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Epiretinal Membrane (epiretinal + membrane)

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Medical Sciences	100%

Selected Abstracts

Chemokines in proliferative diabetic retinopathy and proliferative vitreoretinopathy

ACTA OPHTHALMOLOGICA, Issue 2008
AM ABU EL ASRAR
Purpose To determine levels of the chemokines I-309, MCP-1, MIP-1,, MIP-1,, MCP-3, MCP-2, ENA-78, GCP-2, IP-10 and I-TAC in vitreous and serum from patients with proliferative diabetic retinopathy (PDR), proliferative vitreoretinopathy (PVR) and retinal detachment with no PVR (RD) and expression of MCP-1, SDF-1 and the chemokine receptor CXCR3 in epiretinal membranes. Methods Vitreous and serum samples were obtained from 57 RD, 32 PVR and 88 PDR patients. The levels of chemokines were measured by ELISAs. Epiretinal membranes were studied by immunohistochemistry. Results MCP-1 and IP-10 were the only chemokines detected in vitreous. Levels and incidence of detection in vitreous were significantly higher than that in serum for MCP-1 (p<0.001 for both comparisons) and IP-10 (p=0.0035; <0.001, respectively). Levels were significantly higher in vitreous from patients with PVR and PDR compared with RD for MCP-1 (p=0.0002) and IP-10 (p=0.0083). Incidence of IP-10 detection was significantly associated with increased levels of MCP-1 in vitreous (p<0.001). MCP-1, SDF and CXCR3 were expressed by myofibroblasts and vascular endothelial cells in membranes. Conclusion MCP-1, IP-10 and SDF-1 may participate in pathogenesis of PVR. Clinical Relevance: Chemokines and their receptors could be molecular targets for preventing angiogenesis / fibrosis in the eye. [source]

1263: Symptoms and signs of posterior uveitis

ACTA OPHTHALMOLOGICA, Issue 2010
M KHAIRALLAH
Purpose Posterior uveitis (PU) is an important anatomic form of uveitis in which the primary site of inflammation is the choroid or retina, with or without subsequent vitreous involvement. Methods Review of symptoms and signs of PU. Results The onset of PU can be sudden or less frequently insidious. Most common ocular symptoms include blurred vision, loss of vision, and floaters. Some patients with PU may have no symptoms, especially if inflammatory process is asymmetric. PU is usually associated with vitritis that can vary from mild to severe. Vitritis should be graded according to standardized grading systems. Other vitreous changes may include vitreous strands, vitreous hemorrhage, vitreous traction, and posterior vitreous detachment. Retinal and/or choroidal inflammation can be focal, multifocal, or more diffuse. It is important to distinguish between active and inactive chorioretinal disease. Retinal vasculitis can occur in the setting of several PU entities. It can involve retinal veins or arteries. It appears as focal, multifocal, or diffuse vascular cuffing or sheathing. Other retinal vasculitic changes include retinal hemorrhages, retinal vascular occlusion, retinal/optic disc neovascularization, and aneurysms. Maculopathy is common patients with PU. It may result from direct inflammatory infiltration, macular edema, serous retinal detachment, retinal ischemia, epiretinal membrane, or macular hole. Optic nerve involvement that can occur in association with PU include optic disc hyperemia/edema, optic neuritis, neuroretinitis, optic disc exudate, and optic disc granuloma. Conclusion Clinical examination is a key step in the diagnostic approach to PU. Clinician should be aware of the array of ocular symptoms of signs and their importance in orienting the differential diagnosis. [source]

3415: Treatment of postoperative macular edema

ACTA OPHTHALMOLOGICA, Issue 2010
I PETROPOULOS
Purpose Cystoid macular edema (CME) is a frequent complication of a number of interventions in ophthalmology, such as cataract surgery (Irvine-Gass syndrome), laser procedures, and trabeculectomy. The purpose of this talk is to present the latest bibliographic data regarding the appropriate treatment of postoperative CME. Methods A review of the existing literature concerning the treatment of postoperative CME is performed. Characteristic personal cases are presented. Results In more than two-thirds of the cases, postoperative CME resolves spontaneously within weeks or months. Prophylactic topical treatment with indomethacin or flurbiprofen seems to reduce the frequency of clinical and angiographic CME, but its beneficial effect on final visual acuity is not established. Curative therapy includes topical corticosteroids; topical non-steroidal anti-inflammatory drugs (e.g. ketorolac); oral acetazolamide; sub-Tenon or intravitreal injection of triamcinolone acetonide; intravitreal injection of anti-VEGF drugs; and pars plana vitrectomy. The indications, role, and efficacy of each of the above treatment modalities are discussed, based on the latest bibliographic data. Conclusion Most cases of postoperative CME are mild and resolve spontaneously. In refractory cases, sub-Tenon or intravitreal injection of triamcinolone acetonide can be effective, but the risk of ocular hypertony is high. Intravitreal injection of anti-VEGF drugs offers promising results, yet large-scale randomized studies are necessary to validate their utility. Finally, pars plana vitrectomy is the treatment of choice when vitreomacular traction and/or epiretinal membrane is present. [source]

2123: Transferrin and transthyretin in vitreoretinal surgery

ACTA OPHTHALMOLOGICA, Issue 2010
C ARNDT
Purpose The concentration of transferrin in the vitreous is known to be higher than in plasma or aqueous humor. This has been related to a local synthesis of transferrin by the ciliary body. Increased levels have been found in vitro-retinal proliferation. A relationship between the level of transthyretin and the functional outcome has been previously reported. The purpose of the study was to look for a relation between transferrin and transthyretin. Methods Patients with epiretinal membrane and rhegmatogenous retinal detachment were prospectively enrolled. The vitreous samples were obtained without intraocular infusion. The levels of transferrine and transthyretin (prealbumin) were determined in all cases. Results In the group of patients with retinal detachment (n=18), two groups could be identified: the transferrin levels were either low between 40 and 70 mg/l with low transthyretin (<17,8 mg/l)(n=6) or high (>400 mg/l) with transthyretin levels between 200 and 400 mg/l (n=12). No relationship to any clinical parameters (extension of the detachment, onset of symptoms or degre of vitreo-retinal proliferation) could be demonstrated. In patients with epiretinal membranes (n=6), the transferrin levels <40 mg/l, transthyretin < 17,8 mg/l. Conclusion Increased transferrin seems to correlate with increased transthyretin levels in the vitreous. The clinical signification of this relationship remains to be demonstrated and probably requires a larger patient sample. [source]

Longterm follow-up of children with traumatic optic nerve avulsion

ACTA OPHTHALMOLOGICA, Issue 4 2010
Veit Sturm
Abstract. Purpose:, We report the longterm follow-up of children with optic nerve avulsion (ONA) caused by traumatic events. The remarkable differences in courses and outcomes may elucidate the spectrum of ONA-associated symptoms and injuries. Methods:, During the last 15 years, three children with ONA were referred to our department. These cases are presented with special attention to their longterm follow-up. Results:, Two patients suffered from complete ONA after head injury. The third patient presented with partial ONA caused by a bicycle accident. Longterm follow-up varied between 7 and 15 years. In the first patient, a pale swollen retina without any visible retinal vasculature was observed early in the course of follow-up. The retina later completely detached. In the second patient, extended fibroglial scarring occurred and an extremely large epiretinal membrane formed and was finally released spontaneously into the vitreous. The third patient developed only mild fibroglial scarring and retinal pigment epithelium hyperplasia. The optic nerve head in this patient came to resemble a morning glory disc. Conclusions:, Optic nerve avulsion can adopt different courses and outcomes in different patients. Final visual outcome seems to depend on the degree of visual acuity immediately after injury. Substantial intraocular architecture changes can occur as a result of ONA. [source]

Long-term study of vascular perfusion effects following arteriovenous sheathotomy for branch retinal vein occlusion

ACTA OPHTHALMOLOGICA, Issue 3 2010
Mahiul M. K. Muqit
Abstract. Purpose:, To evaluate the perfusion effects and long-term visual outcome of pars plana vitrectomy (PPV) combined with arteriovenous sheathotomy (AVS) with or without triamcinolone for nonischaemic branch retinal vein occlusion (NI-BRVO). Methods:, Prospective, interventional case series of eight patients with NI-BRVO and haemorrhagic macular oedema. Patients underwent PPV and AVS (n = 5), or PPV, AVS and intravitreal triamcinolone (IVT, n = 3). A masked grading technique assessed fundus photographs and fluorescein angiography (FFA) following surgery. Scanning laser ophthalmoscopy/optical coherence tomography (SLO/OCT) evaluated macular oedema and outer retinal architecture. Main outcomes examined included visual acuity (VA), retinal reperfusion, collateral vessel regression, vascular dilatation, cystoid macular oedema (CMO), and ocular neovascularization. Results:, Seven of eight patients underwent uncomplicated surgery, with increased intraretinal perfusion and reduced engorgement of distal retinal veins. The mean pre-logMAR VA was 0.8 (SD 0.17) and did not improve significantly after surgery (post-logMAR 0.6, SD 0.38; p = 0.11, paired t -test). SLO/OCT showed persistent CMO in four patients, and subfoveal thinning of the photoreceptor layer. Collateral vessels disappeared at the blockage site post-AVS in 7/8 eyes, and this was associated with improved retinal perfusion. Six of eight patients developed epiretinal membrane. No patients developed ocular neovascularization. The average follow-up was 34.5 months. Conclusions:, PPV with AVS is a safe procedure, and adjunctive IVT had no additional effects on vascular perfusion. Successful decompressive surgery was followed by disappearance of collateral vessels at the BRVO blockage site and was a clinical marker for intravascular reperfusion. Long-term epiretinal gliosis and subfoveal photoreceptor atrophy limited functional and visual recovery. [source]

Macular appearance after diabetic vitrectomy for fibrovascular proliferation: an optical coherence tomography study

ACTA OPHTHALMOLOGICA, Issue 2 2010
Chung-May Yang
Abstract. Purpose:, To investigate morphological variations in the macular area with optical coherence tomography (OCT) after vitrectomy for diabetic fibrovascular proliferation. Methods:, We reviewed 108 cases using OCT 7,15 months after vitrectomy. Of these, 32 received OCT within 3 months postoperatively. Morphological variations were categorized and correlated with visual outcome. Results:, Only 24 cases (21.4%) had no obvious abnormalities. The most frequent findings were epiretinal membrane (52.8%), macular thickening (37.0%) and macular cysts (28.7%). Multivariate regression showed that diffuse macular thickening, loss of foveal depression and diffuse retinal thinning were significantly associated with poor visual acuity. Sequential OCT (< 3 and , 7 months) revealed that epiretinal membrane and oedema outside of fovea changed significantly between two examinations. Conclusion:, OCT may identify diverse morphological changes in the macular area after diabetic vitrectomy for fibrovascular proliferation. Macular appearance may change over time, and certain types of morphological changes may be associated with poor visual function. [source]

Macular edema in epiretinal membrane and vitreomacular traction

ACTA OPHTHALMOLOGICA, Issue 2009
C CREUZOT
Purpose Macular edema occuring during macular diseases is a frequent situation. The purpose of this course is to highlight the clinical signs and the different treatments which can be used to treat macular edema occuring during epiretinal membrane and vitreomacular traction syndrome. Methods Macular edema is frequently associated with epiretinal membranes and vitreomacular traction. Up to now, no specific preoperative macular edema phenotype can predict the postoperative recovery. Different methods were proposed to improve functional results: ILM peeling, intravitreal steroid injection, intravitreal antiangiogenic injections, Results The widespread use of transconjunctival vitrectomy, the combination of cataract and macular surgeries will probably change the indication of macular surgery leading to sooner surgical indications for better recovery. By contrast, vitreomacular traction often leads to a rapidly progressive visual loss. The analysis should distinguish diffuse diabetic macular edema which remains the only validated surgical indication of macular edema in diabetes and the vitreomacular traction without diabetes. This latter needs a rapid surgical management as macular edema is often severe. Conclusion Macular edema is a frequent situation associated to macular disease. It can compromise the outcomes after macular surgeriy. Attempts to define the best moment to consider surgery should improve the functional results. [source]

What is the consequence of retinal detachment on anatomy and function?

ACTA OPHTHALMOLOGICA, Issue 2009
C CREUZOT
Purpose To present the structural and functional consequences on retina after retinal detachment Methods Author will show the consequences of experimental retinal detachment in animal models. These changes prevent retinal cells from a normal post-operative functioning. However, these conditions have to be differentiated from post-operative visual loss due to macular edema, long-standing subretinal fluid, epiretinal membrane or macular hole formation. Results Retinal detachment leads to severe changes on retinal cells: outer segment shortening, fibrosis, glial proliferation. This situation is the target of neuroprotective treatment. By contrast, some situations where the bad recevoery is due to an associated disease (edema, membrane...) illustrated by clinical cases can need surgical treatment. Conclusion Bad functional recovery after retinal detachment can be explained by anatomic consequences on photoreceptors with subclinical fibrosis or some associated complications. [source]

Macular thickness alterations after cataract surgery determined by optical coherence tomography

ACTA OPHTHALMOLOGICA, Issue 2009
M ELEFTHERIADOU
Purpose To evaluate macular thickness alterations with optical coherence tomography after phacoemulsification and posterior champer intraocular lens implantation. Methods In this prospective study,201 patients who underwent phacoemulsication(102 men and 99 women)with mean age 65±8years were included.Best corrected visual acuity,complete slit lamp examination with lens and OCT examination were performed in all patients before surgery and at one,three and six months postoperatively.Patients were divided into five groups:Group 1(control group-100 eyes):patients without any predisponding factors for cystoid macular edema,Group 2(15 eyes):patients with complicated surgery,Group 3(27 eyes):patients with epiretinal membrane,Group 4(35 eyes):patients with diabetes and Group 5(24 eyes):patients with glaucoma. Results The preoperative mean minimal foveal thickness(MMFT)in groups 1 and 2 was 204±24,m and 213±47,m respectively and had no significant changes throughout the follow up period(p>0,05). In groups 3,4 and 5 a significant increase of macular thickness was detected. In group 3 the preoperative MMTF was 248±72,m and at 1,3 and 6 months it was 263±86,m(p=0,01),240±30,m(p=0,18)and 270±64,m(p<0,01)respectively. In group 4 the preoperative MMTF was 219±39,m,after 1month the MMTF increased at 257±78,m(p=0,002),at 3months it was 231±46,m(p=0,005)and at the last examination at 6 months it was 236±49,m(p=0,005). In group 5 the initially MMTF(206±21,m)had significant increase in the first[213±30,m(p=0,07)]and in the third month[223±24,m(p=0,03)]. Conclusion Diabetic retinopathy, epiretinal membranes and glaucoma may predispose to increase in macular thickness after cataract surgery. [source]

Temporal changes in retinal thickness after removal of the epiretinal membrane

ACTA OPHTHALMOLOGICA, Issue 4 2009
Hitoshi Aso
Abstract. Purpose:, We aimed to study the temporal aspects of the postoperative reduction of retinal thickness in eyes with epiretinal membrane after vitrectomy with peeling of the epiretinal membrane and internal limiting membrane. Methods:, In a retrospective study performed as a non-comparative, interventional case series, 16 eyes from 15 patients with idiopathic epiretinal membrane who underwent vitrectomy and removal of the epiretinal membrane were followed up using optical coherence tomography measurements. Retinal thickness in the macular area was assessed by the foveal thickness and macular volume in a circle 6 mm in diameter. Results:, Scattergrams of the foveal thickness and macular volume were best fitted with exponential curves. The average time constants of the exponential curve for foveal thickness and macular volume changes were 31 days (range 4,109 days) and 36 days (range 5,100 days), respectively. The average expected final values for foveal thickness and macular volume were 334 ,m (range 206,408 ,m) and 7.53 mm3 (range 6.57,8.66 mm3), respectively, which were significantly greater than those in normal controls (p < 0.0001, t -test). Conclusions:, Retinal thickness decreases rapidly immediately after surgical removal of the epiretinal membrane and the reduction rate gradually slows thereafter. Approximation of the exponential curve provides an estimation of final retinal thickness after surgical removal of the epiretinal membrane; final thickness is expected to be greater than in normal eyes. [source]

Jamming of 25-gauge instruments in the cannula during vitrectomy for vitreous haemorrhage

ACTA OPHTHALMOLOGICA, Issue 2 2008
Hajime Shinoda
Abstract. Purpose:, To report the jamming of 25-gauge instruments in the cannula during vitreous surgery for non-clearing vitreous haemorrhage. Methods:, Forty-five eyes underwent vitrectomy with 25-gauge instruments for non-clearing vitreous haemorrhage (VH group). The incidence of 25-gauge instruments jamming in the cannula was determined retrospectively and compared with that in 112 eyes that underwent vitrectomy for epiretinal membrane (ERM group), also using 25-gauge instruments. Results:, The 25-gauge vitreous cutter or light pipe became jammed in the cannula in three eyes (7%) in the VH group and the instrument locked inside the cannula had to be removed with the cannula. None of the 25-gauge instruments in the ERM group jammed (p = 0.022, Fisher's exact probability test). Two of three eyes developed giant retinal breaks near the sclerotomy but no retinal break related to the sclerotomy was detected in the ERM group. Examination of the cutter revealed blood trapped between the cutter and the cannula. Conclusions:, Twenty-five gauge instruments may become jammed in the cannula in eyes with non-clearing vitreous haemorrhage. Clinicians should be aware of this surgical complication when 25-gauge instruments are used in vitreous haemorrhage. [source]

Outcome of vitrectomy in patients with Terson syndrome

ACTA OPHTHALMOLOGICA, Issue 2 2002
Jan Ståle Ritland
ABSTRACT. Purpose:, To report findings and evaluate the results of vitrectomy in 22 eyes with Terson syndrome. Methods:, We reviewed retrospectively the records of patients who underwent pars plana vitrectomy as a result of vitreous haemorrhage. Twelve cases concerned unilateral vitrectomy and five concerned bilateral vitrectomy. The time interval between intracranial haemorrhage and vitrectomy was 1,10 months (mean 5.9 months). Results:, During a mean follow-up of 23.3 months (range 1,69 months) visual acuity (VA) improved in 21 of 22 eyes. Preoperative VA was ,,0.1 in 20 of 22 eyes, while postoperative VA was ,,0.5 in 16 of 21 eyes. Poor visual outcomes were mainly caused by retinal detachments (seven eyes, in which three were caused by proliferative vitreoretinopathy), epiretinal membranes (seven eyes) and optic atrophy (one eye). Our study concurs with recent reports suggesting early vitrectomy in bilateral cases and in cases where ultrasonography shows epiretinal membrane or proliferative retinopathy formation. [source]

Visual outcomes following vitrectomy and peeling of epiretinal membrane

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 4 2005
James G Wong MMed
Abstract Background:, Visual outcomes of patients following vitrectomy and peeling of visually significant epiretinal membranes were assessed to determine the influence of specific perioperative factors and surgical complications on final visual acuity and functional vision. Methods:, In an unmatched, consecutive surgical series, vitrectomy and membrane peeling were performed on 125 eyes of 123 patients with visually significant macular epiretinal membranes. Patients were followed for 6,36 months. Visual outcome measures included postoperative logMAR visual acuity, change in visual acuity and functional vision tasks evaluated by questionnaire. Perioperative factors including duration of symptoms, preoperative visual acuity, aetiology, membrane type and leakage on fundal fluorescein angiogram were correlated with final visual outcomes. Results:, Visual acuity improved by a mean of 0.31 Â± 0.21 units (three lines of vision). In 104 cases (83%), visual acuity improved in patients by two lines or more, with 20 cases (16%) having unchanged acuity and one case (1%) having worse acuity. Ninety-three per cent of interviewed cases reported improvement in functional vision, especially reduction of distortion. Cataract was observed in 52 cases (52% of phakic eyes) postoperatively compared with 19 cases (19%) preoperatively. Postoperative visual acuity correlated with preoperative visual acuity. Patients with worse preoperative vision recorded greater visual improvement following surgery. No other perioperative factors were found to have a prognostic value in this study. Conclusion:, Epiretinal membrane peeling improves vision in the majority of patients with significant symptoms, even if preoperative visual acuity is not substantially reduced. Surgery improves functional vision including metamorphopsia not measurable by visual acuity, and thus assessment of functional vision should be included in surgical case planning. [source]

4411: Immunohistochemical methods to evaluate vitreoretinal scaring

ACTA OPHTHALMOLOGICA, Issue 2010
ML BOCHATON-PIALLAT
Purpose Formation of scarlike epiretinal membranes (ERMs) constitutes potentially the end stage of evolution of proliferative vitreoretinopathy (PVR), proliferative diabetic retinopathy (PDR) and idiopathic vitreoretinopathy. Among various cellular populations, ERMs contain cells with contractile features typical of myofibroblasts. Myofibroblasts have been described in granulation tissue during wound healing and in practically all fibrocontractive diseases, in which they participate in the generation of isometric tension and in the synthesis of extracellular matrix components; these phenomena are in turn responsible for granulation tissue remodeling and retraction. The main marker of the myofibroblastic phenotype is the expression of alpha-SMA. The transforming growth factor-beta1 and the ED-A splice variant of cellular fibronectin, an extracellular matrix component, are key players of the complex process of myofibroblast differentiation. Methods Proteins were detected by means of immunohistochemical staining on paraffin sections from formol fixed tissues and double immunofluorescence staining on whole tissues. Samples were observed by using classical light and confocal microscopes. Results The presence of alpha-SM actin-positive myofibroblasts was associated with the expression of TGF-beta1, TGF-beta receptor II, and ED-A FN in all types of ERMs studied. Conclusion The results furnish new data on the mechanism of alpha-SM actin stimulation in fibroblasts in a human pathologic setting. [source]

3416: Surgical therapy of macular edema

ACTA OPHTHALMOLOGICA, Issue 2010
CJ POURNARAS
Purpose Persistent macular oedema (ME) is the main cause of poor visual outcome during the evolution of retinal ischemic microangiopathies and traction related macular distortion. Among multiples treatment approaches, vitreoretinal surgery is applied with the goal to achieve the release of a traction related component of macular oedema . Methods Vitrectomy with peeling of the posterior hyaloid, epiretinal membranes, vitreoretinal tractions and/or internal limiting membrane removal, were studied in numerous nonrandomized cases series. Results Pars plana vitrectomy has been shown to reduce macular oedema with significant change in best corrected visual acuity, in epiretinal membranes, vitreoretinal traction syndrome and ischemic microangiopathies related macular thickening central, hemiretinal, branch retinal vein occlusion and diabetic macular edema). Evidence to date does not support any therapeutic benefit from radial optic neurotomy and arteriovenous crossing sheathotomy for BRVO and CRVO related macular oedema. Conclusion In the era of intravitreal injection of steroids and anti VEGF substances, vitrectomy seems to have a beneficial effect in traction related, selected pathologies associated to chronic macular edema. [source]

2123: Transferrin and transthyretin in vitreoretinal surgery

Internal limiting membrane staining

ACTA OPHTHALMOLOGICA, Issue 2009
J KATSIMPRIS
Purpose To describe the different modalities of internal limiting membrane (ILM) staining for the treatment of idiopathic macular hole (IMH). Methods Search of the MEDLINE database by using Medical Subject Heading search terms and key words related to ILM staining, macular hole surgery. Results ILM removal has been closely related with increased closure rates. However, because of poor ILM visibility the surgical removal of ILM is very difficult and poses serious complications. To obtain better visibility of ILM some special techniques have been developed using specific dyes such as, trypan blue (TB), indocyanine green (ICG), infracyanine green or triamsinolone acetonide(TA). Anatomic success rates with one surgery have increased (>90%) however, concern for toxicity has emerged. Patients with ICG-assisted ILM peeling appear to have a depressed recovery of visual acuity compared to those not using ICG. Concentrations of ICG that are <0.5 mg/mL have been shown to be non-toxic in cultures of RPE cells. Infracyanine green is a similar molecule that does not contain iodine and is less likely to induce osmolarity related toxic effects on the PRE cells when compared to ICG. It has been used also for ILM staining in combination with trypan(TB). TB is a second generation vital dye that stains epiretinal membranes (ERMs) directly and ILM to a lesser extent. Thus TB is useful for both macular hole and macular pucker surgery. TA may be also used to help highlight the ILM, although it is not a dye. It does adhere to the posterior hyaloid, making the detection of ILM easier. Conclusion This review largely reflects the great advent of different techniques for ILM staining. The use of ICG is more toxic when compared with TB. For TA long-term effects have not been well studied. [source]

Macular edema in epiretinal membrane and vitreomacular traction

Circulating bone marrow-derived endothelial precursor cells contribute to neovascularization in diabetic epiretinal membranes

ACTA OPHTHALMOLOGICA, Issue 2009
A ABU EL ASRAR
Purpose Role of vasculogenesis, recruitment and differentiation of circulating bone marrow-derived endothelial precursor cells into mature endothelium, in proliferative diabetic retinopathy (PDR) remains undefined. We investigated the presence of bone marrow-derived endothelial precursor cells and the expression of the chemotactic pathway SDF-1/CXCL12?CXCR4 in PDR epiretinal membranes. Methods Membranes from 8 patients with active PDR and 9 patients with inactive PDR were studied by immunohistochemistry using antibodies against CD133, vascular endothelial growth factor receptor-2 (VEGFR-2), CD14, SDF-1 and CXCR4. Results Blood vessels expressed CD133, VEGFR-2, CD14, SDF-1 and CXCR4 in 10, 10, 10, 7 and 7 out of 17 membranes, respectively. There were significant correlations between number of blood vessels expressing CD34 and number of blood vessels expressing CD133 (rs=0.646; p=0.005), VEGFR-2 (rs=0.704; p=0.002), CD14 (rs=0.564; p=0.018), and SDF-1 (rs=0.577; p=0.015). Stromal cells in close association with blood vessels expressed CD133, VEGFR-2, CD14, and CXCR4 in 10, 12, 13, and 14 membranes, respectively. Number of blood vessels expressing CD133 (p=0.013), VEGFR-2 (p=0.005), CD14 (p=0.008) and SDF-1 (p=0.005), and stromal cells expressing CD133 (p=0.003), VEGFR-2 (p=0.013) and CD14 (p=0.002) was significantly higher in active membranes than in inactive membranes. Conclusion Bone marrow-derived CD133+ endothelial progenitor cells and CD14+ monocytes may contribute to vasculogenesis in PDR. [source]

Macular thickness alterations after cataract surgery determined by optical coherence tomography

Chemokines in proliferative diabetic retinopathy and proliferative vitreoretinopathy

The role of arachidonic acid metabolites in DR

ACTA OPHTHALMOLOGICA, Issue 2008
AM ABU EL ASRAR
Purpose The inducible enzyme cyclooxygense-2 (COX-2) and its metabolic products are important mediators for angiogenesis. We investigated the expression of COX-2 and its downstream enzymes microsomal prostaglandin-E synthase (mPGES)-1, cytosolic PGES (cPGES) and thromboxane synthase (TXS) and correlated it with vascular endothelial growth factor (VEGF) expression and level of vascularization in proliferative diabetic retinopathy (PDR) epiretinal membranes. Methods Fourteen membranes were studied by immunohistochemistry. Results Vascular endothelial cells expressed COX-2, mPGES-1 and VEGF in 75.6%, 64.3% and 50% of the membranes, respectively. TXS was expressed in stromal cells in 85.7% of the membranes. There was no immunoreactivity for cPGES. There were significant correlations between number of blood vessels expressing CD34 and the numbers of blood vessels expressing COX-2 (rs = 0.858; p<0.001), mPGES-1 (rs = 0.743; p = 0.002) and VEGF (rs = 0.845; p = 0.001) and the number of cells expressing TXS (rs = 0.74; p = 0.002). Number of blood vessels expressing VEGF correlated significantly with the numbers of blood vessels expressing COX-2 (rs = 0.879; p<0.001) and mPGES-1 (rs = 0.942; p<0.001) and the number of cells expressing TXS (rs = 0.702; p = 0.011). Conclusion COX-2 and its metabolic products might contribute to PDR angiogenesis. [source]

Outcome of vitrectomy in patients with Terson syndrome

Expression of advanced glycation end products and related molecules in diabetic fibrovascular epiretinal membranes

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 1 2010
Ahmed M Abu El-Asrar MD PhD
Abstract Purpose:, To investigate associations between expressions of advanced glycation end products (AGEs), transforming growth factor-, (TGF-,), tumour necrosis factor-, (TNF-,) and integrins and correlations between their expression and level of vascularization and proliferative activity in diabetic fibrovascular epiretinal membranes. Methods:, Membranes from eight patients with active proliferative diabetic retinopathy and nine patients with inactive proliferative diabetic retinopathy were studied by immunohistochemistry. Results:, Blood vessels expressed AGEs, TGF-,, TNF-, and ,v,3 integrin in 5, 13, 8 and 8 membranes, respectively. Stromal cells expressed AGEs, TNF-, and ,v,3 integrin in 15, 13 and 3 membranes, respectively. There was no immunoreactivity for ,v,5, ,5,1 and ,2,1 integrins. There were significant correlations between number of blood vessels expressing CD34 and number of blood vessels expressing AGEs (rs = 0.496; P = 0.043), TGF-, (rs = 0.777; P < 0.001) and TNF-, (rs = 0.699; P = 0.002). There were significant correlations between number of blood vessels expressing AGEs and number of blood vessels expressing TGF-, (rs = 0.532; P = 0.028) and TNF-, (rs = 0.626; P = 0.007). The correlation between number of blood vessels expressing TNF-, and ,v,3 integrin was significant (rs = 0.617; P = 0.008). Number of blood vessels expressing CD34 (P = 0.001), TGF-, (P = 0.006) and TNF-, (P = 0.002) and stromal cells expressing AGEs (P = 0.001) and TNF-, (P = 0.004) were significantly higher in active membranes than in inactive membranes. Conclusion:, Interactions of AGEs, TGF-,, TNF-, and ,v,3 integrin might be involved in pathogenesis of proliferative diabetic retinopathy fibrovascular proliferation. [source]