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1.
Transl Vis Sci Technol ; 10(10): 3, 2021 08 12.
Artículo en Inglés | MEDLINE | ID: mdl-34383879

RESUMEN

Purpose: Mesenchymal stromal cells (MSCs) have been shown to enhance tissue repair as a cell-based therapy. In preparation for a phase I clinical study, we evaluated the safety, dosing, and efficacy of bone marrow-derived MSCs after subconjunctival injection in preclinical animal models of mice, rats, and rabbits. Methods: Human bone marrow-derived MSCs were expanded to passage 4 and cryopreserved. Viability of MSCs after thawing and injection through small-gauge needles was evaluated by vital dye staining. The in vivo safety of human and rabbit MSCs was studied by subconjunctivally injecting MSCs in rabbits with follow-up to 90 days. The potency of MSCs on accelerating wound healing was evaluated in vitro using a scratch assay and in vivo using 2-mm corneal epithelial debridement wounds in mice. Human MSCs were tracked after subconjunctival injection in rat and rabbit eyes. Results: The viability of MSCs after thawing and immediate injection through 27- and 30-gauge needles was 93.1% ± 2.1% and 94.9% ± 1.3%, respectively. Rabbit eyes demonstrated mild self-limiting conjunctival inflammation at the site of injection with human but not rabbit MSCs. In scratch assay, the mean wound healing area was 93.5% ± 12.1% in epithelial cells co-cultured with MSCs compared with 40.8% ± 23.1% in controls. At 24 hours after wounding, all MSC-injected murine eyes had 100% corneal wound closure compared with 79.9% ± 5.5% in controls. Human MSCs were detectable in the subconjunctival area and peripheral cornea at 14 days after injection. Conclusions: Subconjunctival administration of MSCs is safe and effective in promoting corneal epithelial wound healing in animal models. Translational Relevance: These results provide preclinical data to support a phase I clinical study.


Asunto(s)
Lesiones de la Cornea , Células Madre Mesenquimatosas , Animales , Médula Ósea , Ensayos Clínicos Fase I como Asunto , Córnea , Lesiones de la Cornea/terapia , Ratones , Conejos , Ratas , Cicatrización de Heridas
2.
PLoS One ; 12(8): e0182816, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28832670

RESUMEN

PURPOSE: To identify the risk factors for development of peripapillary retinal splitting (schisis) in patients with glaucoma or suspicion of glaucoma. SETTING: Glaucoma Clinic, Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL. METHODS: In this institutional cross-sectional study, 495 patients (990 eyes) who had undergone spectral-domain optical coherence tomography (OCT Spectralis HRA-OCT, Heidelberg Engineering) optic nerve head (ONH) imaging and did not have identifiable optic nerve pits, pseudopits or coloboma were included. OCT scans were reviewed by two observers. MAIN OUTCOME MEASURES: Presence of peripapillary retinal splitting identified on OCT raster scans. RESULTS: Eleven of 990 glaucoma and glaucoma suspect eyes (1.1%) of 7 patients (2 females, 5 males, mean age 64.5 ± 9.2 years) had peripapillary retinal splitting. Two of these 11 eyes had extension of the splitting into the macula but none to the fovea. Of these 11 patients, 2 (28.6%) were glaucoma suspects, 3 (42.9%) had primary open-angle glaucoma, 1 (14.3%) had chronic angle-closure glaucoma and 1 (14.3%) had pigmentary glaucoma. 7/11 (63.6%) eyes had vitreous traction to the disc visualized on OCT and 6/11 eyes (54.5%) had beta-zone peripapillary atrophy. CONCLUSIONS: We observed peripapillary retinal splitting in 1.1% of a series of 990 glaucoma and glaucoma-suspect eyes. Evidence of adherent vitreous with traction and peripapillary atrophy was found in a majority of the involved eyes. A comparison to an age and axial length matched cohort is required to determine if this is a condition that is associated with glaucoma.


Asunto(s)
Glaucoma/diagnóstico por imagen , Retina/diagnóstico por imagen , Tomografía de Coherencia Óptica/métodos , Estudios Transversales
3.
Curr Opin Ophthalmol ; 28(4): 337-342, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28594648

RESUMEN

PURPOSE OF REVIEW: To identify and evaluate the risk factors of iatrogenic ectasia after refractive surgery. RECENT FINDINGS: We reviewed recently published papers that identified various risk factors associated with ectasia after LASIK, photorefractive keratectomy, small incision lenticule extraction, and other refractive surgical procedures. We also attempted to evaluate the relative contributions of these factors to the development of ectasia following refractive surgery. Forme fruste keratoconus, genetic predisposition to keratoconus, low residual stromal bed thickness (through high myopia, thin preoperative cornea, or thick LASIK flap), and irregular corneal topography have been identified as risk factors for keratectasia development after refractive surgical procedures. A newly proposed metric, percentage tissue altered, has been reported to be a robust indicator for post LASIK ectasia risk calculation. Several cases of keratectasia have also been reported 6 to 12 months following minimally invasive small incision lenticule extraction procedure. Other risk factors associated with iatrogenic ectasia include eye rubbing, young age, and pregnancy. SUMMARY: Ectasia after refractive surgery is a relatively rare complication which can lead to sight-threatening complications if not detected and treated in time. It is important to continue our quest to improve our methods of identifying absolute and relative risk factors of ectasia and their cut-off values following various keratorefractive surgical procedures.


Asunto(s)
Enfermedades de la Córnea/etiología , Complicaciones Posoperatorias/etiología , Procedimientos Quirúrgicos Refractivos/efectos adversos , Adolescente , Adulto , Factores de Edad , Enfermedades de la Córnea/patología , Topografía de la Córnea , Dilatación Patológica/etiología , Femenino , Humanos , Enfermedad Iatrogénica , Masculino , Procedimientos Quirúrgicos Refractivos/métodos , Factores de Riesgo , Colgajos Quirúrgicos , Adulto Joven
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