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1.
BMC Ophthalmol ; 20(1): 17, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31914956

RESUMO

BACKGROUND: To evaluate the macular vessel density (VD) and ganglion cell complex (GCC) thickness in pre-perimetric (PPG) and early perimetric primary open-angle glaucoma (PG) eyes, and to compare the diagnostic ability of the two measurements to discriminate PPG and early PG eyes from healthy eyes. METHODS: Seventy-nine eyes in 72 subjects (31 normal, 26 PPG, and 22 early PG eyes) were included in the consecutive case series. Macular VD and GCC thickness were acquired simultaneously using the 6 × 6 mm2 high-density AngioRetina scanning mode. Diagnostic abilities were assessed using the area under the receiver operating characteristic curve (AUROC). RESULTS: Compared to healthy eyes, whole image VD (wiVD) and GCC thickness were significantly lower in PPG and early PG eyes (all P < 0.025). The percent reduction of wiVD was lower than that of GCC thickness in early PG eyes (P < 0.05), while they were similar in PPG eyes (P > 0.05). Regionally, greater VD attenuation and GCC thinning were identified in the perifovea than in the parafovea in both groups (all P < 0.05). Moreover, the percent reduction of VD was less than that of GCC thickness in the perifoveal region in PPG eyes (P < 0.05). The AUROCs for wiVD and GCC thickness were 0.824 and 0.881, respectively, in PPG eyes (P > 0.05), and 0.918 and 0.977, respectively, in early PG eyes (P > 0.05). CONCLUSIONS: Macular VD and GCC thickness significantly decreased in PPG and early PG eyes. The perifoveal region appeared to be more vulnerable to macular VD attenuation and GCC thinning in early glaucoma. Our results showed that macular VD measurements may be helpful for detecting and understanding early glaucomatous damage.

2.
PLoS One ; 15(1): e0227602, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31990918

RESUMO

OBJECTIVES: To provide in vivo measurements of anterior chamber angle structures and their relationship with age as evaluated by high-frequency ultrasound biomicroscopy (UBM) in patients with primary congenital glaucoma (PCG). METHODS: High-frequency UBM was done for 51 PCG eyes from 40 patients (aged from 3 to 96 months) and 11 unaffected contralateral eyes. Parameters, including the proportion of observable abnormal tissue membrane and Schlemm's canal, the largest cross-sectional area (CSA) of Schlemm's canal (SC), SC meridional diameter, trabecular-iris angle (TIA), trabecular meshwork (TM) thickness, iris thickness, ciliary process length, and corneal limbus thickness were compared between the two groups and their relationship with age was explored in PCG eyes. RESULTS: Abnormal tissue membrane was detected in 27.5% of PCG eyes and none in unaffected eyes. SC was observed in 73.1% of PGC eyes compared to 100% in unaffected eyes (P<0.001). The largest CSA of SC, SC meridional diameter, iris thickness, and corneal limbus thickness were all significantly smaller in PCG eyes compared to unaffected eyes (all P<0.05). TIA and ciliary process length in unaffected eyes were smaller than PCG eyes (both P<0.05). The largest CSA of SC, TM thickness, iris thickness, and ciliary process length were all significantly correlated to age in PCG eyes (P<0.05). CONCLUSIONS: The anatomical information evaluated by high-frequency UBM may provide glaucoma specialists a useful tool to aid in understanding the dysgenesis and changes with age of anterior chamber angle in PCG.

3.
Transl Vis Sci Technol ; 8(6): 22, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31788351

RESUMO

Purpose: To investigate the association between changes in arterial blood gases and intraocular pressure (IOP) after acute, short-term exposure to simulated elevation of 4000 m above sea level. Methods: Twenty-five healthy young lowlanders participated in this prospective study. IOP was measured in both eyes with an Accupen tonometer. Arterial blood gas parameters (partial oxygen pressure [PaO2], partial carbon dioxide pressure [PaCO2], pH, and bicarbonate ion [HCO3 -]) were checked using a blood gas analyzer. Measurements were taken at sea level (T1), at 15-minute (T2) and at 2-hour (T3) exposure times to simulated 4000 m above sea level in a hypobaric chamber, and upon return to sea level (T4). Associations between arterial blood gas parameters and IOP were evaluated using multivariate linear regression. Results: PaO2 significantly decreased at T2 and T3, resolving at T4 (P < 0.001). pH significantly increased at T2 and returned to baseline at T3 (P = 0.004). Actual and standard bicarbonate ion both dropped with IOP at T3 and T4. IOP significantly decreased from 16.4 ± 3.4 mm Hg at T1 to 15.1 ± 2.1 mm Hg (P = 0.041) at T3 and remained lower (14.9 ± 2.4 mm Hg; P = 0.029) at T4. IOP was not correlated with pH. Multivariate linear regression showed that lower IOP was associated with lower standard bicarbonate ion (beta = -1.061; 95% confidence interval, -0.049 to -2.074; P = 0.04) when adjusted for actual bicarbonate and diastolic blood pressure. Conclusions: Hypobaric hypoxia triggers plasma bicarbonate ion reduction which, rather than pH, may decrease aqueous humor formation and subsequently cause IOP reduction. These findings may shed light on the mechanism of IOP regulation at high altitude. Translational Relevance: Hypoxia-triggered reduction in plasma bicarbonate ion may decrease aqueous humor production, leading to IOP reduction at high altitude. These findings may provide new insight into a potential mechanism of IOP regulation. Hypobaric hypoxia at high altitude is an environmental factor that can reduce IOP and, therefore, deserves further study.

4.
Clin Immunol ; 209: 108267, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31639448

RESUMO

Treg is essential to limit the extend and duration of the immune response, but its stability is still under debate. Here we demonstrate that IL-17-producing Treg cells (Th17-like cells) increased in peripheral blood of patients with Systemic Lupus Erythematosus (SLE). Notably, the Th17-like cells from patient with active SLE were characterized with some phenotype and function of Th17 cells. Upon stimulation, Helios-Foxp3 + CD4+ T cells decrease Foxp3 expression but increase expression of IL-17 and RORγt. Damage associated molecule pattern and inflammatory cytokines are important for induction of IL-17 expression in Treg cells. The Th17-like cells from patients with active SLE lose suppressive function and have robust response to stimulation of autoantigens. We also observed that the level of Th17-like cells in peripheral blood is closely associated with the clinical index of SLE. These findings suggest that instability of Treg plays a critical role in pathogenesis of autoimmune diseases.

5.
JAMA Ophthalmol ; 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31513266

RESUMO

Importance: A deep learning system (DLS) that could automatically detect glaucomatous optic neuropathy (GON) with high sensitivity and specificity could expedite screening for GON. Objective: To establish a DLS for detection of GON using retinal fundus images and glaucoma diagnosis with convoluted neural networks (GD-CNN) that has the ability to be generalized across populations. Design, Setting, and Participants: In this cross-sectional study, a DLS for the classification of GON was developed for automated classification of GON using retinal fundus images obtained from the Chinese Glaucoma Study Alliance, the Handan Eye Study, and online databases. The researchers selected 241 032 images were selected as the training dataset. The images were entered into the databases on June 9, 2009, obtained on July 11, 2018, and analyses were performed on December 15, 2018. The generalization of the DLS was tested in several validation datasets, which allowed assessment of the DLS in a clinical setting without exclusions, testing against variable image quality based on fundus photographs obtained from websites, evaluation in a population-based study that reflects a natural distribution of patients with glaucoma within the cohort and an additive dataset that has a diverse ethnic distribution. An online learning system was established to transfer the trained and validated DLS to generalize the results with fundus images from new sources. To better understand the DLS decision-making process, a prediction visualization test was performed that identified regions of the fundus images utilized by the DLS for diagnosis. Exposures: Use of a deep learning system. Main Outcomes and Measures: Area under the receiver operating characteristics curve (AUC), sensitivity and specificity for DLS with reference to professional graders. Results: From a total of 274 413 fundus images initially obtained from CGSA, 269 601 images passed initial image quality review and were graded for GON. A total of 241 032 images (definite GON 29 865 [12.4%], probable GON 11 046 [4.6%], unlikely GON 200 121 [83%]) from 68 013 patients were selected using random sampling to train the GD-CNN model. Validation and evaluation of the GD-CNN model was assessed using the remaining 28 569 images from CGSA. The AUC of the GD-CNN model in primary local validation datasets was 0.996 (95% CI, 0.995-0.998), with sensitivity of 96.2% and specificity of 97.7%. The most common reason for both false-negative and false-positive grading by GD-CNN (51 of 119 [46.3%] and 191 of 588 [32.3%]) and manual grading (50 of 113 [44.2%] and 183 of 538 [34.0%]) was pathologic or high myopia. Conclusions and Relevance: Application of GD-CNN to fundus images from different settings and varying image quality demonstrated a high sensitivity, specificity, and generalizability for detecting GON. These findings suggest that automated DLS could enhance current screening programs in a cost-effective and time-efficient manner.

6.
Medicine (Baltimore) ; 98(26): e16130, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261534

RESUMO

Pro-gastrin-releasing peptide (ProGRP) is the promising molecular tumor marker of small cell lung cancer (SCLC). Here we study the influence of different blood samples treatment methods on ProGRP.Serum with and without separation gel and heparin plasma from 10 SCLC patients and 5 healthy individuals were assayed for ProGRP immediately and 2, 4, 6, 8, 24, and 48 hours after collection.ProGRP of serum with and without separation gel and heparin plasma detected immediately was basically consistent, whereas there was a significant difference in the level of them assayed after 2 hours. No significant variation with time was observed in heparin plasma, but in serum with and without separation gel, ProGRP concentrations gradually declined with time, with statistical significance. When assayed within 2 hours, each time point of ProGRP in heparin plasma had no significant difference and the difference of PrpGRP in serum separating gel existed at 1.5 hours.Heparin plasma is the best option for clinical test of ProGRP. If serum with separation gel is used, optimization methods of turn-around-time which guarantee samples detected within 1 hour after collection can make results more instructive for clinical treatment.


Assuntos
Coleta de Amostras Sanguíneas/métodos , Peptídeo Liberador de Gastrina/sangue , Biomarcadores Tumorais/sangue , Humanos , Neoplasias Pulmonares/sangue , Carcinoma de Pequenas Células do Pulmão/sangue , Fatores de Tempo
7.
Brain Res ; 1718: 83-90, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31071304

RESUMO

Parameters derived from diffusion tensor imaging (DTI) have been found to be significantly altered in the optic tracts, optic nerves, and optic radiations in patients with primary open-angle glaucoma (POAG). In this study, DTI-derived parameters were further constructed into fiber connectivity, and we investigated anatomical fiber connectivity changes within and beyond the visual pathway in POAG patients. DTI and T1-weighted magnetic resonance images were acquired in 18 POAG patients and 26 healthy controls (HC). White matter tracts based on the Brodmann atlases (BA) were constructed using the deterministic fiber tracking method. The mean fractional anisotropy (FA), fiber number (FN), and mean fiber length (FL) were measured and then evaluated using two-sample t-tests between POAG and HC. The fiber connectivity between regions was taken as the features for classifying HC and POAG using a machine learning method known as naïve Bayesian classification. The mean FA decreased in connections between visual cortex BA17/BA18 and cortex BA23/BA25/BA35/BA36, while it increased in the connections between cortex BA3/BA7/BA9 and BA5/BA6/BA45/BA25 in POAG. Classification using fibers where a significant difference in FN had been identified produced better accuracy (ACC = 0.89) than using FA or FL (ACC = 0.77 and 0.75, respectively). The FN of individual fiber connections with higher accuracy and significant changes in POAG involved brain regions associated with vision (BA19), depression (BA10/BA46/BA25), and memory (BA29). These findings strengthen the hypothesis that POAG involves changes in anatomical connectivity within and beyond the visual pathway. Classification using the machine learning method reveals that mean FN has the potential to be used as a biomarker for detecting white matter microstructure changes in POAG.

8.
Sci China Life Sci ; 62(7): 930-936, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30929195

RESUMO

Optical coherence tomography angiography (Angio-OCT) has introduced a new non-invasive, quantitative method to assess superficial and deep capillary networks of the retina. In this study, we investigated macular retinal thickness and flow density change following posterior scleral reinforcement (PSR) surgery, using an RTVue XR Avanti Angio-OCT (A2016.2.0.35, Optovue, Fremont, CA), in patients with pathological myopia. A total of 13 patients with pathological myopia were recruited and all patients completed the 6 months follow-up visit. Data from 22 eyes were used in this study. The mean age was 36.23±15.29 years, and 43% (n=6) were men. Spherical equivalent refractive error (SE) ranged from -8.0 to -24.0 D. Post-operative axial length, best-corrected visual acuity and SE did not change significantly at each follow-up, compared with preoperative measure (all P>0.05). Postoperative flow density of superficial and deep retinal layers at each sector did not change significantly at each follow-up, compared to pre-operative measure (all P>0.05). However, we found significant decrease in retinal thickness of parafovea-inferior sector after PSR surgery (P<0.01), indicating potential relaxation of vitreofoveal traction after PSR surgery.

9.
Endocrine ; 64(3): 648-656, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30887277

RESUMO

PURPOSE: Hyperprolactinemia (HPRL) has been reported in many autoimmune diseases. However, the serum autoantibody profile and peripheral B-cell subset distribution in women with HPRL are largely unknown. The current study aimed to investigate the autoantibody prevalence and cytokine levels as well as to further explore the B-cell subset distribution in women with HPRL. METHODS: Sera from 202 women with HPRL and 97 healthy women were included in this study. All sera were examined for prolactin (PRL), anti-nuclear antibody (ANA), rheumatoid factor, anticardiolipin (ACL), immunoglobulin G, immunoglobulin M, complement 3, complement 4, interleukin 4 (IL-4) and interleukin 6 (IL-6). Peripheral blood was collected from 22 women with HPRL and 19 healthy women, and B-cell subsets were measured by flow cytometry. RESULTS: At least one autoantibody was found in 47 out of 202 women with HPRL compared with 9 of 97 healthy women (p < 0.001). The levels of IL-4 (p < 0.0001) and IL-6 (p < 0.0001) were significantly higher in women with HPRL than in healthy women. The percentages of naive IgD+IgM- B cells (BND cells, p < 0.0001), antibody-secreting cells (p = 0.007) and unswitched memory B cells (p = 0.004) among the total B cells from HPRL women were significantly higher than those from healthy women. CONCLUSIONS: Women with HPRL had a higher prevalence of autoantibodies, higher serum levels of IL-4 and IL-6, and more BND cells, antibody-secreting B cells and unswitched memory B cells than healthy women. These data imply that a high level of PRL is associated with autoimmune diseases.

10.
Acta Cir Bras ; 34(2): e201900201, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-30843934

RESUMO

PURPOSE: To investigated the effects of ginsenoside Rb1 on diabetic retinopathy in streptozotocin-induced diabetic rats. METHODS: Diabetes was induced by a single intraperitoneal injection of streptozotocin (80 mg/kg) in male Wistar rats. Ginsenoside Rb1 (20, 40 mg/kg) was injected (i.p.) once a day for 4 weeks. Then, using fundus photography, the diameter and vascular permeability of retinal vessels were investigated. Retinal histopathology was undertaken. Contents of malondialdehyde (MDA) and glutathione (GSH) in retinas were assayed. Levels of nuclear factor erythroid 2-related factor 2 (Nrf2), glutathione cysteine ligase catalytic subunit (GCLC), and glutathione cysteine ligase modulatory subunit (GCLM) were measured. RESULTS: Treatment with ginsenoside Rb1 attenuated the diabetes-induced increase in the diameter of retinal blood vessels. Ginsenoside Rb1 reduced extravasation of Evans Blue dye from retinal blood vessels. Ginsenoside Rb1 partially inhibited the increase in MDA content and decrease in GSH level in rat retinas. Nrf2 levels in the nuclei of retinal cells and expression of GCLC and GCLM were increased significantly in rats treated with ginsenoside Rb1. CONCLUSION: These findings suggest that ginsenoside Rb1 can attenuate diabetic retinopathy by regulating the antioxidative function in rat retinas.


Assuntos
Diabetes Mellitus Experimental/tratamento farmacológico , Retinopatia Diabética/tratamento farmacológico , Ginsenosídeos/uso terapêutico , Animais , Masculino , Ratos , Ratos Wistar , Vasos Retinianos/efeitos dos fármacos , Vasos Retinianos/patologia , Estreptozocina
11.
J Glaucoma ; 28(1): 1-6, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30358646

RESUMO

PURPOSE: To evaluate the effectiveness of microcatheter-assisted trabeculotomy (MAT) to treat primary congenital glaucoma after failed previous glaucoma surgeries. MATERIALS AND METHODS: Retrospective, noncomparative, interventional case series conducted at Beijing Tongren Eye Center, China. Outcome measures were compared between 3 groups: successful and complete (≥330 degrees) MAT; successful and partial (<330 degrees) MAT; or cases converted to traditional trabeculotomy when the Schlemm's canal could not be catheterized >180 degrees. Success was defined as final intraocular pressure ≤21 mm Hg, with (qualified success) or without (complete success) glaucoma medications. RESULTS: In total, 74 eyes of 63 consecutive patients were included. MAT was performed in 50 eyes (67.6%). Postoperative intraocular pressure and number of glaucoma drops (17.7±8.6 mm Hg, 0.6±1.2 medications) was significantly less than the preoperative values (35.3±7.2 mm Hg, 2.7±0.8 medications; P<0.001). Cumulative probabilities of qualified and complete success were 84.0% and 80.0% at 3-year follow-up with no difference between complete and partial trabeculotomies. MAT was not successfully performed in 24 eyes (32.4%), requiring conversion to traditional trabeculotomy and associated with greater incidence of previous surgeries (P<0.001), earlier age of disease onset (P=0.024) and worse corneal transparency (P=0.010). Cumulative probabilities of qualified and complete success were 37.0% and 29.2% at 3-year follow-up. CONCLUSIONS: Both complete and partial MAT achieved significant pressure reduction in cases of primary congenital glaucoma with previous failed glaucoma surgeries in intermediate term.


Assuntos
Hidroftalmia/cirurgia , Trabeculectomia/métodos , Adolescente , Anti-Hipertensivos/administração & dosagem , Cateterismo , Cateteres , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Hidroftalmia/tratamento farmacológico , Hidroftalmia/fisiopatologia , Lactente , Pressão Intraocular/fisiologia , Masculino , Estudos Retrospectivos , Tonometria Ocular , Falha de Tratamento , Resultado do Tratamento , Adulto Jovem
12.
Acta cir. bras ; 34(2): e201900201, 2019. graf
Artigo em Inglês | LILACS-Express | ID: biblio-989059

RESUMO

Abstract Purpose: To investigated the effects of ginsenoside Rb1 on diabetic retinopathy in streptozotocin-induced diabetic rats. Methods: Diabetes was induced by a single intraperitoneal injection of streptozotocin (80 mg/kg) in male Wistar rats. Ginsenoside Rb1 (20, 40 mg/kg) was injected (i.p.) once a day for 4 weeks. Then, using fundus photography, the diameter and vascular permeability of retinal vessels were investigated. Retinal histopathology was undertaken. Contents of malondialdehyde (MDA) and glutathione (GSH) in retinas were assayed. Levels of nuclear factor erythroid 2-related factor 2 (Nrf2), glutathione cysteine ligase catalytic subunit (GCLC), and glutathione cysteine ligase modulatory subunit (GCLM) were measured. Results: Treatment with ginsenoside Rb1 attenuated the diabetes-induced increase in the diameter of retinal blood vessels. Ginsenoside Rb1 reduced extravasation of Evans Blue dye from retinal blood vessels. Ginsenoside Rb1 partially inhibited the increase in MDA content and decrease in GSH level in rat retinas. Nrf2 levels in the nuclei of retinal cells and expression of GCLC and GCLM were increased significantly in rats treated with ginsenoside Rb1. Conclusion: These findings suggest that ginsenoside Rb1 can attenuate diabetic retinopathy by regulating the antioxidative function in rat retinas.

13.
Am J Ophthalmol ; 196: 57-64, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30142328

RESUMO

PURPOSE: To evaluate ultrasound biomicroscopy (UBM) characteristics of trabeculodysgenesis and explore its correlation with the outcomes of microcatheter-assisted trabeculotomy (MAT) in eyes with primary congenital glaucoma (PCG). DESIGN: A prospective, interventional case series. METHODS: Patients with newly diagnosed PCG were consecutively recruited, and subsequently MAT was tried as their first glaucoma surgery. All participants underwent UBM prior to surgery. The trabeculodysgenesis was classified into 3 types according to the severity of the anterior insertion of iris and ciliary processes (type 1, severe trabeculodysgenesis; type 2, moderate trabeculodysgenesis; type 3, mild trabeculodysgenesis). Surgical success was defined as a postoperative intraocular pressure of ≤ 21 mm Hg with at least a 30% reduction from preoperative intraocular pressure without additional medical or surgical therapy, and with decreased corneal edema, stabilized corneal diameter, and no additional optic nerve damage for at least 6 months after surgery. RESULTS: MAT was tried on 49 eyes with PCG (33 patients) as the first glaucoma surgery. The ratios of the type of trabeculodysgenesis (type 1: type 2: type 3) were 1:1:1.7 among eyes. In multivariate analysis, age (at the time of operation) (P < .001) and sex (P = .002) were factors associated with the type of trabeculodysgenesis. At 24-month follow-up, type 1 achieved a 57.1% surgical success rate, type 2 achieved 70.5%, and type 3 achieved 95.5% (P = .022). Severe trabeculodysgenesis (P = .014), as well as poorer corneal transparency (P = .037), was associated with worse surgical outcome. CONCLUSIONS: UBM grading of trabeculodysgenesis in PCG is helpful for MAT prognosis. Combined with preoperative corneal opacity score, it may be used to predict the outcome of MAT surgery.


Assuntos
Glaucoma/patologia , Malha Trabecular/patologia , Fatores Etários , Pré-Escolar , Feminino , Glaucoma/cirurgia , Humanos , Lactente , Estimativa de Kaplan-Meier , Masculino , Microscopia Acústica , Análise Multivariada , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Trabeculectomia
14.
Int J Ophthalmol ; 11(5): 791-796, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29862177

RESUMO

AIM: To evaluate the ability of macular ganglion cell complex (GCC) thickness using Fourier domain optical coherence tomography (FD-OCT) to detect glaucoma in highly myopic eyes. METHODS: Cross-sectional study. A total of 114 participants, consecutively were enrolled. Macular GCC thickness and peripapillary retinal nerve fiber layer (RNFL) thickness were obtained with RTVue FD-OCT. Receiver operating characteristics curves were constructed for each measurement parameter, and areas under the curves (AUCs) were compared. RESULTS: Both the average GCC and average RNFL thickness showed negative correlations with axial length (rGCC=-0.404, P=0.001; rRNFL=-0.561, P<0.001). The largest AUCs from GCC, and RNFL parameters were 0.968 [global loss volume (GLV)], and 0.855 (average RNFL), respectively. GLV was significantly better for detecting high myopic glaucoma than average RNFL (P<0.001). CONCLUSION: Macular GCC thickness has higher diagnostic power than peripapillary RNFL thickness to discriminate glaucoma patients from non-glaucoma subjects in high myopia.

15.
J Glaucoma ; 27(9): 816-822, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29952821

RESUMO

PURPOSE: Altered ocular and cerebral vascular autoregulation and vasoreactivity have been demonstrated in patients with primary open-angle glaucoma (POAG). In the present study, we investigated the correlations between reduced cerebral blood flow (CBF) in early and higher-tier visual cortical areas and glaucomatous changes in the retinas of patients with mild to moderate POAG. PATIENTS AND METHODS: 3-dimensional pseudocontinuous arterial spin labelling magnetic resonance imaging at 3 T was performed in 20 normal controls and 15 mild to moderate POAG patients. Regions of interest were selected based on the Population-Average, Landmark- and Surface-based (PALS) atlas of the human cerebral cortex. Arterial spin labelling-measured CBF values were extracted in the early and higher-tier visual cortical areas and were compared between patients and controls using a 2-sample t test. Pearson correlation analyses were used to assess the correlations between reduced CBF and cup-to-disc ratio, retinal nerve fiber layer thickness, and ganglion cell complex thickness. RESULTS: Reduced CBF in early visual cortical areas (V1, V2, and ventral posterior area) and in the higher-tier visual left lateral occipital cortex was presented in mild to moderate POAG patients compared with controls. Furthermore, reduced CBF of the right areas V2 and ventral posterior area was correlated with cup-to-disc ratio, total ganglion cell complex thickness, and average retinal nerve fiber layer thickness. CONCLUSIONS: In conclusion, the complex pathologic progress of POAG includes abnormal cerebral perfusion within the visual cortex since the mild to moderate disease stages. The association of cerebral perfusion changes with alterations of the optic disc and the retina may contribute to the early diagnosis of POAG.


Assuntos
Circulação Cerebrovascular/fisiologia , Glaucoma de Ângulo Aberto/fisiopatologia , Retina/fisiopatologia , Córtex Visual/irrigação sanguínea , Adulto , Idoso , Feminino , Humanos , Pressão Intraocular/fisiologia , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Disco Óptico/patologia , Perfusão , Células Ganglionares da Retina/patologia
16.
Invest Ophthalmol Vis Sci ; 59(5): 1861-1868, 2018 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-29677346

RESUMO

Purpose: To investigate if abnormal interhemispheric homotopic functional connectivity were accompanied by corresponding anatomic connectivity changes in primary open-angle glaucoma (POAG) patients, and to relate connectivity changes with retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) thickness. Methods: Resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI) were performed in 16 POAG patients and 19 healthy controls. Indices of interhemispheric homotopic functional connectivity and the underlying anatomic connectivity changes were derived with voxel-base whole-brain voxel-mirrored homotopic connectivity (VMHC) analyses and VMHC-guided probabilistic tractography. Pearson correlation analyses were used to explore the correlations between interhemispheric homotopic functional connectivity changes and anatomic connectivity alterations, and RNFL and GCC thickness. Results: Reduced VMHC values between bilateral homotopic cortical areas located in Brodmann area (BA)17, BA18, and BA19. Decreased anatomic connectivity connecting bilateral visual cortical areas inside BA17 and BA18 were observed in POAG patients. Furthermore, positive correlations between average RNFL thickness and reduced VMHC values of BA17 (r = 0.572, P = 0.021)/BA18 (r = 0.600, P = 0.014)/BA19 (r = 0.550, P = 0.027) are found using Pearson correlation analyses. Conclusions: Combinations of interhemispheric homotopic functional connectivity and anatomic connectivity changes may help to elucidate the mechanism of interhemispheric synchronization injury in POAG patients. Reduced VMHC values positively correlate with glaucomatous changes of RNFL thickness, which strengthens the hypothesis that POAG affects the visual cortex using a novel functional MRI characteristic.


Assuntos
Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/fisiopatologia , Imagem de Tensor de Difusão , Glaucoma de Ângulo Aberto/diagnóstico por imagem , Glaucoma de Ângulo Aberto/fisiopatologia , Imagem por Ressonância Magnética , Descanso/fisiologia , Adulto , Feminino , Neuroimagem Funcional , Humanos , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Células Ganglionares da Retina/patologia
17.
Acta Cir Bras ; 33(3): 250-258, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29668779

RESUMO

PURPOSE: To investigate the effects of propofol pretreatment on lung morphology and heme oxygenase-1 expression in oleic acid -induced acute lung injury in rats. METHODS: A total of 32 male Sprague-Dawley rats (250-300g) were randomly divided into the following four groups (n=8/group): group C, group OA, group OA+PR, and group OA+IX to compare related parameter changes. RESULTS: PaO2, PCO2, and PaO2/FiO2 were significantly different among the four treatment groups (P<0.05 or P<0.01). Lung wet/dry weight ratio and HO-1 protein expression also significantly differed among the groups (P<0.01). Immunohistochemistry showed that the expression of HO-1 in group OA+PR was stronger than those in groups OA, OA+IX, and C. Light microscopy revealed that pathological changes in lung tissues in group OA+PR were milder than those in group OA and group OA+IX. Electron microscopy showed that alveolar type II epithelial cell ultrastructure in group OA was relatively irregular with cell degeneration and disintegration and cytoplasmic lamellar bodies were vacuolized. Changes in group OA+PR were milder than those in group OA; however, they were more severe in group OA+IX than in group OA. CONCLUSION: Propofol significantly increases the expression of HO-1 in the lung tissueand prevents changes in lung morphology due to ALI in rats.


Assuntos
Lesão Pulmonar Aguda/tratamento farmacológico , Heme Oxigenase-1/metabolismo , Pulmão/efeitos dos fármacos , Propofol/farmacologia , Lesão Pulmonar Aguda/induzido quimicamente , Lesão Pulmonar Aguda/metabolismo , Animais , Imuno-Histoquímica , Pulmão/enzimologia , Pulmão/ultraestrutura , Masculino , Ácido Oleico , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley
18.
Acta Ophthalmol ; 96(5): e570-e576, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29575652

RESUMO

PURPOSE: To compare the orbital cerebral spinal fluid pressure (CSFP) and trans-lamina cribrosa pressure difference (TLCPD) determined noninvasively in ocular hypertensive (OH) subjects and controls. METHODS: Cross-sectional observational study. Magnetic resonance imaging was used to measure orbital subarachnoid space width (OSASW). The CSFP (mm Hg) was estimated from a published formula as 17.54 × MRI derived OSASW at 15 mm behind the globe + 0.47 × body mass index + 0.13 × mean arterial blood pressure -21.52. Estimated TLCPD was calculated as IOP- CSFP. RESULTS: The orbital subarachnoid space width was significantly wider (p = 0.01) in the OH group than in the control group at all three measurement locations. The MRI derived CSFP value in OH (14.9 ± 2.9 mm Hg) was significantly higher than in the normal group (12.0 ± 2.8 mm Hg; p < 0.01). The estimated TLCPD value in OH (9.0 ± 4.2 mm Hg) was significantly higher than in controls (3.6 ± 3.0 mm Hg; p < 0.01). CONCLUSION: The wider OSASW and higher estimated CSFP in OH subjects suggest a higher orbital CSFP. Despite a higher orbital CSFP that could be protective, the higher TLCPD in OH may play a significant role in the risk of developing glaucoma.


Assuntos
Pressão do Líquido Cefalorraquidiano/fisiologia , Pressão Intraocular/fisiologia , Hipertensão Ocular/fisiopatologia , Adulto , Pressão Sanguínea/fisiologia , Estudos Transversais , Feminino , Gonioscopia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Hipertensão Ocular/diagnóstico , Disco Óptico/diagnóstico por imagem , Disco Óptico/patologia , Nervo Óptico/diagnóstico por imagem , Nervo Óptico/patologia , Órbita/diagnóstico por imagem , Órbita/patologia , Espaço Subaracnóideo/diagnóstico por imagem , Tomografia de Coerência Óptica , Tonometria Ocular , Acuidade Visual/fisiologia , Testes de Campo Visual
19.
Acta cir. bras ; 33(3): 250-258, Mar. 2018. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-886273

RESUMO

Abstract Purpose: To investigate the effects of propofol pretreatment on lung morphology and heme oxygenase-1 expression in oleic acid -induced acute lung injury in rats. Methods: A total of 32 male Sprague-Dawley rats (250-300g) were randomly divided into the following four groups (n=8/group): group C, group OA, group OA+PR, and group OA+IX to compare related parameter changes. Results: PaO2, PCO2, and PaO2/FiO2 were significantly different among the four treatment groups (P<0.05 or P<0.01). Lung wet/dry weight ratio and HO-1 protein expression also significantly differed among the groups (P<0.01). Immunohistochemistry showed that the expression of HO-1 in group OA+PR was stronger than those in groups OA, OA+IX, and C. Light microscopy revealed that pathological changes in lung tissues in group OA+PR were milder than those in group OA and group OA+IX. Electron microscopy showed that alveolar type II epithelial cell ultrastructure in group OA was relatively irregular with cell degeneration and disintegration and cytoplasmic lamellar bodies were vacuolized. Changes in group OA+PR were milder than those in group OA; however, they were more severe in group OA+IX than in group OA. Conclusion: Propofol significantly increases the expression of HO-1 in the lung tissueand prevents changes in lung morphology due to ALI in rats.

20.
Sci China Life Sci ; 61(5): 534-540, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29282607

RESUMO

Glaucoma is the leading cause of irreversible blindness worldwide. The reconstruction of aqueous outflow drainage (RAOD) has recently been proposed to aid in restoring aqueous outflow drainage in primary open-angle glaucoma. However, the mechanism of RAOD remains to be fully understood. Based on literature review and research studies, the potential mechanisms of RAOD are the following: (i) Circumferential dilation of the Schlemm's canal (SC) and surrounding collector channels. (ii) Instant formation of microcracks through RAOD procedures. (iii) Formation of more pores, and local detachment between the SC endothelium (SCE) and basement membrane. (iv) Activation of stem cells by constant mechanical stress caused by the tensional suture placed at the anterior part of the SC. (v) Reversal of trabecular meshwork (TM) herniation. (vi) Mobilization of the reserve of the aqueous drainage. (vii) Change of SCE phenotype. (viii) Mechanosensing and mechanotransducing of TM.


Assuntos
Humor Aquoso/fisiologia , Glaucoma de Ângulo Aberto/cirurgia , Pressão Intraocular/fisiologia , Procedimentos Cirúrgicos Reconstrutivos , Malha Trabecular/cirurgia , Animais , Matriz Extracelular/fisiologia , Glaucoma de Ângulo Aberto/patologia , Humanos , Células-Tronco/metabolismo , Células-Tronco/patologia , Técnicas de Sutura , Malha Trabecular/patologia
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