-
Journal of Ophthalmic & Vision Research 2023To report the development of malignant epiretinal membrane after radiation of ciliary body melanoma.
PURPOSE
To report the development of malignant epiretinal membrane after radiation of ciliary body melanoma.
CASE REPORT
A 65-year-old woman was referred for evaluation of a ciliary body tumor in her right eye. On examination, a pigmented ciliary body tumor, displacing the iris anteriorly, was visible superotemporally and ultrasound biomicroscopy revealed a large solid ciliary body tumor. She was diagnosed with ciliary body melanoma and treated with proton beam radiation. Over the following 29 months, the treated tumor regressed but optical coherence tomography (OCT) showed the development of a dense epiretinal membrane. Enucleation was performed and histopathological examination showed viable melanoma cells in the vitreous cavity with sheet-like growth of viable spindle melanoma cells on the epiretinal surface.
CONCLUSION
The development of a pigmented epiretinal membrane in eyes with uveal melanoma should raise the possibility of a malignant epiretinal membrane.
PubMed: 38250230
DOI: 10.18502/jovr.v18i4.14558 -
PloS One 2024VitreoDx is an experimental device enabling push-button collection of a neat vitreous liquid biopsy incidental to an intravitreal injection. We explored the ability of...
PURPOSE
VitreoDx is an experimental device enabling push-button collection of a neat vitreous liquid biopsy incidental to an intravitreal injection. We explored the ability of the device to collect a sample usable for proteomic biomarker discovery and testing.
DESIGN
Pilot study using ex vivo human eyes.
METHODS
Non-vitrectomized, human eyes from nine donors 75-91 years of age were refrigerated in BSS and used within 5 days of death. Four VitreoDx devices fitted with 25G needles, and four staked needle insulin syringes with 30G needles, were inserted at equal intervals through the pars plana of each eye and held in place by a fixture. The sampling mode of each VitreoDx device was triggered to attempt to acquire a liquid biopsy up to 70 μL. The plunger of each insulin syringe was retracted to attempt to obtain a liquid biopsy with a maximum volume of 50 μL. Samples acquired with the VitreoDx were extracted to polypropylene cryovials, refrigerated to -80 ºC, and sent for offsite proteomic analysis by proximity extension assay with a focus on panels containing approved and pipelined drug targets for neovascular disease and inflammatory factors.
RESULTS
Of the attempted liquid biopsies with the novel 25G VitreoDx, 92% (66 of 72) resulted in successful acquisition (>25 μL) while 89% (64 of 72) attempted by a traditional 30G needle resulted in a successful acquisition. Sample volume sufficient for proteomics array analysis was acquired by the VitreoDx for every eye. Detectable protein was found for 151 of 166 unique proteins assayed in at least 25% of eyes sampled by VitreoDx.
CONCLUSIONS
The high acquisition rate achieved by the prototype was similar to that achieved in previous clinical studies where a standard syringe was used with a 25G needle to biopsy vitreous fluid directly prior to standard intravitreal injection. Successful aspiration rates were likewise high for 30G needles. Together, these suggest that it is possible to routinely acquire liquid vitreous biopsies from patients who typically receive intravitreal injections with an injection device using a standard size needle without a vitreous cutter. Protein analysis shows that proteins of interest survive the sampling mechanism and may have potential to direct care in the future.
Topics: Humans; Infant, Newborn; Intravitreal Injections; Proteomics; Feasibility Studies; Pilot Projects; Vitreous Body; Biopsy; Needles; Liquid Biopsy; Insulins
PubMed: 38241211
DOI: 10.1371/journal.pone.0294526 -
International Journal of Retina and... Jan 2024Perfluorocarbon (PFC)possesses unique chemical properties that favor the pigment epithelium's adhesion and allows the drainage of subretinal fluid through retinal holes... (Review)
Review
BACKGROUND
Perfluorocarbon (PFC)possesses unique chemical properties that favor the pigment epithelium's adhesion and allows the drainage of subretinal fluid through retinal holes present in retinal detachment cases. However, PFC as a temporary tamponade agent has been limited due to its high potential for toxicity.
MAIN BODY
We conducted a scoping review regarding the use of PFC in vitreoretinal surgery as a temporary tamponade in subjects with severe ocular trauma or severe retinal detachment who received a therapeutic intervention (vitrectomy via posterior approach with the use of PFC as a temporary tamponade), compared to vitrectomy without the use of PFC as a temporary tamponade. Outcomes of interest were retinal reattachment, visual acuity (VA), postoperative complications and retinal toxicity. The search was performed in Medline, Medline In-Process & Other Non-Indexed Citations, Medline Daily Update, Embase databases. Reference lists from relevant review articles were also included. Two hundred thirty-eight studies were found, with no duplicate entries. In the first selection, 230 articles were eliminated; in the second selection, 6 additional articles were discarded. In total, 8 articles were obtained in this review. Two selected articles corresponded to animal studies and 6 to studies in humans. Regarding study design, 5 were case series, and 1 was a cohort study.
CONCLUSION
PFC as a short-term tamponade had high rates of reapplication, improved VA, and the most frequent adverse effects were reversible after PFC withdrawal. Nonetheless, the quality of the studies was poor. Studies with more rigorous methodologies are needed to determine visual and structural outcomes and potential risks of PFC use as a temporary tamponade in vitreoretinal surgery.
PubMed: 38238791
DOI: 10.1186/s40942-023-00504-6 -
PloS One 2024In this study, we propose a comprehensive mechanical model of ocular bulb vibrations and discuss its implications for acoustic tonometry. The model describes the eye...
In this study, we propose a comprehensive mechanical model of ocular bulb vibrations and discuss its implications for acoustic tonometry. The model describes the eye wall as a spherical, pre-stressed elastic shell containing a viscoelastic material and accounts for the interaction between the elastic corneoscleral shell and the viscoelastic vitreous humor. We investigate the natural frequencies of the system and the corresponding vibration modes, expanding the solution in terms of scalar and vector spherical harmonics. From a quantitative point of view, our findings reveal that the eyebulb vibration frequencies significantly depend on IOP. This dependency has two origins: "geometric" stiffening, due to an increase of the pre-stress, and "material" stiffening, due to the nonlinearity of the stress-strain curve of the sclera. The model shows that the second effect is by far dominant. We also find that the oscillation frequencies depend on ocular rigidity, but this dependency is important only at relatively large values of IOP. Thus close to physiological conditions, IOP is the main determinant of ocular vibration frequencies. The vitreous rheological properties are found to mostly influence vibration damping. This study contributes to the understanding of the mechanical behavior of the eye under dynamic conditions and thus has implications for non-contact intraocular pressure measurement techniques, such as acoustic tonometry. The model can also be relevant for other ocular pathological conditions, such as traumatic retinal detachment, which are believed to be influenced by the dynamic behavior of the eye.
Topics: Vibration; Intraocular Pressure; Tonometry, Ocular; Sclera; Acoustics
PubMed: 38236823
DOI: 10.1371/journal.pone.0294825 -
PloS One 2024To investigate relationship between vitreous interleukin-6 levels and vitreous particles findings on widefield optical coherence tomography in posterior uveitis.
PURPOSE
To investigate relationship between vitreous interleukin-6 levels and vitreous particles findings on widefield optical coherence tomography in posterior uveitis.
METHODS
This retrospective study examined vitreous inflammatory cells (hyperreflective particles) of posterior uveitis on widefield optical coherence tomography (WOCT). We examined the number of hyperreflective particles (possibility of vitreous inflammatory cells) observed on WOCT and the correlations with interleukin-6 (IL-6) levels. The relationship between vitreous IL-6 levels and image findings from WOCT from 37 eyes (34 patients) with posterior uveitis were analyzed. Mean patient age was 63.4±15.7 years. (Mean± standard deviation) IL-6 concentration in vitreous humor was 79.9±7380.9 pg/mL Uveitis was infectious in 9 cases and non-infectious in 28 cases with multiplex polymerase chain reaction system. We measured the number and size of vitreous cells in the posterior vitreous, defined as the space between the upper vitreous and the internal limiting membrane on WOCT at the macular, upper, and lower regions. Image analysis software was also used for cell counting.
RESULTS
A strong correlation was seen between human and software counts. Pearson's correlation coefficient (PCC) was performed to compare categorial variables (on macular +0.866; upper cavity +0.713; lower cavity +0.568; total vitreous cavity +0.834; P<0.001 each). IL-6 levels correlated with both vitreous cell counts and cell counts observed on macular WOCT (human-counted group +0.339, P = 0.04; software-counted group +0.349, P = 0.03). Infectious uveitis showed higher IL-6 levels (P = 0.016) and high cell counts compared with non-infectious uveitis (P = 0.04).
CONCLUSIONS
Vitreous number of hyperreflective particles (cells) findings on WOCTcorrelated well with human and software cell counts. Vitreous cells findings on WOCT also correlated with IL-6 concentrations on macular.
Topics: Humans; Middle Aged; Aged; Interleukin-6; Retrospective Studies; Tomography, Optical Coherence; Uveitis, Posterior; Uveitis; Retina
PubMed: 38232093
DOI: 10.1371/journal.pone.0297201 -
Radiology Case Reports Mar 2024Tuberous sclerosis complex (TSC) is a genetic disorder that causes noncancerous growths and tumors in various body systems. This case report discusses an unusual eye...
Tuberous sclerosis complex (TSC) is a genetic disorder that causes noncancerous growths and tumors in various body systems. This case report discusses an unusual eye condition called retinal astrocytic hamartoma (RAH) in a TSC patient, along with a brain tumor called subependymal giant cell astrocytoma (SEGA). These conditions, linked to TSC gene mutations, can be atypical in size and cause complications like vitreous hemorrhage. Surgical treatment is generally effective. Recognizing similarities between SEGA and RAH can help with early detection and comprehensive care for TSC patients.
PubMed: 38226050
DOI: 10.1016/j.radcr.2023.11.039 -
Molecular Vision 2023Increased inflammatory factor levels have been reported in the vitreous humor (VH) of diabetic retinopathy and neovascular age-related macular degeneration, ocular...
PURPOSE
Increased inflammatory factor levels have been reported in the vitreous humor (VH) of diabetic retinopathy and neovascular age-related macular degeneration, ocular diseases generally associated with the formation of new retinal blood vessels and leakage. However, the levels of inflammatory mediators are less known in retinal degeneration without neovascularization. Human retinitis pigmentosa (RP) and animal models of light-induced retinal degeneration (LIRD) share several features, such as photoreceptor death and retinal inflammation. Here, we aimed to determine the levels of inflammatory factors in the VH of the LIRD mouse model.
METHODS
LIRD was induced by exposing BALB/c mice to white light (15,000 lx, 2 h), and the mice were recovered for 2 days before analysis (n = 50 mice). We assessed retinal morphology using optical coherence tomography and hematoxylin and eosin staining; retinal cell viability was determined using terminal deoxynucleotidyl transferase dUTP nick-end labeling, and retinal responses were measured based on electroretinogram signals. Total retinal RNAs were extracted and subjected to RNA sequencing analysis. VH samples from control (n = 4) and LIRD mice (n = 9) were assayed in triplicate for a panel of four inflammatory mediators using the Simple Plex Cartridge on an Ella System.
RESULTS
Retinal degeneration, photoreceptor death, infiltration of microglia/macrophages into the photoreceptor layer, and loss of a- and b-waves were obviously detected after LIRD. RNA sequencing revealed that light damage (LD) led to the significant upregulation of inflammatory factors in mouse retinas. In the VH, LD increased the total protein concentration. Dramatic induction of CCL2 (~3000 fold) and IL6 (~10 fold) was detected in VH in response to LD. Increased but not significant levels of TNFα and IL1β were also detected in light-exposed VH.
CONCLUSIONS
Given that the LIRD model mimics RP pathogenesis in some aspects, these results suggest a causative link between retinal degeneration and VH inflammation in RP progression, and the increased CCL2 level in VH may reflect similar elevated CCL2 expression in the degenerative retina.
Topics: Mice; Humans; Animals; Retinal Degeneration; Vitreous Body; Retina; Retinitis Pigmentosa; Inflammation; Disease Models, Animal; Inflammation Mediators
PubMed: 38222454
DOI: No ID Found -
Trials Jan 2024Vitreous floaters are a common ocular condition that affects individuals of all ages. Although vitreous floaters are typically benign, they can significantly impair...
BACKGROUND
Vitreous floaters are a common ocular condition that affects individuals of all ages. Although vitreous floaters are typically benign, they can significantly impair visual acuity and quality of life. Laser vitreolysis, which uses an Nd: YAG laser to vaporize collagenous vitreous opacities, is increasingly being used as a treatment option. However, there is currently a lack of evidence regarding its efficacy and the appropriate timing of its application. This study aims to evaluate the efficacy and safety of early intervention with YAG laser vitreolysis in treating symptomatic vitreous floaters.
METHODS
The present study is a randomized, controlled, double-blind clinical trial. A total of 70 participants with symptomatic floaters for 1 month were prospectively recruited. These participants will be randomly assigned to two groups, with 35 individuals in each group: the early treatment group and the delayed treatment group. Participants assigned to the early treatment group will undergo YAG laser vitreolysis immediately, followed by a sham laser treatment 3 months later. On the other hand, participants assigned to the delayed treatment group will receive a sham laser treatment and then undergo YAG laser vitreolysis 3 months later. The follow-up time points will be 1, 3, 6, and 12 months from randomization. Primary outcomes will be participants' self-reported improvement in visual disturbance on a scale of 1 to 10 and their scores on the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Secondary outcomes will be an objective evaluation of the effectiveness of the treatment in reducing vitreous floaters through OCT and fundus photography and tracking any adverse events related to the eyes or overall health.
DISCUSSION
This clinical trial aims to evaluate the effectiveness of YAG laser vitreolysis in treating symptomatic vitreous floaters and assess the safety of performing early intervention with YAG laser vitreolysis.
TRIAL REGISTRATION
ClinicalTrials.gov NCT05800353 . Registered on 10 March 2023.
Topics: Humans; Vitreous Body; Vitrectomy; Lasers, Solid-State; Quality of Life; Laser Therapy; Randomized Controlled Trials as Topic; Vision Disorders
PubMed: 38218919
DOI: 10.1186/s13063-024-07924-1 -
Journal of Forensic and Legal Medicine Jan 2024Analysis and interpretation of the findings for γ-hydroxybutyrate (GHB) in related fatalities remains problematic. Indeed, GHB is a naturally occurring compound present... (Review)
Review
Analysis and interpretation of the findings for γ-hydroxybutyrate (GHB) in related fatalities remains problematic. Indeed, GHB is a naturally occurring compound present in both the mammalian central nervous system and peripheral tissue. Moreover, a postmortem increase in endogenous GHB concentration has been observed, especially in blood. Facing this issue, the use of an alternative matrix such as vitreous humor (VH) can thus be particularly interesting for GHB testing and quantification. VH is considered to be less prone to postmortem redistribution, is easy to collect, and has relatively few interfering compounds for the analytical process. In this context, the authors report the case of a GHB-related fatality involving 22-year-old male. In this case, GHB femoral blood (FB) (790 mg/L) and vitreous (750 mg/L) concentrations appeared similar with a FB to VH (FB/VH) ratio of 1.05. In addition, other similar cases with both GHB blood and vitreous concentrations were reviewed. Five cases were identified. The blood to VH ratios ranging from 0.13 to 2.58. Finally, GHB stability was documented in postmortem blood and VH, in order to address the reliability of VH as an alternative matrix for GHB quantitation at postmortem. GHB appeared relatively stable in postmortem blood specimens (at 50 mg/L) over a period of 28 days when stored at +4 °C or -20 °C. The same results were observed in VH specimens.
Topics: Male; Humans; Young Adult; Adult; Sodium Oxybate; Vitreous Body; Reproducibility of Results; Autopsy; Femur
PubMed: 38199094
DOI: 10.1016/j.jflm.2024.102641 -
STAR Protocols Mar 2024Total antioxidant capacity (TAC), representative of the capacity to combat oxidative stress, is closely linked to numerous diseases. Here, we present a protocol for...
Total antioxidant capacity (TAC), representative of the capacity to combat oxidative stress, is closely linked to numerous diseases. Here, we present a protocol for measuring TAC using minimal samples that are stable across varying pH levels and at room temperature. We describe steps for preparing and loading samples and working solutions and conducting and analyzing the colorimetric reaction. Sample sources include aqueous humor, vitreous, tears, and plasma, which allow the protocol to be used in various clinical diagnostic settings. For complete details on the use and execution of this protocol, please refer to publications by Tsao et al. (2022)..
Topics: Humans; Antioxidants; Colorimetry
PubMed: 38194341
DOI: 10.1016/j.xpro.2023.102822