantly higher in the research group than those in the control group (P < .05). Additionally, after nursing, the levels of interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in the research group were lower than those in the control group (P < .05). The patients in the research group exhibited higher recognition scores of nursing compared to those in the control group (P < .05). Through the implementation of "Internet + Nursing" for patients with thyroid eye disease discharged from our hospital, we can provide better out-of-hospital nursing for patients, reduce the occurrence of complications, improve ocular surface symptoms, promote visual acuity recovery, and improve patients' psychological status and quality of life.
Topics: Humans; Quality of Life; Female; Male; Middle Aged; Adult; Internet; Graves Ophthalmopathy; Aged
PubMed: 38669376
DOI: 10.1097/MD.0000000000037974 -
Alternative Therapies in Health and... Apr 2024Diabetic macular edema (DME) is one of the primary causes of decreased visual acuity in patients with diabetic retinopathy (DR). Rapid, effective, and safe treatment of...
BACKGROUND
Diabetic macular edema (DME) is one of the primary causes of decreased visual acuity in patients with diabetic retinopathy (DR). Rapid, effective, and safe treatment of DME is important to ensure patients' vision.
OBJECTIVE
In this study, we observed the efficacy and safety of internal limiting membrane (ILM) peeling in conjunction with subretinal injection of balanced salt solution (BSS) in treating refractory DME.
METHODS
A prospective, non-case-control study. Patients diagnosed with refractory DME in our hospital between October 2021 and June 2022 were included. All patients received 23G PPV in conjunction with internal limiting membrane removal and subretinal injection of BSS. During and after surgery, intravitreal injections of an anti-VEGF drug were administered. We compared and analyzed the best-corrected visual acuities (BCVA), central macular thickness (CMT), recurrence rate, complications, and other observation indicators.
RESULTS
The investigation included 32 patients (32 eyes). The BCVA at each time point after surgery was significantly higher than it was before the surgery (P < .001). One month after the surgery, the BCVA was significantly higher than it was before surgery and one week after the surgery. Postoperative CMT was statistically significantly lower than before surgery, and the difference was statistically significant (P < .001). One month after surgery, CMT was significantly lower than before and one week after surgery, and the difference was statistically significant (P < .001). Still, there was no significant difference between three and six months after surgery. Three times of intravitreal injections of anti-VEGF drugs were administered. At the most recent follow-up, DME recurred in three eyes (9.4%). During the follow-up period, no complications such as vitreous hemorrhage, retinal detachment, macular epiretinal membrane, or macular hole were observed.
CONCLUSION
Subretinal injection of BSS can be an effective treatment for refractory DME and is recommended for clinical use.
PubMed: 38639628
DOI: No ID Found -
Romanian Journal of Ophthalmology 2024To report patients who first presented with various ocular manifestations and eventually ascertained to have underlying dengue. A prospective study was conducted at...
To report patients who first presented with various ocular manifestations and eventually ascertained to have underlying dengue. A prospective study was conducted at multiple tertiary eye-care centers in India from 2012 to 2022. Cases reporting initially with ocular features along with fever/past history of fever over the last two weeks or with clinical features of dengue were selected. After an ophthalmological examination, patients underwent complete serological and biochemical analysis and those with reduced platelet counts were evaluated for dengue. Out of 564 cases, 15 patients were verified to be afflicted with dengue eventually. A rising trend of cases was seen every year and out of 15 cases, eight cases were reported during the Covid-19 pandemic (from 2020 to 2022), but were COVID-negative. 9 cases presented with acute redness followed by diminished vision. Seven cases presented a history of fever over the last few days and one had traveled from dengue endemic area. The various ocular presentations included subconjunctival hemorrhage, viral keratitis, anterior uveitis, sixth-nerve palsy, and vitreous hemorrhage. On serological examination, all 15 patients were detected to have low platelets. All cases responded well with supportive treatment and the ocular features subsided in all within a couple of weeks with good visual recovery. In a tropical nation, such as India, with endemic dengue zones and increasing figures of dengue lately, ophthalmologists must include dengue fever among the differential diagnoses in various ocular presentations like subconjunctival hemorrhage, viral keratitis, anterior uveitis, sixth nerve palsy, and vitreous hemorrhage. DHF = dengue hemorrhagic fever, PCR = polymerase chain reaction, RT-PCR = real-time automated reverse transcriptase (RT-PCR), SD = standard deviation, MAC-ELIS = IgM antibodies capture enzyme-linked immunosorbent assay, RE = right eye, LE = left eye, CECT = Contrast-enhanced computed tomography.
Topics: Humans; Vitreous Hemorrhage; Pandemics; Prospective Studies; Uveitis, Anterior; Abducens Nerve Diseases; Eye Infections, Viral; Keratitis; Dengue
PubMed: 38617719
DOI: 10.22336/rjo.2024.07 -
BMC Ophthalmology Apr 2024To report a case with bilateral Terson syndrome presented with a unique mushroom-like mass lesion on the optic disc along with proliferative vitreoretinopathy and...
BACKGROUND
To report a case with bilateral Terson syndrome presented with a unique mushroom-like mass lesion on the optic disc along with proliferative vitreoretinopathy and tractional retinal detachment.
CASE PRESENTATION
A 33-year-old man was injured during a traffic accident and had diffuse brain swelling and intraocular hemorrhage. Poor vision in both eyes was noted after the patient regained consciousness. B-scan ultrasonography showed extensive vitreous opacity with a posterior vitreous detachment and without obvious retinal detachment. Vitrectomy was performed in both eyes five months after the accident. After clearing up the vitreous opacity, a peculiar pigmented mushroom-like mass lesion was noted in the posterior pole and had severe adhesion to the underneath optic disc. Extensive multilayered peripapillary epiretinal membrane was found covering the posterior pole and led to tractional retinal detachment around the macula. The mass was presumed to be an organized vitreous hemorrhage originated from the optic disc. The extensive and adherent epiretinal membrane together with the mass lesion were removed as much as possible and silicon oil was injected for tamponade. However, in the right eye, the retina redetached under silicon oil, whereas in the left eye, his vision improved to 20/100.
CONCLUSIONS
Terson syndrome usually has a favorable prognosis but may be complicated by proliferative vitreoretinopathy and tractional retinal detachment. Careful monitoring is warranted and early vitrectomy should be considered in cases suspecting additional pathologies.
Topics: Adult; Humans; Male; Epiretinal Membrane; Orbital Diseases; Retina; Retinal Detachment; Vitrectomy; Vitreoretinopathy, Proliferative; Vitreous Hemorrhage
PubMed: 38589883
DOI: 10.1186/s12886-024-03407-8 -
Korean Journal of Ophthalmology : KJO Jun 2024Dense vitreous hemorrhage is a vision-threatening disease with varied clinical manifestations. Herein, we aimed to evaluate its causes and outcomes in patients without...
PURPOSE
Dense vitreous hemorrhage is a vision-threatening disease with varied clinical manifestations. Herein, we aimed to evaluate its causes and outcomes in patients without diabetes.
METHODS
A retrospective cohort including 60 eyes from 60 patients with an initial diagnosis of nontraumatic fundus-obscuring dense vitreous hemorrhages and without diabetes was recruited. The relevant medical records from January 2013 to December 2019 were reviewed and analyzed. We classified patients into the following four groups, depending on the underlying cause of dense vitreous hemorrhage: eight cases in the age-related macular degeneration group, four cases in the posterior vitreous detachment group, 20 cases in the tear group, and 28 cases in the vascular group.
RESULTS
The most common cause of dense vitreous hemorrhage was retinal vascular obstructive disease (46.7%); the age-related macular degeneration group showed the worst prognosis. The extent of best-corrected visual acuity change was significantly better in patients who underwent vitrectomy compared to those receiving conservative treatment; best-corrected visual acuity change (logarithm of the minimum angle of resolution) was 1.62 ± 0.57 in the surgical group and 1.06 ± 0.88 in the nonsurgical group (Student t-test, p = 0.007).
CONCLUSIONS
Retinal vascular disease is the most common cause of vitreous hemorrhages, and surgical treatments have a better visual outcome than nonsurgical treatments.
Topics: Humans; Vitreous Hemorrhage; Retrospective Studies; Male; Visual Acuity; Female; Middle Aged; Aged; Vitrectomy; Adult; Follow-Up Studies; Tomography, Optical Coherence; Aged, 80 and over; Fluorescein Angiography
PubMed: 38584442
DOI: 10.3341/kjo.2023.0116