Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.188
Filtrar
1.
PLoS One ; 15(1): e0227641, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31929571

RESUMO

Retinal pigment epithelium (RPE) transplantation for the treatment of macular degeneration has been studied for over 30 years. Human clinical trials have demonstrated that RPE monolayers exhibit improved cellular engraftment and survival compared to single cell suspensions. The use of a scaffold facilitates implantation of a flat, wrinkle-free, precisely placed monolayer. Scaffolds currently being investigated in human clinical trials are non-degradable which results in the introduction of a chronic foreign body. To improve RPE transplant technology, a degradable scaffold would be desirable. Using human fibrin, we have generated scaffolds that support the growth of an RPE monolayer in vitro. To determine whether these scaffolds are degraded in vivo, we developed a surgical approach that delivers a fibrin hydrogel implant to the sub-retinal space of the pig eye and determined whether and how fast they degraded. Using standard ophthalmic imaging techniques, the fibrin scaffolds were completely degraded by postoperative week 8 in 5 of 6 animals. Postmortem histologic analysis confirmed the absence of the scaffold from the subretinal space at 8 weeks, and demonstrated the reattachment of the neurosensory retina and a normal RPE-photoreceptor interface. When mechanical debridement of a region of native RPE was performed during implantation surgery degradation was accelerated and scaffolds were undetectable by 4 weeks. These data represent the first in situ demonstration of a fully biodegradable scaffold for use in the implantation of RPE and other cell types for treatment of macular degeneration and other retinal degenerative diseases.


Assuntos
Implantes Absorvíveis , Fibrina , Retina/cirurgia , Tecidos Suporte , Animais , Desenho de Equipamento , Feminino , Retina/citologia , Retina/diagnóstico por imagem , Degeneração Retiniana/cirurgia , Sus scrofa
2.
Rom J Ophthalmol ; 63(3): 264-267, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31687629

RESUMO

Objective. To report a rare presentation of solitary retinal capillary hemangioma manifesting with combined retinal detachment as initial presentation and its successful management. Methods. A 35-year-old healthy Indian male presented with combined retinal detachment associated with solitary retinal capillary hemangioma as initial presentation; a clinical entity still not reported in literature. Patient was managed with pars plana vitrectomy combined with retinectomy, endolaser, & silicon oil tamponade with good visual & anatomical recovery. Results. Patient had good clinical outcome with final best-corrected visual acuity (BCVA) of 6/ 24 and well attached retina at last follow-up. Conclusion. Solitary retinal capillary hemangiomas can rarely present with advanced vitreo-retinal complications like combined retinal detachment as initial manifestation that can be effectively managed with skilled & appropriate surgical intervention.


Assuntos
Angiofluoresceinografia/métodos , Hemangioma Capilar/diagnóstico , Descolamento Retiniano/etiologia , Neoplasias da Retina/diagnóstico , Recurvamento da Esclera/métodos , Acuidade Visual , Vitrectomia/métodos , Adulto , Seguimentos , Fundo de Olho , Hemangioma Capilar/complicações , Hemangioma Capilar/cirurgia , Humanos , Masculino , Retina/patologia , Retina/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/cirurgia , Neoplasias da Retina/complicações , Neoplasias da Retina/cirurgia
3.
Adv Exp Med Biol ; 1186: 141-170, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31654389

RESUMO

Developing successful surgical strategies to deliver cell therapeutics to the back of the eye is an essential pillar to success for stem cell-based applications in blinding retinal diseases. Within this chapter, we have attempted to gather all key considerations during preclinical animal trials.Guidance is provided for choices on animal models, options for immunosuppression, as well as anesthesia. Subsequently we cover surgical strategies for RPE graft delivery, both as suspension as well as in monolayers in small rodents, rabbits, pigs, and nonhuman primate. A detailed account is given in particular on animal variations in vitrectomy and subretinal surgery, which requires a considerable learning curve, when transiting from human to animal. In turn, however, many essential subretinal implantation techniques in large-eyed animals are directly transferrable to human clinical trial protocols.A dedicated subchapter on photoreceptor replacement provides insights on preparation of suspension as well as sheet grafts, to subsequently outline the basics of subretinal delivery via both the transscleral and transvitreal route. In closing, a future outlook on vision restoration through retinal cell-based therapeutics is presented.


Assuntos
Terapia Baseada em Transplante de Células e Tecidos , Retina , Doenças Retinianas , Epitélio Pigmentado da Retina , Animais , Humanos , Imunossupressão , Modelos Animais , Células Fotorreceptoras/citologia , Retina/cirurgia , Doenças Retinianas/cirurgia , Doenças Retinianas/terapia , Epitélio Pigmentado da Retina/cirurgia
4.
Exp Eye Res ; 188: 107812, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31550445

RESUMO

In this work, we investigated changes in the morphology of intrinsically photosensitive retinal ganglion cells (ipRGCs), M1 subtype, and pupillary light reflex following local and selective ablation of photoreceptors in mice. Laser photocoagulation was used to selectively destroy four patches of photoreceptors per eye at around 4 papillary diameters from the optic disc and at the 3, 6, 9, and 12 o'clock positions between the retinal vessels in the adult mouse retina, leaving cells in the inner retina intact. Morphological parameters of individual M1 cells specifically labeled by the antibody against melanopsin (PA1-780), including dendritic field size, total dendritic length, and dendritic branch number, were examined 1, 2, 4, and 8 weeks after photocoagulation with Neurolucida software. A considerable reduction in these parameters in M1 cells in the "lesioned areas" was found at all the four time points after photocoagulation, as compared with those in the "unlesioned areas". Although M1 cells in the lesioned areas showed significant changes as early as 1 week after laser treatment and the changes gradually increased, reaching a peak value at 2 weeks, morphological restoration was clearly seen in these cells over time. However, no difference in the morphological parameters of M1 cells was observed between the unlesioned areas of laser-treated mice and the corresponding areas of age-matched normal mice without laser lesions. Fluorescence intensity of the somata of melanopsin-positive M1 cells located inside the lesioned areas was significantly decreased at all the four time points after photocoagulation, whereas no changes in pupillary light reflex were detected at different light irradiations, indicating that photocoagulation-induced local photoreceptor loss and alterations of ipRGCs may be insufficient to cause abnormalities in non-image-forming (NIF) visual functions. The results suggest that intact photoreceptors could be crucial for maintaining the expression levels of melanopsin and normal morphology of M1 cells.


Assuntos
Fotocoagulação a Laser , Reflexo Pupilar/fisiologia , Retina/cirurgia , Células Ganglionares da Retina/patologia , Animais , Luz , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Células Fotorreceptoras de Vertebrados/metabolismo , Células Ganglionares da Retina/metabolismo , Células Ganglionares da Retina/efeitos da radiação , Opsinas de Bastonetes/metabolismo
5.
Nepal J Ophthalmol ; 11(21): 86-90, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31523073

RESUMO

BACKGROUND: Ocular ischemic syndrome is not a common condition so most of these cases are often misdiagnosed or treated as a different entity. Therefore, it is very important for the ophthalmologists to have this condition in mind as a differential so that the patients can be diagnosed and treated as early as possible. A 42 years female presented with painless, progressive diminution of vision in right eye over the period of 1 month. She doesn't give any history of redness of eyes, fever or trauma. There is no history of diabetes mellitus or hypertension as well. On examination, vision in right and left eyes was 1.78 and 0.30 Log Mar Units respectively. On anterior segment examination, revascularization of iris (1o 4 'o'clock hrs) in right eye was noted. On dilated fund us copy, revascularization of disc (1/3rd) was present in right eye. Cotton wool spots blot hemorrhages and micro aneurysms were also noted in right eye. Likewise, attenuation of arteries were noted on both sides. Fund us fluorescent angiography revealed delayed artery covetous and venous phase. Carotid Doppler was done which showed complete occlusion of right common carotid and bilateral internal carotid artery. These findings lead to the diagnosis as ocular ischemic syndrome so she was then referred to the cardiologist who further confirmed that no active intervention was required at present. The patient was planned for right eye pan retinal photocoagulation (PRP) and was completed in 2 sittings and was asked to follow up regularly. CONCLUSION: Early diagnosis and management is very important for uncommon conditions such as ocular ischemic syndrome to prevent further complications.


Assuntos
Artéria Carótida Primitiva , Estenose das Carótidas/complicações , Oftalmopatias/diagnóstico , Olho/irrigação sanguínea , Isquemia/diagnóstico , Retina/diagnóstico por imagem , Adulto , Estenose das Carótidas/diagnóstico , Oftalmopatias/etiologia , Oftalmopatias/cirurgia , Feminino , Angiofluoresceinografia , Fundo de Olho , Humanos , Isquemia/etiologia , Isquemia/cirurgia , Fotocoagulação/métodos , Retina/cirurgia , Síndrome , Ultrassonografia Doppler
6.
Medicine (Baltimore) ; 98(29): e16422, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335693

RESUMO

RATIONALE: Managing retinal detachment due to posterior retinal holes is problematic since standard laser retinopexy or scleral buckling may be difficult to apply and may have brought serious complication. Another surgical method in treating posterior hole related retinal detachment is desired. PATIENT CONCERNS: Three high myopia patients with previous vitrectomy and membrane peeling history suffered from blurred vision and retinal detachment due to posterior pole retinal holes was diagnosed. DIAGNOSES: Patient diagnosed retinal detachment due to posterior retinal holes either as paracentral retinal breaks or macular hole from both indirect ophthalmoscope exam and fundus photography INTERVENTIONS:: The patient underwent lens capsular flap insertion into all the retinal holes, along with gas tamponade or silicone oil tamponade. No laser retinopexy was performed around the retinal holes. OUTCOMES: Of 3 included patients, 1 patient had insertion of the lens capsular flap, an incomplete air-fluid exchange, and 24% sulfur hexafluoride gas tamponade. The other 2 patients, after lens capsular flap insertion, had air-fluid exchange and subretinal fluid drainage with extrusion via soft needle through superior drainage retinotomy and silicon oil tamponade. The retinal holes of all eyes were sealed with retina attached postoperatively. LESSONS: Lens capsular flap is effective in sealing posterior retinal holes and treating the associated retinal detachment without the complication resulting from laser retinopexy, especially in eyes without sufficient internal limiting membrane (ILM) tissue due to previous ILM peeling.


Assuntos
Miopia Degenerativa , Descolamento Retiniano , Perfurações Retinianas , Cirurgia Vitreorretiniana , Idoso , Técnicas de Diagnóstico Oftalmológico , Tamponamento Interno/métodos , Feminino , Humanos , Cristalino/cirurgia , Masculino , Pessoa de Meia-Idade , Miopia Degenerativa/complicações , Miopia Degenerativa/diagnóstico , Miopia Degenerativa/fisiopatologia , Retina/diagnóstico por imagem , Retina/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Perfurações Retinianas/diagnóstico , Perfurações Retinianas/etiologia , Óleos de Silicone/uso terapêutico , Resultado do Tratamento , Acuidade Visual , Cirurgia Vitreorretiniana/instrumentação , Cirurgia Vitreorretiniana/métodos
7.
World Neurosurg ; 130: e172-e187, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31252082

RESUMO

BACKGROUND: The central retinal artery (CRA) has been described as one of the first branches of the ophthalmic artery.It arises medial to the ciliary ganglion and after a sinuous path within the orbital cavity it penetrates the lower surface of the dura mater that covers the optic nerve, approximately 1 cm behind the eyeball. However, the numerous anatomic descriptions that were made of the CRA have been insufficient or unclear in relation to certain characteristics that are analyzed in the present study. METHODS: An electronic literature search was made in the PubMed database and a cadaver dissection was performed on 11 orbits fixed in formaldehyde. RESULTS: Results were obtained regarding the source, collateral branches, curves, direction, length of the optic nerve, dural perforation site, distance, path and relations, diameter, and area of the central artery of the retina. CONCLUSIONS: Our anatomic study innovates in 2 aspects of the CRA: area and curves. Not only was there a simple count of the number of curves, but it also analyzed the angle presented by each of the curves based on photos obtained in high definition, with a digital program to reduce the margin of error. These curvatures of the CRA were classified according to their spatial disposition within the orbital cavity based on a pattern that was easy to understand. Data were obtained from the area of the CRA on the penetration of the CRA into the dural sheath of the optic nerve.


Assuntos
Microcirurgia/métodos , Retina/anatomia & histologia , Retina/cirurgia , Artéria Retiniana/anatomia & histologia , Artéria Retiniana/cirurgia , Adulto , Feminino , Humanos , Masculino , Retina/patologia , Artéria Retiniana/patologia
8.
Indian J Ophthalmol ; 67(7): 1105-1108, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31238421

RESUMO

Purpose: To determine the effect of ultra-widefield fluorescein angiography (UWFFA)-guided targeted retinal photocoagulation (TRP) in branch retinal vein occlusion (BRVO) with macular edema after intravitreal Ranibizumab (RBZ). Methods: 33 eyes of 32 treatment naïve patients diagnosed as BRVO with macular edema were prospectively randomized to 0.5 mg Ranibizumab only (RBZ group) (n = 17) or Ranibizumab with UWFFA-guided laser (RBZ + TRP group) (n = 16). Both groups received three injections at monthly intervals and PRN henceforth. RBZ + TRP group additionally underwent UWFFA-guided TRP of peripheral capillary nonperfusion areas 1 week post injection. Outcome measures included improvement in visual acuity, central subfoveal thickness (CST), and the number of injections required with a minimum follow-up of 9 months. Results: Both groups showed significant improvement in mean BCVA (25.7 ± 8.19 letters, P < 0.001 vs. 23.38 ± 7.56 letters, P < 0.001; in RBZ and RBZ + TRP group, respectively) and reduction in mean central subfoveal thickness (379.12 ± 242.7 µm, P < 0.001 vs. 253.75 ± 137.9 µm, P < 0.001 in RBZ and RBZ + TRP group, respectively) at 9 months. The number of injections in the RBZ group (5.76 ± 1.3) was significantly greater than RBZ + TRP (4.06 ± 0.99) (P < 0.001). Both groups had significant improvement in contrast sensitivity and mean deviation on visual fields; however, the difference between the groups was not significant (P = 0.62 and P = 0.79, respectively). Conclusion: UWFFA-guided TRP reduced the number of injections of Ranibizumab in patients having BRVO with macular edema, while maintaining similar benefits in the improvement of BCVA, central subfoveal thickness without deleterious effect on the visual field, and contrast sensitivity.


Assuntos
Fotocoagulação a Laser/métodos , Edema Macular/terapia , Ranibizumab/administração & dosagem , Retina/cirurgia , Oclusão da Veia Retiniana/terapia , Acuidade Visual , Inibidores da Angiogênese/administração & dosagem , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Injeções Intravítreas , Edema Macular/diagnóstico , Edema Macular/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Retina/diagnóstico por imagem , Oclusão da Veia Retiniana/complicações , Oclusão da Veia Retiniana/diagnóstico , Tomografia de Coerência Óptica , Resultado do Tratamento , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
9.
Digit J Ophthalmol ; 25(1): 1-4, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31080369

RESUMO

Purpose: To describe a simple and inexpensive model eye that allows lifelike simulation of indirect ophthalmoscopy and retinal photocoagulation. Methods: A 60 D examination lens, a bulb syringe, foam poster-board, a manila folder, a hobby knife, a fine pair of scissors, a glue gun, and a 2.5 cm square Optos color fundus photograph printed at 1200 dpi resolution on glossy photographic paper were used to create a model eye. Results: This model produces a high-quality, inverted, and aerial image that closely simulates clinical indirect ophthalmoscopy. Pupil size and retinal pathology can be easily changed. Binocular indirect laser photocoagulation can also be simulated, because white laser burns will appear on the glossy inkjet photograph. Conclusions: Binocular indirect ophthalmoscopy and indirect laser photocoagulation are technically challenging diagnostic and therapeutic techniques. This simple and easy-to-build eye model allows for lifelike simulation of indirect ophthalmoscopy and indirect laser retinal photocoagulation.


Assuntos
Fotocoagulação/educação , Modelos Anatômicos , Procedimentos Cirúrgicos Oftalmológicos/educação , Oftalmoscopia/métodos , Retina , Humanos , Retina/diagnóstico por imagem , Retina/cirurgia
10.
Indian J Ophthalmol ; 67(6): 860-865, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124503

RESUMO

Purpose: To evaluate the safety and efficacy of 532 nm frequency-doubled Nd-YAG green laser for treatment of retinopathy of prematurity (ROP). Methods: This retrospective interventional case series included infants undergoing treatment for ROP with 532 nm green laser between January 2012 and March 2017 at a single tertiary-care referral center. Review of clinical records was done to identify baseline ROP characteristics, procedural difficulties, complications related to the laser procedure and outcome of treatment at ≥ 1 year of follow-up. Results: There are about 347 eyes of 182 infants were included in this present study. ROP presented in zone I in 76 eyes (21.9%) and zone II in 271 eyes (78.1%). Tunica vasculosa lentis (TVL) was present in 43.8% and pre-existing vitreous hemorrhage in 4.6% of the eyes. 532 nm green laser could be performed as a primary procedure in all eyes, including those with TVL. 322 eyes completed a minimum follow up of 1 year with a mean follow up of 22.8 months (range, 12-54 months). At the last follow-up visit, 298 (92.5%) of the 322 eyes had a favorable outcome. On logistic regression analysis, pre-existing fibrovascular proliferation (p = 0.04) and new-onset fibrovascular proliferation after treatment (p = 0.001) were the most significant independent predictors of poor outcome. Complications encountered were new-onset hemorrhage in 36 eyes (11.2%), anterior segment ischemia in two eyes (0.006%) and cataract in one eye (0.003%). Conclusion: 532 nm frequency-doubled Nd-YAG green laser appears to be safe and effective in the treatment of ROP.


Assuntos
Fotocoagulação a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Retina/cirurgia , Retinopatia da Prematuridade/cirurgia , Feminino , Seguimentos , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Retina/patologia , Retinopatia da Prematuridade/diagnóstico , Estudos Retrospectivos , Resultado do Tratamento
11.
Indian J Ophthalmol ; 67(6): 866-870, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124504

RESUMO

Purpose: To compare the outcomes of conventional laser photocoagulation versus additional posterior barrage laser in advanced stage 3 retinopathy of prematurity (ROP). Methods: A total of 20 infants with bilateral symmetric zone 2 stage 3 advancing ROP were treated with conventional laser treatment followed by randomization of one eye to receive additional posterior retinal laser treatment. Disc-fovea and inter-arcade distance was measured. The patients were followed up prospectively for 3 months. Structural and functional outcomes and safety profile were analyzed. Results: 18/20 (90%) eyes in the study group and 19/20 (95%) eyes in the control group achieved regression of disease. Faster and complete regression was observed at 4 weeks after posterior laser compared to the control group (P = 0.024). Disc-fovea and inter-arcade distance was comparable in both groups. Conclusion: Additional posterior barrage laser is a safe technique that led to faster and more complete regression in eyes with advancing ROP. Final regression profile was comparable in both treatment modalities.


Assuntos
Fotocoagulação a Laser/métodos , Retina/diagnóstico por imagem , Retinopatia da Prematuridade/cirurgia , Acuidade Visual , Progressão da Doença , Feminino , Seguimentos , Humanos , Recém-Nascido , Masculino , Estudos Prospectivos , Retina/cirurgia , Retinopatia da Prematuridade/diagnóstico , Índice de Gravidade de Doença , Resultado do Tratamento
14.
Indian J Ophthalmol ; 67(6): 962-964, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31124533

RESUMO

Oculocutaneous albinism is characterized by partial or complete absence of melanin in retinal pigment epithelium (RPE) and uveal melanocytes. Absence of typical fundal background from RPE and choroid makes it difficult to diagnose retinal disorders in ocular albinism. Lack of melanin in RPE makes the laser photocoagulation very challenging in these cases. This report presents a unique case of preterm infant of oculocutaneous albinism diagnosed as aggressive posterior retinopathy of prematurity (APROP), which was successfully treated with diode laser photocoagulation. The parameters of the laser used in this case were higher than usual, just enough to achieve blanching of retina. This report highlights the fact that the diagnosis of APROP and its treatment with laser is challenging in the presence of oculocutaneous albinism, but it is possible to achieve complete regression using diode laser at higher parameters.


Assuntos
Albinismo Ocular/diagnóstico , Fotocoagulação a Laser/métodos , Lasers Semicondutores/uso terapêutico , Retina/patologia , Retinopatia da Prematuridade/cirurgia , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Oftalmoscopia/métodos , Retina/cirurgia , Retinopatia da Prematuridade/diagnóstico
15.
J Vis Exp ; (145)2019 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-30933080

RESUMO

The Drosophila pupal retina provides an excellent model system for the study of morphogenetic processes during development. In this paper, we present a reliable protocol for the dissection of the delicate Drosophila pupal retina. Our surgical approach utilizes readily-available microdissection tools to open pupae and precisely extract eye-brain complexes. These can be fixed, subjected to immunohistochemistry, and retinas then mounted onto microscope slides and imaged if the goal is to detect cellular or subcellular structures. Alternatively, unfixed retinas can be isolated from brain tissue, lysed in appropriate buffers and utilized for protein gel electrophoresis or mRNA extraction (to assess protein or gene expression, respectively). Significant practice and patience may be required to master the microdissection protocol described, but once mastered, the protocol enables relatively quick isolation of mainly undamaged retinas.


Assuntos
Dissecação , Drosophila melanogaster/citologia , RNA/isolamento & purificação , Retina/citologia , Retina/cirurgia , Animais , Western Blotting , Proteínas de Drosophila/genética , Proteínas de Drosophila/metabolismo , Drosophila melanogaster/genética , Regulação da Expressão Gênica no Desenvolvimento , Imuno-Histoquímica , Pupa/citologia , RNA/metabolismo , Retina/metabolismo
16.
Acta Ophthalmol ; 97(7): e1013-e1018, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30968579

RESUMO

PURPOSE: Patients with proliferative diabetic retinopathy (PDR) treated with panretinal photocoagulation (PRP) can have abnormal visual functioning that may be missed by Snellen visual acuity alone. We investigated reading deficits in patients treated with PRP for PDR using the Minnesota reading (MNREAD) test. METHODS: Thirty patients treated with PRP and 15 controls underwent best-corrected visual acuity (BCVA), the MNREAD, frequency doubling perimetry (FDP), and fundus photography. Panretinal photocoagulation (PRP)-treated subjects were compared to controls on MNREAD results by two-sample t-tests and Wilcoxon tests and Pearson correlations were used to assess the association between performance on MNREAD and other central visual function tests within PRP subjects. RESULTS: Panretinal photocoagulation (PRP)-treated patients had reduced MNREAD acuity (p < 0.0001) and increased critical print size (p = 0.01) compared to controls but not a significantly reduced maximum reading speed (p = 0.06). Logmar MNREAD acuity was strongly positive correlated with logMAR BCVA (r = 0.58, p = 0.0098) and strongly negatively correlated with FDP foveal threshold (r = -0.63, p = 0.0030). Maximum reading speed was positively correlated with FDP foveal threshold (r = 0.57, p = 0.0143) and FDP mean deviation (r = 0.51, p = 0.0432). Visual acuity did not correlate with the sensitivities on the FDP. CONCLUSION: The MNREAD test reveals that PRP reduces reading ability and other aspects of macular function, and thus provides new understanding of how vision-related quality of life is impaired. These findings may lead to improved means to evaluate and enhance vision following treatment for PDR.


Assuntos
Retinopatia Diabética/fisiopatologia , Fotocoagulação a Laser/métodos , Qualidade de Vida , Leitura , Retina/patologia , Acuidade Visual/fisiologia , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Retina/cirurgia , Tomografia de Coerência Óptica
17.
Exp Eye Res ; 184: 1-7, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30928489

RESUMO

The laser-induced choroidal neovascularization (CNV) model in nonhuman primates has played a critical role in the development of new therapies for neovascular age-related macular degeneration. The widespread use of this model, however, has been limited by its high costs, mainly due to the lower efficiency of animal use. We optimized the CNV model by administering repeated photocoagulation treatments to the same eye of each animal, and preliminarily evaluated this model using an assessment of the efficacy of an anti-vascular endothelial growth factor (VEGF) agent to address this problem. Seven rhesus monkeys were included and divided into two groups, which were named the laser-only and laser-bevacizumab groups. Each animal underwent 3 retinal photocoagulation sessions in the same eye at 4-week intervals to induce CNV. Three weeks after the first laser treatment, the animals in the laser-bevacizumab group were administered an intravitreal injection of bevacizumab. Fluorescein angiography (FA) was performed in all animals at multiple time points within 12 weeks to assess the severity and development of CNV following each laser treatment. The laser lesions produced in each photocoagulation session were analysed separately using grading and densitometry methods, and CNV severity was represented by the CNV incidence and the mean integrated fluorescence intensity (MIFI), respectively. Our results showed that in the animals in the laser-only group, the average CNV incidence rates were 62.5%, 42% and 50% at 2 weeks after each laser treatment, and the average MIFI values (x105) were 3.83 ±â€¯2.36, 2.66 ±â€¯1.42 and 2.52 ±â€¯0.18, respectively. No significant differences were found among treatments. After week 2, the CNVs progressed or regressed continuously over 2-6 weeks before stabilization, and the time course of CNV development in each animal was generally the same after each photocoagulation session. In the laser-bevacizumab group, however, the average CNV incidence rates of each laser treatment at week 2 were 50%, 0 and 37.5%, respectively, and the average MIFI values were 3.79 ±â€¯0.47, 1.09 ±â€¯0.35 and 2.37 ±â€¯1.35, respectively. The differences between treatments 1 and 2 were statistically significant. Meanwhile, the CNVs induced by laser treatment 1, which progressed during weeks 2-3, were reduced after bevacizumab administration. The average CNV incidence decreased from 50% at week 3 to 4.2% at week 4, and the average MIFI decreased from 4.62 ±â€¯1.15 to 1.76 ±â€¯0.81, both of which were statistically significant. On the other hand, the CNVs induced by treatments 2 and 3 did not show any significant changes over time. Our study demonstrated that repeated retinal photocoagulation in the monkey eye produces relatively consistent CNVs, which can be used to assess the efficacies of anti-angiogenic agents more efficiently.


Assuntos
Neovascularização de Coroide/etiologia , Modelos Animais de Doenças , Fotocoagulação a Laser , Retina/cirurgia , Inibidores da Angiogênese/uso terapêutico , Animais , Bevacizumab/uso terapêutico , Neovascularização de Coroide/diagnóstico por imagem , Neovascularização de Coroide/tratamento farmacológico , Avaliação Pré-Clínica de Medicamentos , Angiofluoresceinografia , Injeções Intravítreas , Macaca mulatta , Masculino , Retratamento , Tomografia de Coerência Óptica , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
18.
Ophthalmol Retina ; 3(1): 73-76, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30935659

RESUMO

PURPOSE: To report the efficacy of the use of a new scleral depressor marker during scleral buckling surgery for retinal detachment. DESIGN: Noncomparative, consecutive case series study. PARTICIPANTS: Eleven patients (11 eyes) with rhegmatogenous retinal detachment who underwent scleral buckling surgery performed by 2 experienced vitreoretinal surgeons. METHODS: The prototype of a new indenter marker was used during scleral buckling surgery. MAIN OUTCOME MEASURES: The possibility of performing simultaneous indentation and selected marking of the desired area was assessed. Additionally, the precision of the fiber light-assisted indentation as well as force of indentation were evaluated. RESULTS: The use of a new depressor marker facilitated a quick and effective flow of the standard surgery for retinal detachment. It was possible to perform indentation and marking as separate steps of 1 session. Only desired areas of the sclera were marked during the same indentation session. The indentation required less force. When combined with chandelier light, the precision of the marking was improved as demonstrated by a light from the chandelier indicating the highest point of the indentation area. There were no complications related to the use of the new instrument. CONCLUSIONS: The newly developed scleral depressor marker facilitated simultaneous indentation and marking on the sclera. The new instrument allowed for the selective marking of the desired areas during the same session of indentation. Additionally, it can be combined with chandelier fiber light, which improves the precision of the marking.


Assuntos
Descolamento Retiniano/cirurgia , Esclera/diagnóstico por imagem , Recurvamento da Esclera/instrumentação , Acuidade Visual , Adulto , Idoso , Desenho de Equipamento , Feminino , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Oftalmoscopia , Retina/patologia , Retina/cirurgia , Descolamento Retiniano/diagnóstico , Esclera/cirurgia , Resultado do Tratamento , Adulto Jovem
19.
Ophthalmic Surg Lasers Imaging Retina ; 50(4): 238-241, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30998246

RESUMO

The authors present an interventional case report of a patient with von Hippel-Lindau (VHL) syndrome who developed simultaneous exudative and combined tractional, rhegmatogenous, and exudative retinal detachment (RD) in the right and left eyes, respectively, following uneventful cryotherapy application of retinal capillary hemangioblastoma (RCH). After pars plana vitrectomy combined with encircling scleral buckling with radial element placement and silicone oil injection, complete retinal reattachment was achieved. The exudative RD of the fellow eye was managed initially with intense topical corticosteroid treatment and subsequent placement of a radial scleral buckle due to the presence of clinically apparent traction. Both eyes remained stable after successful surgical interventions, and long-term follow-up revealed no evidence of recurrent disease. The authors conclude that rapid worsening of vitreoretinal traction and exudation are complications that can occur after treatment of RCH in patients with VHL syndrome leading to complex retinal detachments. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:238-241.].


Assuntos
Retina/diagnóstico por imagem , Descolamento Retiniano/cirurgia , Recurvamento da Esclera/métodos , Óleos de Silicone/administração & dosagem , Acuidade Visual , Vitrectomia/métodos , Doença de von Hippel-Lindau/complicações , Adolescente , Tamponamento Interno/métodos , Feminino , Angiofluoresceinografia/métodos , Fundo de Olho , Humanos , Injeções , Retina/cirurgia , Descolamento Retiniano/diagnóstico , Descolamento Retiniano/etiologia , Tomografia de Coerência Óptica/métodos , Doença de von Hippel-Lindau/diagnóstico
20.
Exp Eye Res ; 184: 162-171, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31002822

RESUMO

Aim of the study was to compare optical coherence tomography angiography (OCT-A) and conventional fluorescein angiography (FA) for quantitative analysis of the retinal and choroidal vasculature in the animal model of laser-induced choroidal neovascularization (CNV). Therefore, Dark Agouti rats underwent argon laser photocoagulation to induce CNV at D0. In vivo imaging using combined confocal scanner laser ophthalmoscopy (cSLO)-based FA and OCT-A (Heidelberg Engineering GmbH, Heidelberg, Germany) was performed before and immediately after laser treatment as well as at day 2, 7, 14 and 21. OCT-A en-face images were compared to cSLO images obtained by conventional FA topographic uptake recorded using a series of different pre-defined focus settings. For a quantitative comparison of CNV imaging by OCT-A and FA, CNV area, vessel density, number of vessel junctions, total vessel length and number of vessel end points were analyzed. Subsequent ex vivo analyses of the CNV included immunofluorescence staining of vessels in retinal and RPE/choroidal/scleral flatmount preparations. We found, that OCT-A allowed for high-resolution non-invasive imaging of the superficial, intermediate and deep retinal capillary plexus as well as the choroidal blood vessels in rats. Compared with OCT-A, visualization of CNV progression by invasive FA was less accurate, in particular the deep vascular plexus was visualized in more detail by OCT-A. The area of neovascularization was mainly detected in the deep retinal vascular plexus, outer nuclear layer (ONL), ellipsoid zone (EZ) and the choroid. Within the laser lesions, signs of CNV formation occurred at day 7 with progression in size and number of small vessels until day 21. Due to leakage and staining effects, CNV areas appeared significantly larger in FA compared to OCT-A images (p ≤ 0.0001 for all tested layers). Vessel density, number of vessel junctions, total vessel length and number of vessel end points were significantly higher in intermediate vascular plexus (IVP) and deep vascular plexus (DVP) in OCT-A compared to FA images. Overall, CNV area in flatmounts was similar to OCT-A results and much smaller compared to the area of dye leakage by FA. This study demonstrates that in vivo OCT-A imaging in small animals is feasible and allows for precise analysis of the formation of new blood vessel formation in the animal model of laser-induced CNV. Given its superior axial resolution, sensitivity and non-invasiveness compared to conventional FA imaging, OCT-A opens the door for a more detailed evaluation of CNV development in such a model and, thus, enables the analysis of the response to novel therapeutic interventions in longitudinal in vivo studies.


Assuntos
Coagulação com Plasma de Argônio , Corioide/irrigação sanguínea , Corioide/diagnóstico por imagem , Neovascularização de Coroide/diagnóstico por imagem , Retina/cirurgia , Epitélio Pigmentado da Retina/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem , Animais , Neovascularização de Coroide/fisiopatologia , Angiofluoresceinografia , Masculino , Microscopia de Fluorescência , Modelos Animais , Oftalmoscopia , Ratos , Epitélio Pigmentado da Retina/patologia , Vasos Retinianos/patologia , Tomografia de Coerência Óptica
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA