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Blood Oct 2021Primary vitreoretinal lymphoma (PVRL) is a rare form of primary central nervous system (CNS) lymphoma (PCNSL) arising in the intraocular compartment without brain... (Review)
Review
Primary vitreoretinal lymphoma (PVRL) is a rare form of primary central nervous system (CNS) lymphoma (PCNSL) arising in the intraocular compartment without brain involvement. Despite its apparent indolent clinical course, PVRL can cause permanent vision loss and CNS relapse, the major cause of death in patients with PVRL. The pathophysiology of PVRL is unknown. As in PCNSL, the transformation of the tumor cells likely originates outside the CNS, before the cells migrate to the eye and proliferate within an immune-permissive microenvironment. PVRL exhibits a biased immunoglobulin repertoire, suggesting underlying antigen selection. The diagnosis remains challenging, requiring close coordination between ophthalmologists and cytologists. Because of their rarity and fragility in the vitreous, lymphoma cells cannot always be identified. Interleukin levels, molecular biology, and imaging are used in combination with clinical ophthalmological examination to support the diagnosis of PVRL. Multi-institutional prospective studies are urgently needed to validate the equivocal conclusions regarding treatments drawn from heterogeneous retrospective or small cohort studies. Intravitreal injection of methotrexate or rituximab or local radiotherapy is effective at clearing tumor cells within the eyes but does not prevent CNS relapse. Systemic treatment based on high-dose methotrexate chemotherapy, with or without local treatment, might reduce this risk. At relapse, intensive consolidation chemotherapy followed by stem cell transplantation can be considered. Single-agent ibrutinib, lenalidomide, and temozolomide treatments are effective in patients with relapsed PVRL and should be tested as first-line treatments. Therapeutic response assessment based on clinical examination is improved by measuring cytokine levels but still needs to be refined.
Topics: Animals; Disease Management; Humans; Retina; Retinal Neoplasms; Vitreous Body
PubMed: 34036310
DOI: 10.1182/blood.2020008235 -
Translational Vision Science &... Sep 2022Vitreous substitutes are traditionally used to stabilize the retina after vitrectomy. In recent years, various approaches have been developed for using the vitreous... (Review)
Review
Vitreous substitutes are traditionally used to stabilize the retina after vitrectomy. In recent years, various approaches have been developed for using the vitreous substitute not only as a tamponade but also as a drug release system to tackle ocular diseases. This review provides an overview of the requirements for vitreous substitutes and discusses the current clinically applied as well as novel polymer-based vitreous substitutes as drug delivery systems, including their release mechanisms, efficiencies, challenges, and future perspectives.
Topics: Drug Liberation; Polymers; Retina; Vitrectomy; Vitreous Body
PubMed: 36125790
DOI: 10.1167/tvst.11.9.14 -
Ophthalmic Surgery, Lasers & Imaging... Oct 2018Vital dyes contain complex molecules with chromophores that stain living tissues and have greatly enhanced identification and removal of transparent vitreoretinal... (Review)
Review
Vital dyes contain complex molecules with chromophores that stain living tissues and have greatly enhanced identification and removal of transparent vitreoretinal tissues during surgery. Several "chromovitrectomy" dyes are frequently used by vitreoretinal specialists, including indocyanine green, trypan blue, brilliant blue G, and triamcinolone acetonide; other dyes are also under investigation. Trypan Blue was approved by the U.S. Food and Drug Administration (FDA) for epiretinal membrane removal, and preservative-free triamcinolone acetonide was approved by the FDA for intraocular use. However, currently available chromovitrectomy dyes have their limitations, and of particular concern for some of them is the possibility for acute and chronic toxicity to the neurosensory retina and retinal pigmented epithelium. The potentially irreversible acute toxicity and other limitations, such as lack of long-term safety profiles, highlight the need for further advancements. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:788-798.].
Topics: Coloring Agents; Humans; Indocyanine Green; Intraoperative Period; Macula Lutea; Retinal Diseases; Trypan Blue; Vitreoretinal Surgery; Vitreous Body
PubMed: 30395665
DOI: 10.3928/23258160-20181002-07 -
Graefe's Archive For Clinical and... Mar 2008
Topics: Eye Diseases; Humans; Vitreous Body
PubMed: 18228032
DOI: 10.1007/s00417-007-0743-x -
Journal of the Mechanical Behavior of... Oct 2022Vitreoretinal mechanics plays an important role in retinal trauma and many sight-threatening diseases. In age-related pathologies, such as posterior vitreous detachment... (Review)
Review
Vitreoretinal mechanics plays an important role in retinal trauma and many sight-threatening diseases. In age-related pathologies, such as posterior vitreous detachment and vitreomacular traction, lingering vitreoretinal adhesions can lead to macular holes, epiretinal membranes, retinal tears and detachment. In age-related macular degeneration, vitreoretinal traction has been implicated in the acceleration of the disease due to the stimulation of vascular growth factors. Despite this strong mechanobiological influence on trauma and disease in the eye, fundamental understanding of the mechanics at the vitreoretinal interface is limited. Clarification of adhesion mechanisms and the role of vitreoretinal mechanics in healthy eyes and disease is necessary to develop innovative treatments for these pathologies. In this review, we evaluate the existing literature on the structure and function of the vitreoretinal interface to gain insight into age- and region-dependent mechanisms of vitreoretinal adhesion. We explore the role of vitreoretinal adhesion in ocular pathologies to identify knowledge gaps and future research areas. Finally, we recommend future mechanics-based studies to address the critical needs in the field, increase fundamental understanding of vitreoretinal mechanisms and disease, and inform disease treatments.
Topics: Humans; Retinal Perforations; Tissue Adhesions; Vitreous Body
PubMed: 35963021
DOI: 10.1016/j.jmbbm.2022.105399 -
The New England Journal of Medicine Aug 2018
Topics: Diabetes Mellitus, Type 2; Eye Diseases; Female; Humans; Middle Aged; Visual Acuity; Vitreous Body
PubMed: 30134134
DOI: 10.1056/NEJMicm1712355 -
Mediators of Inflammation 2012Vitreous body is an intraocular structure, origin of diverse pathologies, but is also the place where cells and inflammatory mediators are released coming from several... (Review)
Review
Vitreous body is an intraocular structure, origin of diverse pathologies, but is also the place where cells and inflammatory mediators are released coming from several pathologic processes. These inflammatory reactions can happen in any other ocular location like choroid, retina, optic nerve, or ciliary body and vitreous humor constitutes a stagnant reservoir for these resulting substances and debris. Through the recent techniques of vitreous collecting, handling, and analysis, increasingly more sophisticated and with fewer complications, cellularity and molecules in the vitreous of challenging pathologies for the ophthalmologist can now be studied. The most usefulness for vitreous diagnosis would be the masquerade syndromes, and the best exponent in this group is the primary vitreoretinal lymphoma (PVRL), in which cytology and an IL-10/IL-6 ratio more than 1 is fundamental for the diagnosis.
Topics: Eye Diseases; Eye Neoplasms; Humans; Interleukin-10; Interleukin-6; Vitreous Body
PubMed: 23055575
DOI: 10.1155/2012/930704 -
Ophthalmologica. Journal International... 2011The goal of all vitreous surgery is to perform the desired intraoperative intervention with minimum collateral damage in the most efficient way possible. An... (Review)
Review
The goal of all vitreous surgery is to perform the desired intraoperative intervention with minimum collateral damage in the most efficient way possible. An understanding of the principles of fluidics is of importance to all vitreoretinal surgeons to achieve these aims. Advances in technology mean that surgeons are being given increasing choice in the settings they are able to select for surgery. Manufacturers are marketing systems with aspiration driven by peristaltic, Venturi and hybrid pumps. Increasingly fast cut rates are offered with optimised, and in some cases surgeon-controlled, duty cycles. Function-specific cutters are becoming available and narrow-gauge instrumentation is evolving to meet surgeon demands with higher achievable flow rates. In parallel with the developments in outflow technology, infusion systems are advancing with lowering flow resistance and intraocular pressure control to improve fluidic stability during surgery. This review discusses the important aspects of fluidic technology so that surgeons can select the optimum machine parameters to carry out safe and effective surgery.
Topics: Drainage; Humans; Hydrodynamics; Infusion Pumps; Vitrectomy; Vitreous Body
PubMed: 21778777
DOI: 10.1159/000328207 -
Investigative Ophthalmology & Visual... Feb 2021Details of the posterior eye water dynamics are unclear. Aquaporin-4 (AQP4), a water channel, plays an important role in water dynamics in the central nervous system and...
PURPOSE
Details of the posterior eye water dynamics are unclear. Aquaporin-4 (AQP4), a water channel, plays an important role in water dynamics in the central nervous system and is also present in the ocular tissue. The purpose of this study was to reveal the role of AQP4 in the water dynamics of the posterior eye using in vivo JJ vicinal coupling proton exchange (JJVCPE) magnetic resonance imaging (MRI) of AQP4 knockout (KO) mice and their wild-type littermates (controls).
METHODS
JJVCPE MRI of the eye was performed on five AQP4 KO mice and seven control mice. We assessed the normalized signal intensities of a region of interest (ROI) set in the vitreous body after H217O administration. The results of the two groups were compared using a two-tailed Mann-Whitney U test.
RESULTS
A statistical analysis revealed that the normalized ROI signal intensities at the steady state were significantly lower (P = 0.010, <0.05) in the AQP4 KO mice (mean ± SD, 84.5% ± 2.7%) than the controls (mean ± SD, 88.8% ± 1.9%).
CONCLUSIONS
The present study using JJVCPE MRI of the eye demonstrated that retinal AQP4 has a potential role in the regulation of water inflow into the vitreous body. Absence of AQP4 in the KO mice probably induces lower water outflow from the vitreous body. Our results could help clarify the pathogenesis of various ocular diseases.
Topics: Animals; Aquaporin 4; Female; Magnetic Resonance Imaging; Male; Mice; Mice, Knockout; Models, Animal; Retina; Vitreous Body; Water
PubMed: 33599736
DOI: 10.1167/iovs.62.2.24 -
BMC Ophthalmology Dec 2022This study was to evaluate the efficacy and safety of the implantation of foldable capsular vitreous body (FCVB) in severe retinal detachment eyes.
BACKGROUND
This study was to evaluate the efficacy and safety of the implantation of foldable capsular vitreous body (FCVB) in severe retinal detachment eyes.
METHODS
A retrospective study in retinal detachment eyes was performed at Shandong Provincial Hospital Affiliated to Shandong First Medical University. A standard three-port pars plana vitrectomy was performed, and the FCVB was triple folded and implanted into the vitreous cavity. The silicone oil (SO) was then injected into the capsule of the FCVB to support the retina and eye. During the follow-up period, The treated eyes were examined by ophthalmoscopy, fundus photography, and tonometry. B-scan ultrasonography, optical coherence tomography (OCT), and computed tomography (CT), were also performed.
RESULTS
From May 2020 to November 2021, 31 cases with severe retinal detachment were enrolled in the study. The postoperative follow-up time gradient ranged from 1 to 72 weeks, At various observation time points during the 72 weeks after surgery, The postoperative IOP was maintained at around 10 mmhg at various time points, with a slight decrease compared to the preoperative IOP (14.2 ± 4.6 mmHg n = 18), and was statistically significant. 9 of 31 patients had clear refractive media, both fundus and OCT showed retinal reattachment, OCT showed the 200 μm thick FCVB capsule support retina. The remaining 22 patients with unclear refractive media, B-scan showed arcuate hyperechoes in front of the retina. There was also no significant difference in visual acuity compared to preoperative. The FCVB was well positioned in the vitreous cavity, and no serious complications such as endophthalmitis, glaucoma, silicone oil emulsification, product exposure, or sympathetic uveitis were found.
CONCLUSIONS
FCVB has retinal support with certain ability to maintain IOP and eye morphology and avoid eye removal in patients with severe retinal detachment during the 72-week observation period.
Topics: Humans; Retinal Detachment; Vitreous Body; Silicone Oils; Retrospective Studies; Vitrectomy
PubMed: 36522622
DOI: 10.1186/s12886-022-02729-9