Effect of autologous growth factors on apoptosis and thickness of the outer nuclear layer in an experimental retinal degeneration model.

Retinal pigment epithelium and photoreceptor cells are a microenvironment where 90 different peptides are synthesized for transduction, visual cycle, intracellular electron transport chain, and removal of metabolic wastes. Depending on the inheritance pattern, either mutant proteins accumulate inside the cells or the energy cycle is disrupted. Disruption of homeostasis causes the cells to switch to the dormant phase; if the improper conditions last longer, then apoptosis eventually develops resulting in a loss of visual function. In neural tissues, growth factors such as neural growth factor, brain-derived neurotrophic factor, ciliary neurotrophic factor, and insulin-like growth factor are regulatory peptides for intracellular energy cycle and intracellular digestion. In this study, it has been shown histopathologically that autologous growth factors can prevent apoptosis and prevent loss of outer retinal thickness in the retinal degeneration model created with sodium iodate.

The Diagnostic Value of Ultrasound Biomicroscopy in Anterior Segment Diseases.

Objectives: The purpose of this study was to analyze the use of ultrasound biomicroscopy (UBM) in the diagnosis and follow-up anterior segment diseases. Materials and Methods: The records of patients who presented to our clinic for UBM between January 1, 2004, and December 31, 2018 were reviewed retrospectively. Demographic characteristics, indications for UBM imaging and findings of the patients were recorded. Also, the change in clinical indications over the years were analyzed. Results: The study included 1.256 eyes of 917 patients, of whom 723 (57.6%) were female and 533 (42.4%) were male. The mean age was 48.7±14.8 years (range: 12-85 years). Indications for UBM imaging were to evaluate glaucoma pathogenesis and surgical outcomes (n=764, 60.8%), iris and ciliary body masses (n=263, 20.9%), congenital anomalies of the crystalline lens and complications of cataract surgery (n=86, 6.8%), the etiology of hypotony (n=57, 4.5%), corneal diseases (n=46, 3.7%), anterior segment findings after trauma (n=22, 1.8%), conjunctival pathologies (n=11, 0.9%), and scleral pathologies (n=7, 0.6%). In patients with glaucoma, the most common reason for requesting UBM according to years was to investigate the plateau iris configuration. Conclusion: UBM is an important imaging method used in the determination of the pathophysiology of anterior segment diseases, clinical evaluation, planning of surgical treatment and analyzing the outcomes.

The Final Diagnosis: Retinoblastoma or Pseudoretinoblastoma.

PURPOSE: To review the authors' experience in the diagnosis of retinoblastoma and to explore the frequency of intraocular conditions that mimic this malignancy according to patient age at presentation. METHODS: This was a retrospective observational study including 549 patients (769 eyes) who were referred for confirmation and/or management of retinoblastoma between October 1998 and June 2019 at a single tertiary center. A detailed ocular examination was done by the same ocular oncologist under general anesthesia for every patient. RESULTS: Of 549 patients referred for diagnostic confirmation or management of retinoblastoma, 393 (71.6%) patients were found to have retinoblastoma and 156 (28.4%) patients received the diagnosis of pseudoretinoblastoma. The mean patient age at presentation was 52.1 months, ranging from 1 to 276 months. The most common diagnoses among patients with pseudoretinoblastoma younger than 1 year were persistent fetal vasculature (PFV) (n = 19; 28.8%), Coats disease (n = 7; 10.6%), chorioretinal coloboma (n = 4; 6.1%), retinal dysplasia (n = 4; 6.1%), and retinal detachment (n = 4; 6.1%). In patients with pseudoretinoblastoma who were 1 to 5 years old, the most common diagnoses were Coats disease (n = 10; 25.6%), PFV (n = 7; 17.9%), and optic disc hypoplasia (n = 3; 7.7%). Patients older than 5 years were most likely to have Coats disease (n = 8; 15.7%), optic disc drusen (n = 5; 9.8%), retinopathy of prematurity (n = 4; 7.8%), and combined hamartoma (n = 4; 7.8%). CONCLUSIONS: This study shows that 28.4% of patients referred for suspicion or management of retinoblastoma were classified as having pseudoretinoblastoma. The most common conditions causing diagnostic confusion with retinoblastoma included PFV and Coats disease, similar to previous publications from both high-and low-income countries. [J Pediatr Ophthalmol Strabismus. 2021;58(3):161-167.].

Systematized Epidermal Nevus Syndrome Involving the Upper and Lower Eyelids Bilaterally

A 29-year-old woman presented with dark-colored raised lesions on both eyelids since early childhood. Ophthalmological examination revealed pigmented verrucous lesions on her upper and lower eyelids bilaterally. The patient had a history of generalized tonic-clonic seizures. Dermatological examination revealed hyperpigmented verrucous plaques arranged along lines of Blaschko on the neck, trunk, and arms. On the basis of these findings, the diagnosis of epidermal nevus syndrome (ENS) was made. She had surgery for debulking of the lesions. Histological analysis revealed hyperkeratosis with foci of parakeratosis, acanthosis, and papillomatosis, consistent with linear verrucous epidermal nevus. Postoperative residual lesions did not respond to oral acitretin therapy (10 mg/kg/day for 2 months). Systematized ENS can rarely cause linear verrucous nevi on the upper and lower eyelids on both sides. These patients should be investigated for accompanying systemic anomalies and followed for potential malignant transformation of the skin lesions.

Comparison of Morphological Features of Type 1 CNV in AMD and Pachychoroid Neovasculopathy: An OCTA Study.

BACKGROUND AND OBJECTIVE: The purpose of this study is to compare the morphological features of type 1 choroidal neovascularization (CNV) in eyes with age-related macular degeneration (AMD) and pachychoroid neovasculopathy (PNV) using optical coherence tomography angiography (OCTA). PATIENTS AND METHODS: Nineteen eyes of 17 patients with PNV and 30 eyes of 30 patients with AMD were evaluated. The size and area of CNV and morphological patterns during a 6-month period were analyzed using optical coherence tomography angiography. RESULTS: The presence of a feeder vessel was more common in AMD than in PNV. Indistinct pattern was more common in PNV than AMD. Pruned vascular tree pattern was rare in PNV eyes during follow-up. The mean size and flow of selected CNV area was significantly smaller in PNV group. CONCLUSION: This study demonstrated that type 1 CNVs in the PNV group is characterized by a smaller area. Morphologic pattern differences between them might be explained by different etiopathogenesis under these circumstances. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:640-647.].

Microvascular Changes Associated with Optic Disc Drusen: Case Report

Optic disc drusen (ODD) is an important clinical entity that is sometimes misdiagnosed as papilledema because of elevated and blurred disc margins. A 17-year-old male who presented with headaches underwent detailed ophthalmological examination as well as colored fundus photography, B-scan ultrasonography (USG), fundus autofluorescence (FAF), optical coherence tomography (OCT), optical coherence tomography angiography (OCTA), and visual field testing. His visual acuity was 10/10 in both eyes. Fundus examination revealed bilateral blurred and elevated optic disc margins. Diagnosis of bilateral ODD was confirmed with B-scan USG. FAF imaging revealed hyperautofluorescent areas on both optic discs. Optic nerve head OCT scans showed elevated irregular disc borders and thinning of the retinal nerve fiber layer in both eyes. On visual field testing, loss of the nasal visual field was detected in the left eye. OCTA imaging showed focal capillary dropout, especially in the nasal peripapillary area, in both eyes and reduced peripapillary and macular vessel density. In this case report, we evaluated the clinical findings and the structural features of bilateral ODD with multimodal imaging modalities including OCTA.

Multimodal Imaging in Pachychoroid Neovasculopathy: A Case Report.

Pachychoroid neovasculopathy (PNV) is a form of type 1 neovascularization characterized by dilated choroidal vessels in areas of increased choroidal thickness. In this article, we describe a patient diagnosed with PNV. A 50-year-old male with a 2-month history of blurred vision was referred to our clinic. His best corrected visual acuity was 20/100 in both eyes. Retinal pigment epithelium alterations, which were more prominent in fundus autofluorescence, were detected in both eyes on dilated fundus examination. Characteristic findings of PNV were detected in fundus fluorescein angiography, indocyanine green angiography, spectral domain optical coherence tomography, and optical coherence tomography angiography.