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1.
Sci Rep ; 10(1): 10509, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32601497

RESUMO

Differentiating glaucoma from myopic eye is a challenge to ophthalmologists. We try to develop a new discrete Fourier transform (DFT) model for analyzing optical coherence tomography data for the circumpapillary retinal nerve fiber layer (cpRNFL), and investigate DFT as a new diagnostic tool for glaucomatous myopic eyes. The thicknesses of 12 equidistant cpRNFL points were transformed into 6 signals in the frequency domain, ranging from 1 to 6 Hz. In all 232 eyes, generalized linear model showed that 1 Hz, 2 Hz, and 4 Hz were associated with glaucoma, high myopia, and the interaction between glaucoma and high myopia. The 3 Hz signal was associated with glaucoma and high myopia exclusively. A receiver operating characteristic curve analysis of the 3 Hz signals showed areas under the curves of 0.93 (95% CI 0.90-0.96) and 0.93 (95% CI 0.88-0.98), for diagnosing glaucoma in all subjects and in the highly myopic group, respectively. The DFT model is useful to differentiate glaucoma from non-glaucomatous change and showed potential as a diagnostic tool for glaucomatous myopic eyes.

2.
PLoS One ; 15(5): e0233079, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32407355

RESUMO

PURPOSE: To evaluate ways to improve the generalizability of a deep learning algorithm for identifying glaucomatous optic neuropathy (GON) using a limited number of fundus photographs, as well as the key features being used for classification. METHODS: A total of 944 fundus images from Taipei Veterans General Hospital (TVGH) were retrospectively collected. Clinical and demographic characteristics, including structural and functional measurements of the images with GON, were recorded. Transfer learning based on VGGNet was used to construct a convolutional neural network (CNN) to identify GON. To avoid missing cases with advanced GON, an ensemble model was adopted in which a support vector machine classifier would make final classification based on cup-to-disc ratio if the CNN classifier had low-confidence score. The CNN classifier was first established using TVGH dataset, and then fine-tuned by combining the training images of TVGH and Drishti-GS datasets. Class activation map (CAM) was used to identify key features used for CNN classification. Performance of each classifier was determined through area under receiver operating characteristic curve (AUC) and compared with the ensemble model by diagnostic accuracy. RESULTS: In 187 TVGH test images, the accuracy, sensitivity, and specificity of the CNN classifier were 95.0%, 95.7%, and 94.2%, respectively, and the AUC was 0.992 compared to the 92.8% accuracy rate of the ensemble model. For the Drishti-GS test images, the accuracy of the CNN, the fine-tuned CNN and ensemble model was 33.3%, 80.3%, and 80.3%, respectively. The CNN classifier did not misclassify images with moderate to severe diseases. Class-discriminative regions revealed by CAM co-localized with known characteristics of GON. CONCLUSIONS: The ensemble model or a fine-tuned CNN classifier may be potential designs to build a generalizable deep learning model for glaucoma detection when large image databases are not available.

3.
Sci Rep ; 10(1): 5608, 2020 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-32221379

RESUMO

There is distinct pathogenesis between primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). Although elevated intraocular pressure (IOP) is the major risk factor for glaucoma, non-IOP risk factors such as vascular abnormalities and lower systolic/diastolic perfusion pressure may play a role in the pathogenic process. This study aimed to compare the vessel density (VD) in the optic disc and macula using optical coherence tomography angiography (OCTA) between POAG and PACG eyes. Thirty-two POAG eyes, 30 PACG eyes, and 39 control eyes were included. All the optic disc VD parameters except the inside disc VD were significantly lower in glaucomatous eyes than in control eyes. Compared with PACG eyes, only the inferior temporal peripapillary VD was significantly lower in POAG eyes. The parafoveal VD was significantly lower in each quadrant in glaucomatous eyes than in control eyes. The central macular and parafoveal VD did not differ between POAG and PACG eyes. In conclusion, the inferior temporal peripapillary VD was significantly reduced in POAG eyes compared with PACG eyes, while PACG eyes showed a more evenly distributed reduction in the peripapillary VD. The distinct patterns of VD change may be associated with the different pathogenesis between POAG and PACG.

4.
J Chin Med Assoc ; 83(3): 313-317, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31904660

RESUMO

BACKGROUND: We investigated the performance of glaucoma assessment using RS-3000 spectral domain optical coherence tomography with a long axial length (AL) normative database versus Cirrus HD-OCT in eyes with high myopia. METHODS: This is a prospective case-control study. Eyes with AL ≥26 mm were enrolled, including 40 control eyes and 41 eyes with primary open-angle glaucoma. Each participant received OCT imaging with both devices at the same visit. We calculated the area under receiver operating characteristic curve (AUROC) for circumpapillary retinal nerve fiber layer (cpRNFL) and macular ganglion cell complex (GCC) parameters, and compared the false-positive and false-negative rates between the two devices. RESULTS: Both devices performed comparably well in glaucoma assessment regarding cpRNFL parameters, with the best parameter being the average cpRNFL for RS-3000 (AUROC: 0.899) and the clock-hour 7 cpRNFL for Cirrus HD (AUROC: 0.912). Regarding macular GCC parameters, although the nasal-inferior outer sector of the RS-3000 (AUROC 0.873) and the inferior-temporal sector of the Cirrus HD (AUROC 0.840) performed well in glaucoma assessment, generally speaking there was a higher false-positive rate using Cirrus HD when compared with that of RS-3000. CONCLUSION: For eyes with long AL, both OCT devices are comparable in the ability of discriminating glaucoma from non-glaucoma in terms of cpRNFL parameters, while the macular GCC parameters of RS-3000 were less likely to over-diagnose glaucoma in highly myopic eyes.

5.
J Chin Med Assoc ; 83(3): 307-312, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31972833

RESUMO

BACKGROUND: We evaluated the usefulness of neuroretinal rim (NRR) thicknesses, measured in clock-hour sectors with Cirrus HD optical coherence tomography, for diagnosing preperimetric glaucoma (PPG). METHODS: This prospective study included 39 eyes of 39 patients with PPG and 39 eyes of 39 controls that were matched to patients for age and refractive error. We measured the circumpapillary retinal nerve fiber layer (cpRNFL) thickness, macular ganglion cell-inner plexiform layer (GCIPL) thickness, and optic nerve head (ONH) parameters with optical coherence tomography. The clock-hour NRR thicknesses were derived from a 360° circumferential rim thickness curve. We analyzed the area under the receiver operating characteristics curve (AUROC), cutoff values, and sensitivities at specificities of 90% and 95%. RESULTS: The largest area under the receiver operating characteristics curves were observed for the NRR thickness at 6 o'clock (0.823), the inferior RNFL thickness (0.821), the average RNFL thickness (0.819), and the NRR thickness at 7 o'clock (0.818). The performance of the NRR thickness at 6 o'clock was comparable to the best performances of the cpRNFL, GCIPL, and ONH parameters (all p > 0.05). CONCLUSION: The ability of the clock-hour NRR thickness assessment to diagnose PPG was comparable to the diagnostic abilities of cpRNFL, GCIPL, and ONH parameters. The best indicator of PPG was the NRR thickness parameter that was at 6 o'clock. This finding could play a role in detecting early structural changes in PPG.

6.
J Biomed Mater Res B Appl Biomater ; 108(1): 8-13, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30897300

RESUMO

In the field of ophthalmology, postoperative endophthalmitis (POE) is a serious surgical complication, which may lead to poor visual outcome even after the infection has been controlled. In the study, we develop a sustained drug releasing system loaded with levofloxacin which is expected to be effective against common pathogens responsible for POE for at least 7 days after single application at the end of surgery. The results of study showed that the sol-gel transition temperature of the levofloxacin-loaded chitosan-gelatin-based solution was ~34°C. The gelation time of the developed formulation was ~81 s at 34°C. The results showed that the osmolality of developed hydrogel was 304 mOsm/L. The in vitro drug release studies revealed that levofloxacin release from the developed hydrogel displayed a sustained-release profile. The long-term antibacterial property of the developed hydrogel has been demonstrated. The biocompatibility of the developed hydrogel was evaluated in vitro. These results suggest that the levofloxacin-containing hydrogel could be applied to ocular surface at the end of ophthalmic surgery, without the risks of intracameral injection of antibiotics. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:8-13, 2020.

7.
J Chin Med Assoc ; 82(4): 335-339, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30946212

RESUMO

BACKGROUND: To compare the diagnostic ability of Cirrus high-definition spectral-domain optical coherence tomography measurements of the macular ganglion cell-inner plexiform layer (GCIPL) vs the circumferential retinal nerve fiber layer (cpRNFL) to detect early glaucoma with hemifield visual field (VF) defects. METHODS: This prospective study included 96 patients with primary open-angle glaucoma (48 with superior hemifield defects and 48 with inferior hemifield defects) and 48 normal control subjects. All glaucomatous eyes had a mean deviation of the VF defect ≥-6.0 dB confined to one hemifield. cpRNFL and GCIPL thicknesses were recorded. Area under the receiver operating characteristic curve (AUROC) was calculated for each parameter and compared. RESULTS: All GCIPL parameters and most cpRNFL parameters (except at the nasal quadrant, and 2-, 3-, and 4-o'clock sectors) were significantly lower in glaucomatous eyes vs those in normal controls. In the superior hemifield defect group, the best discriminating parameters were 7-o'clock-sector cpRNFL thickness (AUROC value, 0.963), inferior cpRNFL thickness (0.926), and inferotemporal GCIPL thickness (0.923). Performance was comparable between the best measures of GCIPL analysis (inferotemporal GCIPL thickness) and those of cpRNFL (7-o'clock-sector thickness, p = 0.28). In the inferior hemifield defect group, the best discriminating parameters were 11- and 10-o'clock-sector cpRNFL thickness (0.940 and 0.904, respectively), and average cpRNFL thickness (0.909). Performance was comparable between the best measures from each method (superotemporal GCIPL thickness vs. 11-o'clock-sector cpRNFL thickness [0.857 vs 0.940, p = 0.07]). CONCLUSION: Diagnostic abilities of GCIPL parameters and cpRNFL parameters for early glaucoma were comparable for eyes with either superior or inferior hemifield VF defects.


Assuntos
Glaucoma de Ângulo Aberto/diagnóstico , Fibras Nervosas/patologia , Retina/patologia , Células Ganglionares da Retina/patologia , Campos Visuais , Adulto , Idoso , Feminino , Glaucoma de Ângulo Aberto/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tomografia de Coerência Óptica
8.
BMC Ophthalmol ; 19(1): 12, 2019 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-30621639

RESUMO

BACKGROUND: To evaluate the diagnostic ability of macular ganglion cell asymmetry to diagnose preperimetric glaucoma (PPG), using Cirrus spectral domain optical coherence tomography (OCT). METHODS: This prospective study included 67 eyes of 67 patients with PPG and 67 eyes of 67 age- and refractive error-matched controls. We measured circumpapillary RNFL (cpRNFL) thickness, macular ganglion cell-inner plexiform layer (GCIPL) thickness and optic nerve head (ONH) parameters using OCT. Macular ganglion cell asymmetries were expressed as absolute difference and ratios between inferior hemisphere and superior hemisphere, inferotemporal (IT) and superotemporal (ST), IT and superonasal (SN), IT and inferonasal (IN), ST and IN as well as temporal and nasal. An asymmetry index was assigned by taking the absolute value of log10 of the ratio. The area under the receiver operating characteristics curve (AUROC), partial AUROC (pAUROC) ≥ specificities 90 and 95%, cutoff values and sensitivities at specificities 90 and 95% was analyzed. RESULTS: Parameters with largest AUROCs were IT GCIPL thickness (0.784), average RNFL thickness (0.767), and average C/D (0.746). For macular asymmetry parameters, log IT/SN index had the largest AUROC (0.734), followed by log IT/IN index (0.725), and absolute difference of IT-SN GCIPL thickness (0.715). Performance was comparable between the best measures of asymmetry analysis (log IT/SN index) and those of cpRNFL, GCIPL, and ONH parameters (all P > 0.05). The IT/SN asymmetry index not only had the largest pAUROC based on the pAUROCs ≥90 and 95% specificity (0.044 and 0.019) but also had the highest diagnostic sensitivity at 90 and 95% specificities (52.2 and 46.3%). CONCLUSIONS: GCIPL asymmetry measurements have diagnostic ability comparable to cpRNFL, GCIPL, and ONH analysis for PPG. The best macular ganglion cell asymmetry parameter was IT/SN asymmetry index, which could be a new parameter to detect early structural changes in PPG.


Assuntos
Glaucoma/diagnóstico , Macula Lutea/patologia , Células Ganglionares da Retina/patologia , Adulto , Idoso , Área Sob a Curva , Estudos de Casos e Controles , Feminino , Humanos , Pressão Intraocular/fisiologia , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Disco Óptico/patologia , Estudos Prospectivos , Curva ROC , Sensibilidade e Especificidade , Tomografia de Coerência Óptica/métodos , Campos Visuais/fisiologia
9.
Exp Eye Res ; 179: 179-187, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30471279

RESUMO

Elevated intraocular pressure (IOP) in glaucoma is due to impairment of aqueous humor drainage via the uveoscleral or trabecular outflow pathway. Latanoprost reduces IOP by increasing the uveoscleral outflow. Despite its potency, long-term daily application of it may cause undesirable side effects and many require more than one medication for IOP control. Recent studies have suggested that oxidative stress in the trabecular meshwork (TM) play an important role in the pathogenesis of impaired trabecular outflow facility. Curcumin, a natural phenolic compound, possesses anti-oxidant and anti-inflammation properties. In this study, we developed a thermosensitive hydrogel containing latanoprost and curcumin-loaded nanoparticles (CUR-NPs), and evaluated its possible therapeutic effects with cultured human TM cells under oxidative stress. The results demonstrated that 20 µM of CUR-NPs might be the optimal concentration to treat TM cells without causing cytotoxicity. Using the newly developed system, both latanoprost and CUR-NPs displayed a sustained-release profile. Treatment with this hydrogel containing CUR-NPs effectively decreased the oxidative stress-mediated damage in TM cells via decreasing inflammation-related gene expression, mitochondrial reactive oxygen stress (ROS) production and apoptosis level. The in vivo biocompatibility revealed no signs of inflammation or damage after topical application of developed hydrogel in rabbits. These results suggest that this dual-drug delivery system might enhance both trabecular and uveoscleral outflow and is promising to develop into a novel treatment for glaucoma.


Assuntos
Quitosana/administração & dosagem , Curcumina/administração & dosagem , Sistemas de Liberação de Medicamentos , Gelatina/administração & dosagem , Glaucoma/tratamento farmacológico , Latanoprosta/administração & dosagem , Temperatura , Animais , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/química , Anti-Hipertensivos/administração & dosagem , Apoptose , Western Blotting , Células Cultivadas , Quitosana/química , Curcumina/química , Combinação de Medicamentos , Epitélio Anterior/efeitos dos fármacos , Epitélio Anterior/metabolismo , Epitélio Anterior/patologia , Gelatina/química , Humanos , Hidrogéis , Peróxido de Hidrogênio/toxicidade , Marcação In Situ das Extremidades Cortadas , Mitocôndrias/metabolismo , Nanopartículas/administração & dosagem , Estresse Oxidativo , Tamanho da Partícula , Coelhos , Espécies Reativas de Oxigênio/metabolismo , Malha Trabecular/efeitos dos fármacos , Malha Trabecular/metabolismo , Malha Trabecular/patologia
10.
Chempluschem ; 84(9): 1375-1383, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31944041

RESUMO

The instability of the organic light-emitting diodes (OLEDs) during operation can be attributed to the existence of point defects on the organic layers. In this work, the effect of mixed-host emissive layer and the thermal annealing treatment were investigated to eliminate defects and to boost the device performance. The mixed-host system includes 4,4',4''-tri (9-carbazoyl) triphenylamine (TCTA) and 2,7-bis(diphenylphosphoryl)-9, 9'-spirobi[fluorene] (SPPO13). The mixed-host emissive layer with thermal annealing treatment showed low roughness and few pinholes, and the devices fabricated from this emissive layer exhibited high efficiencies, high stabilities, and long lifetimes. The red and orange-red OLEDs exhibited efficiencies of 13.9 cd/A and 24.35 cd/A, respectively. The longest half-lifetime (L0 =500 cd/m2 ) of the red and orange-red OLEDs were 158 h and 180 h, respectively. Efforts were made to solve problems in large-area coating and to reduce the number of defects on in organic layer. Large-active-area (active area=3 cm×4 cm) red phosphorescent OLEDs (PhOLEDs) devices were realized with very high current efficiency up to 9 cd/A.

11.
Clin Ophthalmol ; 12: 2253-2260, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30464386

RESUMO

Purpose: We evaluated macular ganglion cell asymmetry as a tool for diagnosing paracentral scotoma (PCS) in early glaucoma. Patients and methods: This prospective study compared 58 patients with early glaucoma and PCS to 58 age-matched control individuals. All glaucomatous eyes had scotoma within the central 12 degrees of fixation and confined to one hemifield. We measured circumpapillary retinal nerve fiber layer (cpRNFL) thickness, macular ganglion cell-inner plexiform layer (GCIPL) thickness, and optic nerve head (ONH) parameters with Cirrus spectral domain optical coherence tomography. Macular ganglion cell asymmetry was expressed as the absolute differences and the ratios between the inferior and superior hemispheres, inferotemporal (IT) and superotemporal (ST) areas, IT and superonasal (SN) areas, IT and inferonasal (IN) areas, and ST and IN areas. The asymmetry index was the absolute log10 of the ratio. The area under the receiver operating characteristics curve (AUROC) and partial AUROC (pAUROC, specificities ≥90%) were analyzed for each parameter. Results: All GCIPL parameters and most cpRNFL parameters were significantly lower in early glaucoma than in controls. The best discriminating parameters were inferior RNFL thickness, average RNFL thickness, and minimum GCIPL thickness. The macular ganglion cell asymmetry parameters with the largest AUROCs were the log IT/ST index, the absolute difference in IT-ST GCIPL thicknesses, and the log IT/SN index. Performance was comparable between the log IT/ST index and the cpRNFL (inferior RNFL thickness, P=0.129), GCIPL (minimum GCIPL thickness, P=0.358), and ONH parameters (vertical cup-to-disc ratio, P=0.475). Conclusion: The IT/ST asymmetry index may be useful as a new parameter for detecting structural changes in glaucoma patients with PCS.

12.
Cell Physiol Biochem ; 48(2): 605-617, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30021209

RESUMO

BACKGROUND/AIMS: Huntington's disease (HD) is a heritable neurodegenerative disorder, and there is no cure for HD to date. A type of fibroblast growth factor (FGF), FGF9, has been reported to play prosurvival roles in other neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease. However, the effects of FGF9 on HD is still unknown. With many similarities in the cellular and pathological mechanisms that eventually cause cell death in neurodegenerative diseases, we hypothesize that FGF9 might provide neuroprotective functions in HD. METHODS: In this study, STHdhQ7/Q7 (WT) and STHdhQ111/Q111 (HD) striatal knock-in cell lines were used to evaluate the neuroprotective effects of FGF9. Cell proliferation, cell death and neuroprotective markers were determined via the MTT assay, propidium iodide staining and Western blotting, respectively. The signaling pathways regulated by FGF9 were demonstrated using Western blotting. Additionally, HD transgenic mouse models were used to further confirm the neuroprotective effects of FGF9 via ELISA, Western blotting and immunostaining. RESULTS: Results show that FGF9 not only enhances cell proliferation, but also alleviates cell death as cells under starvation stress. In addition, FGF9 significantly upregulates glial cell line-derived neurotrophic factor (GDNF) and an anti-apoptotic marker, Bcl-xL, and decreases the expression level of an apoptotic marker, cleaved caspase 3. Furthermore, FGF9 functions through ERK, AKT and JNK pathways. Especially, ERK pathway plays a critical role to influence the effects of FGF9 toward cell survival and GDNF production. CONCLUSIONS: These results not only show the neuroprotective effects of FGF9, but also clarify the critical mechanisms in HD cells, further providing an insight for the therapeutic potential of FGF9 in HD.


Assuntos
MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Fator 9 de Crescimento de Fibroblastos/farmacologia , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Butadienos/farmacologia , Caspase 3/metabolismo , Linhagem Celular , MAP Quinases Reguladas por Sinal Extracelular/antagonistas & inibidores , Fator Neurotrófico Derivado de Linhagem de Célula Glial/metabolismo , Doença de Huntington/metabolismo , Doença de Huntington/patologia , Proteínas Quinases JNK Ativadas por Mitógeno/metabolismo , Camundongos , Camundongos Transgênicos , Nitrilos/farmacologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Córtex Visual/citologia , Córtex Visual/efeitos dos fármacos , Córtex Visual/metabolismo , Proteína bcl-X/metabolismo
13.
J Chin Med Assoc ; 81(5): 487-495, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29428319

RESUMO

BACKGROUND: To investigate the clinical manifestations and imaging features of near-infrared autofluorescence (NIA), infrared reflectance (IR), fundus autofluorescence (FAF), indocyanine green angiography (ICGA) and fluorescein angiography (FAG) in the detection of patients with focal choroidal excavation (FCE) identified by cross-sectional spectral-domain optical coherence tomography (SD-OCT). METHODS: This retrospective cross-sectional study included 12 eyes of 10 Taiwanese patients with FCE diagnosed by SD-OCT. The areas and depths of FCE in serial cross-sectional and en-face OCT were compared in different imaging modalities. NIA, IR, FAF, ICGA and FAG images were obtained. Best corrected visual acuity, subjective distortion area in the Amsler grid and history of maculopathies were also recorded. RESULTS: In areas where the choroid started to excavate as shown in SD-OCT, hypo-autofluorescence in NIA was noted. The area of hypo-fluorescence in NIA of all the FCE lesions showed good correlation with the size. The area of FCE was associated with complications such as choroidal neovascularization and central serous chorioretinopathy (p = 0.014, d.f = 1) and the volume (NIA area × Depth measured by SD-OCT × 1/3) was associated with subjective distortion strongly (p = 0.051, Spearman's correlation = 0.600). CONCLUSION: Among all image modalities, NIA was the most sensitive tool in area measurement of FCE and peripheral lesion detection. Also, the volume of FCE was associated with subjective distortion and the area was related to complications. Recording the area and volume of FCE could play an important role in monitoring complications.


Assuntos
Doenças da Coroide/diagnóstico por imagem , Imagem Multimodal/métodos , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Imagem Óptica , Estudos Retrospectivos , Tomografia de Coerência Óptica
14.
Retina ; 38(8): 1533-1540, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-28665871

RESUMO

PURPOSE: To assess the long-term functional and anatomical outcomes for vitreomacular traction syndrome (VMT) after vitrectomy and to analyze the predictive factors regarding visual outcome. METHODS: A retrospective, consecutive case series of 22 eyes in 22 patients with VMT who underwent vitrectomy to relieve macular edema were studied. Eyes were classified into two groups according to the diameter of vitreomacular adhesion based on spectral domain optical coherence tomography: Group 1 (14 eyes) focal attachment ≤1,500 µm; and Group 2 (eight eyes) broad attachment >1,500 µm. RESULTS: Mean postoperative follow-up was 25.4 months (range, 6-68). The preoperative mean logarithm of the minimal angle of resolution visual acuity was 0.73 (20/107), which significantly improved to 0.49 (20/62) postoperatively (P < 0.01). Seventeen eyes (77%) had Snellen visual acuity improvement ≧ two lines, and nine eyes had improvement ≧ three lines. The improvement of visual acuity was significantly better in Group 1 than in Group 2 (2.7 lines vs. 0.8 lines) (P = 0.03). The preoperative mean central macular thickness was 563 µm ± 176 µm, which significantly improved to 298 µm ± 69 µm postoperatively (P < 0.01). In multivariate analysis, better final visual acuity was significantly associated with Group 1 VMT (P < 0.01) and with shorter symptom duration (P < 0.01). Greater improvement of visual acuity was also significantly associated with younger age of patients (P = 0.02) and with Group 1 VMT (P < 0.01). In linear regression analysis, patients with longer symptom duration had worse final visual acuity (ß = 0.02) and patients of younger age had greater visual acuity improvement (ß = 0.008). CONCLUSION: Most patients of VMT gained significant functional and anatomical improvements after vitrectomy. Group 1 optical coherence tomography pattern, shorter symptom duration, and younger age are significant predictive factors of better visual outcome.


Assuntos
Acuidade Visual/fisiologia , Vitrectomia , Descolamento do Vítreo/cirurgia , Fatores Etários , Idoso , Feminino , Humanos , Edema Macular/patologia , Edema Macular/cirurgia , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Estudos Retrospectivos , Fatores de Risco , Descolamento do Vítreo/fisiopatologia
15.
Biomed Res Int ; 2017: 8614580, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29181406

RESUMO

Objective: To evaluate the efficacy and complications of a novel surgical technique for cicatricial lower lid ectropion that uses a vertical-to-horizontal (V-to-H) rotational myocutaneous flap procedure (Tsai procedure). Methods: We performed the V-to-H rotational myocutaneous flap procedure on 20 eyelids in 20 patients with mild to moderate cicatricial lower lid ectropion. A vertical myocutaneous flap was created from the anterior lamella of the vertical pedicle in the lateral third of the lower eyelid. Following a horizontal relaxing incision from the base of the flap, a vertical myocutaneous flap was created and rotated to horizontal. Two patients with combined cicatricial ectropion and paralytic lagophthalmos simultaneously underwent additional lateral tarsorrhaphy. Results: After a minimum follow-up period of 6 months, all patients showed good anatomical and functional improvement with decreased dependence on topical lubricants and a satisfactory cosmetic appearance. Two patients with combined cicatricial and paralytic ectropion had mild residual asymptomatic lagophthalmos. No patients required further revision surgery and there were no complications or recurrence. Conclusion: The V-to-H rotational myocutaneous flap technique was an effective and simple one-stage procedure for correcting cicatricial lower lid ectropion. It lengthened the anterior lamella and tightened horizontal eyelid laxity without the need for a free skin graft.


Assuntos
Ectrópio/patologia , Ectrópio/cirurgia , Pálpebras/patologia , Pálpebras/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
16.
Theranostics ; 7(9): 2452-2462, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28744327

RESUMO

MicroRNAs (miRNAs) play important roles in several neurobiological processes, including the development and progression of diseases. Previously, we identified that one specific miRNA, miR-196a, provides neuroprotective effects on Huntington's disease (HD), although the detailed mechanism is still unclear. Based on our bioinformatic analyses, we hypothesize miR-196a might offer neuroprotective functions through improving cytoskeletons of brain cells. Here, we show that miR-196a could enhance neuronal morphology, further ameliorating intracellular transport, synaptic plasticity, neuronal activity, and learning and memory abilities. Additionally, we found that miR-196a could suppress the expression of RAN binding protein 10 (RANBP10) through binding to its 3' untranslated region, and higher expression of RANBP10 exacerbates neuronal morphology and intracellular transport. Furthermore, miR-196a enhances neuronal morphology through suppressing RANBP10 and increasing the ability of ß-tubulin polymerization. Most importantly, we observed higher expression of RANBP10 in the brains of HD transgenic mice, and higher expression of RANBP10 might exacerbate the pathological aggregates in HD. Taken together, we provide evidence that enhancement of neuronal morphology through RANBP10 is one of the neuroprotective mechanisms for miR-196a. Since miR-196a has also been reported in other neuronal diseases, this study might offer insights with regard to the therapeutic use of miR-196a in other neuronal diseases.


Assuntos
Fatores de Troca do Nucleotídeo Guanina/antagonistas & inibidores , Doença de Huntington/patologia , MicroRNAs/metabolismo , Proteínas Associadas aos Microtúbulos/antagonistas & inibidores , Neurônios/citologia , Neurônios/patologia , Neuroproteção , Animais , Modelos Animais de Doenças , Camundongos Transgênicos , Multimerização Proteica , Tubulina (Proteína)/metabolismo
17.
Front Mol Neurosci ; 10: 196, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28676741

RESUMO

Spinocerebellar ataxia type 3 (SCA3), known as Machado-Joseph disease, is an autosomal dominant disease caused by an abnormal expansion of polyglutamine in ATXN3 gene, leading to neurodegeneration in SCA3 patients. Similar to other neurodegenerative diseases, the dysfunction of mitochondria is observed to cause neuronal death in SCA3 patients. Based on previous studies, proteolytic cleavage of mutant ATXN3 is found to produce truncated C-terminal fragments in SCA3 models. However, whether these truncated mutant fragments disturb mitochondrial functions and result in pathological death is still unclear. Here, we used neuroblastoma cell and transgenic mouse models to examine the effects of truncated mutant ATXN3 on mitochondria functions. In different models, we observed truncated mutant ATXN3 accelerated the formation of aggregates, which translocated into the nucleus to form intranuclear aggregates. In addition, truncated mutant ATXN3 caused more mitochondrial fission, and decreased the expression of mitochondrial fusion markers, including Mfn-1 and Mfn-2. Furthermore, truncated mutant ATXN3 decreased the mitochondrial membrane potential, increased reactive oxygen species and finally increased cell death rate. In transgenic mouse models, truncated mutant ATXN3 also led to more mitochondrial dysfunction, neurodegeneration and cell death in the cerebellums. This study supports the toxic fragment hypothesis in SCA3, and also provides evidence that truncated mutant ATXN3 is severer than full-length mutant one in vitro and in vivo.

18.
Medicine (Baltimore) ; 96(48): e8958, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29310395

RESUMO

INTRODUCTION: Corticosteroid treatment for uveitis can lead to delayed-onset pressure-induced interlamellar stromal keratitis (PISK), even years after laser in situ keratomileusis (LASIK).A 35-year-old man presented to our clinic after experiencing blurred vision in his left eye for 1 month. For the past month, he had been prescribed topical steroid and anti-glaucomatous medication. He had undergone LASIK for both eyes 5 years earlier, and had suffered uveitis attacks in his left eye over the last 2 years.Slit-lamp examination revealed stromal haziness with interface fluid accumulation in the left eye. The left eye showed an intraocular pressure (IOP) of 35 mm Hg and visual acuity of 6/20. Anterior segment ocular coherence tomography (OCT) confirmed the diagnosis of PISK. Steroid treatment was tapered, and latanoprost treatment was started. One month later, the patient's symptoms resolved, with IOP reduced to 10 mm Hg and visual acuity increased to 6/6 in the left eye. Latanoprost treatment was discontinued to avoid potential uveitis reactivation, and the patient's visual field defect progressed and IOP rebounded. Due to evident glaucomatous damage, trabeculectomy was suggested but was refused. CONCLUSION: Patients with PISK plus uveitis should be treated with a tailored regimen involving corticosteroid and antiglaucomatous medication or surgical intervention based on the individual condition. Early recognition and appropriate treatment may aid in preventing severe visual sequela in such patients.


Assuntos
Ceratite/complicações , Ceratite/tratamento farmacológico , Uveíte/complicações , Adulto , Progressão da Doença , Humanos , Pressão Intraocular , Ceratite/diagnóstico por imagem , Ceratite/fisiopatologia , Masculino , Transtornos da Visão/etiologia
19.
JPEN J Parenter Enteral Nutr ; 41(5): 805-814, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-26231059

RESUMO

BACKGROUND: Sepsis is a common cause of death in critically ill patients. An overwhelming inflammatory response and imbalance of helper T (Th) cells and regulatory T (Treg) cells are thought to be involved in the progression of sepsis. ω-3 Polyunsaturated fatty acids (PUFAs) were found to have anti-inflammatory and immunomodulatory properties. This study investigated the effects of ω-3 PUFAs on the balance of Th subsets, Treg cells, and the inflammatory response in septic mice. METHODS: Mice were randomly assigned to soybean oil (SO) and fish oil (FO) groups. The 2 groups received an identical nutrient distribution except for the sources of the fat. The SO group was fed soybean oil, while part of the soybean oil was replaced by fish oil in the FO group. The FO group had an ω-6/ω-3 PUFA ratio of 2:1. After feeding the diets for 3 weeks, sepsis was induced by cecal ligation and puncture (CLP), and mice were sacrificed on days 0, 1, and 3. RESULTS: Compared with the SO group, the FO group had lower inflammatory mediator levels in the plasma and peritoneal lavage fluid after CLP. Also, the FO group had lower Th1, Th2, and Th17 percentages and a higher Th1/Th2 ratio in blood. In lung tissues, neutrophil infiltration was reduced, whereas peroxisome proliferator-activated receptor γ expression was upregulated. CONCLUSIONS: A fish oil diet with an ω-6/ω-3 PUFA ratio of 2:1 may elicit more balanced Th polarization, alleviate inflammatory responses, and attenuate lung injury in CLP-induced sepsis.


Assuntos
Anti-Inflamatórios/farmacologia , Linfócitos T CD4-Positivos/efeitos dos fármacos , Ácidos Graxos Ômega-3/farmacologia , Homeostase/efeitos dos fármacos , Lesão Pulmonar/tratamento farmacológico , Sepse/tratamento farmacológico , Animais , Líquido da Lavagem Broncoalveolar/química , Linfócitos T CD4-Positivos/metabolismo , Citocinas/sangue , Modelos Animais de Doenças , Ácidos Graxos Ômega-6/farmacologia , Óleos de Peixe/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , PPAR gama/genética , PPAR gama/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Sepse/microbiologia
20.
J Chin Med Assoc ; 79(12): 672-677, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27686500

RESUMO

BACKGROUND: The aim of this study was to verify the accuracy of a formula predicting postoperative intraocular pressure (IOP) after phacoemulsification and intraocular lens implantation (PHCE-IOL) in primary angle-closure glaucoma (PACG). In a retrospective chart review of patients with PACG who underwent PHCE-IOL between 2011 and 2014, we collected preoperative IOP, axial length, anterior chamber depth (ACD), number of pre-PHCE glaucoma medications, and IOP and glaucoma medications at 1 month and 3 months post-PHCE. METHODS: Post-PHCE IOP values at 1 month and 3 months were compared with those predicted using the formula: postoperative IOP = 6.354 + 0.186 pre-PHCE IOP × pre-PHCE ACD. Agreements between measured and predicted IOP values were analyzed using correlation coefficients and Bland-Altman plots. RESULTS: Of the 62 eyes included, the average pre-PHCE IOP was 19.47 ± 5.84 mm Hg. Post-PHCE IOP values were 14.94 ± 4.03 mm Hg at 1 month and 14.21 ± 3.51 mm Hg at 3 months. Patients using more preoperative medications tended to show greater postoperative declines in medication usage. Predicted IOP significantly correlated with post-PHCE IOP measured at 1 month (R = 0.314, p = 0.013) and 3 months (R = 0.325, p = 0.01). Bland-Altman plots of difference against average of measured and estimated IOP revealed two cases falling outside±1.96 standard deviation at 1 month, and five cases at 3 months, indicating good consistency between measurement and prediction. CONCLUSION: This formula was useful for predicting IOP at 1 month and 3 months after PHCE-IOL in PACG. It aids clinicians in preoperative assessment of whether PHCE-IOL alone is likely to achieve acceptable postoperative IOP control.


Assuntos
Extração de Catarata , Glaucoma de Ângulo Fechado/terapia , Pressão Intraocular , Implante de Lente Intraocular , Facoemulsificação , Idoso , Feminino , Glaucoma de Ângulo Fechado/fisiopatologia , Humanos , Masculino , Período Pós-Operatório , Estudos Retrospectivos
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