scholarly journals Anatomic and Topographic Vitreous and Vitreoretinal Interface Features in Proliferative Diabetic Vitreoretinopathy

2020 ◽  
Vol 17 (2) ◽  
pp. 249-257
Author(s):  
N. M. Kislitsyna ◽  
S. V. Novikov ◽  
S. V. Kolesnik ◽  
A. I. Kolesnik ◽  
M. P. Veselkova
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Imaging Techniques ◽  
Posterior Vitreous Detachment ◽  
Vitreous Body ◽  
Diabetic Patients ◽  
Vitreoretinal Interface ◽  
Posterior Cortex ◽  
Vitreous Cortex

The role of the vitreous body and vitreomacular interface (VMI) is key in many processes including proliferative diabetic retinopathy (PDR). In PDR patients, the VMI changes can significantly influence the emergence and progression of the disease. There are multiple factors at work in the VMI including taut posterior cortical layers, vitreoschisis, posterior vitreous detachment (PVD), and vitreous adhesions. But there is no general consensus about their role in proliferative complications. Further understanding the VMI relationship in a case of PDR is warranted in order to design better treatments, to arrest and possibly even reverse progression of PDR.  Today there is no imaging techniques to determine normal vitreous and VMI interactions in different PDR stages intraoperatively. Purpose: to analyze intraoperative vitreous and vitreoretinal interface features during chromovitrectomy in patients with A-C stages of PDR. Patients and methods. Seventy-four diabetic patients (74 eyes) were included. We performed standard 25 Gauge pars plana vitrectomy using Vitreocontrast for vitreous and vitreoretinal interface (VRI) visualization. Intravitreal “Vitreocontrast” suspension is the most favored agent of those studied and it is increasingly used as an adjunct during surgery to delaminate fine tissue planes and pockets of formed vitreous and VRI structures that may not be visible with routine operative illumination systems, or using modern vital dyes. Results. “Vitreocontrast” suspension allows to visualize posterior cortex changes during different stages of PDR. We investigated vitreous and VRI anatomy, topography and structure and determined safety of retrociliary and equatorial cisterns walls in 97 % in stage A of PDR, 95 % in stage B and in 82 % of stage C. In 3–5–18 % cases, correspondently, we determined disorganization of some vitreous cisterns. In 94 % cases of PDR A and 96 % cases of PDR B we visualized preretinal vitreous layer in a central macular zone, within the boundaries of vascular arcades. It has specific topography and strong adhesion to the internal retinal membrane. It’s the first time when this new vitreous cortex layer was revealed. The presence of this layer is the result of a strong vitreomacular adhesion that causes the posterior vitreous cortex split as it attempts to detach from the inner retinal surface. Such outermost layer remains attached to the macula and can induce further proliferation process. On a stage B of PDR this area correspond with multiple vitreoschisis, on a stage C of PDR — with fibrovascular membrane. The complete PVD was revealed in 61 cases. Conclusion. In this article we analyze the results of surgical treatment in 74 patients with A-C stages of proliferative diabetic retinopathy. Newer imaging technique with new dye — suspension “Vitreocontrast” allows to detect sensitive relationships of vitreous and VRI in each stage of the disease. The role of vitreous body in this process gives us a reason to consider it as an important object for further research. Moreover, the understanding of their relations in different stages of PDR enables to develop optimal surgical approach on each stage of PDR.

The Level of Cytokines in the Vitreous Body of Severe Proliferative Diabetic Retinopathy Patients Undergoing Posterior Vitrectomy

2018 ◽  
Vol 24 (27) ◽  
pp. 3276-3281 ◽  
Author(s):  
Dorota Raczyńska ◽  
Katarzyna A. Lisowska ◽  
Krzysztof Pietruczuk ◽  
Joanna Borucka ◽  
Mateusz Ślizień ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Body ◽  
Control Group ◽  
Slit Lamp ◽  
Corrected Visual Acuity ◽  
Cytokine Levels ◽  
Pars Plana ◽  
Eye Examination

Objective: The objective of the study was to compare cytokine levels in the vitreous body of patients with proliferative diabetic retinopathy (PDR) undergoing posterior vitrectomy. Patients and methods: The study included 39 patients (39 eyes) undergoing pars plana vitrectomy (PPV). Patients were divided into three groups: patients with proliferative diabetic retinopathy (PDR) without aflibercept injection prior to the surgery, PDR patients administered aflibercept injection prior to the surgery, and patients without diabetes mellitus (control group). All patients underwent a comprehensive eye examination one day before and 3 weeks after the surgery, including measurements of: best-corrected visual acuity (BVCA) and intraocular pressure (IOP), slit-lamp examination and spectral domain optical coherence tomography (SOCT). Concentrations of cytokines: IL-6, IL-8, IL-12p70, TNF, IL-10, IL-1β were measured in the vitreous body of patients with BD™ Cytometric Bead Array (CBA) Human Inflammatory Cytokines Kit. Results: PDR patients who received pretreatment with aflibercept injection showed significantly lower concentrations of IL-12p70, TNF, IL-10 and IL-1β in the vitreous body compared to the control group. Meanwhile, patients without prior aflibercept injection had a significantly higher concentration of IL-8. There was also a significant positive correlation between IOP before PPV and IL-8 concentration in both PDR patients’ groups. Conclusion: Findings of our study suggest an important role of IL-8 in the development of severe PDR. Aflibercept administration on the day before elective vitrectomy facilitated the surgery.

Proteomic Analysis of the Vitreous Body in Proliferative and Non-Proliferative Diabetic Retinopathy

2020 ◽  
Vol 17 ◽  
Author(s):  
Van-An Duong ◽  
Jeeyun Ahn ◽  
Na-Young Han ◽  
Jong-Moon Park ◽  
Jeong-Hun Mok ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Microvascular Complications ◽  
Treatment Options ◽  
Vitreous Body ◽  
Control Group ◽  
Diabetic Patients ◽  
Protein Protein Interaction ◽  
Alpha Beta ◽  
New Treatment

Background: Diabetic Retinopathy (DR), one of the major microvascular complications commonly occurring in diabetic patients, can be classified into Proliferative Diabetic Retinopathy (PDR) and Non-Proliferative Diabetic Retinopathy (NPDR). Currently available therapies are only targeted for later stages of the disease in which some pathologic changes may be irreversible. Thus, there is a need to develop new treatment options for earlier stages of DR through revealing pathological mechanisms of PDR and NPDR. Objective: The purpose of this study was to characterize proteomes of diabetic through quantitative analysis of PDR and NPDR. Methods: Vitreous body was collected from three groups: control (non-diabetes mellitus), NPDR, and PDR. Vitreous proteins were digested to peptide mixtures and analyzed using LC-MS/MS. MaxQuant was used to search against the database and statistical analyses were performed using Perseus. Gene ontology analysis, related-disease identification, and protein-protein interaction were performed using the differential expressed proteins. Results: Twenty proteins were identified as critical in PDR and NPDR. The NPDR group showed different expressions of kininogen-1, serotransferrin, ribonuclease pancreatic, osteopontin, keratin type II cytoskeletal 2 epidermal, and transthyretin. Also, prothrombin, signal transducer and activator of transcription 4, hemoglobin subunit alpha, beta, and delta were particularly up-regulated proteins for PDR group. The up-regulated proteins related to complement and coagulation cascades. Statherin was down-regulated in PDR and NPDR compared with the control group. Transthyretin was the unique protein that increased its abundance in NPDR compared with the PDR and control group. Conclusion: This study confirmed the different expressions of some proteins in PDR and NPDR. Additionally, we revealed uniquely expressed proteins of PDR and NPDR, which would be differential biomarkers: prothrombin, alpha-2-HS-glycoprotein, hemoglobin subunit alpha, beta, and transthyretin.

scholarly journals Modern Possibilities for the Vireoretinal Interface Contrasting (Experimental Study)

2018 ◽  
Vol 15 (2S) ◽  
pp. 231-238 ◽  
Author(s):  
N. M. Kislitsyna ◽  
S. V. Kolesnik ◽  
S. V. Novikov ◽  
A. I. Kolesnik ◽  
M. P. Veselkova
Keyword(s):  
Morphological Analysis ◽  
Posterior Vitreous Detachment ◽  
Vitreous Body ◽  
Vitreoretinal Surgery ◽  
Vitreoretinal Interface ◽  
Vitreous Detachment ◽  
Vitreous Cortex ◽  
Thin Membranes ◽  
Fine Structures ◽  
The Ideal

The contrast agents in vitreoretinal surgery are necessary to ensure the visualization of translucent and ultra-thin membranes and vitreoretinal interface (VRI) structures, but the ideal staining agent has not been found yet.Purpose. To investigate and compare staining properties of two vital dyes for vitreous body (VB) and vitreoretinal interface visualization: “Kenalog-40” and “Vitreocontrast”.Patients and methods. The study was performed on 20 cadaveric eyes. After eyeball dissection with the original technology, we carried out posterior vitreous cortex separation and comparative staining of retinal fragments on the side of VB and corresponding section of the VB by “Kenalog-40” and “Vitreokontrast”. Vitreo-retinal interface samples underwent morphological analysis.Results. In contrast to «Kenalog-40», «Vitreocontrast» enables the visualization of thin layer of VB on retina surface after splitting of cortical layers during posterior vitreous detachment induction. Upon that, the adherent particles of the “Vitreocontrast” suspension remained on the corresponding splitted fragment of the VB. After staining with “Kenalog-40”, the VB surface remained smooth, shiny, with no visible changes. The results of histological examination of the obtained retinal and VB samples confirmed the presence of VB layer on the retina surface at the site of vitreoshisis formation during the induction of posterior vitreous detachment.Conclutions. Received data confirm the possibility of vitreoshisis formation during posterior vitreous body detachment, and demonstrate the advantages of the staining properties of the “Vitreokontrast” suspension for visualization of fine structures of vitreoretinal interface. 

scholarly journals Elevated Levels of Plasma IgA Autoantibodies against Oxidized LDL Found in Proliferative Diabetic Retinopathy but Not in Nonproliferative Retinopathy

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Satu Vavuli ◽  
Tuire Salonurmi ◽  
Sirpa Loukovaara ◽  
Antti E. Nissinen ◽  
Markku J. Savolainen ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Oxidized Ldl ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 1 Diabetic Patients ◽  
Type 2 Diabetic

Aims. This study investigated the association of autoantibodies binding to oxidized low-density lipoproteins (oxLDL) in diabetic retinopathy (DR). Methods. Plasma from 229 types 1 and 2 patients with DR including diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) was analysed with ELISA-based assay to determine IgA, IgG, and IgM autoantibody levels binding to oxLDL. The controls were 106 diabetic patients without retinopathy (NoDR) and 139 nondiabetic controls (C). Results. PDR group had significantly higher IgA autoantibody levels than DME or NoDR: mean 94.9 (SD 54.7) for PDR, 75.5 (41.8) for DME (p=0.001), and 76.1 (48.2) for NoDR (p=0.008). There were no differences in IgG, IgM, or IgA that would be specific for DR or for DME. Type 2 diabetic patients had higher levels of IgA autoantibodies than type 1 diabetic patients (86.0 and 65.5, resp., p=0.004) and the highest levels in IgA were found in type 2 diabetic patients with PDR (119.1, p>0.001). Conclusions. IgA autoantibodies were increased in PDR, especially in type 2 diabetes. The high levels of IgA in PDR, and especially in type 2 PDR patients, reflect the inflammatory process and enlighten the role of oxLDL and its autoantibodies in PDR.

Evaluating the role of serum apolipoprotein B to serum apolipoprotein A ratio in type 2Egyptian diabetic patient with retinopathy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Salwa Seddik Hosny ◽  
Merhan Samy Nasr ◽  
Rana Hashem Ibrahim ◽  
Moata zM. W AbdElfattah ◽  
Samar Helmy Abdel Dayem Abdel Razek
Keyword(s):  
Diabetic Retinopathy ◽  
Diabetic Patient ◽  
Proliferative Diabetic Retinopathy ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Apo B ◽  
Apolipoprotein A ◽  
Type 2 Diabetic

Abstract Background Diabetes mellitus (DM) has routinely been described as a metabolic disorder characterized by hyperglycemia that develops as a consequence of defects in insulin secretion, insulin action, or both. Type 2 Diabetes encompasses individuals who have insulin resistance (IR) and usually relative (rather than absolute) insulin deficiency. The pathologic hallmark of DM involves the vasculature leading to both micro vascular and macro vascular complications. Diabetic retinopathy (DR) is a chronic progressive, potentially sight-threatening disease of the retinal microvasculature associated with the prolonged hyperglycemia and other conditions linked to diabetes mellitus such as hypertension. Legal blindness due to DR is estimated to be 25 times more common among the diabetic population than in those without diabetes Objective To evaluate the role of novel serum lipid markers (serum apolipoprotein B to serum apolipoprotein A ratio) in various grades of diabetic retinopathy . Methods This study was conducted on 80 type 2 diabetic patients. Their age between 40-70 years old. There were collected from outpatient ophthalmology clinic at el Demerdash hospital, it was conducted from March to September, 2018. The study was explained to all patients and control subjects, and consent was obtained from them before starting the study. They were subdivided into 3 groups; type 2 diabetic patients with proliferative diabetic retinopathy (group I), type 2 diabetic patients with non-proliferative diabetic retinopathy (group II) and type 2 diabetic patients without retinopathy as control group (group III). Results Our results showed that the serum apo B to serum apo A ratio is higher in the diabetic patient with proliferative diabetic retinopathy than the diabetic patient with non-proliferative diabetic retinopathy. Which is higher than the diabetic patient without retinopathy. Drawing attention to the possible relationship between the serum apo B to serum apo A ratio and the progression of diabetic retinopathy. Conclusion We found that the serum apo B to serum apo A ratio is higher in the diabetic patient with proliferative diabetic retinopathy than the diabetic patient with non-proliferative diabetic retinopathy. Which is higher than the diabetic patient without retinopathy. Drawing attention to the possible relationship between the serum apo B to serum apo A ratio and the progression of diabetic retinopathy. We found a highly significant difference regarding triglycerides, total cholesterol, Apo B and B/A ratio being higher in diabetic patient with proliferative diabetic retinopathy than diabetic patient with non- proliferative diabetic retinopathy and diabetic patient without retinopathy suggesting the relation between these factors and the progression of diabetic retinopathy. We found that hypertension duration is the most independent factor affecting B/A ratio. So lowering blood pressure can decrease retinopathy progression and improve prognosis in people with type 2 diabetes especially in the first 4- 5 years.

scholarly journals Alterations of the Gut Microbiome and Metabolome in Patients With Proliferative Diabetic Retinopathy

2021 ◽  
Vol 12 ◽  
Author(s):  
Panpan Ye ◽  
Xueyou Zhang ◽  
Yufeng Xu ◽  
Jia Xu ◽  
Xiaoxiao Song ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Gut Microbiota ◽  
Proliferative Diabetic Retinopathy ◽  
Gut Microbiome ◽  
16S Rrna Gene Sequencing ◽  
Diabetic Patients ◽  
Rrna Gene ◽  
Bacterial Composition ◽  
Rrna Gene Sequencing

Diabetic retinopathy (DR) has been reported to associate with gut microbiota alterations in murine models and thus “gut-retina-axis” has been proposed. However, the role of gut microbiome and the associated metabolism in DR patients still need to be elucidated. In this study, we collected fecal samples from 45 patients with proliferative diabetic retinopathy (PDR) and 90 matched diabetic patients (1:2 according to age, sex, and duration of diabetes) without DR (NDR) and performed 16S rRNA gene sequencing and untargeted metabolomics. We observed significantly lower bacterial diversity in the PDR group than that in the NDR group. Differential gut bacterial composition was also found, with significant depletion of 22 families (e.g., Coriobacteriaceae, Veillonellaceae, and Streptococcaceae) and enrichment of two families (Burkholderiaceae and Burkholderiales_unclassified) in the PDR group as compared with the NDR group. There were significantly different fecal metabolic features, which were enriched in metabolic pathways such as arachidonic acid and microbial metabolism, between the two groups. Among 36 coabundance metabolite clusters, 11 were positively/negatively contributed to PDR using logistic regression analysis. Fifteen gut microbial families were significantly correlated with the 11 metabolite clusters. Furthermore, a fecal metabolite-based classifier was constructed to distinguish PDR patients from NDR patients accurately. In conclusion, PDR is associated with reduced diversity and altered composition of gut microbiota and specific microbe-metabolite interplay. Our findings help to better understand the disease pathogenesis and provide novel diagnostic and therapeutic targets for PDR.

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