Role of Surgical Slit-lamp in Endothelial Transplantation and Anterior Segment Surgery

PurposeTo study the role of two anterior segment optical coherence tomography angiography (AS-OCTA) systems in eyes with acute chemical injury.MethodsProspective study in subjects with unilateral chemical injuries. Sequential slit-lamp assessment with spectral domain (SD) (AngioVue, Optovue, USA) and swept source (SS) (Plex Elite, Zeiss, Carl Zeiss Meditec, Dublin, California, USA) AS-OCTA was performed in both eyes within 24–48 hours of injury. Subjects were managed with a standard clinical protocol and followed-up for 3 months. We assessed limbal disruption (loss of normal limbal vessel architecture), limbal vessel density measurements and agreement (kappa coefficient, κ) between masked assessors of limbal disruption based on AS-OCTA scans and slit-lamp assessment.ResultsTen subjects with median age 31 (25–33) years, 20% women, 60% suffered alkali injuries (Roper-Hall grade 1.5±0.7, Dua grade 2.3±1.2) at presentation. Mean limbal vessel density was lower in quadrants of affected eyes compared with controls detected by SD AS-OCTA (9.4%±2.0% vs 15.5%±1.8%, p<0.001) and SS AS-OCTA (8.8%±2.5% vs 13.9%±1.3%, p=0.01). There was substantial agreement when assessing limbal disruption on AS-OCTA (κ=0.7) compared with slit-lamp evaluation (κ=0.4). Overall, we found good agreement between SD and SS AS-OCTA systems in assessing limbal vessel density in eyes with chemical injury at presentation (mean paired difference: −1.08, 95% CI −3.2 to 0.5; p=0.189).ConclusionsIn this pilot study, AS-OCTA provided objective, non-contact, rapid assessment of limbal vasculature involvement in eyes with acute chemical injury. Further studies are required to establish the role of AS-OCTA in determining the prognosis of eyes with chemical injury.

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Atypical presentation of peripheral posterior lenticonus and role of multi-modal ocular imaging in its diagnosis and management

BMJ Case Reports ◽

10.1136/bcr-2020-238801 ◽

2021 ◽

Vol 14 (2) ◽

pp. e238801

Author(s):

Rinky Agarwal ◽

Vatika Jain ◽

Manpreet Kaur ◽

Jeewan S Titiyal

Keyword(s):

Ciliary Body ◽

Anterior Segment ◽

Posterior Capsule ◽

Slit Lamp ◽

Posterior Subcapsular Cataract ◽

Diagnosis And Management ◽

Scheimpflug Imaging ◽

Ocular Imaging ◽

Lens Implantation

A 6-year-old systemically healthy child presented with visual acuity of 1/60, N18 oculusdextrus (OD), and 6/18, N6 oculus sinister (OS). Slit-lamp biomicroscopy revealed suspicious bilateral inferotemporal pigmented ciliary body (CB) tumour, protruding posterior capsule and temporal posterior subcapsular cataract oculus uterque. Anterior segment optical coherence tomography, ultrasonography, ultrasonic biomicroscopy and Scheimpflug imaging revealed protruding posterior capsule and cortex abutting but not arising from CB suggestive of peripheral pigmented posterior lenticonus with hypermetropia (axial length 20.27 mm OD and 19.97 mm OS). Aberrometry revealed high internal aberrations and low Dysfunctional Lens Index (DLI). Lens aspiration with intraocular lens implantation in the bag OD and contact lens correction OS were undertaken. The child had a postoperative visual gain of 3/60, N18 with improved aberrometric profile OD, and was advised amblyopia therapy. Rarely posterior lenticonus can mimic a CB mass. Multi-modal ocular imaging can aid in its diagnosis and management. DLI may serve as a useful indicator of surgery in such cases.

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The Protective Effect of Low Dose of Lipopolysaccharide Pretreatment on Endotoxin-Induced Uveitis in Rats Is Associated with Downregulation of CSF-1 and Upregulation of LRR-1

Journal of Immunology Research ◽

10.1155/2020/9314756 ◽

2020 ◽

Vol 2020 ◽

pp. 1-11

Author(s):

Yunli Ling ◽

Jing Wang ◽

Shuo Yu ◽

Wenjie Li ◽

Hong Lu

Keyword(s):

Aqueous Humor ◽

Subcutaneous Injection ◽

Low Dose ◽

Anterior Segment ◽

Endotoxin Tolerance ◽

Suppressive Effect ◽

Enzyme Linked Immunosorbent Assay ◽

Slit Lamp ◽

Tlr4 Signaling Pathway

Purpose. To observe the effect of low dose of lipopolysaccharide (LPS) pretreatment on the expression of CSF-1 and LRR-1 in rats with endotoxin-induced uveitis (EIU), and to explore the possible role of TLR4. Method. EIU was induced by a single subcutaneous injection of 200 μg LPS. For the endotoxin tolerance group, the induction of EIU was preceded by a daily subcutaneous injection of 0.1 mg/kg LPS for five days. Clinical scores were graded at 24 h after EIU under a slit lamp microscope. HE stain was performed to observe the histopathology. The concentrations of IL-17, INF-γ, and IL-6 in aqueous humor were quantified with enzyme-linked immunosorbent assay. Real-time PCR, Western blot, and immunofluorescence analysis were used to determine the expression of NF-κB P65 and the activation of CSF-1, LRR-1. Results: Low dose of LPS pretreatment produced a suppressive effect by significantly reducing the inflammatory reaction of anterior segment as measured by slit lamp and histopathology. It also significantly reduced the concentrations of IL-17, INF-γ, and IL-6 in aqueous humor and the expression of CSF-1 and NF-κB P65, while increased the expression of LRR-1 compared to the EIU group. Conclusions. Low dose of LPS pretreatment can ameliorate endotoxin-induced uveitis in rats. This protection may be associated with upregulation of LRR-1 and downregulation of CSF-1, which is regulated by TLR4 signaling pathway.

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ON THE ROLE OF MICRO ANISOMETROPIA (THE “BUTTERFLY” EFFECT) IN THE OCCURRENCE OF ESOTROPIA IN CHILDREN

Ophthalmology Cases & Hypotheses ◽

10.30546/2788-516x.2020.1.1.14 ◽

2020 ◽

Vol 01 (Fall) ◽

pp. 14-17

Author(s):

Narmina Hajiyeva

Keyword(s):

Anterior Segment ◽

Case Analysis ◽

Small Degree ◽

Fundus Examination ◽

Slit Lamp ◽

Slight Degree ◽

Ophthalmic Examination ◽

Statistical Studies ◽

Cover Test

Purpose: This report presents 3 cases of esotropia in children and an attempt is made to explain the cause of the development of esotropia in these children.Methods: A comprehensive ophthalmic examination was carried out in the following order: photorefraction using the Plusoptix A09 photoscreener without cycloplegia; orthoptic examination with the alternate prism cover test; anterior segment assessment using a slit lamp; fundus examination and cycloplegic retinoscopy; and, for autorefractometry measurements, Sure-Sight.Results: Threecases of esotropia in children are presented. In all cases, a slight microanisometropia was observed along the cylindrical component ofthe squinting eye.Conclusion:Our three examples show how a slight degree of ametropia can cause a deviation of the eyeball. Therefore, case-by-case analysis can be more informative than large statistical studies. Thus, it is appropriate to evaluate eachcase from these new perspectives. The timely elimination of a small degree of anisometropia in the astigmatic or spherical components can lead to the restoration of the symmetrical position of the eyes

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

Current Pharmaceutical Design ◽

10.2174/1381612824666180926110704 ◽

2018 ◽

Vol 24 (27) ◽

pp. 3276-3281 ◽

Cited By ~ 3

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.

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Abstract 12770: The Significant Role of Endothelium and Arterial Wall Properties in Patients With Pseudoexfoliative Glaucoma

Circulation ◽

10.1161/circ.132.suppl_3.12770 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Georgia Siasou ◽

Gerasimos Siasos ◽

Marilita M Moschos ◽

Nikolaos Gouliopoulos ◽

Evangelos Oikonomou ◽

...

Keyword(s):

Arterial Stiffness ◽

Endothelial Function ◽

Significant Role ◽

Vascular Function ◽

Arterial Wall ◽

Augmentation Index ◽

Open Angle Glaucoma ◽

Anterior Segment ◽

Pseudoexfoliative Glaucoma

Introduction: Primary open-angle glaucoma (POAG) is one of the most prevalent causes of irreversible blindness and is associated with endothelial dysfunction and arterial stiffness. Pseudoexfoliative glaucoma (PEG) is another type of glaucoma observed in pseudoexfoliation syndrome. It is characterized by the deposition of pseudoexfoliative material not only to the anterior segment of the eye, but also to the vessels, heart and other organs. Hypothesis: Endothelial function and arterial stiffness are impaired in patients with POAG and PEG supporting the significant role of vascular function impairment in the progression of the disease. Methods: Forty four POAG patients, 22 PEG and 38 healthy subjects (Cl) were included in this study. All subjects were free of cardiovascular or inflammatory diseases. Endothelial function was evaluated by flow-mediated dilatation (FMD). Carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness and augmentation index (AIx) as a measure of arterial wave reflections Results: Between the three study groups CL, POAG, PEG there was no difference in age (67±10years vs. 70±9years vs. 66±12yeras, p=0.12) or prevalence of male sex (70% vs. 57% vs. 50%, p=0.21). Importantly, there was a linear impairment of FMD (7.35±2.77% vs. 6.58±3.18% vs. 4.88±3.29%, p=0.006), PWV (7.98±1.56m/sec vs. 9.20±1.84m/sec vs. 9.22±2.16m/sec, p=0.004) and AIx (21.29±8.77% vs. 25.14±5.71% vs. 28.20±8.75%, p=0.002) from CL to POAG and PEG. Interestingly post hoc test after Scheffe correction revealed also that PEG subjects had not only significantly impaired FMD, compared to control subjects, but also compared to POAG subjects (4.88±3.29% vs. 6.58±3.18%, p=0.02). Conclusions: Endothelial function and arterial stiffness are significantly impaired in patients with pseudoexfoliative glaucoma. These findings shed some light in the pathophysiology of pseudoexfoliative glaucoma and support the theory that pseudoexfoliative fibrils may also accumulate and damage the arterial wall.

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