AbstractBackground:To compare the proportion of rhegmatogenous retinal detachment associated with choroidal detachment (RRDCD) in the emergency surgery group with the routine inpatient surgery group and determine risk factors for RRDCD. Methods:A total of 694 patients (eyes) diagnosed with rhegmatogenous retinal detachment (RRD) in the emergency surgery group were included from the Department of Ophthalmic Emergency, and 692 patients (eyes) in the routine inpatient surgery group were selected randomly from the Ocular Fundus Department. Demographics, refractive status, macular status, lens status, extent of retinal detachment, number of retinal breaks, duration of symptoms before surgery, and the incidence of RRDCD were compared. A logistic regression analysis was used to determine potential risk factors for RRDCD. Results: Compared to the routine inpatient surgery group, the emergency surgery group had a significant less median time to surgery (P < 0.001) and a decreased proportion of RRDCD (2.88% vs. 10.84%, P < 0.001). Logistic regression analysis revealed that a prolonged duration of RRD [OR 3.51, 95% CI (1.98-6.23)], pseudophakia/aphakia status [OR 2.74, 95% CI (1.50-4.98)], multiple retinal breaks [OR 1.67, 95% CI (1.03-2.70)], and a substantial extent of RRD [OR 11.58, 95% CI (7.12-18.84)] were independent risk factors for RRDCD. Conclusions: Emergency surgical pattern of RRD demonstrated a lower incidence of RRDCD. The adoption of an expedited surgical approach has the potential to reduce the duration of RRD, possibly correlating with a decreased risk of RRDCD development.
Retinal ischemia/reperfusion (I/R) is one of the most common pathologies of many vision-threatening diseases and is caused by blood-retinal barrier (BRB) breakdown and the resulting inflammatory infiltration. Targeting BRB is promising for retinal I/R treatment. Mesenchymal stromal cells (MSCs) are emerging as novel therapeutic strategies. Although intravitreal injection targets the retina, the restricted number of injected cells still requires the precise biodistribution of MSCs near the injury site. Here, we found that retinal I/R led to BRB breakdown, which induced protein and cell leakage from the circulation. Retinal cell death and diminished visual function were subsequently detected. Moreover, the expression of the chemokine CCL5 increased after retinal I/R, and CCL5 colocalized with the BRB. We then overexpressed CCR5 in human induced pluripotent stem cell-derived MSCs (iMSCs). In vivo, intravitreal-injected iMSCCCR5 preferentially migrated and directly integrated into the BRB, which preferably restored BRB integrity and eventually promoted retinal function recovery after retinal I/R. In summary, our work suggested that iMSCs act as biopatches for BRB preservation and that iMSC-based therapy is a promising therapeutic approach for retinal diseases related to I/R.
Purpose: To study the morphology of the posterior lens cortex and posterior capsules (PCs) in pediatric patients with posterior lens opacities using intraoperative optical coherence tomography (iOCT). Setting: Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. Design: Prospective observational study. Methods: Pediatric patients with posterior lens opacities were imaged using iOCT during cataract surgery. The morphology of the posterior lens cortex and PC, along with the common patterns to indicate PC integrity, was assessed. Moreover, PC rent during surgery was observed. Results: A total of 62 eyes from 53 patients were included. The mean age of patients was 3.8 years. 4 morphological variants of posterior lens opacity were observed: type I (34/62 [54.8%]) with an intact PC; type II (20/62 [32.3%]) with an intact PC, which protruded into the anterior vitreous; type III (3/62 [4.8%]) with a deficient PC and an inability to delineate the PC; and type IV (5/62 [8.1%]) with dense opacity and an inability to characterize the posterior cortex and PC. Phacoemulsification could be performed in types I and II. In types III and IV, manual nucleus removal was performed instead of phacoemulsification. 3 cases (100%) of type III PC dehiscence developed during surgery, whereas no cases developed PC dehiscence of other types. Conclusions: The morphology of the PC and posterior lens cortex in pediatric posterior lens opacities could be categorized, and PC integrity could be assessed using iOCT, which was useful to guide surgical strategies and increase safety in pre-existing PC dehiscence in pediatric cataract surgery.
Purpose: To assess the accuracy of swept-source optical coherence tomography (SS-OCT) in detecting complete posterior vitreous detachment (PVD) in comparison with intraoperative findings. Methods: The retrospective study included 145 eyes of 145 consecutive patients who underwent surgery for epiretinal membranes or macular holes. Within a week prior to surgery, PVD status was evaluated by SS-OCT with a depth of field of 3 mm and a capture window of 16 × 8 mm. Complete PVD was identified when the hyaloid condensation was visible clearly on any B-scan or when the vitreous cortex reflectivity was not visible on all 33 B-scans. Sensitivity, specificity, positive predictive value, and negative predictive value of SS-OCT for detection of complete PVD were then compared with those evaluated during a triamcinolone acetonide-assisted vitrectomy. Results: Of the 101 eyes diagnosed as complete PVD by SS-OCT preoperatively, 97 eyes were found to have complete PVD and four eyes were found to have attached vitreous intraoperatively. Of the 44 eyes categorized as attached vitreous by SS-OCT preoperatively, 43 eyes were graded as attached vitreous and one eye was graded as complete PVD during surgery. The sensitivity of SS-OCT for detecting complete PVD was 99.0% and the specificity was 91.5%. The positive predictive value and the negative predictive value were 96.0% and 97.7%, respectively. Conclusions: Widefield (16 × 8 mm) SS-OCT showed high accuracy for the diagnosis of complete PVD in patients with epiretinal membranes or macular holes. Translational Relevance: Widefield SS-OCT has great potential to evaluate PVD status preoperatively and explore the mechanisms of vitreoretinal diseases.
The enhancer of zeste homolog 2 (EZH2) is a member of the polycomb repressive complex 2 (PRC2) and is important in cell-cycle regulation. Increased expression of EZH2 has been reported in retinoblastoma (RB). The aim of the study was to determine EZH2 expression, compare this with clinicopathological parameters in RB, and assess its relationship with tumor cell proliferation.Ninety-nine retrospective cases of enucleated RB were included in the present study. Expression of EZH2 and the marker of cell proliferation, Ki67, were investigated by immunohistochemistry.Among the 99 cases of RB in this study, EZH2 was found highly expressed (positive expression rate ≥70%) in 92 cases. EZH2 was expressed in tumor cells but absent in normal retinal tissues. The expression of EZH2 was positively linked to Ki67 expression (r = 0.65, p < 0.001).Elevated EZH2 expression was found in most RB cases, indicating that EZH2 could be a potential therapeutic target for RB.
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