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1.
Exp Eye Res ; 212: 108802, 2021 11.
Article in English | MEDLINE | ID: mdl-34688623

ABSTRACT

Vitreous humor (VH) is not considered as a critical structure in the radiotherapy planning process. In the present study, an experimental animal model was performed to examine the effects of radiotherapy on VH. The right eyes of twelve New Zealand rabbits were irradiated to 60 Gy in 3 fractions in accordance with the scheme used in the treatment of uveal melanoma in our clinic, and contralateral (left) eyes were considered as control. Weekly ophthalmologic examination was performed after irradiation, for three months. At the end of the third month, enucleation and vitreous collection were conducted. The vitreous samples were subjected to metabolomic analyses, ELISA analyses, viscosity measurements, and electron microscopic examination. In control and experimental vitreous samples, 275 different metabolites were identified, and 34 were found to differ significantly between groups. In multivariate analyzes, a clear distinction was observed between control and irradiated vitreous samples. Pathway analysis revealed that nine pathways were affected, and these pathways were mainly related to amino acid metabolism. A significant decrease was observed in the expressions of type II, V, and XI collagens in protein level in the ELISA. There was a non-significant decrease in type IX collagen and viscosity. Electron microscopic examination revealed disrupted collagen fibrillar ultra-structure and dispersed collagen fragments in the experimental vitreous. An intact vitreous is essential for a healthy eye. In this study, we observed that radiation causes changes in the vitreous that may have long-term consequences.


Subject(s)
Body Fluids/metabolism , Collagen/metabolism , Melanoma/radiotherapy , Neoplasms, Experimental , Uveal Neoplasms/radiotherapy , Vitreous Body/radiation effects , Animals , Male , Melanoma/metabolism , Melanoma/pathology , Rabbits , Uveal Neoplasms/metabolism , Uveal Neoplasms/pathology , Vitreous Body/diagnostic imaging , Vitreous Body/metabolism
2.
Adv Sci (Weinh) ; 8(20): e2101754, 2021 10.
Article in English | MEDLINE | ID: mdl-34448360

ABSTRACT

Retinoblastoma is one of the most severe ocular diseases, of which current chemotherapy is limited to the repetitive intravitreal injections of chemotherapeutics. Systemic drug administration is a less invasive route; however, it is also less efficient for ocular drug delivery because of the existence of blood-retinal barrier and systemic side effects. Here, a photoresponsive drug release system is reported, which is self-assembled from photocleavable trigonal small molecules, to achieve light-triggered intraocular drug accumulation. After intravenous injection of drug-loaded nanocarriers, green light can trigger the disassembly of the nanocarriers in retinal blood vessels, which leads to intraocular drug release and accumulation to suppress retinoblastoma growth. This proof-of-concept study would advance the development of light-triggered drug release systems for the intravenous treatment of eye diseases.


Subject(s)
Drug Carriers/pharmacology , Drug Liberation/drug effects , Retina/drug effects , Retinoblastoma/drug therapy , Administration, Intravenous , Animals , Aqueous Humor/radiation effects , Blood-Retinal Barrier/drug effects , Disease Models, Animal , Drug Carriers/chemistry , Drug Liberation/radiation effects , Humans , Lenses, Intraocular , Light , Mice , Retina/pathology , Retina/radiation effects , Retinoblastoma/genetics , Retinoblastoma/pathology , Topotecan/chemistry , Topotecan/pharmacology , Vitreous Body/drug effects , Vitreous Body/radiation effects
3.
J Biophotonics ; 12(11): e201900193, 2019 11.
Article in English | MEDLINE | ID: mdl-31297950

ABSTRACT

Retinoblastoma (RB) is a rare form of cancer of the retina most prevalent in young children. We successfully show that laser-induced cell disruption, mediated by gold plasmonic nanoparticle (NP), is a potential and efficient therapy to kill the cancerous cells. The proof of concept is demonstrated in vitro on cultured Y79 RB cancer cells with a nanosecond laser at 527 nm, for both attached cells at the bottom of a Petri dish and for floating, clustered cells in a viscous vitreous phantom comprised of hyaluronan. We report a cellular death of 82% after irradiation in classic culture medium and a cellular death of 98% in vitreous phantom, for similar number of NPs in each sample. It is found that the NPs efficiently penetrate the floating Y79 clusters cells in the vitreous phantom, leading to a cellular death of over 85% even within the centre of the aggregates. The proposed treatment technique is based on a similar nanosecond laser used to eliminate floaters in the vitreous, but with much lower (100-1000 times) fluences of 20 J cm-2 .


Subject(s)
Laser Therapy/instrumentation , Phantoms, Imaging , Retinal Neoplasms/therapy , Retinoblastoma/therapy , Vitreous Body/radiation effects , Cell Line, Tumor , Humans , Viscosity
4.
Am J Hematol ; 94(3): 291-298, 2019 03.
Article in English | MEDLINE | ID: mdl-30516868

ABSTRACT

Vitreoretinal lymphoma (VRL) management remains a challenge. We present 72 patients with VRL, diagnosed at Mayo Clinic between 1990-2018. Three nondiffuse large B-cell lymphoma (DLBCL) histology cases were excluded. Among 69 DLBCL, 33 patients had primary VRL (PVRL), 18 concurrent intraocular and central nervous system (CNS) or systemic disease and 18 secondary VRL. Patients received intraocular chemotherapy (intraocular injections of rituximab or metothrexate or steroids or in combination), radiotherapy, systemic or combined systemic plus intraocular treatment in 9, 10, 35, and 15 cases, respectively. Among primary and concurrent VRL, median failure free survival (FFS), CNS relapse-free survival (CNS-RFS) and overall survival (OS) were: 1.8, 4.9, and 4.1 years, respectively; among PVRL, median FFS, CNS-RFS, and OS were: 2.6 year, Not Reached and 9.3 year, respectively. No CNS relapse occurred beyond 4 years in PVRL. Median OS for patients diagnosed between 1990 and 1999 vs between 2000 and 2018 was 1.5 vs 9.4 years, respectively (P = .0002). OS was significantly higher in PVRL, as compared with concurrent VRL (P = .04). Previous immunosuppression and poor performance status were predictive of worse outcome. In PVRL, a combined systemic and intraocular therapy showed higher FFS (P = .002) and CNS-RFS (P = .003), but no differences in OS. Among 18 secondary VRL, at a median follow-up of 1.1 year after vitreoretinal relapse, median FFS and OS were 0.3 and 1.3 years. An improvement in survival of VRL has been observed over the decades. PVRL should undergo combined systemic and intraocular chemotherapy to prevent CNS progression.


Subject(s)
Antineoplastic Agents, Immunological/therapeutic use , Combined Modality Therapy/methods , Lymphoma/therapy , Methotrexate/therapeutic use , Retinal Neoplasms/therapy , Rituximab/therapeutic use , Adult , Aged , Aged, 80 and over , Female , Gamma Rays/therapeutic use , Humans , Injections, Intravenous , Intravitreal Injections , Lymphoma/mortality , Lymphoma/pathology , Male , Middle Aged , Recurrence , Retina/drug effects , Retina/pathology , Retina/radiation effects , Retinal Neoplasms/mortality , Retinal Neoplasms/pathology , Retrospective Studies , Survival Analysis , Treatment Outcome , Vitreous Body/drug effects , Vitreous Body/pathology , Vitreous Body/radiation effects
5.
PLoS One ; 9(12): e114437, 2014.
Article in English | MEDLINE | ID: mdl-25502697

ABSTRACT

The emerging use of femtosecond lasers with high repetition rates in the MHz regime together with limited scan speed implies possible mutual optical and dynamical interaction effects of the individual cutting spots. In order to get more insight into the dynamics a time-resolved photographic analysis of the interaction of cavitation bubbles is presented. Particularly, we investigated the influence of fs-laser pulses and their resulting bubble dynamics with various spatial as well as temporal separations. Different time courses of characteristic interaction effects between the cavitation bubbles were observed depending on pulse energy and spatio-temporal pulse separation. These ranged from merely no interaction to the phenomena of strong water jet formation. Afterwards, the mechanisms are discussed regarding their impact on the medical application of effective tissue cutting lateral to the laser beam direction with best possible axial precision: the mechanical forces of photodisruption as well as the occurring water jet should have low axial extend and a preferably lateral priority. Furthermore, the overall efficiency of energy conversion into controlled mechanical impact should be maximized compared to the transmitted pulse energy and unwanted long range mechanical side effects, e.g. shock waves, axial jet components. In conclusion, these experimental results are of great importance for the prospective optimization of the ophthalmic surgical process with high-repetition rate fs-lasers.


Subject(s)
Lasers , Animals , Gelatin , Hydrodynamics , Optical Phenomena , Spatio-Temporal Analysis , Swine , Time Factors , Vitreous Body/radiation effects , Volatilization , Water
6.
Cell Biochem Biophys ; 68(2): 267-74, 2014 Mar.
Article in English | MEDLINE | ID: mdl-23797611

ABSTRACT

This work aimed to consider the hazardous side effect of eye floaters treatment with Q-switched Nd:YAG laser on the protein and viscoelastic properties of the vitreous humor, and evaluate the protective role of vitamin C against laser photo disruption. Five groups of New Zealand rabbits were divided as follows: control group for (n = 3) without any treatment, the second group (n = 9) treated with Q-switched Nd:YAG laser energy of 5 mJ × 100 pulse delivered to the anterior, middle, and posterior vitreous, respectively (n = 3 for each). The third group (n = 9) received a daily dose of 25 mg/kg body weight vitamin C for 2 weeks, and then treated with laser as the previous group. The fourth group (n = 9) treated with 10 mJ 9 50 pulse delivered to the anterior, middle, and posterior vitreous, respectively (n = 3 rabbits each). The fifth group (n = 9) received a daily dose of 25 mg/kg body weight vitamin C for 2 weeks, and then treated with laser as the previous group. After 2 weeks of laser treatment, the protein content, refractive index (RI), and the rheological properties of vitreous humor, such as consistency, shear stress, and viscosity, were determined. The results showed that, the anterior vitreous group exposed to of 5 mJ × 100 pulse and/or supplemented with vitamin C, showed no obvious change. Furthermore, all other treated groups especially for mid-vitreous and posterior vitreous humor showed increase in the protein content, RI and the viscosity of vitreous humor. The flow index remained below unity indicating the non-Newtonian behavior of the vitreous humor. Application of Q-switched Nd:YAG laser should be restricted to the anterior vitreous humor to prevent the deleterious effect of laser on the gel state of the vitreous humor.


Subject(s)
Lasers, Solid-State , Rheology , Vitreous Body/radiation effects , Animals , Antioxidants/pharmacology , Ascorbic Acid/pharmacology , Male , Rabbits , Refractometry , Viscosity , Vitreous Body/drug effects , Vitreous Body/physiology
8.
PLoS One ; 8(5): e63229, 2013.
Article in English | MEDLINE | ID: mdl-23658814

ABSTRACT

To investigate refractive and axial responses to the shift of focal plane resulting from the interchange of two monochromatic lights separately corresponding to the peak wavelengths of the cones absorption spectrum in retina, fifty 2-week-old pigmented guinea pigs were randomly assigned to five groups based on the mode of illumination: short-wavelength light (SL), middle-wavelength light (ML) and broad-band white light (BL) for 20 weeks, SL for 10 weeks followed by ML for 10 weeks (STM), as well as ML for 10 weeks followed by SL for 10 weeks (MTS). Biometric and refractive measurements were then performed every 2 weeks. After 10 weeks, SL and STM groups became more hyperopic and had less vitreous elongation than BL group. However, ML and MTS groups became more myopic and had more vitreous elongation. After interchange of the monochromatic light, the refractive error decreased rapidly by about 1.93D and the vitreous length increased by 0.14 mm in STM group from 10 to 12 weeks. After that, there were no significant intergroup differences between STM and BL groups. The interchange from ML to SL quickly increased the refractive error by about 1.53D and decreased the vitreous length by about 0.13 mm in MTS group after two weeks. At this time, there were also no significant intergroup differences between MTS and BL groups. The guinea pig eye can accurately detect the shift in focal plane caused by interchange of two monochromatic lights and rapidly generate refractive and axial responses. However, an excessive compensation was induced. Some properties of photoreceptors or retina may be changed by the monochromatic light to influence the following refractive development.


Subject(s)
Fixation, Ocular/radiation effects , Light , Refraction, Ocular/radiation effects , Animals , Color , Guinea Pigs , Refractive Errors/physiopathology , Vitreous Body/physiology , Vitreous Body/physiopathology , Vitreous Body/radiation effects
9.
Curr Eye Res ; 37(10): 871-8, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22632164

ABSTRACT

PURPOSE: This study was designed to measure vitamin D metabolites in the aqueous and vitreous humor and in tear fluid, and to determine if dietary vitamin D3 supplementation affects these levels. We also determined if the corneal epithelium can synthesize vitamin D following UV-B exposure. METHODS: Rabbits were fed a control or vitamin D3 supplemented diet. Pilocarpine-stimulated tear fluid was collected and aqueous and vitreous humor were drawn from enucleated eyes. Plasma vitamin D was also measured. To test for epithelial vitamin D synthesis, a human corneal limbal epithelial cell line was irradiated with two doses of UV-B (10 and 20 mJ/cm(2)/day for 3 days) and vitamin D was measured in control or 7-dehydrocholesterol treated culture medium. Measurements were made using mass spectroscopy. RESULTS: 25(OH)-vitamin D3 and 24,25(OH)(2)-vitamin D3 increased significantly following D3 supplementation in all samples except vitreous humor. Tear fluid and aqueous humor had small but detectable 1,25(OH)(2)-vitamin D3 levels. Vitamin D2 metabolites were observed in all samples. Vitamin D3 levels were below the detection limit for all samples. Minimal vitamin D3 metabolites were observed in control and UV-B-irradiated epithelial culture medium except following 7-dehydrocholesterol treatment, which resulted in a UV-B-dose dependent increase in vitamin D3, 25(OH)-vitamin D3 and 24,25(OH)(2)-vitamin D3. CONCLUSIONS: There are measurable concentrations of vitamin D metabolites in tear fluid and aqueous and vitreous humor, and oral vitamin D supplementation affects vitamin D metabolite concentrations in the anterior segment of the eye. In addition, the UV exposure results lead us to conclude that corneal epithelial cells are likely capable of synthesizing vitamin D3 metabolites in the presence of 7-dehydrocholesterol following UV-B exposure.


Subject(s)
24,25-Dihydroxyvitamin D 3/pharmacokinetics , Calcifediol/pharmacokinetics , Ultraviolet Rays , 24,25-Dihydroxyvitamin D 3/metabolism , Animals , Aqueous Humor/drug effects , Aqueous Humor/metabolism , Aqueous Humor/radiation effects , Calcifediol/metabolism , Cell Line , Epithelium, Corneal/cytology , Epithelium, Corneal/metabolism , Epithelium, Corneal/radiation effects , Humans , Limbus Corneae/cytology , Limbus Corneae/metabolism , Limbus Corneae/radiation effects , Miotics/pharmacology , Pilocarpine/pharmacology , Rabbits , Tears/drug effects , Tears/metabolism , Vitreous Body/drug effects , Vitreous Body/metabolism , Vitreous Body/radiation effects
10.
Vision Res ; 48(21): 2329-35, 2008 Sep.
Article in English | MEDLINE | ID: mdl-18684394

ABSTRACT

Continuous exposure of chicks to light was shown to result in severe hyperopia, accompanied by anterior segment changes, such as severe corneal flattening. Since rearing chicks in complete darkness results only in mild hyperopia and minor changes in corneal curvature, we hypothesized that light intensity may play a role in the development of refractive changes under continuous light illumination. To test this hypothesis, we examined the effects of rearing chicks under various continuous light intensities. More specifically, we investigated the refractive parameters of the chicks' eyes, and avoided light cycling effects on ocular development. To this end, thirty-eight chicks were reared under 24-h incandescent illumination, at three different light intensities: 10,000 lux (n=13), 500 lux (n=12), and 50 lux (n=13). Their eyes underwent repeated retinoscopy, keratometry, and ultrasound biometry, as well as caliper measurements of enucleated eyes. Both refraction and corneal refractive power were found to be correlated with light intensity. On day 90 after hatching, exposure to light intensities of 10,000, 500, and 50 lux resulted in hyperopia of +11.97+/-3.7 (mean+/-SD) +7.9+/-4.08 and +0.63+/-3.61 diopters (D), respectively. Under those intensities, corneal refractive power was 46.10+/-3.62, 49.72+/-4.16, and 56.88+/-4.92D, respectively. Axial length did not differ significantly among the groups. The vitreous chamber was significantly deeper in the high than in the low-intensity groups. Thus, during the early life of chicks exposed to continuous lighting, light intensity affects the vitreous chamber depth as well as the anterior segment parameters, most notably the cornea. The higher the intensity, the more severe was the corneal flattening observed and the hyperopia that developed, whereas continuous illumination at low intensities resulted in emmetropia. Thus, light intensity is an important factor that should be taken into account when studying refractive development.


Subject(s)
Eye/growth & development , Eye/radiation effects , Light , Refraction, Ocular/radiation effects , Aging/physiology , Animals , Anterior Chamber/growth & development , Anterior Chamber/radiation effects , Biometry , Chickens , Cornea/growth & development , Cornea/physiology , Cornea/radiation effects , Corneal Topography/methods , Dose-Response Relationship, Radiation , Female , Hyperopia/etiology , Hyperopia/pathology , Lighting/adverse effects , Lighting/methods , Vitreous Body/growth & development , Vitreous Body/radiation effects
11.
Lasers Surg Med ; 39(4): 353-7, 2007 Apr.
Article in English | MEDLINE | ID: mdl-17457837

ABSTRACT

BACKGROUND AND OBJECTIVE: Until now, UV lasers could not be applied to vitreoretinal surgery because of the absence of a practical beam guiding system. A flexible, freely mobile hollow core waveguide, capable of delivering UV laser light, was recently developed. We evaluated the feasibility of this UV laser guiding system for vitreoretinal surgery in enucleated porcine and rabbit eyes and in vivo on rabbit retina. MATERIALS AND METHODS: 193-nm argon fluoride (ArF) excimer laser and a 5th harmonic Nd:YAG laser with the wavelength of 213 nm were used as a light source. A hollow core waveguide was connected to a handpiece with a 20-gauge endoprobe as an instrument for vitreoretinal surgery. RESULTS: Cutting of the retina was possible only with contact technique. With a selected repetition rate of 20 Hz, sharp, full-depth dissection of porcine retinas was achieved only with 1.0 J/cm2. With the repetition rate of 50 Hz, even 0.05 J/cm2 could incise the total thickness of rabbit retina with no histological damage of the underlying retinal pigment epithelium. The ease in using the instrument for vitreoretinal surgery was confirmed by the in vivo experiment. CONCLUSION: This study revealed the potential use of the new type of the UV laser scalpel, connected to a hollow core waveguide, to perform precise, "cold," and tractionless cutting during vitreoretinal surgery.


Subject(s)
Laser Therapy/methods , Microsurgery/methods , Retina/surgery , Ultraviolet Rays , Vitreous Body/surgery , Animals , Feasibility Studies , Needles , Rabbits , Retina/radiation effects , Swine , Vitreous Body/radiation effects
12.
Int J Radiat Oncol Biol Phys ; 67(3): 933-41, 2007 Mar 01.
Article in English | MEDLINE | ID: mdl-17293242

ABSTRACT

PURPOSE: To compare the numerous external radiotherapy (RT) techniques for the treatment of retinoblastoma, as well as an intensity-modulated RT (IMRT) technique. The latter was elaborated to evaluate the potential dose reduction in the surrounding tissue, as well as the potential avoidance of subdosage in the ora serrata retinae. METHODS AND MATERIALS: A 2-year-old patient with unilateral retinoblastoma underwent CT. With the aid of an ophthalmologist, the ocular structures were delimited, and 13 techniques described in published reports were reproduced on three-dimensional planning software and identified according to their authors. A technique with four noncoplanar fields using IMRT was also elaborated. These techniques were compared according to the dose to the ora serrata retinae, lens, orbit (volume that received a dose of >or=20 Gy), vitreous, optic nerve, lacrimal gland (volume that received a dose of >or=34 Gy), and cornea and according to their ease of reproducibility. RESULTS: The techniques that attained the therapeutic dose to the ora serrata retinae were the IMRT technique and the techniques of Haye, Cassady, Cormack, and al-Beteri. The Cormack technique had the lowest volume that received a dose of >or=20 Gy in the orbit, followed by the IMRT technique. The IMRT technique also achieved the lowest volume that received a dose of >or=34 Gy (14%) in the lacrimal gland. The Abramson/McCormick/Blach, Cassady, Reese, and Schipper techniques were the easiest to reproduce and the Chin the most complex. CONCLUSION: Retinoblastoma treatment with IMRT has an advantage over the other techniques, because it allows for the greatest reduction of dose to the orbit and lacrimal gland, while maintaining the therapeutic dose to the ora serrata retinae and vitreous.


Subject(s)
Retinal Neoplasms/radiotherapy , Retinoblastoma/radiotherapy , Child, Preschool , Humans , Lacrimal Apparatus/radiation effects , Lens, Crystalline/radiation effects , Optic Nerve/radiation effects , Radiation Injuries/prevention & control , Radiotherapy/methods , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted , Radiotherapy, Intensity-Modulated/methods , Reproducibility of Results , Retina/radiation effects , Retinal Neoplasms/diagnostic imaging , Retinoblastoma/diagnostic imaging , Tomography, X-Ray Computed , Vitreous Body/radiation effects
13.
Clin Exp Ophthalmol ; 34(1): 74-6, 2006.
Article in English | MEDLINE | ID: mdl-16451262

ABSTRACT

Herein a clinical case of an unusual metastasis from breast cancer to the retina and vitreous confirmed by diagnostic vitrectomy is described. Further investigation also demonstrated the central nervous system metastasis.


Subject(s)
Adenocarcinoma/secondary , Brain Neoplasms/secondary , Breast Neoplasms/pathology , Eye Neoplasms/secondary , Retinal Neoplasms/secondary , Vitreous Body/pathology , Adenocarcinoma/radiotherapy , Brain Neoplasms/radiotherapy , Breast Neoplasms/radiotherapy , Eye Neoplasms/radiotherapy , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Retinal Neoplasms/radiotherapy , Tomography, Optical Coherence , Vitrectomy , Vitreous Body/radiation effects
14.
Invest Ophthalmol Vis Sci ; 46(4): 1468-72, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15790917

ABSTRACT

PURPOSE: To assess the histology of the retinal surface after staining of the inner limiting membrane (ILM) with indocyanine green (ICG) followed by illumination with halogen or xenon light sources in human donor and porcine eyes. METHODS: Ten eyes of six human donors and six porcine eyes were used in the study. In human donor eyes, the postmortem time varied between 7 and 38 hours, and porcine eyes were evaluated 9 hours after death. In all eyes, the vitreous was removed, and a few drops of 0.5% ICG were poured over the trephined posterior pole and carefully washed out after a period of 1 minute, with balanced salt solution. Then the stained retina was illuminated for 3 minutes with different light sources: a halogen light source of 145-W power or a xenon light source of 50-W power. Adjacent, unstained retina of each eye served as a control to assess postmortem artifacts. In two human and two porcine eyes ICG was applied without illumination. Retinal specimens were evaluated by light and electron microscopy. RESULTS: In human eyes, severe disorganization of the innermost retina and ILM loss were observed after ICG application with subsequent illumination with the halogen light source. After illumination with the xenon light source, there was only slight vacuolization of the innermost retina, with mostly intact Muller cells. The ILM remained in situ in relation to the retinal surface. Intact cellular architecture was found in all specimens after ICG staining without subsequent illumination and control specimens of unstained retina. In porcine eyes, no impact attributable to the light source or ICG alone was noted in this experimental setting. CONCLUSIONS: These findings suggest that adverse effects of ICG at the retinal surface may depend on the light source used during vitrectomy and correlate with the emission spectrum of the different light sources. In addition, care should be taken when comparing results obtained in human eyes and porcine eyes.


Subject(s)
Coloring Agents , Indocyanine Green , Light , Retina/ultrastructure , Vitreous Body/ultrastructure , Adolescent , Aged , Animals , Basement Membrane/drug effects , Basement Membrane/radiation effects , Basement Membrane/ultrastructure , Halogens , Humans , Middle Aged , Retina/drug effects , Retina/radiation effects , Staining and Labeling/methods , Swine , Tissue Donors , Vitreous Body/drug effects , Vitreous Body/radiation effects , Xenon
15.
Am J Ophthalmol ; 137(2): 345-8, 2004 Feb.
Article in English | MEDLINE | ID: mdl-14962428

ABSTRACT

PURPOSE: To evaluate the effect of indocyanine green (ICG) diluted with glucose 5% on the human retina in an experimental setting in postmortem eyes and during surgery for macular hole formation. DESIGN: Histopathological evaluation. METHODS: Possible adverse effects of two different solutions of 0.05% ICG (Pulsion, Munich, Germany; and Infracyanine, Laboratoire SERB, Paris, France) diluted with glucose 5% were evaluated in four eyes of two donors. In one eye of each donor, the ICG-stained macula was illuminated with 380 to 760 nm using the light source of a commonly used vitrectomy machine. In the other eye, ICG was applied to the macula without illumination. The retinal specimens were evaluated using light- and electron microscopy. Additionally, the ultrastructure of the internal limiting membrane (ILM) of four eyes that underwent ICG-assisted vitrectomy for macular hole formation was examined. RESULTS: In the postmortem study, both solutions of ICG caused significant morphologic alterations of the inner retina after light exposure. There was disorganization of the inner retina and complete loss of ILM after application of the dye and illumination. In contrast, no abnormalities were found after application of the dye without illumination and in unstained control specimens. No differences were noted between the two ICG products. Specimens of the ILM harvested during vitrectomy revealed cellular elements adjacent to the retinal side of the ILM. CONCLUSIONS: Staining of the ILM using ICG diluted in glucose 5% followed by illumination might induce an adverse effect on the inner retina and may result in an alteration of the cleavage plane from the ILM to the innermost retinal layers.


Subject(s)
Basement Membrane/ultrastructure , Glucose/chemistry , Indocyanine Green/analogs & derivatives , Indocyanine Green/toxicity , Retina/drug effects , Vitreous Body/drug effects , Adult , Coloring Agents , Humans , Indocyanine Green/chemistry , Male , Retina/radiation effects , Retinal Perforations/surgery , Staining and Labeling/methods , Vitreous Body/radiation effects
16.
J Biomed Opt ; 8(4): 583-93, 2003 Oct.
Article in English | MEDLINE | ID: mdl-14563195

ABSTRACT

Ablation at wavelengths near lambda = 6.45 microm results in tissue ablation with minimal collateral damage (< 40 microm) yet yields a high ablation rate that is useful for human surgery. However, delivery of this wavelength has been limited to that in air and thus to applications in which the target tissue can be readily exposed. The goal of this study is to investigate the potential of a pulsed infrared laser at lambda = 6.45 microm for noncontact ablation in a liquid environment. To this end we investigated fiber delivery in combination with the use of infrared transparent liquids. Transmission characteristics and damage thresholds for two types of fiber materials (silver halide and arsenic sulfide), for high-power pulsed laser radiation were determined using the Mark III free electron laser. Both fibers had comparable bulk losses (0.54 dB/m and 0.62 dB/m, respectively) while the arsenic sulfide fibers showed more coupling losses (37 versus 27%). Damage thresholds were higher in arsenic sulfide fibers than in silver halide fibers (1.12 GW/cm2 versus 0.54 GW/cm2), but both fibers were sufficient to deliver radiant exposures well above the ablation threshold in tissue. Seven different perfluorocarbon liquids (PFCLs), known for their transparency at lambda = 2.94 microm, were investigated and their optical transmission was determined using Fourier transform infrared and direct Beer's law measurements. All of the PFCLs tested had similar values for an absorption coefficient mu(a) at a given wavelength (mu(a) = 0.05 mm(-1) at lambda = 2.94 microm and mu(a) is approximately 3 mm(-1) at lambda = 6.45 microm). Pump-probe imaging showed the ablation sequence (lambda = 6.45 microm) at the fiber tip in a water environment, which revealed a fast expanding and collapsing bubble. In contrast, the volatile PF-5060 showed no fast bubble expansion and collapse, but rather formation of nontransient gas bubbles. Perfluorodecalin did not show any bubble formation at the radiant exposures used. It was shown that using the lambda = 6.45 microm wavelength delivered via fiber optics in combination with perfluorodecalin allows a noncontact laser surgical procedure. Deeper structures, however, are effectively shielded because the radiant exposure of the beam will fall below the ablation threshold owing to the absorption by perfluorodecalin. This may optimize the efficacy and safety of laser-based vitreoretinal surgery.


Subject(s)
Biomimetic Materials/radiation effects , Fiber Optic Technology/instrumentation , Fluorocarbons/chemistry , Fluorocarbons/radiation effects , Infrared Rays/therapeutic use , Laser Therapy/methods , Retina/surgery , Vitreous Body/surgery , Dose-Response Relationship, Radiation , Feasibility Studies , Fiber Optic Technology/methods , Laser Therapy/instrumentation , Optical Fibers , Retina/radiation effects , Solutions , Vitreous Body/radiation effects
17.
Article in English | MEDLINE | ID: mdl-12839188

ABSTRACT

It is well-known that changes in the mechanical properties of tissues are correlated with the presence of disease. In the eye, for example, the vitreous body undergoes dramatic changes in mechanical properties during age-related degradation. These changes may play a significant role in the formation of retinal detachment or other vitreoretinal diseases. We previously presented a noninvasive method called kinetic acoustic vitreoretial examination (KAVE), which may be used to detect these mechanical changes. KAVE uses acoustic radiation force as a means to produce small, localized displacements within the tissues. Returning echoes are processed using ultrasonic motion tracking so that the response of the tissue to the induced force can be evaluated. By repeating this process at a number of locations, images depicting viscoelastic properties of tissues can be formed. Through the combination of appropriate mechanical modeling and signal processing, we are able to generate images of parameters such as relative mass, relative elasticity, and relative viscosity. These parameters are called relative because they depend on the force applied, which is typically unknown. In this paper, we present new force-free images depicting the time constant tau, the damping ratio xi, and the natural frequency omega of the phantom material. These images are significant in that they lack the artifacts common in the relative property images. Experiments were conducted on a set of three acrylamide-based phantoms with varying gel concentrations. We present images depicting B-mode echogenicity, maximum radiation force-induced displacement, relative material parameters, and force-free characteristics of the series of phantoms. The presented force-free images depict mechanical properties without artifacts from local force variation due to acoustic reflection, refraction, and attenuation. Force-free images should prove particularly useful for in vivo imaging through inhomogeneous tissues.


Subject(s)
Connective Tissue/diagnostic imaging , Connective Tissue/physiology , Motion , Physical Stimulation/methods , Vitreous Body/diagnostic imaging , Vitreous Body/physiology , Artifacts , Computer Simulation , Connective Tissue/radiation effects , Elasticity , Micromanipulation/instrumentation , Micromanipulation/methods , Models, Biological , Phantoms, Imaging , Physical Stimulation/instrumentation , Quality Control , Reproducibility of Results , Scattering, Radiation , Sensitivity and Specificity , Stress, Mechanical , Ultrasonics , Ultrasonography/methods , Viscosity , Vitreous Body/radiation effects
18.
Eur J Ophthalmol ; 13(5): 424-32, 2003 Jun.
Article in English | MEDLINE | ID: mdl-12841564

ABSTRACT

PURPOSE: To quantify erbium (Er):YAG laser ablation of vitreous in relation to different pulse repetition rates < or = 200 Hz, in order to examine the feasibility of laser for removal of vitreous gel (photovitrectomy) in clinically acceptable times. METHODS: Fresh porcine vitreous samples and saline controls were ablated in air with an Er:YAG laser connected to a sapphire fiber at pulse energies between 1.0 and 21.2 mJ and at pulse repetition rates between 10 and 200 Hz. Net ablation rates were determined by weight measurement. RESULTS: Reproducible and constant ablation rates were found for given laser parameters. Net ablation rates increased linearly with pulse repetition rate and nonlinearly with pulse energy. Expanded laser parameter domains permitted vitreous ablation rates as low as 1 microg/s to as high as 1031 microg/s. Ablation rates did not differ significantly between vitreous and saline. CONCLUSIONS: The study documents clinically useful vitreous ablation rates that scale linearly with high repetition rates of Er:YAG laser, and suggests directions for further development of laser technology for enhanced removal of vitreous and other tissues. However, nonlinear effects of pulse energy also exist, indicating need for careful examination of ablation characteristics in various instruments.


Subject(s)
Laser Therapy/methods , Vitrectomy/methods , Vitreous Body/surgery , Animals , Eye Diseases/surgery , Feasibility Studies , Sodium Chloride , Swine , Vitrectomy/instrumentation , Vitreous Body/radiation effects
19.
Histol Histopathol ; 17(3): 721-9, 2002.
Article in English | MEDLINE | ID: mdl-12168780

ABSTRACT

Terminal dendrites of cone horizontal cells (HCs) in teleost retinas show numerous spine-like protrusions named spinules, which are invaginated into the cone pedicles during light-adaptation, but retracted during dark-adaptation. Somata of HC show nematosomes whose size decreases as the number of spinules increases. Mechanisms regulating these changes in nematosomes and spinules are only partially understood, being an area of controversy in retinal cell biology. It has been suggested that efferent fibres from the brain to the retina might be involved in the control of spinule formation. Moreover, we have reported that actin depolymerization has an interocular effect on spinule formation, which could be mediated by these fibres. In the present report, we show an interocular effect on spinule dynamics: the monocular intravitreal injection of dopamine (DA) and 6-hydroxydopamine (6-OHDA), two drugs that affect the spinule formation, produces the same effects in the contralateral, untreated eye as in the injected eye. Our results reinforce the idea of an interocular central control of this phenomenon of synaptic plasticity. Dopamine-dependent events in the retina appear to be necessary to forge the afferent signals eliciting this interocular effect.


Subject(s)
Dopamine/pharmacology , Oxidopamine/pharmacology , Retina/drug effects , Vitreous Body/radiation effects , Adrenergic Agents/pharmacology , Animals , Bass , Immunohistochemistry , Light , Microscopy, Electron , Retina/ultrastructure
20.
Cesk Slov Oftalmol ; 55(3): 155-9, 1999 May.
Article in Czech | MEDLINE | ID: mdl-10493013

ABSTRACT

In the submitted paper the authors pay attention to infrared radiation close to visible light is intensely absorbed by haemoglobin, melanin and xanthophyll whereby part of the radiation energy is transformed into heat. The authors present three series of experiments where they investigated by different methods changes in the vitreous body after exposure to light, infrared radiation or raised temperature. They assume that on the defocused eye with a myopic conus which developed as a result of an inborn inadequate closure of the optic cup the light can cause a rise of temperature in the vitreous body. This leads to metabolic changes characterized by increased activity of lysosomal enzymes causing loss of the spatial structure of hyaluronic acid and collagen biomolecules. Penetration of the altered vitreous fluid thought the conus can lead to degradation of the interstitial substances of the sclera. Suitable absorption glasses filtering infrared light close to visible light could reduce the hyperthermia of the vitreous body.


Subject(s)
Infrared Rays , Myopia/pathology , Vitreous Body/radiation effects , Humans , In Vitro Techniques , Light , Myopia/metabolism , Temperature , Vitreous Body/metabolism , Vitreous Body/pathology
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