Optic Nerve
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Zhenzhen Li ◽  
Jian Guo ◽  
Xiaolin Xu ◽  
Wenbin Wei ◽  
Junfang Xian

Objectives: To develop an MRI-based radiomics model to predict postlaminar optic nerve invasion (PLONI) in retinoblastoma (RB) and compare its predictive performance with subjective radiologists’ assessment. Methods: We retrospectively enrolled 124 patients with pathologically proven RB (90 in training set and 34 in validation set) who had MRI scans before surgery. A radiomics model for predicting PLONI was developed by extracting quantitative imaging features from axial T2-weighted images and contrast-enhanced T1-weighted images in the training set. The Kruskal-Wallis test, least absolute shrinkage and selection operator regression, and recursive feature elimination were used for feature selection, whereupon a radiomics model was built with a logistic regression (LR) classifier. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve and the accuracy were assessed to evaluate the predictive performance in the training and validation set. The performance of the radiomics model was compared to radiologists’ assessment by DeLong test. Results: The AUC of the radiomics model for the prediction of PLONI was 0.928 in the training set and 0.841 in the validation set. Radiomics model produced better sensitivity than radiologists’ assessment (81.1% vs  43.2% in training set, 82.4vs 52.9% in validation set). In all 124 patients, the AUC of the radiomics model was 0.897, while that of radiologists’ assessment was 0.674 (p < 0.001, DeLong test). Conclusion: MRI-based radiomics model to predict PLONI in RB patients was shown to be superior to visual assessment with improved sensitivity and AUC, may serve as a potential tool to guide personalized treatment.

2021 ◽  
pp. bjsports-2021-103961
Michael Dinsmore ◽  
Zakir Hajat ◽  
Connor TA Brenna ◽  
Joseph Fisher ◽  
Lashmi Venkatraghavan

BackgroundMild internal jugular vein (IJV) compression, aimed at increasing intracranial fluid volume to prevent motion of the brain relative to the skull, has reduced brain injury markers in athletes suffering repeated traumatic brain injuries. However, an increase in intracranial volume with IJV compression has not been well demonstrated. This study used transorbital ultrasound to identify changes in optic nerve sheath diameter (ONSD) as a direct marker of accompanying changes in intracranial volume.MethodsNineteen young, healthy adult volunteers (13 males and 6 females) underwent IJV compression of 20 cm H2O low in the neck, while in upright posture. IJV cross-sectional area at the level of the cricoid cartilage, and the change in right ONSD 3 mm behind the papillary segment of the optic nerve, were measured by ultrasound. Statistical analysis was performed using a paired t-test with Bonferroni correction.ResultsMean (SD) cross-sectional area for the right IJV before and after IJV compression was 0.10 (0.05) cm2 and 0.57 (0.37) cm2, respectively (p=0.001). ONSD before and after IJV compression was 4.6 (0.5) mm and 4.9 (0.5) mm, respectively (p=0.001).ConclusionsThese data verify increased cerebral volume following IJV compression, supporting the potential for reduced brain ‘slosh’ as a mechanism connecting IJV compression to possibly reducing traumatic brain injury following head trauma.

2021 ◽  
Vol 11 (1) ◽  
David J. Mathew ◽  
Izhar Livne-Bar ◽  
Jeremy M. Sivak

AbstractGlaucoma is a chronic and progressive neurodegenerative disease of the optic nerve resulting in loss of retinal ganglion cells (RGCs) and vision. The most prominent glaucoma risk factor is increased intraocular pressure (IOP), and most models focus on reproducing this aspect to study disease mechanisms and targets. Yet, current models result in IOP profiles that often do not resemble clinical glaucoma. Here we introduce a new model that results in a gradual and sustained IOP increase over time. This approach modifies a circumlimbal suture method, taking care to make the sutures ‘snug’ instead of tight, without inducing an initial IOP spike. This approach did not immediately affect IOPs, but generated gradual ocular hypertension (gOHT) as the sutures tighten over time, in comparison to loosely sutured control eyes (CON), resulting in an average 12.6 mmHg increase in IOP at 17 weeks (p < 0.001). Corresponding characterization revealed relevant retinal and optic nerve pathology, such as thinning of the retinal nerve fiber layer, decreased optokinetic response, RGC loss, and optic nerve head remodeling. Yet, angles remained open, with no evidence of inflammation. Corresponding biochemical profiling indicated significant increases in TGF-β2 and 3, and IL-1 family cytokines in gOHT optic nerve tissues compared to CON, with accompanying microglial reactivity, consistent with active tissue injury and repair mechanisms. Remarkably, this signature was absent from optic nerves following acute ocular hypertension (aOHT) associated with intentionally tightened sutures, although the resulting RGC loss was similar in both methods. These results suggest that the pattern of IOP change has an important impact on underlying pathophysiology.

2021 ◽  
Vol 22 (22) ◽  
pp. 12529
Mira Park ◽  
Hyun-Mun Kim ◽  
Hyun-Ah Shin ◽  
Seung-Hyun Lee ◽  
Dong-Youn Hwang ◽  

Human pluripotent stem cell-derived neural progenitor cells (NPCs) have the potential to recover from nerve injury. We previously reported that human placenta-derived mesenchymal stem cells (PSCs) have neuroprotective effects. To evaluate the potential benefit of NPCs, we compared them to PSCs using R28 cells under hypoxic conditions and a rat model of optic nerve injury. NPCs and PSCs (2 × 106 cells) were injected into the subtenon space. After 1, 2, and 4 weeks, we examined changes in target proteins in the retina and optic nerve. NPCs significantly induced vascular endothelial growth factor (Vegf) compared to age-matched shams and PSC groups at 2 weeks; they also induced neurofilaments in the retina compared to the sham group at 4 weeks. In addition, the expression of brain-derived neurotrophic factor (Bdnf) was high in the retina in the NPC group at 2 weeks, while expression in the optic nerve was high in both the NPC and PSC groups. The low expression of ionized calcium-binding adapter molecule 1 (Iba1) in the retina had recovered at 2 weeks after NPC injection and at 4 weeks after PSC injection. The expression of the inflammatory protein NLR family, pyrin domain containing 3 (Nlrp3) was significantly reduced at 1 week, and that of tumor necrosis factor-α (Tnf-α) in the optic nerves of the NPC group was lower at 2 weeks. Regarding retinal ganglion cells, the expressions of Brn3a and Tuj1 in the retina were enhanced in the NPC group compared to sham controls at 4 weeks. NPC injections increased Gap43 expression from 2 weeks and reduced Iba1 expression in the optic nerves during the recovery period. In addition, R28 cells exposed to hypoxic conditions showed increased cell survival when cocultured with NPCs compared to PSCs. Both Wnt/β-catenin signaling and increased Nf-ĸb could contribute to the rescue of damaged retinal ganglion cells via upregulation of neuroprotective factors, microglial engagement, and anti-inflammatory regulation by NPCs. This study suggests that NPCs could be useful for the cellular treatment of various optic neuropathies, together with cell therapy using mesenchymal stem cells.

2021 ◽  
Vol 8 ◽  
Kieran Joymungul ◽  
Zisos Mitros ◽  
Lyndon da Cruz ◽  
Christos Bergeles ◽  
S.M.Hadi Sadati

This paper presents a multi-purpose gripping and incision tool-set to reduce the number of required manipulators for targeted therapeutics delivery in Minimally Invasive Surgery. We have recently proposed the use of multi-arm Concentric Tube Robots (CTR) consisting of an incision, a camera, and a gripper manipulator for deep orbital interventions, with a focus on Optic Nerve Sheath Fenestration (ONSF). The proposed prototype in this research, called Gripe-Needle, is a needle equipped with a sticky suction cup gripper capable of performing both gripping of target tissue and incision tasks in the optic nerve area by exploiting the multi-tube arrangement of a CTR for actuation of the different tool-set units. As a result, there will be no need for an independent gripper arm for an incision task. The CTR innermost tube is equipped with a needle, providing the pathway for drug delivery, and the immediate outer tube is attached to the suction cup, providing the suction pathway. Based on experiments on various materials, we observed that adding a sticky surface with bio-inspired grooves to a normal suction cup gripper has many advantages such as, 1) enhanced adhesion through material stickiness and by air-tightening the contact surface, 2) maintained adhesion despite internal pressure variations, e.g. due to the needle motion, and 3) sliding resistance. Simple Finite Element and theoretical modeling frameworks are proposed, based on which a miniature tool-set is designed to achieve the required gripping forces during ONSF. The final designs were successfully tested for accessing the optic nerve of a realistic eye phantom in a skull eye orbit, robust gripping and incision on units of a plastic bubble wrap sample, and manipulating different tissue types of porcine eye samples.

2021 ◽  
Vol Publish Ahead of Print ◽  
Diem-Trang Nguyen ◽  
Nathalie Boddaert ◽  
Dominique Bremond-Gignac ◽  
Matthieu P. Robert

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Fatemeh Sanie-Jahromi ◽  
Ali Azizi ◽  
Sahar Shariat ◽  
Mohammadkarim Johari

Tissue engineering is biomedical engineering that uses suitable biochemical and physicochemical factors to assemble functional constructs that restore or improve damaged tissues. Recently, cell therapies as a subset of tissue engineering have been very promising in the treatment of ocular diseases. One of the most important biophysical factors to make this happen is noninvasive electrical stimulation (ES) to target ocular cells that may preserve vision in multiple retinal and optic nerve diseases. The science of cellular and biophysical interactions is very exciting in regenerative medicine now. Although the exact effect of ES on cells is unknown, multiple mechanisms are considered to underlie the effects of ES, including increased production of neurotrophic agents, improved cell migration, and inhibition of proinflammatory cytokines and cellular apoptosis. In this review, we highlighted the effects of ES on ocular cells, especially on the corneal, retinal, and optic nerve cells. Initially, we summarized the current literature on the in vitro and in vivo effects of ES on ocular cells and then we provided the clinical studies describing the effect of ES on ocular complications. For each area, we used some of the most impactful articles to show the important concepts and results that advanced the state of these interactions. We conclude with reflections on emerging new areas and perspectives for future development in this field.

2021 ◽  
Vol 11 (1) ◽  
Kyoung Min Lee ◽  
Hyoung Jun Ahn ◽  
Martha Kim ◽  
Sohee Oh ◽  
Seok Hwan Kim

AbstractWe compared the central retinal vascular trunk (CRVT) position, as a surrogate of lamina cribrosa (LC) offset, with the anterior scleral opening (ASCO) offset from the Bruch’s membrane opening (BMO). Based on the BMO-centered radial scans, the BMO and ASCO margins were demarcated, and each center was determined as the center of the best-fitted ellipse for each margin. The ASCO/BMO offset was defined as the offset between each center. Angular deviations and the extent of ASCO and CRVT offsets from the BMO center were compared directly. Incomplete demarcation of ASCO was found in 20%, which was associated with a larger BMO area and a larger ASCO offset from the BMO. The angular deviation of ASCO offset was associated with that of CRVT offset and that of the longest externally oblique border. The ASCO offset was smaller than the CRVT offset, and, unlike the CRVT offset, it was rarely deviated to the inferior side. The complete ASCO margin might not be demarcatable when determined on BMO-centered radial scans in the presence of an offset. Also, the ASCO, which reflects only the superficial scleral layer, might not reflect the LC position, because the LC might be shifted further from the ASCO.

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