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We have described the hyperreflective ganglion cell layer band (HGCB) in a series of cases of gyrate atrophy. Clinical fundus examination and multimodal imaging which included optical coherence tomography (OCT) was done in all cases. Four patients (one male, three female) were studied. In all four cases, a hyperreflective band was noted in the ganglion cell layer. In three patients, the band was continuous, and in one patient, the band was patchy. To conclude, HGCB is a novel OCT sign in gyrate atrophy and can be valuable in prognostication of disease. [Ophthalmic Surg Lasers Imaging Retina 2024;55:XX-XX.].
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PURPOSE: To report occurrence of central serous chorioretinopathy(CSCR) which mimicked recurrence of ODP maculopathy in a young adult in whom surgery for the same had been done. METHODS: Clinical fundus examination and multimodal imaging which included optical coherence tomography(OCT) and fundus autofluorescence(FFA) was done. RESULTS: Patient had undergone surgery for ODP maculopathy. At 1 year follow up, there was recurrence of subretinal fluid at the macula. Fundus fluorescein angiography was done and the presence of ink blot pattern leakage clinched the diagnosis of CSCR, ruling out ODP maculopathy. CONCLUSION: CSCR is a great masquerade and correct diagnosis is very important to prevent permanent visual impairment. Subretinal fluid(SRF) associated with ODP must be examined carefully to rule out other pathologies like CSCR. Serous macular detachment after surgery for ODP maculopathy has been done, does not necessarily mean recurrence of the maculopathy. Other pathologies like CSCR should be ruled out. This case highlights the importance of multimodal imaging along with clinical signs in correct diagnosis and treatment of conditions with overlapping features like CSCR and ODP maculopathy.
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Acute Zonal Occult Outer Retinopathy (AZOOR) is characterized by sudden visual impairment, often presenting with scotoma and photopsia in young to middle-aged adults, showing a female predominance. This condition, distinct from genetic disorders like retinitis pigmentosa, lacks a hereditary basis and exhibits unique fundus changes and imaging features indicative of outer retinal dysfunction. Recent advancements have broadened our understanding, identifying variants like Acute Annular Outer Retinopathy (AAOR) and Multizonal outer retinopathy and retinal pigment epitheliopathy (MORR), each with specific clinical presentations and imaging characteristics. The diagnosis of AZOOR and its variants primarily relies on excluding other conditions through comprehensive evaluation, including imaging and serological testing. Treatment approaches, including the use of corticosteroids and immunosuppressives, remain debated, with some evidence suggesting benefits in the early stages. The prognosis of AZOOR varies, with most patients experiencing stabilization, although complications like choroidal neovascularization may occur, requiring targeted therapy. This manuscript elucidates the complexity of AZOOR, emphasizing the necessity of high clinical suspicion and the role of advanced imaging in diagnosis and management.
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Angiografía con Fluoresceína , Fondo de Ojo , Escotoma , Tomografía de Coherencia Óptica , Síndromes de Puntos Blancos , Humanos , Síndromes de Puntos Blancos/diagnóstico , Escotoma/diagnóstico , Escotoma/fisiopatología , Tomografía de Coherencia Óptica/métodos , Angiografía con Fluoresceína/métodos , Agudeza Visual , Campos Visuales/fisiología , ElectrorretinografíaRESUMEN
PURPOSE: To study the role of artificial intelligence (AI) in developing diabetic macular edema (DME) management recommendations by creating and comparing responses to clinicians in hypothetical AI-generated case scenarios. The study also examined whether its joint recommendations followed national DME management guidelines. METHODS: The AI hypothetically generated 50 ocular case scenarios from 25 patients using keywords like age, gender, type, duration and control of diabetes, visual acuity, lens status, retinopathy stage, coexisting ocular and systemic co-morbidities, and DME-related retinal imaging findings. For DME and ocular co-morbidity management, we calculated inter-rater agreements (kappa analysis) separately for clinician responses, AI-platforms, and the "majority clinician response" (the maximum number of identical clinician responses) and "majority AI-platform" (the maximum number of identical AI responses). Treatment recommendations for various situations were compared to the Indian national guidelines. RESULTS: For DME management, clinicians (ĸ=0.6), AI platforms (ĸ=0.58), and the 'majority clinician response' and 'majority AI response' (ĸ=0.69) had moderate to substantial inter-rate agreement. The study showed fair to substantial agreement for ocular co-morbidity management between clinicians (ĸ=0.8), AI platforms (ĸ=0.36), and the 'majority clinician response' and 'majority AI response' (ĸ=0.49). Many of the current study's recommendations and national clinical guidelines agreed and disagreed. When treating center-involving DME with very good visual acuity, lattice degeneration, renal disease, anaemia, and a recent history of cardiovascular disease, there were clear disagreements. CONCLUSION: For the first time, this study recommends DME management using large language model-based generative AI. The study's findings could guide in revising the global DME management guidelines.
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Agro-food waste is a rich source of biopolymers such as cellulose, chitin, and starch, which have been shown to possess excellent biocompatibility, biodegradability, and low toxicity. These properties make biopolymers from agro-food waste for its application in tissue engineering and regenerative medicine. Thus, this review highlighted the properties, processing methods, and applications of biopolymers derived from various agro-food waste sources. We also highlight recent advances in the development of biopolymers from agro-food waste and their potential for future tissue engineering and regenerative medicine applications, including drug delivery, wound healing, tissue engineering, biodegradable packaging, excipients, dental applications, diagnostic tools, and medical implants. Additionally, it explores the challenges, prospects, and future directions in this rapidly evolving field. The review showed the evolution of production techniques for transforming agro-food waste into valuable biopolymers. However, these biopolymers serving as the cornerstone in scaffold development and drug delivery systems. With their role in wound dressings, cell encapsulation, and regenerative therapies, biopolymers promote efficient wound healing, cell transplantation, and diverse regenerative treatments. Biopolymers support various regenerative treatments, including cartilage and bone regeneration, nerve repair, and organ transplantation. Overall, this review concluded the potential of biopolymers from agro-food waste as a sustainable and cost-effective solution in tissue engineering and regenerative medicine, offering innovative solutions for medical treatments and promoting the advancement of these fields.
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Eliminación de Residuos , Ingeniería de Tejidos , Medicina Regenerativa/métodos , Alimento Perdido y Desperdiciado , Alimentos , Polímeros , BiopolímerosRESUMEN
PURPOSE: To describe the subretinal hyporeflective globule in cases of central serous chorioretinopathy (CSC). METHODS: A retrospective analysis of consecutive cases of CSC presenting to a tertiary eye care center in eastern India was conducted. Subretinal hyporeflective globules were identified as small globular lesions below the external limiting membrane/ellipsoid zone, but above the RPE layer. They had a hyperreflective border with a hyporeflective core and a clear posterior tail of hyper-transmission. RESULTS: The present study analyzed 137 eyes of 137 patients. Eighty (58.4%) eyes had acute disease at presentation, 48 (35%) eyes had chronic disease, and eight (5.8%) eyes had resolved CSC. Subretinal hyporeflective globules were seen in 27 (21.8%) eyes, of which choroidal caverns were seen in seven (5.1%) eyes. Twenty-five eyes with chronic CSC and only two eyes with acute CSC had subretinal hyporeflective globules. Three eyes with resolved CSC had subretinal hyporeflective globules. CONCLUSION: We describe subretinal hyporeflective globule as a novel optical coherence tomography (OCT) finding in cases of CSC and describe its clinical correlates.
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BACKGROUND: The present study compared clinical features and outcomes of central serous chorioretinopathy (CSC) with and without pachychoroid. METHODS: It was a retrospective, longitudinal, record-based study which included eyes with CSC. Patients underwent spectral domain optical coherence tomography and differentiated between pachychoroid and non-pachychoroid groups. Eyes were divided into pachychoroid and non-pachychoroid groups based on the subfoveal choroidal thickness of 300 microns and the presence of pachyvessels. RESULTS: A total of 250 eyes of 250 patients were divided into pachychoroid and non-pachychoroid with 125 eyes in each group. Mean ages of patients in pachychoroid and non-pachychoroid groups were 45.7 ± 9.4 years and 47.4 ± 10.2 years, respectively. Mean initial best-corrected visual acuity (BCVA) was 0.40 ± 0.42 in pachychoroid and 0.39 ± 0.38 in non-pachychoroid group (p = 0.9). Mean final BCVA was 0.37 ± 0.9 in pachychoroid and 0.21 ± 0.33 in non-pachychoroid group (p = 0.04). 36 (28.8%) eyes in pachychoroid and 60 (48%) eyes in non-pachychoroid group had spontaneous resolution of CSC (p = 0.007). A total of 39 (31.2%) eyes in pachychoroid and 13 (10.4%) in non-pachychoroid group had recurrent CSC at the end of follow-up. CONCLUSION: CSC eyes with pachychoroid had more recurrent episodes and less spontaneous resolution compared to CSC eyes in non-pachychoroid group. Final visual acuity was worse in eyes with CSC and pachychoroid. These findings need to be validated in a larger sample size with a prospective study design.
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Coriorretinopatía Serosa Central , Humanos , Adulto , Persona de Mediana Edad , Coriorretinopatía Serosa Central/diagnóstico , Estudios Retrospectivos , Estudios Prospectivos , Angiografía con Fluoresceína/métodos , Coroides , Tomografía de Coherencia Óptica/métodosRESUMEN
OBJECTIVE: Baicalin (BC) is a flavonoid reported to have various pharmacological activities, including antioxidant, anti-cancer, anti-inflammatory, anti-allergy, immune regulation, and anti-diabetic. This study examines the probable mechanism for gestational diabetes mellitus (GDM) brought on by streptozotocin (STZ) and the impact of BC on fetal development via AGEs (advanced serum glycation end products) and RAGE (the role of advanced glycation end products). MATERIAL AND METHOD: STZ has been used in the current experimental study to induce diabetes mellitus in pregnant animals (gestational diabetes mellitus). GDM pregnant animals were separated into five groups and were treated with BC in a dose-dependent pattern for 19 days. At the end of the experiment, the fetus and blood samples were drawn from all the pregnant rats to assess the biochemical parameter as well as AGE-RAGE. RESULT: Administration of BC at varying doses leads to enhancement in the weight of the fetus body and placenta while gestational diabetic pregnant animals induced by STZ had a lower weight of the fetus body and placenta. The dose-dependent pattern of BC also enhanced fasting insulin (FINS), high-density lipoprotein (HDL), serum insulin, and hepatic glycogen. It also significantly enhanced the content of the antioxidant profile and pro-inflammatory cytokines and modulated the gene expression (VCAM- 1, p65, EGFR, MCP-1, 1NOX2, and RAGE) in various tissues in gestational diabetes mellitus pregnant rats. CONCLUSION: Baicalin demonstrated the potential impact on the embryo's development via the AGE-RAGE signaling pathway in STZ-induced GDM pregnant animals.
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Diabetes Mellitus Experimental , Diabetes Gestacional , Embarazo , Humanos , Femenino , Ratas , Animales , Diabetes Gestacional/tratamiento farmacológico , Diabetes Gestacional/metabolismo , Estreptozocina/efectos adversos , Productos Finales de Glicación Avanzada/metabolismo , Receptor para Productos Finales de Glicación Avanzada/metabolismo , Receptor para Productos Finales de Glicación Avanzada/uso terapéutico , Antioxidantes/farmacología , Antioxidantes/uso terapéutico , Transducción de Señal , Flavonoides/farmacología , Flavonoides/uso terapéutico , Diabetes Mellitus Experimental/metabolismo , InsulinaRESUMEN
PURPOSE: To discuss the features of an artifact on optical coherence tomography angiography (OCTA), termed "pupil vignetting artifact," and describe how it may masquerade as true chorioretinal pathology. DESIGN: This was a retrospective, observational case series. METHODS: The authors studied 12 eyes at a vitreoretinal clinic in Eastern India, reviewing a dark shadow such as an artifact on OCTA images. RESULTS: In all 12 eyes, there was an appearance of a dark shadow on OCTA imaging, located at the macula, superior, superotemporal, or superonasal to the fovea, which did not correspond to any ischemic area responsible for flow-void or any media opacity casting a posterior shadow. It was believed to be an artifact caused by the vignetting effect of the pupil as the incident OCT beam clips the iris during OCTA scanning, and therefore reduces the amount of total light incident on the retina. The variability in the size, shape, and location of the artifact is contributed by a few factors such as variable angle of incident light on the pupil, pupillary dynamics, and curvature of the retinal surface. CONCLUSION: Pupil vignetting artifact is a unique undescribed phenomenon appearing at the macula on OCTA imaging that can masquerade as numerous true chorioretinal pathologies. This article aims to describe this artifact to avoid misinterpretation and further confusion in real-life clinical practice.
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Pupila , Tomografía de Coherencia Óptica , Humanos , Tomografía de Coherencia Óptica/métodos , Artefactos , Iris , Angiografía , Angiografía con Fluoresceína/métodos , Vasos Retinianos/diagnóstico por imagen , Vasos Retinianos/patologíaRESUMEN
Multicolor (MC) imaging is an innovative pseudocolor fundus imaging modality based on confocal scanning laser ophthalmoscopy. It effectively scans the retina at different depths to create a composite image. The green reflectance image depicts the middle retinal while blue reflectance image provides images of the retinal surface. The infrared reflectance image depicts retinal structures at the level of outer retina and choroid. We systematically analyze published case reports, case series, and original articles on MC imaging where it has helped in discovering additional clinical features of retinal diseases not readily apparent on conventional color fundus photography and played a role in monitoring the response to treatment.
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Oftalmoscopía , Enfermedades de la Retina , Humanos , Oftalmoscopía/métodos , Enfermedades de la Retina/diagnóstico por imagen , Enfermedades de la Retina/diagnóstico , Retina/diagnóstico por imagen , Retina/patología , Fondo de Ojo , Angiografía con Fluoresceína/métodosRESUMEN
Purpose: Cystoid macular degeneration (CMD) is a feature of chronic central serous chorioretinopathy (CSCR). Present study intended to analyze the clinical presentation, risk factors, choroidal features, and outcome of CMD in CSCR. Methods: This was a retrospective, record-based descriptive study, which included chronic CSCR eyes with CMD. Demographic profile and clinical history were obtained from medical records. Spectralis spectral domain optical coherence tomography (SDOCT; Heidelberg Engineering,Germany) was used for acquiring SDOCT images and for performing fluorescein angiography , indocyanine green angiography , and optical coherence tomography (OCT) angiography. Results: The study included 101 eyes of 69 consecutive patients of CSCR having CMD. The mean age of patients was 56 ± 9.4 years (range 40-79 years), and majority (63, 91.3%) of the patients were male. Prior history of corticosteroid use was present in seven (10.1%) patients. Mean time interval between the first diagnosis of CSCR and appearance of CMD was 55.3 ± 33.9 months. CMD was located away from the fovea in majority of eyes (68, 67.3%). Mean subfoveal choroidal thickness was 396.71 ± 90.5 µm. Subretinal pigment epithelium choroidal neovascularization was noted in four (3.96%) eyes. Conclusion: CMD appears as a late complication of CSCR and is usually present away from the fovea. Such eyes had thickened choroid and fewer cases had associated choroidal neovascularization. Further comparative studies would be needed to validate these findings.
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Coriorretinopatía Serosa Central , Degeneración Macular , Neovascularización Retiniana , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Coriorretinopatía Serosa Central/complicaciones , Coriorretinopatía Serosa Central/diagnóstico , Estudios Retrospectivos , Degeneración Macular/complicaciones , Coroides , Tomografía de Coherencia Óptica/métodos , Neovascularización Retiniana/complicacionesRESUMEN
ABSTRACT: Angular Sign of Henle Fiber Layer Hyperreflectivity (ASHH) is a marker of Henle Fibre layer ischemia. Our aim is to describe ASHH as a novel OCT sign in Purtscher and Purtscher like retinopathy. Here we present 3 Cases, one classical Purtscher Retinopathy and 2 Purtscher like Retinopathy who had ASHH on SD OCT imaging. Modalities like Colour fundus photography, cross-sectional OCT, OCT angiography (OCTA) and fluorescein angiography were used. Presence ASHH in Purtscher Retinopathy and Purtscher like retinopathy points towards a deep capillary plexus insult and has prognostic implications.
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Purpose: To analyze the imaging characteristics and the clinical course of patients showing concomitant paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) post-blunt trauma. Methods: PAMM and AMN lesions post-blunt trauma diagnosed on enhanced depth imaging optical coherence tomography (EDI-OCT) were recruited for the study. Results: : Thirteen eyes of 13 individuals with a history of blunt trauma were included in the study, of whom 11 (85%) were males. Mean age of the patients was 33.62 (range 16-67) years. Mean visual acuity at presentation and the last visit was 1.67 log of minimum angle of resolution (logMAR) and 0.82 logMAR, respectively. Mean interval between trauma and imaging was 5.08 (range 1-15) days. All patients had unilateral involvement, with the right eye being involved in 10 patients (77%). All patients had concomitant PAMM and AMN lesions. Conclusion: : Presence of coincident PAMM and AMN suggests a common pathophysiologic etiology, but the description of concomitant PAMM and AMN in the setting of blunt trauma to eye is hitherto unreported. Identifying AMN in a setting of PAMM requires meticulous examination of the OCT and OCTA images. It can be a cause of suboptimal visual recovery in such eyes.
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Mácula Lútea , Degeneración Macular , Enfermedades de la Retina , Síndromes de Puntos Blancos , Heridas no Penetrantes , Masculino , Humanos , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Femenino , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/etiología , Enfermedades de la Retina/patología , Enfermedad Aguda , Tomografía de Coherencia Óptica/métodos , Mácula Lútea/patología , Heridas no Penetrantes/complicaciones , Heridas no Penetrantes/diagnóstico , Angiografía con Fluoresceína/métodosRESUMEN
Astrocytic hamartoma is a benign glial tumor. It may be associated with tuberous sclerosis and can also be found incidentally on retinal examination as an isolated presentation. Here, we describe multimodal imaging characteristics of astrocytic hamartoma in a patient with retinitis pigmentosa. Spectral domain optical coherence tomography of both eyes showed moth-eaten optically empty spaces and hyperreflective dots along with foveal thinning. Multicolor image highlighted mulberry appearance of the lesion with green shift signifying elevated lesion. In infrared reflectance, lesion was hyporeflective with its margins well delineated. Green reflectance and blue reflectance highlighted calcification as multiple hyperreflective dots. Autofluorescence showed typical hyperautofluorescence.
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The gut microbiota widely varies from individual to individual, but the variation shows stability over a period of time. The presence of abundant bacterial taxa is a common structure that determines the microbiota of human being. The presence of this microbiota greatly varies from geographic location, sex, food habits and age. Microbiota existing within the gut plays a significant role in nutrient absorption, development of immunity, curing of diseases and various developmental phases. With change in age, chronology diversification and variation of gut microbiota are observed within human being. But it has been observed that with the enhancement of age the richness of the microbial diversity has shown a sharp decline. The enhancement of age also results in the drift of the characteristic of the microbes associated with the microbiota from commensals to pathogenic. Various studies have shown that age associated gut-dysbiosis may result in decrease in tlongevity along with unhealthy aging. The host signalling pathways regulate the presence of the gut microbiota and their longevity. The presence of various nutrients regulates the presence of various microbial species. Innate immunity can be triggered due to the mechanism of gut dysbiosis resulting in the development of various age-related pathological syndromes and early aging. The gut microbiota possesses the ability to communicate with the host system with the help of various types of biomolecules, epigenetic mechanisms and various types of signalling-independent pathways. Drift in this mechanism of communication may affect the life span along with the health of the host. Thus, this review would focus on the use of gut-microbiota in anti-aging and healthy conditions of the host system.
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Microbioma Gastrointestinal , Microbiota , Humanos , Microbioma Gastrointestinal/fisiología , Disbiosis/microbiología , Envejecimiento/fisiología , BacteriasRESUMEN
One of the cardinal causes of global deaths from a single-point infectious agent has been reported to be tuberculosis (or TB). At present times, the incidence of TB cases occurs mostly due to multi-drug resistance, which is expected to boost further in the upcoming times. Accordingly, the development of alternative treatment methodologies has received significant research interest. In this regard, the application of nanoparticles has notable cognizance. The literature suggested that nanoparticles have substantial potential to be used as the delivery medium for drug injection as well as they also serve as a potential bactericidal agent. In this present study, the efficacy of the selenium nanoparticles against the inhibition of growth of Mycobacterium tuberculosis was evaluated. The obtained results indicated that the synthesized selenium nanoparticles have notable cognizance towards the inhibition of growth of Mycobacterium tuberculosis by disrupting the integrity of their cell envelope. This study thus proposes a novel approach and opens new dimensional avenues in the field of nanoparticle-induced cell disruption strategies.
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Mycobacterium tuberculosis , Nanopartículas , Selenio , Tuberculosis , Humanos , Antituberculosos/farmacología , Antituberculosos/uso terapéutico , Selenio/farmacología , Tuberculosis/tratamiento farmacológicoRESUMEN
Esophageal carcinoma (EC) is recognized as the 6th most frequent carcinoma in China, with esophageal squamous cell carcinoma (ESCC) being the predominant histologic type. Currently, chemotherapy is one among the most important therapy modalities for patients with ESCC. However, resistance to chemotherapeutic drugs leads to limited treatment options and poor prognosis. In our study, the analysis of small RNA sequencing and digital gene expression (DGE) profiling was done to recognize the microRNAs (miRNAs) and key genes related with drug resistance in ESCC. It was noticed that the hsa-miRNA-140-3p (miR-140-3p) expression was considerably higher in drug-resistant cells than in sensitive cells. In addition, DGE identified target genes of miR-140-3p might perform key roles in ESCC. Furthermore, this work exhibited that miR-140-3p represents the nuclear transcription factor Y subunit alpha (NFYA) gene by targeting its 3'-untranslated regions. Such an interaction might influence the formation of the transcription factor NFY trimer, which in turn may inhibit the transcription of the multidrug resistance 1 gene and, ultimately, to multidrug resistance in ESCC. The inhibition of miR-140-3p decreased resistance to oxaliplatin in EC. Therefore, miR-140-3p may serve as a molecular marker for treatment response, efficacy, and prognosis of chemotherapy in ESCC patients.
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Neoplasias Esofágicas , Carcinoma de Células Escamosas de Esófago , MicroARNs , Humanos , Neoplasias Esofágicas/tratamiento farmacológico , Neoplasias Esofágicas/genética , Neoplasias Esofágicas/metabolismo , Carcinoma de Células Escamosas de Esófago/tratamiento farmacológico , Carcinoma de Células Escamosas de Esófago/genética , Carcinoma de Células Escamosas de Esófago/metabolismo , MicroARNs/genética , MicroARNs/metabolismo , Pronóstico , Factores de Transcripción/genética , Regulación Neoplásica de la Expresión Génica , Línea Celular Tumoral , Proliferación Celular , Movimiento Celular , Factor de Unión a CCAAT/genética , Factor de Unión a CCAAT/metabolismoRESUMEN
Some degenerations involving the peripheral retina can result in a rhegmatogenous retinal detachment. Currently, there are no clear guidelines for retinal screening and/or management of these peripheral retinal degenerations in patients with or without recent onset posterior vitreous detachment or in those prior to refractive surgery or intraocular procedures. This article aims to provide a set of recommendations for the screening and management of peripheral retinal degenerations based on a common consensus obtained from an expert panel of retinal specialists.