RESUMEN
PURPOSE: To describe a case of choroidal detachment (CD) secondary to cavernous sinus thrombosis (CST). METHODS: Case report. RESULTS: A 73-year-old male with a history of primary open angle glaucoma and pseudophakia presented with retrobulbar pain, blurred vision, and diplopia of the right eye. Exam revealed severe non-hemorrhagic bullous chemosis, tortuous retinal vessels, and elevated intraocular pressure (IOP) in the right eye. Although computed tomography venography findings initially raised suspicion of a carotid-cavernous fistula (CCF), the diagnostic angiogram showed no such evidence, instead raising concern for cavernous sinus thrombosis (CST). Dilated fundus exam and MRI were notable for multiple serous choroidal detachments in the right eye, which resolved with systemic management of CST and topical steroids. CONCLUSION: The possibility of choroidal detachment during the clinical course of a CST should be recognized. CST may be related to impaired venous drainage that forces transudate into perivascular spaces and results in choroidal effusion.
Asunto(s)
Autoanticuerpos/sangre , Glicoproteína Mielina-Oligodendrócito/inmunología , Neuritis Óptica/diagnóstico , Síndrome de Sjögren/diagnóstico , Adulto , Acuaporina 4/inmunología , Femenino , Angiografía con Fluoresceína , Glucocorticoides/uso terapéutico , Humanos , Inmunoglobulina G/sangre , Infusiones Intravenosas , Imagen por Resonancia Magnética , Metilprednisolona/uso terapéutico , Neuritis Óptica/tratamiento farmacológico , Neuritis Óptica/inmunología , Síndrome de Sjögren/tratamiento farmacológico , Síndrome de Sjögren/inmunología , Agudeza Visual/fisiología , Campos Visuales/fisiologíaRESUMEN
Engineered three-dimensional biomaterials are known to affect the regenerative capacity of stem cells. The extent to which these materials can modify cellular activities is still poorly understood, particularly for adipose-derived stem cells (ASCs). This study evaluates PEGylated fibrin (P-fibrin) gels as an ASC-carrying scaffold for encouraging local angiogenesis by comparing with two commonly used hydrogels (i.e., collagen and fibrin) in the tissue-engineering field. Human ASCs in P-fibrin were compared to cultures in collagen and fibrin under basic growth media without any additional soluble factors. ASCs proliferated similarly in all gel scaffolds but showed significantly elongated morphologies in the P-fibrin gels relative to other gels. P-fibrin elicited higher von Willebrand factor expression in ASCs than either collagen or fibrin while cells in collagen expressed more smooth muscle alpha actin than in other gels. VEGF was secreted more at 7 days in fibrin and P-fibrin than in collagen and several other angiogenic and immunomodulatory cytokines were similarly enhanced. Fibrin-based matrices appear to activate angiogenic signaling in ASCs while P-fibrin matrices are uniquely able to also drive a vessel-like ASC phenotype. Collectively, these results suggest that P-fibrin promotes the angiogenic potential of ASC-based therapeutic applications.