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1.
Surv Ophthalmol ; 69(1): 1-23, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37544613

RESUMO

Inherited retinal diseases (IRDs) are the most common cause of blindness in working-age adults. Macular neovascularization (MNV) may be a presenting feature or occurs as a late-stage complication in several IRDs. We performed an extensive literature review on MNV associated with IRDs. MNV is a well-known complication of Sorsby fundus dystrophy and pseudoxanthoma elasticum. Those with late-onset Stargardt disease may masquerade as exudative age-related macular degeneration (AMD) when MNV is the presenting feature. Peripherinopathies may develop MNV that responds well to a short course of anti-vascular endothelial growth factor (anti-VEGF) therapy, while bestrophinopathies tend to develop MNV in the early stages of the disease without vision loss. Enhanced S-cone syndrome manifests type 3 MNV that typically regresses into a subfoveal fibrotic nodule. MNV is only a rare complication in choroideraemia and rod-cone dystrophies. Most IRD-related MNVs exhibit a favorable visual prognosis requiring less intensive regimens of anti-vascular endothelial growth factor therapy compared to age-related macular degeneration. We discuss the role of key imaging modalities in the diagnosis of MNV across a wide spectrum of IRDs and highlight the gaps in our knowledge with respect to the natural history and prognosis to pave the way for future directions of research.


Assuntos
Neovascularização de Coroide , Degeneração Macular , Degeneração Retiniana , Neovascularização Retiniana , Adulto , Humanos , Fatores de Crescimento Endotelial , Retina , Degeneração Macular/complicações , Degeneração Macular/diagnóstico , Degeneração Retiniana/complicações , Neovascularização Patológica , Angiofluoresceinografia , Tomografia de Coerência Óptica , Estudos Retrospectivos , Neovascularização Retiniana/complicações
2.
Indian J Ophthalmol ; 71(11): 3489-3493, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37870012

RESUMO

Purpose: Cystoid macular degeneration (CMD) is a feature of chronic central serous chorioretinopathy (CSCR). Present study intended to analyze the clinical presentation, risk factors, choroidal features, and outcome of CMD in CSCR. Methods: This was a retrospective, record-based descriptive study, which included chronic CSCR eyes with CMD. Demographic profile and clinical history were obtained from medical records. Spectralis spectral domain optical coherence tomography (SDOCT; Heidelberg Engineering,Germany) was used for acquiring SDOCT images and for performing fluorescein angiography , indocyanine green angiography , and optical coherence tomography (OCT) angiography. Results: The study included 101 eyes of 69 consecutive patients of CSCR having CMD. The mean age of patients was 56 ± 9.4 years (range 40-79 years), and majority (63, 91.3%) of the patients were male. Prior history of corticosteroid use was present in seven (10.1%) patients. Mean time interval between the first diagnosis of CSCR and appearance of CMD was 55.3 ± 33.9 months. CMD was located away from the fovea in majority of eyes (68, 67.3%). Mean subfoveal choroidal thickness was 396.71 ± 90.5 µm. Subretinal pigment epithelium choroidal neovascularization was noted in four (3.96%) eyes. Conclusion: CMD appears as a late complication of CSCR and is usually present away from the fovea. Such eyes had thickened choroid and fewer cases had associated choroidal neovascularization. Further comparative studies would be needed to validate these findings.


Assuntos
Coriorretinopatia Serosa Central , Degeneração Macular , Neovascularização Retiniana , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Coriorretinopatia Serosa Central/complicações , Coriorretinopatia Serosa Central/diagnóstico , Estudos Retrospectivos , Degeneração Macular/complicações , Corioide , Tomografia de Coerência Óptica/métodos , Neovascularização Retiniana/complicações
3.
Retina ; 43(10): 1780-1787, 2023 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-37399574

RESUMO

PURPOSE: Characterize clinical and socioeconomic factors that impact follow-up to complete retinal vascularization and subsequent pediatric ophthalmology follow-up in neonates with retinopathy of prematurity. METHODS: Medical records of 402 neonates diagnosed with retinopathy of prematurity from neonatal intensive care units at the University of California, Los Angeles Mattel Children's Hospital and the University of California, Los Angeles Santa Monica Hospital, both academic medical centers, and the Harbor-University of California, Los Angeles Medical Center, a safety-net county hospital, were reviewed. Primary study outcomes were the rate of follow-up to complete retinal vascularization and adequate pediatric ophthalmology follow-up. Secondary outcome was the rate of nonretinal ocular comorbidity. RESULTS: In whole-cohort analysis, 93.6% of neonates were followed to complete retinal vascularization, and 53.5% had adequate pediatric ophthalmology follow-up. Public insurance was associated with lower rates of pediatric ophthalmology follow-up (Odds ratio 0.66, 95% confidence interval 0.45-0.98, P = 0.04). Participants screened at the academic medical center had lower rates of pediatric ophthalmology follow-up compared with the safety-net county hospital (50.7% vs. 63.5%, P = 0.034). In subgroup analysis, academic medical center participants with public insurance were less likely to have pediatric ophthalmology follow-up than safety-net county hospital participants with public insurance (36.5% vs. 63.8%, P < 0.001) or those with private insurance at the academic medical center (36.5% vs. 59.2%, P< 0.001). CONCLUSION: This study identified high follow-up rates to complete retinal vascularization, lower pediatric ophthalmology follow-up rates, and nonretinal ocular comorbidity at all hospitals. Insurance status relative to hospital type was identified as a risk factor for loss to follow-up. This demonstrates a need to further study health care disparities in retinopathy of prematurity infants.


Assuntos
Neovascularização Retiniana , Retinopatia da Prematuridade , Recém-Nascido , Lactente , Criança , Humanos , Retinopatia da Prematuridade/diagnóstico , Retinopatia da Prematuridade/epidemiologia , Seguimentos , Recém-Nascido Prematuro , Estudos de Coortes , Fatores de Risco , Neovascularização Retiniana/complicações , Idade Gestacional
4.
Medicina (Kaunas) ; 59(1)2023 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-36676793

RESUMO

Background: Eales disease is a clinical syndrome affecting the mid-peripheral retina with an idiopathic occlusive vasculitis and possible subsequent retinal neovascularization. The disease can develop into visually threatening complications. Case Presentation: We report the case of a 40-year-old Caucasian male with a history of cocaine abuse who presented with blurred vision in the left eye (LE). Fundus examination showed vitreous hemorrhages, peripheral sheathing of venous blood vessels, areas of retinal neovascularization in the LE, and peripheral occlusive phlebitis in the right eye. The full serologic panel was negative except for the heterozygous mutation of factor V Leiden. Clinical and biochemical parameters suggested a diagnosis of Eales disease. Therapy with dexamethasone, 1 mg per kg per day, tapered down slowly over 4 months, and peripheral laser photocoagulation allowed a regression of clinical signs and symptoms. Conclusion: This case shows an uncommon presentation of Eales disease associated with cocaine abuse. Both cocaine abuse and a thrombophilic pattern, as cofactors, might have sensitized the retinal microcirculation on the pathogenetic route to this retinal pathology. Furthermore, in view of this hypothesis, a thorough ocular and general medical history investigating drug abuse and coagulation disorders is recommended for ophthalmologists in such cases.


Assuntos
Transtornos Relacionados ao Uso de Cocaína , Neovascularização Retiniana , Vasculite Retiniana , Humanos , Masculino , Adulto , Neovascularização Retiniana/complicações , Neovascularização Retiniana/patologia , Transtornos Relacionados ao Uso de Cocaína/complicações , Neovascularização Patológica/complicações , Vasculite Retiniana/etiologia , Vasculite Retiniana/complicações
5.
J Drug Target ; 30(6): 673-686, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35289235

RESUMO

Diabetes is a disease that leads to proliferative diabetic retinopathy (PDR), which is associated with an increase of new vessels formation due to an overexpression of angiogenic factors, such as angiopoietin 2 (ANGPT2). The aim of this work was to design a siRNA targeting ANGPT2 to decrease the retinal neovascularization associated with PDR. Adult male Wistar rats weighing 325-375 g were used. Diabetes was induced by a single dose of streptozotocin (STZ, 60 mg/kg i.p.). The siRNAs were designed, synthesised, and administered intravitreally at the beginning of diabetes induction (t0), and after 4 weeks of diabetes evolution (t4), subsequently evaluated the retinal neovascularization (junctions and lacunarity) and ANGPT2 expression in the retina by RT-PCR, after 4 weeks of the siRNAs administration. The results showed that the administration of STZ produced significant increases in blood glucose levels, retinal neovascularization (augmented junctions and lower lacunarity), and ANGPT2 expression, while the administration of the ANGPT2-siRNAs at different groups (t0 and t4) reduces the junctions and increases the lacunarity in diabetic rats. Therefore, we conclude that the administration of siRNAs targeting ANGPT2 could be an option to decrease the retinal neovascularization associated with PDR and halt the progression of blindness caused by diabetes.


Assuntos
Diabetes Mellitus Experimental , Retinopatia Diabética , Neovascularização Retiniana , Angiopoietina-2/genética , Animais , Diabetes Mellitus Experimental/metabolismo , Retinopatia Diabética/genética , Masculino , Neovascularização Patológica/genética , RNA Interferente Pequeno/farmacologia , Ratos , Ratos Wistar , Retina/metabolismo , Neovascularização Retiniana/complicações , Neovascularização Retiniana/genética , Neovascularização Retiniana/metabolismo , Estreptozocina
6.
Retina ; 42(3): 519-528, 2022 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-34743132

RESUMO

PURPOSE: To investigate demographic and clinical factors influencing the longitudinal changes of retinal pigment epithelium (RPE) dehiscence area after RPE tears, including the presence of RPE tear-associated repair proliferation (TARP), and identify factors associated with TARP development over follow-up. METHODS: Retrospective, single-center, observational cohort study of patients with a history of macular neovascularization and RPE tear. The area of RPE dehiscence was measured on repeated short-wavelength fundus autofluorescence imaging. Associations between covariates and RPE dehiscence areas were tested with multivariable linear mixed models. Associations between TARP development and clinical variables were investigated with Cox regression models. Factors associated with visual acuity changing rates were explored with linear mixed models. RESULTS: Thirty-seven eyes of 36 patients were included in this study and followed for a median time of 18 months. Tear-associated repair proliferation was identified in 27 eyes (73%). The median time for TARP detection was 112 days; none of the investigated factors was significantly associated with TARP occurrence. The presence of TARP (estimate: -0.042 mm2/month; P = 0.001) and female gender (estimate: -0.035 mm2/month; P = 0.006) were associated with slower rates of RPE dehiscence enlargement over time. Faster rates of visual improvement were observed in eyes with TARP compared with those without TARP (estimate = -0.010 logarithm of the minimum angle of resolution/month if TARP was present; P = 0.008). CONCLUSION: Retinal pigment epithelium tear repair with TARP and female gender were associated with slower RPE degeneration after RPE tears. The presence of TARP was associated better visual prognosis. Additional research on factors promoting TARP development may have therapeutic and prognostic implications.


Assuntos
Proliferação de Células/fisiologia , Perfurações Retinianas/diagnóstico , Epitélio Pigmentado da Retina/patologia , Cicatrização/fisiologia , Idoso , Idoso de 80 Anos ou mais , Inibidores da Angiogênese/uso terapêutico , Feminino , Angiofluoresceinografia , Seguimentos , Humanos , Masculino , Imagem Multimodal , Fotoquimioterapia , Prognóstico , Neovascularização Retiniana/complicações , Perfurações Retinianas/tratamento farmacológico , Perfurações Retinianas/etiologia , Perfurações Retinianas/fisiopatologia , Estudos Retrospectivos , Fatores de Tempo , Tomografia de Coerência Óptica , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologia
7.
Cytokine ; 143: 155542, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33926775

RESUMO

Interferon-γ (IFNG) is one of the key cytokines that regulates both innate and adaptive immune responses in the body. However, the role of IFNG in the regulation of vascularization, especially in the context of Vascular endothelial growth factor A (VEGFa)-induced angiogenesis is not clarified. Here, we report that IFNG shows potent anti-angiogenic potential against VEGFa-induced angiogenesis. IFNG significantly inhibited proliferation, migration, and tube formation of Human umbilical vein endothelial cells (HUVECs) both under basal and VEGFa-treated conditions. Intriguingly, Knockdown (KD) of STAT1 abolished the inhibitory effect of IFNG on VEGFa-induced angiogenic processes in HUVECs. Furthermore, IFNG exhibited potent anti-angiogenic efficacy in the mouse model of oxygen-induced retinopathy (OIR), an in vivo model for hypoxia-induced retinal neovascularization, without induction of functional side effects. Taken together, these results show that IFNG plays a crucial role in the regulation of VEGFa-dependent angiogenesis, suggesting its potential therapeutic applicability in neovascular diseases.


Assuntos
Interferon gama/uso terapêutico , Isquemia/complicações , Neovascularização Retiniana/complicações , Neovascularização Retiniana/tratamento farmacológico , Animais , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Modelos Animais de Doenças , Regulação para Baixo/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana/metabolismo , Humanos , Hipóxia/complicações , Interferon gama/administração & dosagem , Interferon gama/farmacologia , Injeções Intravítreas , Camundongos , Neovascularização Fisiológica/efeitos dos fármacos , Retina/efeitos dos fármacos , Retina/patologia , Retina/fisiopatologia , Neovascularização Retiniana/fisiopatologia , Fator de Transcrição STAT1/metabolismo , Transdução de Sinais/efeitos dos fármacos
8.
Optom Vis Sci ; 98(4): 418-424, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33828041

RESUMO

SIGNIFICANCE: Although von Willebrand disease is the most common inherited bleeding disorder, there are only a few published reports of ocular complications. To our knowledge, this is the first case of peripheral retinal ischemia and retinal neovascularization in a patient with von Willebrand disease. PURPOSE: This study aimed to demonstrate the value of multispecialty care when exploring a diagnosis for bilateral retinopathy. CASE REPORT: A 55-year-old African American woman presented with peripheral retinal hemorrhages on routine examination. She was asymptomatic and did not have any personal or family history of bleeding disorders. Blood work was ordered, and she was referred to a retinal specialist who found peripheral telangiectasia, retinal ischemia, and leakage on fluorescein angiography, consistent with retinal neovascularization. Laser photocoagulation was performed while numerous specialists were consulted to determine the cause for her retinopathy. Laboratory testing confirmed low-grade type 1 von Willebrand disease. She was monitored without systemic treatment. She remained stable and asymptomatic, but her retinal neovascularization did not regress fully, so laser treatment was repeated. CONCLUSIONS: This case described a new finding of peripheral retinal ischemia and retinal neovascularization in von Willebrand disease. It was discovered in an asymptomatic patient who did not have a history of bleeding but presented with bilateral retinal hemorrhages. Diagnosis was challenging because of the high degree of variation in this bleeding disorder, requiring extensive testing and careful consideration of the individual's clinical profile. Most people with von Willebrand disease do not know they have the disease because symptoms are mild or absent, so most cases are unreported. The von Willebrand factor is poorly recognized in ocular disease, but given its role in angiogenesis, it may be a valuable target to consider in future research.


Assuntos
Isquemia/etiologia , Neovascularização Retiniana/etiologia , Vasos Retinianos/patologia , Doenças de von Willebrand/complicações , Feminino , Angiofluoresceinografia , Humanos , Isquemia/complicações , Isquemia/diagnóstico , Isquemia/fisiopatologia , Pessoa de Meia-Idade , Neovascularização Retiniana/complicações , Neovascularização Retiniana/diagnóstico , Neovascularização Retiniana/fisiopatologia , Acuidade Visual/fisiologia , Doenças de von Willebrand/diagnóstico , Doenças de von Willebrand/tratamento farmacológico , Fator de von Willebrand/uso terapêutico
9.
Curr Opin Ophthalmol ; 32(3): 203-208, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33770016

RESUMO

PURPOSE OF REVIEW: Diabetic retinopathy (DR) is one of the leading causes of preventable vision loss in the world and its prevalence continues to increase worldwide. One of the ultimate and visually impairing complications of DR is proliferative diabetic retinopathy (PDR) and subsequent tractional retinal detachment. Treatment modalities, surgical techniques, and a better understanding of the pathophysiology of DR and PDR continue to change the way we approach the disease. The goal of this review is to provide an update on recent treatment modalities and outcomes of proliferative diabetic retinopathy and its complications including tractional retinal detachment. RECENT FINDINGS: Panretinal photocoagulation (PRP), anti-vascular endothelial growth factor (anti-VEGF), and pars plana vitrectomy are the mainstay of PDR treatment. However, PRP and anti-VEGF are associated with significant treatment burden and multiple subsequent treatments. Early vitrectomy is associated with vision preservation, less treatment burden, and less subsequent treatments than therapy with PRP and anti-VEGF. SUMMARY: Concerning costs, high rates of noncompliance in the diabetic population and significant rates of subsequent treatments with initial PRP and anti-VEGF, early vitrectomy for diabetic retinopathy in patients at risk of PDR is a cost-effective long-term stabilizing treatment for diabetics with advanced disease.


Assuntos
Retinopatia Diabética/cirurgia , Descolamento Retiniano/cirurgia , Neovascularização Retiniana/cirurgia , Vitrectomia/métodos , Inibidores da Angiogênese/uso terapêutico , Retinopatia Diabética/complicações , Retinopatia Diabética/tratamento farmacológico , Humanos , Fotocoagulação a Laser/métodos , Descolamento Retiniano/tratamento farmacológico , Descolamento Retiniano/etiologia , Neovascularização Retiniana/complicações , Neovascularização Retiniana/tratamento farmacológico , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
10.
Retina ; 41(10): 2106-2114, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33625111

RESUMO

PURPOSE: To describe the clinical and multimodal imaging features of bacillary layer detachment (BD), and its response to intravitreal anti-vascular endothelial growth factor therapy, in eyes with macular neovascularization. METHODS: Retrospective, observational case series of 14 eyes (14 patients, 7 men) imaged with eyes (14 patients, 7 men) were imaged with spectral-domain optical coherence tomography, and either fluorescein angiography or optical coherence tomography angiography. Therapeutic response was monitored with serial imaging and best-corrected visual acuity assessments. RESULTS: The mean age was 75 ± 13 (range: 45-96) years, with mean follow-up duration of 27 ± 21 (range: 1-56) months. Neovascular age-related macular degeneration was found in 71% (10/14) eyes. Type 2 macular neovascularization lesions were associated with BD in all 14 eyes. Subretinal hemorrhage was noted in 79% (11/14) eyes. BD promptly resolved after intravitreal antivascular endothelial growth factor therapy in all eyes. The baseline best-corrected visual acuity improved from logarithm of the minimum angle of resolution 0.84 ± 0.32 (Snellen equivalent 20/138) to logarithm of the minimum angle of resolution 0.48 ± 0.31 (Snellen equivalent 20/60) at the last follow-up, with treatment of the macular neovascularization. CONCLUSION: Type 2 macular neovascularization and subretinal hemorrhage are associated with BDs, which may be due to a rapid influx of exudative fluid into the potential space between the external limiting membrane and ellipsoid zone. Intravitreal antivascular endothelial growth factor therapy results in rapid resolution of BDs and visual improvement in most eyes.


Assuntos
Descolamento Retiniano/etiologia , Neovascularização Retiniana/complicações , Segmento Interno das Células Fotorreceptoras da Retina/patologia , Segmento Externo das Células Fotorreceptoras da Retina/patologia , Idoso , Idoso de 80 Anos ou mais , Inibidores da Angiogênese/uso terapêutico , Feminino , Angiofluoresceinografia , Seguimentos , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Descolamento Retiniano/diagnóstico por imagem , Hemorragia Retiniana/induzido quimicamente , Hemorragia Retiniana/diagnóstico por imagem , Hemorragia Retiniana/tratamento farmacológico , Neovascularização Retiniana/diagnóstico por imagem , Neovascularização Retiniana/tratamento farmacológico , Estudos Retrospectivos , Líquido Sub-Retiniano , Tomografia de Coerência Óptica , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual
11.
J Clin Endocrinol Metab ; 106(5): 1235-1244, 2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-33512450

RESUMO

Diabetic retinopathy (DR) is a well-recognized microvascular complication of diabetes. Growing evidence suggests that, in addition to retinal vascular damage, there is significant damage to retinal neural tissue in DR. Studies reveal neuronal damage before clinically evident vascular lesions and DR is now classified as a neurovascular complication. Hyperglycemia causes retinal damage through complex metabolic pathways leading to oxidative stress, inflammation, vascular damage, capillary ischemia, and retinal tissue hypoxia. Retinal hypoxia is further worsened by high oxygen consumption in the rods. Persistent hypoxia results in increases in vascular endothelial growth factor (VEGF) and other pro-angiogenic factors leading to proliferative DR/macular edema and progressive visual impairment. Optimal glucose control has favorable effects in DR. Other treatments for DR include laser photocoagulation, which improves retinal oxygenation by destroying the high oxygen consuming rods and their replacement by low oxygen consuming glial tissue. Hypoxia is a potent stimulator of VEGF, and intravitreal anti-VEGF antibodies are effective in regressing macular edema and in some studies, retinal neovascularization. In this review, we highlight the complex pathophysiology of DR with a focus on retinal oxygen/fuel consumption and hypoxic damage to retinal neurons. We discuss potential mechanisms through which sodium-glucose cotransporter 2 (SGLT2) inhibitors improve retinal hypoxia-through ketone bodies, which are energetically as efficient as glucose and yield more ATP per molecule of oxygen consumed than fat, with less oxidative stress. Retinal benefits would occur through improved fuel energetics, less hypoxia and through the anti-inflammatory/oxidative stress effects of ketone bodies. Well-designed studies are needed to explore this hypothesis.


Assuntos
Retinopatia Diabética/tratamento farmacológico , Hipóxia/prevenção & controle , Cetose/induzido quimicamente , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Animais , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Retinopatia Diabética/metabolismo , Retinopatia Diabética/patologia , Humanos , Cetose/metabolismo , Cetose/patologia , Retina/efeitos dos fármacos , Retina/metabolismo , Retina/patologia , Neovascularização Retiniana/complicações , Neovascularização Retiniana/metabolismo , Neovascularização Retiniana/patologia , Índice de Gravidade de Doença , Inibidores do Transportador 2 de Sódio-Glicose/farmacologia
12.
J Vis Exp ; (163)2020 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-33016936

RESUMO

One of the commonly used models for ischemic retinopathies is the oxygen-induced retinopathy (OIR) model. Here we describe detailed protocols for the OIR model induction and its readouts in both mice and rats. Retinal neovascularization is induced in OIR by exposing rodent pups either to hyperoxia (mice) or alternating levels of hyperoxia and hypoxia (rats). The primary readouts of these models are the size of neovascular (NV) and avascular (AVA) areas in the retina. This preclinical in vivo model can be used to evaluate the efficacy of potential anti-angiogenic drugs or to address the role of specific genes in the retinal angiogenesis by using genetically manipulated animals. The model has some strain and vendor specific variation in the OIR induction which should be taken into consideration when designing the experiments.


Assuntos
Modelos Animais de Doenças , Isquemia/induzido quimicamente , Oxigênio/farmacologia , Doenças Retinianas/induzido quimicamente , Animais , Isquemia/complicações , Camundongos , Camundongos Endogâmicos C57BL , Ratos , Retina/efeitos dos fármacos , Retina/metabolismo , Retina/fisiopatologia , Doenças Retinianas/complicações , Neovascularização Retiniana/complicações
13.
Indian J Ophthalmol ; 68(8): 1693-1695, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32709827

RESUMO

A 45-year-old male presented with diminution of vision in both eyes since the last 2 years. The best-corrected visual acuity was 20/200 in his right eye and 20/600 in left eye. BE fundi had changes of chronic CSCR with PED and NSD in the RE and subretinal fibrosis in the left eye. Both eyes had peripheral pigmentary changes. Multimodal imaging showed peripheral avascular retina in both eyes with neovascularization at disc in the right eye which promptly resolved with a single injection of anti-VEGF. Retinal neovascularization is an unusual finding in the setting of CSCR and has not been reported in the literature.


Assuntos
Coriorretinopatia Serosa Central , Neovascularização Retiniana , Coriorretinopatia Serosa Central/complicações , Coriorretinopatia Serosa Central/diagnóstico , Angiofluoresceinografia , Humanos , Masculino , Pessoa de Meia-Idade , Neovascularização Retiniana/complicações , Neovascularização Retiniana/diagnóstico , Tomografia de Coerência Óptica , Acuidade Visual
14.
BMC Ophthalmol ; 20(1): 168, 2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-32345252

RESUMO

BACKGROUND: To report a case of a young patient with neurofibromatosis type 1 (NF1). METHODS: Here we review the treatment administered to a 7-year-old NF1 patient with neovascular glaucoma as the primary diagnosis. CASE PRESENTATION: A 7-year-old boy developed visual loss in the right eye associated with periocular pain and ipsilateral headache that had persisted for 1 week. The patient's condition did not improve after treatment with topical or systemic glaucoma medications. Fundus examination of the right eye showed superotemporal retinal vasoproliferative tumors (RVPT). Near-infrared reflectance scans of the left eye's fundus revealed bright patchy regions, scattered across the posterior pole; systemic examination showed café-au-lait spots all over the patient's body. The patient had a clear family history. Genetic testing confirmed NF1. The right eye was treated with intravitreal ranibizumab injection, retinal lesion cryotherapy, and transscleral ciliary body photocoagulation. After treatment, RVPT scarring was observed. The patient's intraocular pressure remained within normal limits. CONCLUSIONS: We report a rare case of neurofibromatosis in a pediatric patient with neovascular glaucoma accompanied by RVPT. We suggest that evaluations of young patients with neovascular glaucoma should include careful attention to the overall condition of the patient and his/her parents, as well as family history. If necessary, NF1 molecular testing should be performed to avoid a missed diagnosis or misdiagnosis.


Assuntos
Glaucoma Neovascular/etiologia , Neurofibromatose 1/complicações , Neoplasias da Retina/complicações , Neovascularização Retiniana/complicações , Inibidores da Angiogênese/uso terapêutico , Criança , Corpo Ciliar/cirurgia , Angiofluoresceinografia , Glaucoma Neovascular/diagnóstico , Glaucoma Neovascular/cirurgia , Humanos , Injeções Intravítreas , Fotocoagulação a Laser , Masculino , Neurofibromatose 1/diagnóstico , Neurofibromatose 1/tratamento farmacológico , Linhagem , Ranibizumab/uso terapêutico , Neoplasias da Retina/diagnóstico , Neoplasias da Retina/tratamento farmacológico , Neovascularização Retiniana/diagnóstico , Neovascularização Retiniana/tratamento farmacológico , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
15.
Cell Cycle ; 19(11): 1314-1325, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32292119

RESUMO

BACKGROUND: Retinal neovascularization, which is characterized by the increased proliferation, migration, and tube formation of retinal microvascular endothelial cells (RMECs), contributes to the progression of diabetic retinopathy (DR). MiR-409-5p has been reported to be upregulated in peripheral blood of DR patients and in vascular endothelial growth factor (VEGF)-induced RMECs. However, the role of miR-409-5p in retinal neovascularization of DR remains unelucidated. METHOD: The expression of miR-409-5p was measured in retinal tissues of streptozocin-induced and db/db diabetic mice, in high glucose-induced mouse RMECs (mRMECs), and in vitreous fluid of proliferative DR patients. Antagomir of miR-409-5p was intravitreally injected into diabetic mice. Proliferation, migration, and tube formation were detected using cell counting kit-8 assay, transwell assay, and microscope observation, respectively. Luciferase reporter assay was used to detect the direct interaction between miR-409-5p and peroxisome proliferator-activated receptor-α (PPARα). RESULT: MiR-409-5p was upregulated in retinal tissues of diabetic mice, in high glucose-induced mRMECs, and in vitreous fluid of proliferative DR patients. The knockdown of miR-409-5p attenuated retinal neovascularization in vivo. The overexpression of miR-409-5p promotes the proliferation, migration, and tube formation, and increased VEGF expression and secretion, while the knockdown of miR-409-5p suppressed the VEGF-induced retinal neovascularization in vitro. PPARα is a downstream target of miR-409-5p, and PPARα overexpression negated the promotion of miR-409-5p overexpression on the proliferation, migration, and tube formation of mRMECs. CONCLUSION: Our findings demonstrated that miR-409-5p acted as a neovasculogenic factor in DR, and anti-miR-409-5p therapy may provide a novel strategy in treating DR.


Assuntos
Retinopatia Diabética/complicações , Retinopatia Diabética/genética , MicroRNAs/metabolismo , Neovascularização Retiniana/complicações , Neovascularização Retiniana/genética , Animais , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/metabolismo , Células Endoteliais/patologia , Técnicas de Silenciamento de Genes , Glucose/toxicidade , Masculino , Camundongos Endogâmicos C57BL , MicroRNAs/genética , Microvasos/patologia , PPAR alfa/metabolismo , Retina/patologia , Regulação para Cima/genética , Fator A de Crescimento do Endotélio Vascular/metabolismo
16.
Sci Rep ; 9(1): 19447, 2019 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-31857597

RESUMO

Neovascular age-related macular degeneration (nAMD) is a complex and multi-factorial disease, and low-grade inflammation is associated with pathogenesis of nAMD. Aqueous humor could reflect intraocular immune environments in various eye diseases. The research so far used aqueous humor samples and revealed that inflammation is involved in pathophysiology of nAMD, although immunological roles of cytokines were evaluated inadequately with aspect to individual effects. Here we used 27 kinds of cytokines covering general immunologic reactions, examined specific expression patterns of cytokines, and assessed relationships between inflammation and pathophysiology of nAMD by multivariate analyses. In nAMD eyes, principal component analysis showed that IL-7, MCP-1, MIP-1ß and VEGF had high principal component loadings of over 0.6 in the first principal component constituting 32.6% of all variability of the data. In exploratory factor analysis, IL-6, MCP-1 and MIP-1ß had high factor loadings (FL) of over 0.5 in Factor 1 constituting 32.6% of all variability, while VEGF had FL of over 1.0 in Factor 3 constituting 10.7% of all variability. In hierarchical cluster analysis, MCP-1 and VEGF were located in the cluster of first proximate mutual distance to central retinal thickness. These data could suggest that low-grade inflammation is a principal contributor in nAMD.


Assuntos
Humor Aquoso/metabolismo , Neovascularização de Coroide/complicações , Citocinas/metabolismo , Degeneração Macular/imunologia , Neovascularização Retiniana/complicações , Idoso , Idoso de 80 Anos ou mais , Humor Aquoso/imunologia , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/imunologia , Citocinas/imunologia , Feminino , Angiofluoresceinografia , Perfilação da Expressão Gênica , Humanos , Degeneração Macular/diagnóstico , Degeneração Macular/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Retina/diagnóstico por imagem , Retina/imunologia , Retina/patologia , Neovascularização Retiniana/diagnóstico , Neovascularização Retiniana/imunologia , Neovascularização Retiniana/patologia , Vasos Retinianos/patologia , Tomografia de Coerência Óptica
17.
Ther Deliv ; 10(11): 737-747, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31718481

RESUMO

Pathologic posterior neovascularization of eye is a major cause of irreversible vision loss and limitations of therapeutics to be successfully delivered to back of the eye has been a main obstacle for its effective treatment. Current pharmacological treatment using anti-VEGF agents being delivered intravitreally are effective but complicated due to anatomical and physiological barriers, as well as administration of high and frequent doses. With expanding horizons of nanotechnology, it can be possible to formulate promising nanoscale delivery system to improve penetration and sustained the release of therapeutic in posterior segment of the eye. Taking into consideration advances in the field of nanoscale delivery systems, this special report focuses on emerging strategies and their applications for treatment of posterior ocular neovascularization.


Assuntos
Inibidores da Angiogênese/administração & dosagem , Portadores de Fármacos/química , Nanopartículas/química , Neovascularização Retiniana/terapia , Adenoviridae/genética , Administração Oftálmica , Inibidores da Angiogênese/farmacocinética , Animais , Cegueira/etiologia , Cegueira/prevenção & controle , Barreira Hematoaquosa/metabolismo , Barreira Hematorretiniana/metabolismo , Ensaios Clínicos como Assunto , Modelos Animais de Doenças , Terapia Genética/métodos , Vetores Genéticos/administração & dosagem , Vetores Genéticos/genética , Humanos , Terapia a Laser/métodos , Absorção Ocular , Permeabilidade , Fotoquimioterapia , Retina/metabolismo , Neovascularização Retiniana/complicações , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Fator A de Crescimento do Endotélio Vascular/genética , Baixa Visão/etiologia , Baixa Visão/prevenção & controle , Vitrectomia
19.
Graefes Arch Clin Exp Ophthalmol ; 257(8): 1661-1669, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31144056

RESUMO

PURPOSE: To investigate the clinical significance of focal retinal pigment epithelium (RPE) atrophy in the eyes with type 3 neovascularization. METHODS: This retrospective study included 184 eyes those were diagnosed with type 3 neovascularization and were treated with antivascular endothelial growth factor (VEGF) therapy. Focal RPE atrophy was defined as a localized RPE atrophy found at the same location as the type 3 lesion. The incidence of reactivation after 3 loading injections and the visual outcomes was compared between a focal RPE atrophy group and a nonfocal RPE atrophy group. In the focal RPE atrophy group, the number of injections was compared between before and after the development of RPE atrophy. RESULTS: The mean follow-up period was 37.6 ± 18.8 months; focal RPE atrophy developed in 24 eyes (13.0%). Reactivation of the lesion after 3 loading injections was significantly less frequent in the focal RPE atrophy group (58.3%) than that in the nonfocal RPE atrophy group (85.0%) (P = 0.004). In the focal RPE atrophy group, the mean best-corrected visual acuity (BCVA) was 0.68 ± 0.28 (Snellen equivalent = 20/95) at diagnosis and 0.70 ± 0.48 (20/100) at the final follow-up. In the nonfocal RPE atrophy group, the values were 0.75 ± 0.34 (20/112) and 1.12 ± 0.68 (20/263), respectively. The BCVA at the final follow-up was significantly better in the focal RPE atrophy group (P < 0.001). The mean number of injections per year was 4.9 ± 1.8 and 1.3 ± 1.6 before and after the development of focal RPE atrophy, respectively (P < 0.001). CONCLUSIONS: Development of focal RPE atrophy was associated with a low incidence of reactivation of type 3 neovascularization and was therefore predictive of a favorable visual prognosis.


Assuntos
Degeneração Retiniana/diagnóstico , Neovascularização Retiniana/diagnóstico , Epitélio Pigmentado da Retina/patologia , Tomografia de Coerência Óptica/métodos , Acuidade Visual , Idoso , Inibidores da Angiogênese/administração & dosagem , Atrofia/diagnóstico , Atrofia/tratamento farmacológico , Atrofia/etiologia , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Injeções Intravítreas , Masculino , Prognóstico , Ranibizumab/administração & dosagem , Degeneração Retiniana/tratamento farmacológico , Degeneração Retiniana/etiologia , Neovascularização Retiniana/complicações , Neovascularização Retiniana/tratamento farmacológico , Estudos Retrospectivos , Fatores de Tempo , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
20.
Dokl Biochem Biophys ; 489(1): 373-376, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32130603

RESUMO

This work is dedicated to proving our hypothesis that catecholamines and their metabolites play a crucial role in the development of retinopathy of prematurity, which leads to progressive uncontrollable vascularization in the retina, leading to blindness. The study was performed in an animal model of retinopathy of prematurity, which was achieved by hyperoxygenation in rats on postnatal days 7, 14, 21, and 30. The content of catecholamines and their metabolites in the retina of rats was determined by high performance liquid chromatography with electrochemical detection. It was shown that, in the rats with retinopathy, the content of L-DOPA on days 21 and 30 was decreased as compared to the control, whereas the content of noradrenaline on day 14 life increased compared to the control. However, we did not observe changes in the content of dopamine in the experimental animals relative to the control in any period studied. Given the published data on the involvement of catecholamines in the regulation of vasculogenesis in the retina in normal state, our data on the changes in the catecholamine metabolism in the retina in the model of retinopathy of prematurity can be regarded as evidence of the important role of catecholamines in the pathogenesis of this severe disease.


Assuntos
Catecolaminas/metabolismo , Neovascularização Retiniana/complicações , Neovascularização Retiniana/metabolismo , Retinopatia da Prematuridade/complicações , Animais , Modelos Animais de Doenças , Ratos , Neovascularização Retiniana/patologia
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