Vitreo-retinal interface changes on optical coherence tomography in the fellow eyes of patients with macular hole

AIM:To study the vitreo-retinal interface and macular changes on optical coherence tomography(OCT) in the fellow eyes of patients with macular hole.·METHODS:Patients with idiopathic macular hole in one or both eyes presented to our institute between January 2003 and December 2009 were evaluated retrospectively.Demographic details,best-corrected visual acuity and vitreo-retinal interface,and macular changes of the fellow eye on OCT were studied.·RESULTS:Seventy patients underwent OCT of both eyes during the study period.The average age group was 61.96 years and 35(50%) were females.Among the fellow eyes,normal foveal contour was noted in 36(51.4%) eyes and 34(48.6%) eyes were observed to have vitreo-retinal interface changes.Of them,13(18.6%) eyes had some stage of full thickness macular hole and 21(30.0%) eyes had interface changes.There was no statistical correlation between involved eye lesions(P =0.64) or visual acuity(P =0.55) as predictors of development of either fellow eye lesions or poor visual acuity.·CONCLUSION:There is a significant chance of having vitreo-retinal interface findings in the fellow eyes of patients presenting with macular hole.OCT should be considered in both eyes of patients with macular hole to detect early changes in the fellow eyes,which may require an early intervention.

Retinal circulation and its role in macular disorders in patients without systemic disease

AIM: To determine whether retinal circulatory changes play a role in the pathogenesis of macular disorders in patients who are otherwise healthy. METHODS: Patients with macular disorders that required angiographic imaging were included in this prospective case series. After a complete ocular exam,fluorescein angiography was performed using a standardized technique on the HRA-II(Heidelberg Engineering, Heidelberg, Germany) with special focus on the posterior pole. Only patients with good quality images were included in the analysis. Circulatory parameters recorded included the arm-choroid time,choroid-retinal artery, and finally the retinal artery-vein time. Zonal asymmetry(between the upper and lower zones divided by a line passing through the centre of the fovea) in transit times, if any was also noted. Appropriate statistical analysis was done. Circulation times were compared with age matched historical controls. Changes in retinal dye transit times relative to historical age matched controls, if any, were noted and compared between various disorders.RESULTS: A total of 156 eyes of 156 patients(120 males)were included in the study. Mean age: 49.14 ±14.93 y.Macular disorders studied were age related degeneration,polypoidal vasculopathy, central serous chorioretinopathy(CSCR) and parafoveal telangiectasia. Delayed circulation time was noted in CSCR patients only.CONCLUSION: CSCR patients appear to have delayed arterial filling, retinal circulatory disturbances do not seem to contribute to the pathogenesis of other macular disorders.

Delivery strategies for CRISPR/Cas genome editing tool for retinal dystrophies:challenges and opportunities

CRISPR/Cas,an adaptive immune system in bacteria,has been adopted as an efficient and precise tool for site-specific gene editing with potential therapeutic opportunities.It has been explored for a variety of applications,including gene modulation,epigenome editing,diagnosis,mRNA editing,etc.It has found applications in retinal dystrophic conditions including progressive cone and cone-rod dystrophies,congenital stationary night blindness,X-linked juvenile retinoschisis,retinitis pigmentosa,age-related macular degeneration,leber’s congenital amaurosis,etc.Most of the therapies for retinal dystrophic conditions work by regressing symptoms instead of reversing the genemutations.CRISPR/Cas9 through indel could impart beneficial effects in the reversal of gene mutations in dystrophic conditions.Recent research has also consolidated on the approaches of using CRISPR systems for retinal dystrophies but their delivery to the posterior part of the eye is a major concern due to high molecular weight,negative charge,and in vivo stability of CRISPR components.Recently,non-viral vectors have gained interest due to their potential in tissue-specific nucleic acid(miRNA/siRNA/CRISPR)delivery.This review highlights the opportunities of retinal dystrophies management using CRISPR/Cas nanomedicine.

Inflammatory choroidal neovascularization after tubercular posterior scleritis

A 45-year-old female presented with typical features of posterior scleritis in her left eye with visual acuity of 20/252. After treatment with oral steroids and immunosuppressive drugs, at 2 months follow-up, posterior scleritis resolved and visual acuity improved to 20/50. Five months later she presented with vision loss(20/160) associated with active choroidal neovascular membrane(CNVM) close to scar. Significant choroidal thinning(subfoveal choroidal thickness =137 microns), compared to fellow eye(subfoveal choroidal thickness =247 microns) was noted. Two doses of intravitreal bevacizumab(IVB) were given at 1 month interval. At 9 months follow-up, her visual acuity was maintained at 20/160 with scarred CNVM. In conclusion, IVB is safe and efficacious in treatment of inflammatory CNVM secondary to posterior scleritis. Choroidal changes after posterior scleritis could be contributory factor for formation of CNVM.

Cell proliferation and apoptosis in optic nerve and brain integration centers of adult trout Oncorhynchus mykiss after optic nerve injury

Fishes have remarkable ability to effectively rebuild the structure of nerve cells and nerve fibers after central nervous system injury.However,the underlying mechanism is poorly understood.In order to address this issue,we investigated the proliferation and apoptosis of cells in contralateral and ipsilateral optic nerves,after stab wound injury to the eye of an adult trout Oncorhynchus mykiss.Heterogenous population of proliferating cells was investigated at 1 week after injury.TUNEL labeling gave a qualitative and quantitative assessment of apoptosis in the cells of optic nerve of trout 2 days after injury.After optic nerve injury,apoptotic response was investigated,and mass patterns of cell migration were found.The maximal concentration of apoptotic bodies was detected in the areas of mass clumps of cells.It is probably indicative of massive cell death in the area of high phagocytic activity of macrophages/microglia.At 1 week after optic nerve injury,we observed nerve cell proliferation in the trout brain integration centers：the cerebellum and the optic tectum.In the optic tectum,proliferating cell nuclear antigen（PCNA）-immunopositive radial glia-like cells were identified.Proliferative activity of nerve cells was detected in the dorsal proliferative（matrix） area of the cerebellum and in parenchymal cells of the molecular and granular layers whereas local clusters of undifferentiated cells which formed neurogenic niches were observed in both the optic tectum and cerebellum after optic nerve injury.In vitro analysis of brain cells of trout showed that suspension cells compared with monolayer cells retain higher proliferative activity,as evidenced by PCNA immunolabeling.Phase contrast observation showed mitosis in individual cells and the formation of neurospheres which gradually increased during 1–4 days of culture.The present findings suggest that trout can be used as a novel model for studying neuronal regeneration.

前房内注射全氟丙烷(C_3F_8)气体治疗急性角膜水肿

Purpose: To report a case of acute hydrops with intrastromal cleft in a patient of keratoconus with associated Marfan’ s syndrome, treated with intracameral injection of perfluoropropane (C3F8) gas. Design: Interventional case report. Methods: A nonexpansile concentration of perfluoropropane gas (0.2 ml)- was injected intracamerally in the operating room under aseptic precautions. Results: There was complete and rapid resolution of corneal edema. Conclusion: Intracameral perfluoropropane gas in nonexpansile concentrationmay be a useful modality for treatment of corneal edema in acute corneal hydrops.

NATURAL HISTORY OF OCCLUDABLE ANGLES AND PRIMARY ANGLE CLOSURE - KEY TO TREATMENT

Purpose: To report the 5 year progression of occludable angles to primary angle closure (PAC) and PAC to primary angle closure glaucoma (PACG) in a south Indian population. Material and Methods: All persons between 30 and 60 years of age, residing in 12 randomly chosen clusters representing Vellore town were invited for an ophthalmic examination in 1995. 972 of

Neurodegeneration in branch retinal vein occlusion

One of the most common forms of visual impairment and reduction in overall visual acuity is branch retinal vein occlu- sion （BRVO）, second only to diabetic retinopathy （Rogers et al., 2010; Sun et al., 2013）. Unlike central retinal vein occlusion （CRVO） which is a similar macular disease, BRVO is extremely more prevalent and generally only affects a smaller portion of the retina （Osborne et al., 2004） due to the nature of the dis- ease.

Hydrogen Sulfide in Proliferating and Differentiated Cells in Primary Cultures of Juvenile Brain of Masu Salmon <i>Oncorhynchus masou</i>

Analysis of proliferative activity and the ability to neuron differentiation was performed in cultured cells of the brain and spinal cord of juvenile masu salmon Oncorhynchus masou. Proliferating cell nuclear antigen (PCNA) was used as a proliferative marker, while the markers of neuronal differentiation—a neuron protein HuCD, and a neuron-specific transcriptional factor with two DNA- binding sites Pax6—detected neurons. The results showed that cell proliferation occurred mainly in the suspension cell fraction. In monolayer, a few cells were only found to express PCNA. The results of morphological and immunohistochemical analysis allow us to conclude that proliferative activity in primary cultures from the O. masou brain is mainly connected with the suspension fraction of small cells. In contrast, a positive correlation between the cells expressing cystathionine β-synthase (CBS), a marker of H2S synthesis, and the cells expressing PCNA in the monolayer, indicates the participation of H2S in proliferative activity of neurons in primary cultures. The data obtained suggest that the hydrogen sulphide is also involved in the process of differentiation.

局限性脉络膜血管瘤光动力治疗后持续性脉络膜肥厚

A 19-year-old man presented with blurred vision in the right eye,which was diagnosed as a circumscribed choroidal hemangioma. The choroidal thickening on B-scan ultrasonography persisted after receiving repeat photodynamic therapy with verteporfin,although there was regression of the tumor.

2个患严重颗粒状角膜营养不良的印度家系中基因-表型间的关系

Objectives: To determine genotypes in 2 Indian families with severe granular corneal dystrophy, to document clinical and histopathologic features, and to attempt a genotype-phenotype correlation. Methods: Mutation analysis of exon 12 of the TGFBI gene was carried out in 9 individuals from 2 families. Results: A C→ T mutation at residue 1710 of TGFBI complementary DNA, corresponding to an Arg555Trp mutation in keratoepithelin, was found in affected members of both families. In 5 patients, this mutation was homozygous, and it was heterozygous in the other 4. Clinical examination revealed a severe form of granular corneal dystrophy with early onset and superficial lesions in the homozygous individuals and a milder phenotype in the heterozygous individuals. Histopathologic evaluation of corneal specimens from 2 homozygous patients confirmed the presence of superficial granular deposits. Conclusions: To our knowledge, this is the first molecular and clinical characterization of severe granular corneal dystrophy in India. Genotype-phenotype correlation and comparison with earlier reports on this entity highlight the uniform expressivity of the Arg555Trp allele in homozygous individuals. Clinical Relevance: Homozygous granular corneal dystrophy has a severe phenotype and can be recognized based on clinical and histopathologic features, especially in association with consanguinity or inbreeding.