RESUMEN

PURPOSE: This study was performed to assess the prevalence of the vascularized foveal zone, including macular-foveal capillaries (MFC) and congenital retinal macrovessels (CRM), and to analyze the structural characteristics of the macular area in patients with MFC. MATERIAL AND METHODS: The first phase of the study evaluated the prevalence of MFC and CRM. Optical coherence tomography angiography (OCT-A) was performed, and OCT-A images of the foveal avascular zone were analyzed. In the second phase, two groups were formed: the MFC group (12 eyes, 9 patients, mean age 43.8±10.7 years) and the control group (18 eyes, 17 patients, mean age 43.0±11.8 years). A comparative analysis was performed assessing central retinal thickness (CRT), thickness of retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), and foveal pit depth. RESULTS: MFCs were detected in 45 eyes from a total sample of 1031 eyes of 536 patients. The presence of CRM was recorded in three eyes of three patients. RNFL thickness was significantly higher in the MFC group in the inferior parafoveal sector (26.50 [26.00; 29.50] and 24.50 [21.75; 26.50] µm; p=0.022) and in the foveal zone (15.50 [14.00; 16.00] and 12.00 [11.00; 14.00] µm; p=0.017). Additionally, patients with MFC had a higher thickness of GCL and IPL in the fovea, inferior, nasal, and temporal parafoveal sectors. The depth of the foveal pit was significantly lower in the MFC group compared to the control group (83.0 [77.4; 101.6] and 128.0 [107.5; 147.05] µm; p=0.001). CONCLUSION: The prevalence of MFC was 4.36% (calculated per number of eyes), while the prevalence of CRM - 0.29%. The macular area in patients with MFC had increased thickness of the inner retinal layers and decreased depth of the foveal pit, suggesting potential disruption in the natural process of ganglion cell migration and apoptosis during embryogenesis.

Asunto(s)

Fóvea Central , Vasos Retinianos , Tomografía de Coherencia Óptica , Humanos , Fóvea Central/irrigación sanguínea , Fóvea Central/diagnóstico por imagen , Adulto , Femenino , Masculino , Tomografía de Coherencia Óptica/métodos , Prevalencia , Persona de Mediana Edad , Vasos Retinianos/diagnóstico por imagen , Capilares/diagnóstico por imagen , Capilares/patología , Enfermedades de la Retina/epidemiología , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/etiología , Federación de Rusia/epidemiología , Agudeza Visual , Angiografía con Fluoresceína/métodos

RESUMEN

BACKGROUND: To describe Purtscher's and Purtscher-like retinopathy clinical features, etiologies, management options, and visual outcomes. METHODS: Our protocol was registered on PROSPERO [registration number: CRD42023406843]. Seven online databases were searched: PubMed, Scopus, Medline, ScienceDirect, CENTRAL, clinicaltrials.gov, and Google Scholar. Original articles were included if they reported at least one subject diagnosed with Purtscher's or Purtscher-like retinopathy. The primary outcome is to describe the clinical features of Purtscher and Purtscher-like retinopathies, including etiologies, results of related investigations, management lines, and visual outcomes. All analyses were conducted with the use of Statistical Package for Social Sciences (SPSS) version 27 (IBM SPSS Corp, SPSS Statistics ver. 26, USA) and Cochrane's RevMan software. The methodological quality of included studies was assessed using the NIH quality assessment tools. RESULTS: A total of 114 articles were included, describing 168 cases of Purtscher's and Purtscher-like retinopathy. Patients were evenly distributed between males (50.89%) and females (49.11%). Average age of patients was 34.62 years old. Trauma was the leading cause of retinopathy, being reported in 39.88% of our patients, followed by systemic lupus erythematosus (SLE) (13.1%) and acute pancreatitis (11.9%). Bilateral symptoms were reported in 57.7% of patients with centrally blurred vision being the most complained symptom (OS: 34.32% and OD: 18%). 75% of patients elicited bilateral retinal findings. Cotton-wool spots were of highest prevalence (58%). Purtscher flecken was seen in 53% of patients. Macular edema was seen in 13% of patients. Overall, patients had a favorable prognosis (53%). CONCLUSION: Purtscher's and Purtscher-like retinopathies are rare sight-threatening retinopathies that develop most commonly following trauma or other systemic diseases as SLE and acute pancreatitis. Little data is available regarding these conditions, and available data is of low quality. Patients develop bilateral disease in approximately 50% of cases, and several retinal findings are observed, with no specific tendency. Most observed signs are cotton-wool spots in around 55% of patients and Purtscher flecken in 51% of patients. Patients spontaneously recovered, although data is not conclusive. No clear prognostic value of etiological factors is identified, and further research is required in this regard.

Asunto(s)

Enfermedades de la Retina , Humanos , Enfermedades de la Retina/terapia , Enfermedades de la Retina/etiología , Masculino , Femenino , Adulto

Asunto(s)

Fibrilación Atrial , Humanos , Fibrilación Atrial/complicaciones , Masculino , Femenino , Anciano , Accidente Cerebrovascular/etiología , Vasos Retinianos/patología , Vasos Retinianos/diagnóstico por imagen , Factores de Riesgo , Enfermedades de la Retina/etiología , Enfermedades de la Retina/diagnóstico , Persona de Mediana Edad

RESUMEN

The retina is one of the highest metabolically active tissues with a high oxygen consumption, so insufficient blood supply leads to visual impairment. The incidence of related conditions is increasing; however, no effective treatment without side effects is available. Furthermore, the pathomechanism of these diseases is not fully understood. Our aim was to develop an optimal ischemic retinopathy mouse model to investigate the retinal damage in a time-dependent manner. Retinal ischemia was induced by bilateral common carotid artery occlusion (BCCAO) for 10, 13, 15 or 20 min, or by right permanent unilateral common carotid artery occlusion (UCCAO). Optical coherence tomography was used to follow the changes in retinal thickness 3, 7, 14, 21 and 28 days after surgery. The number of ganglion cells was evaluated in the central and peripheral regions on whole-mount retina preparations. Expression of glial fibrillary acidic protein (GFAP) was analyzed with immunohistochemistry and Western blot. Retinal degeneration and ganglion cell loss was observed in multiple groups. Our results suggest that the 20 min BCCAO is a good model to investigate the consequences of ischemia and reperfusion in the retina in a time-dependent manner, while the UCCAO causes more severe damage in a short time, so it can be used for testing new drugs.

Asunto(s)

Modelos Animales de Enfermedad , Proteína Ácida Fibrilar de la Glía , Hipoxia , Isquemia , Retina , Tomografía de Coherencia Óptica , Animales , Ratones , Isquemia/metabolismo , Isquemia/patología , Proteína Ácida Fibrilar de la Glía/metabolismo , Retina/metabolismo , Retina/patología , Hipoxia/metabolismo , Enfermedades de la Retina/metabolismo , Enfermedades de la Retina/patología , Enfermedades de la Retina/etiología , Masculino , Células Ganglionares de la Retina/patología , Células Ganglionares de la Retina/metabolismo , Ratones Endogámicos C57BL , Factores de Tiempo

Asunto(s)

Angiografía con Fluoresceína , Oclusión de la Arteria Retiniana , Síndrome de Susac , Tomografía de Coherencia Óptica , Humanos , Oclusión de la Arteria Retiniana/etiología , Oclusión de la Arteria Retiniana/diagnóstico , Síndrome de Susac/diagnóstico , Síndrome de Susac/complicaciones , Tomografía de Coherencia Óptica/métodos , Angiografía con Fluoresceína/métodos , Femenino , Enfermedad Aguda , Enfermedades de la Retina/etiología , Enfermedades de la Retina/diagnóstico , Adulto , Mácula Lútea/diagnóstico por imagen , Mácula Lútea/patología , Agudeza Visual/fisiología , Masculino

RESUMEN

Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organs and systems. Ocular involvement is estimated to manifest in one-third of individuals with SLE, of which lupus retinopathy and choroidopathy represent the severe subtype accompanied by vision impairment. Advancements in multimodal ophthalmic imaging have allowed ophthalmologists to reveal subclinical microvascular and structural changes in fundus of patients with SLE without ocular manifestations. Both ocular manifestations and subclinical fundus damage have been shown to correlate with SLE disease activity and, in some patients, even precede other systemic injuries as the first presentation of SLE. Moreover, ocular fundus might serve as a window into the state of systemic vasculitis in patients with SLE. Given the similarities of the anatomy, physiological and pathological processes shared among ocular fundus, and other vital organ damage in SLE, such as kidney and brain, it is assumed that ocular fundus involvement has implications in the diagnosis and evaluation of other systemic impairments. Therefore, evaluating the fundus characteristics of patients with SLE not only contributes to the early diagnosis and intervention of potential vision damage, but also holds considerate significance for the evaluation of SLE vasculitis state and prediction of other systemic injuries.

Asunto(s)

Fondo de Ojo , Lupus Eritematoso Sistémico , Humanos , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/diagnóstico , Enfermedades de la Retina/etiología , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/patología , Enfermedades de la Coroides/etiología , Enfermedades de la Coroides/diagnóstico

RESUMEN

Purpose: High altitude retinopathy (HAR) is a retinal functional disorder caused by inadequate adaptation after exposure to high altitude. However, the cellular and molecular mechanisms underlying retinal dysfunction remain elusive. Retinal ganglion cell (RGC) injury is the most important pathological basis for most retinal and optic nerve diseases. Studies focusing on RGC injury after high-altitude exposure (HAE) are scanty. Therefore, the present study sought to explore both functional and morphological alterations of RGCs after HAE. Methods: A mouse model of acute hypobaric hypoxia was established by mimicking the conditions of a high altitude of 5000 m. After HAE for 2, 4, 6, 10, 24, and 72 hours, the functional and morphological alterations of RGCs were assessed using retinal hematoxylin and eosin (H&E) sections, retinal whole mounts, transmission electron microscopy (TEM), and the photopic negative response (PhNR) of the electroretinogram. Results: Compared with the control group, the thickness of the ganglion cell layer and retinal nerve fiber layer increased significantly, RGC loss remained significant, and the amplitudes of a-wave, b-wave, and PhNR were significantly reduced after HAE. In addition, RGCs and their axons exhibited an abnormal ultrastructure after HAE, including nuclear membrane abnormalities, uneven distribution of chromatin in the nucleus, decreased cytoplasmic electron density, widening and vacuolization of the gap between axons, loosening and disorder of myelin sheath structure, widening of the gap between myelin sheath and axon membrane, decreased axoplasmic density, unclear microtubule and nerve fiber structure, and abnormal mitochondrial structure (mostly swollen, with widened membrane gaps and reduced cristae and vacuolization). Conclusions: The study findings confirm that the morphology and function of RGCs are damaged after HAE. These findings lay the foundation for further study of the specific molecular mechanisms of HAR and promote the effective prevention.

Asunto(s)

Modelos Animales de Enfermedad , Electrorretinografía , Ratones Endogámicos C57BL , Microscopía Electrónica de Transmisión , Células Ganglionares de la Retina , Animales , Células Ganglionares de la Retina/patología , Células Ganglionares de la Retina/ultraestructura , Ratones , Masculino , Mal de Altura/fisiopatología , Mal de Altura/patología , Enfermedades de la Retina/fisiopatología , Enfermedades de la Retina/etiología , Enfermedades de la Retina/patología , Altitud , Enfermedad Aguda

RESUMEN

INTRODUCTION: We aimed to analyze the thicknesses of the retinal sublayer and peripapillary retinal nerve fiber layer (pRNFL) in patients with juvenile systemic lupus erythematosus (JSLE) without lupus retinopathy. METHODS: Thirty-six patients with JSLE (36 eyes) and 30 control subjects (30 eyes) were included retrospectively. Demographic data, disease duration, and clinical manifestations were recorded. Optical coherence tomography was used to examine the macula and optic disc. The thicknesses of the retina, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE), and pRNFL were measured. The correlation between the thickness of retina and disease duration, erythrocyte sedimentation rate (ESR) were investigated. RESULTS: The retinal thicknesses of I3 and T3 were thinner in the JSLE group than in the control group (P = 0.019, P = 0.043, respectively). The thicknesses of the I3 and S6 sectors of the GCL decreased significantly (P = 0.013, and P = 0.022, respectively). The thickness of the S6 sector of the IPL was reduced in the JSLE group compared with the control group (P = 0.047). The JSLE group showed significant decrease in the thickness of the central sector of the ONL (P = 0.034). No statistically significant differences in INL, OPL, RPE, and pRNFL thicknesses were found. The retinal thicknesses of I3 (r = -0.386, P = 0.020) and T3 (r = -0.384, P = 0.021) presented negative associations with ESR, but had no significant correlations with disease duration. CONCLUSIONS: Retinal thinning was observed in patients with JSLE without lupus retinopathy, and this change was more pronounced in the inner layer. Key Points • Retinal thinning occurs in JSLE patients without lupus retinopathy. • Changes in retinal thicknesses are related to the ESR.

Asunto(s)

Lupus Eritematoso Sistémico , Retina , Tomografía de Coherencia Óptica , Humanos , Femenino , Lupus Eritematoso Sistémico/complicaciones , Masculino , Adolescente , Retina/diagnóstico por imagen , Retina/patología , Estudios Retrospectivos , Niño , Fibras Nerviosas/patología , Adulto Joven , Estudios de Casos y Controles , Enfermedades de la Retina/diagnóstico por imagen , Enfermedades de la Retina/etiología , Disco Óptico/diagnóstico por imagen , Disco Óptico/patología

RESUMEN

Visible light serves as a crucial medium for vision formation.;however, prolonged or excessive exposure to light is recognized as a significant etiological factor contributing to retinal degenerative diseases. The retina, with its unique structure and adaptability, relies on the homeostasis of cellular functions to maintain visual health. Under normal conditions, the retina can mount adaptive responses to various insults, including light-induced damage. Unfortunately, exposure to intense and excessive light triggers a cascade of pathological alterations in retinal photoreceptor cells, pigment epithelial cells, ganglion cells, and glial cells. These alterations encompass disruption of intracellular REDOX and Ca²âº homeostasis, pyroptosis, endoplasmic reticulum stress, autophagy, and the release of inflammatory cytokines, culminating in irreversible retinal damage. We first delineate the mechanisms of retinal light damage through 4 main avenues: mitochondria function, endoplasmic reticulum stress, cell autophagy, and inflammation. Subsequently, we discuss protective strategies against retinal light damage, aiming to guide research toward the prevention and treatment of light-induced retinal conditions.

Asunto(s)

Autofagia , Luz , Humanos , Luz/efectos adversos , Autofagia/fisiología , Estrés del Retículo Endoplásmico/fisiología , Estrés del Retículo Endoplásmico/efectos de la radiación , Animales , Retina/efectos de la radiación , Degeneración Retiniana/etiología , Degeneración Retiniana/prevención & control , Degeneración Retiniana/metabolismo , Traumatismos por Radiación/prevención & control , Mitocondrias/efectos de la radiación , Mitocondrias/metabolismo , Enfermedades de la Retina/etiología , Enfermedades de la Retina/prevención & control

RESUMEN

Ischemia-induced retinopathy is a hallmark finding of common visual disorders including diabetic retinopathy (DR) and central retinal artery and vein occlusions. Treatments for ischemic retinopathies fail to improve clinical outcomes and the design of new therapies will depend on understanding the underlying disease mechanisms. Histone deacetylases (HDACs) are an enzyme class that removes acetyl groups from histone and non-histone proteins, thereby regulating gene expression and protein function. HDACs have been implicated in retinal neurovascular injury in preclinical studies in which nonspecific HDAC inhibitors mitigated retinal injury. Histone deacetylase 3 (HDAC3) is a class I histone deacetylase isoform that plays a central role in the macrophage inflammatory response. We recently reported that myeloid cells upregulate HDAC3 in a mouse model of retinal ischemia-reperfusion (IR) injury. However, whether this cellular event is an essential contributor to retinal IR injury is unknown. In this study, we explored the role of myeloid HDAC3 in ischemia-induced retinal neurovascular injury by subjecting myeloid-specific HDAC3 knockout (M-HDAC3 KO) and floxed control mice to retinal IR. The M-HDAC3 KO mice were protected from retinal IR injury as shown by the preservation of inner retinal neurons, vascular integrity, and retinal thickness. Electroretinography confirmed that this neurovascular protection translated to improved retinal function. The retinas of M-HDAC3 KO mice also showed less proliferation and infiltration of myeloid cells after injury. Interestingly, myeloid cells lacking HDAC3 more avidly engulfed apoptotic cells in vitro and after retinal IR injury in vivo compared to wild-type myeloid cells, suggesting that HDAC3 hinders the reparative phagocytosis of dead cells, a process known as efferocytosis. Further mechanistic studies indicated that although HDAC3 KO macrophages upregulate the reparative enzyme arginase 1 (A1) that enhances efferocytosis, the inhibitory effect of HDAC3 on efferocytosis is not solely dependent on A1. Finally, treatment of wild-type mice with the HDAC3 inhibitor RGFP966 ameliorated the retinal neurodegeneration and thinning caused by IR injury. Collectively, our data show that HDAC3 deletion enhances macrophage-mediated efferocytosis and protects against retinal IR injury, suggesting that inhibiting myeloid HDAC3 holds promise as a novel therapeutic strategy for preserving retinal integrity after ischemic insult.

Asunto(s)

Histona Desacetilasas , Ratones Endogámicos C57BL , Ratones Noqueados , Animales , Histona Desacetilasas/metabolismo , Histona Desacetilasas/genética , Ratones , Células Mieloides/metabolismo , Fagocitosis/efectos de los fármacos , Enfermedades de la Retina/metabolismo , Enfermedades de la Retina/patología , Enfermedades de la Retina/etiología , Daño por Reperfusión/metabolismo , Daño por Reperfusión/patología , Retina/metabolismo , Retina/patología , Eferocitosis

RESUMEN

High myopia can lead to pathologic myopia and visual impairment, whereas its causes are unclear. We retrospectively researched high myopia cases from patient records to investigate the association between axial elongation and myopic maculopathy. Sixty-four eyes were examined in patients who visited the department between July 2017 and June 2018, had an axial length of 26 mm or more, underwent fundus photography, and had their axial length measured twice or more. The average axial length was 28.29 ± 1.69 mm (mean ± standard deviation). The average age was 58.3 ± 14.4 years old. Myopic maculopathy was categorized as mild (grades 0 and 1) and severe (grades 2, 3, and 4). The severe group had longer axial lengths than the mild group (P < 0.05). Moreover, the severe group exhibited thinner choroidal thickness than the mild group (P < 0.05). When subjects were grouped by axial elongation over median value within a year, the elongation group showed thinner central choroidal thickness than the non-elongation group (142.1 ± 91.9 vs. 82.9 ± 69.8, P < 0.05). In conclusion, in patients with high myopia, the severity of maculopathy correlated with choroidal thickness and axial length. Thinner choroidal thickness was associated with axial elongation based on the baseline axial length.

Asunto(s)

Longitud Axial del Ojo , Coroides , Miopía , Humanos , Femenino , Masculino , Persona de Mediana Edad , Coroides/patología , Coroides/diagnóstico por imagen , Anciano , Estudios Retrospectivos , Longitud Axial del Ojo/patología , Miopía/patología , Miopía/complicaciones , Adulto , Índice de Severidad de la Enfermedad , Tomografía de Coherencia Óptica , Miopía Degenerativa/patología , Agudeza Visual , Enfermedades de la Retina/patología , Enfermedades de la Retina/etiología

RESUMEN

PURPOSE: To analyze the characteristics of optical coherence tomography in acute macular neuroretinopathy (AMN) following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and discuss the prognostic predictors. METHODS: Patients with AMN following SARS-CoV-2 infection were divided into two groups according to the presence or absence of hyperreflective outer nuclear layer (ONL) lesion involving the fovea. RESULTS: The first visit included 14 eyes in the fovea-involved group and 20 eyes in the no fovea-involved group. Ellipsoid zone (EZ) hyporeflection and interdigitation zone (IZ) interruption were detected in all eyes. Other common manifestations were myoid zone (MZ) hyperreflection (76.5%), ONL hyperreflection (73.5%), outer plexiform layer (OPL) thickening (64.7%), and EZ interruption (50%). The follow-up period was 48.4 ± 55.3 days. At the last visit, 12 eyes were in the fovea-involved group and 13 eyes in the no fovea-involved group. IZ interruption was detected in all eyes. Other common manifestations were EZ hyporeflection (92.0%), ONL atrophy (40.0%), OPL thickening (36.0%), OPL linear (32.0%), and MZ hyperreflection (32%). The improvement of visual acuity (VA) was -0.5 ± 0.5 and -0.2 ± 0.4 in the fovea-involved group and the no fovea-involved group, respectively, with a statistically significant difference between them (P = 0.045). Initial VA, initial cotton wool spot, initial ONL cyst, final ONL cyst, and final OPL linear were associated with final VA (P = 0.000, P = 0.029, P = 0.044, P = 0.049, P = 0.049, respectively). CONCLUSIONS: In the early stage of AMN following SARS-CoV-2 infection, IZ interruption and EZ hyporeflection were the most common manifestations, and pathology of IZ was more serious than that of EZ. Subsequently, OPL and ONL atrophied, and ONL atrophied faster. Regardless of whether hyperreflective ONL involved the fovea, VA improved, with a more noticeable improvement found in the fovea-involved group. The presence of initial ONL cyst and initial cotton wool spot, rapid atrophy of OPL, and poorer initial VA indicating poorer VA outcome.

Asunto(s)

COVID-19 , SARS-CoV-2 , Tomografía de Coherencia Óptica , Agudeza Visual , Humanos , Tomografía de Coherencia Óptica/métodos , COVID-19/complicaciones , COVID-19/diagnóstico , Masculino , Femenino , Pronóstico , Adulto , Persona de Mediana Edad , Estudios Retrospectivos , Enfermedad Aguda , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/etiología , Mácula Lútea/patología , Mácula Lútea/diagnóstico por imagen , Estudios de Seguimiento

RESUMEN

Lycium ruthenicum Murray (LR) is a medicine and edible plant in Northwest China, and L. ruthenicum Murray anthocyanins (LRA) are green antioxidants with various pharmacological activities, such as antioxidant and anti-inflammatory activities. However, the protective effect and mechanism of LRA against retinal damage induced by blue light exposure are poorly understood. This study explored the protective effects and potential mechanisms of LRA on retinal damage induced by blue light exposure in vitro and in vivo. The results showed that LRA could ameliorate oxidative stress injury by activating the antioxidant stress nuclear factor-related factor 2 pathway, promoting the expression of phase II detoxification enzymes (HO-1, NQO1) and endogenous antioxidant enzymes (catalase, superoxide dismutase, glutathione peroxidase), and reducing reactive oxygen species and malondialdehyde levels. Additionally, LRA could inhibit inflammatory response by decreasing the expression of blue light exposure-induced nuclear factor-κB (NF-κB) pathway-related proteins (NF-κB and p-IκBα), as well as interleukin (IL)-6, tumor necrosis factor-α, IL-1ß pro-inflammatory factors and pro-inflammatory chemokine VEGF, and increasing the expression of anti-inflammatory factor IL-10. Furthermore, LRA could ameliorate oxidative stress-induced apoptosis by upregulating Bcl-2 and downregulating Bax and Caspase-3 protein expression. All these results indicate that LRA can be used as an antioxidant dietary supplement for the treatment or prevention of retinal diseases.

Asunto(s)

Antocianinas , Antioxidantes , Apoptosis , Luz , Lycium , Estrés Oxidativo , Retina , Lycium/química , Animales , Antocianinas/farmacología , Estrés Oxidativo/efectos de los fármacos , Estrés Oxidativo/efectos de la radiación , Retina/efectos de la radiación , Retina/efectos de los fármacos , Retina/metabolismo , Luz/efectos adversos , Antioxidantes/farmacología , Ratones , Apoptosis/efectos de los fármacos , Apoptosis/efectos de la radiación , Masculino , Extractos Vegetales/farmacología , Especies Reactivas de Oxígeno/metabolismo , FN-kappa B/metabolismo , Sustancias Protectoras/farmacología , Malondialdehído/metabolismo , Antiinflamatorios/farmacología , Superóxido Dismutasa/metabolismo , Enfermedades de la Retina/prevención & control , Enfermedades de la Retina/etiología , Luz Azul

RESUMEN

BACKGROUND: Prior case reports and animal studies have reported on potential ophthalmologic complications of babesiosis, but this issue has not previously been addressed in a cohort of patients with babesiosis. This cross-sectional descriptive pilot study evaluated the retinas of patients with acute babesiosis to determine if retinal abnormalities are a feature of the disease. METHODS: We screened all patients admitted to Yale New Haven Hospital with laboratory confirmed babesiosis during the summer of 2023 and obtained informed consent. Patients were interviewed and underwent pupil dilation and a retinal examination using an indirect ophthalmoscope. Demographic and clinical information were obtained by questionnaire and through chart review. RESULTS: Ten patients underwent retinal eye exams with results that were generally unremarkable. No study patients showed any signs of retinal inflammation, infection, retinal bleeding, retinal tears, or abnormal vessel formation that could be attributed to infection. CONCLUSION: This small study did not find evidence of retinopathy in patients with babesiosis. Further studies with larger populations, repeated exams, and long term follow up will further elucidate the potential small vessel complications of human babesiosis.

Asunto(s)

Babesiosis , Infecciones Parasitarias del Ojo , Enfermedades de la Retina , Humanos , Proyectos Piloto , Babesiosis/complicaciones , Babesiosis/diagnóstico , Estudios Transversales , Masculino , Femenino , Persona de Mediana Edad , Adulto , Enfermedades de la Retina/parasitología , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/etiología , Infecciones Parasitarias del Ojo/parasitología , Infecciones Parasitarias del Ojo/diagnóstico , Anciano , Retina/parasitología , Retina/patología

RESUMEN

Retinopathy and albuminuria are associated with hip fracture risk. We investigated whether these disorders and endothelial dysfunction (which underlies microvascular diseases) were associated with low trabecular bone density. No significant associations were found, suggesting that microvascular diseases are not related to fracture risk through low trabecular bone density. PURPOSE: Microvascular diseases of the eye, kidney, and brain are associated with endothelial dysfunction and increased hip fracture risk. To explore the basis for higher hip fracture risk, we comprehensively examined whether markers of microvascular disease and/or endothelial dysfunction are related to trabecular bone mineral density (BMD), a proximate risk factor for osteoporotic fractures. METHODS: Among 6814 participants in the Multi-Ethnic Study of Atherosclerosis study (MESA), we derived thoracic vertebral trabecular BMD from computed tomography of the chest and measured urine albumin to creatinine ratios (UACR), retinal arteriolar and venular widths, flow mediated dilation (FMD) of the brachial artery after 5 min of ischemia; and levels of five soluble endothelial adhesion markers (ICAM-1, VCAM-1, L-selectin, P-selectin, and E-selectin). Linear regression models were used to examine the association of trabecular BMD with markers of microvascular disease and with markers of endothelial dysfunction. RESULTS: We observed no significant associations of UACR, retinal arteriolar or venular widths, or FMD with BMD. We also observed no statistically significant association of spine trabecular BMD with levels of endothelial adhesion markers. Men and women had largely similar results. CONCLUSION: We conclude that there is little evidence to connect thoracic spine trabecular BMD to microvascular disorders or to endothelial dysfunction among multi-ethnic middle-aged and older adults. Other factors beyond trabecular BMD (e.g., bone quality or predisposition to falling) may be responsible for the associations of microvascular disease with osteoporotic fractures.

Asunto(s)

Albuminuria , Densidad Ósea , Hueso Esponjoso , Endotelio Vascular , Vértebras Torácicas , Humanos , Femenino , Masculino , Densidad Ósea/fisiología , Anciano , Persona de Mediana Edad , Endotelio Vascular/fisiopatología , Hueso Esponjoso/fisiopatología , Hueso Esponjoso/diagnóstico por imagen , Albuminuria/fisiopatología , Vértebras Torácicas/fisiopatología , Vértebras Torácicas/diagnóstico por imagen , Anciano de 80 o más Años , Fracturas Osteoporóticas/fisiopatología , Fracturas Osteoporóticas/etiología , Tomografía Computarizada por Rayos X/métodos , Biomarcadores/sangre , Osteoporosis/fisiopatología , Osteoporosis/etnología , Enfermedades de la Retina/fisiopatología , Enfermedades de la Retina/etiología , Enfermedades Vasculares/fisiopatología

Asunto(s)

Enfermedades de la Coroides , Humanos , Enfermedades de la Coroides/diagnóstico , Enfermedades de la Coroides/etiología , Enfermedades de la Coroides/patología , Enfermedades de la Retina/diagnóstico , Enfermedades de la Retina/patología , Enfermedades de la Retina/etiología , Tomografía de Coherencia Óptica , Coroides/patología , Coroides/diagnóstico por imagen , Masculino , Femenino , Angiografía con Fluoresceína , Mácula Lútea/patología , Mácula Lútea/diagnóstico por imagen

RESUMEN

BACKGROUND: To report a case of Multiple Evanescent White Dot Syndrome (MEWDS) one month after a COVID-19 infection in a female patient at an age unusual for the occurrence of this disease. CASE PRESENTATION: A 69-year-old Caucasian female reported the presence of floaters, photopsia, and enlarging vision loss in her left eye following the COVID-19 infection. Clinical and multimodal imaging was consistent with the MEWDS diagnosis. Fluorescein angiography examination revealed characteristic hyperfluorescent spots around the fovea in a wreath-like pattern. An extensive lab workup to rule out other autoimmune and infectious etiologies was inconclusive. Visual acuity and white dots resolved after a course of corticosteroids, which was confirmed on follow-up dilated fundus exam and multimodal imaging. CONCLUSIONS: MEWDS is a rare white dot syndrome that may occur following COVID-19 infection in addition to other reported ophthalmic disorders following this infection.

Asunto(s)

COVID-19 , Angiografía con Fluoresceína , Humanos , Femenino , COVID-19/complicaciones , Anciano , SARS-CoV-2 , Tomografía de Coherencia Óptica , Síndromes de Puntos Blancos , Agudeza Visual , Enfermedades de la Retina/virología , Enfermedades de la Retina/etiología , Trastornos de la Visión/etiología , Trastornos de la Visión/virología

RESUMEN

BACKGROUND: Posterior movement of ocular tissue secondary to orbital cavernous venous malformation shrinkage from fractionated stereotactic radiotherapy can allow healthy structures to move into the radiation field during treatment. This may carry an increased risk of radiation-induced retinopathy. METHODS: We present a case of a young female whose radiotherapy treatment for an orbital cavernous venous malformation resulted in a 3 mm reduction in proptosis and subsequent retinopathy. RESULTS: The severity of the patient's radiation-induced radiotherapy exceeded expectations. The venous malformation shrinkage during treatment and ensuing posterior movement of the globe suggested an increased involvement of ocular tissue in the radiation field, prompting consideration of interval neuroimaging and tumour mapping. CONCLUSIONS: We describe and suggest a protocol of onboard neuroimaging during the radiation therapy course to better target tumour volumes and minimise collateral tissue damage. To our knowledge, this has not been previously described in the ophthalmic literature.

Asunto(s)

Imagen por Resonancia Magnética , Traumatismos por Radiación , Radiocirugia , Enfermedades de la Retina , Humanos , Femenino , Radiocirugia/efectos adversos , Enfermedades de la Retina/etiología , Enfermedades de la Retina/diagnóstico , Traumatismos por Radiación/diagnóstico , Traumatismos por Radiación/etiología , Neoplasias Orbitales/radioterapia , Adulto , Fraccionamiento de la Dosis de Radiación , Órbita/irrigación sanguínea , Órbita/diagnóstico por imagen , Exoftalmia/etiología , Exoftalmia/diagnóstico

RESUMEN

To define the characteristics of fundus manifestations in patients after SARS-CoV-2 infection with multimodal imaging techniques. This is a retrospective multicenter and multimodal imaging study including 90 patients. All patients with a visual complaint occurring immediately after SARS-CoV-2 infection were referred to six clinics between December 2022 and February 2023. Demographic information and the temporal relationship between SARS-CoV-2 infection and visual symptoms were documented. The characteristics of the fundus lesions were evaluated using multimodal imaging. Ninety patients from six hospitals were included in this study, including 24 males (26.67%) and 66 (73.33%) females. Seventy-eight patients (86.66%) (146 eyes) were diagnosed with Acute Macular Neuroretinopathy (AMN). The AMN patients were primarily young women (67.95%). Sixty-eight patients (87.18%) had AMN in both eyes. Thirty-eight eyes (24.36%) included Purtscher or Purtscher-like lesions. optical coherence tomography and infrared retinal photographs can show AMN lesions well. Eleven cases were diagnosed with simple Purtscher or Purtscher-like retinopathy (2 cases, 2.22%), Vogt‒Koyanagi‒Harada (VKH) syndrome or VKH-like uveitis (3 cases, 3.33%), multiple evanescent white-dot syndrome (MEWDS) (2 cases, 2.22%), and rhino-orbital-cerebral mucormycosis (ROCM) (5 cases, 5.56%). After SARS-CoV-2 infection, diversified fundus lesions were evident in patients with visual complaints. In this report, AMN was the dominant manifestation, followed by Purtscher or Purtscher-like retinopathy, MEWDS, VKH-like uveitis, and ROCM.

Asunto(s)

COVID-19 , Fondo de Ojo , Imagen Multimodal , SARS-CoV-2 , Tomografía de Coherencia Óptica , Humanos , COVID-19/diagnóstico por imagen , COVID-19/complicaciones , Masculino , Femenino , Adulto , Imagen Multimodal/métodos , Estudios Retrospectivos , Persona de Mediana Edad , Tomografía de Coherencia Óptica/métodos , SARS-CoV-2/aislamiento & purificación , Adulto Joven , Adolescente , Anciano , Enfermedades de la Retina/diagnóstico por imagen , Enfermedades de la Retina/etiología , Niño

RESUMEN

We present a case of diagnostic interest; we present the differential diagnosis and the complementary tests necessary to reach it, in addition to highlighting the importance of a correct collection of background and clinical history. A 54-year-old woman with a history of carcinoma of the floor of the mouth treated with radiotherapy and chemotherapy develops ischemic retinopathy. It was necessary to perform a systemic study and differential diagnosis with entities such as ocular ischemic syndrome and radiation retinopathy, due to the similarity in the clinical findings found. Radiation retinopathy should be ruled out in any patient with visual impairment and a history of radiotherapy treatment. A broad differential diagnosis and systemic study are required to rule out entities such as ocular ischemic syndrome and diabetic retinopathy, in addition to early treatment to avoid possible complications.

Asunto(s)

Isquemia , Traumatismos por Radiación , Enfermedades de la Retina , Humanos , Femenino , Persona de Mediana Edad , Traumatismos por Radiación/etiología , Traumatismos por Radiación/diagnóstico , Traumatismos por Radiación/complicaciones , Isquemia/etiología , Isquemia/diagnóstico , Diagnóstico Diferencial , Enfermedades de la Retina/etiología , Enfermedades de la Retina/diagnóstico , Síndrome , Angiografía con Fluoresceína