We presented a case of full-thickness macular hole progressing into lamellar macular hole as seen in the spectral domain optical coherence tomography. Short review of the literature regarding the ...pathogenesis of lamellar hole was presented and discussed.
Acomprehensive list of patient features that influence the management of patients with diabetic macular oedema (DMO) is discussed. These features are grouped into three overarching themes: ocular, ...systemic and psychosocial. Consensus statements about the relative importance of these features, supported by the literature, were formed by a panel of retinal experts. The major drivers influencing the management of DMO with anti-vascular endothelial growth factor (anti-VEGF) therapy are undoubtedly ocular specific, in particular visual acuity and optical coherence tomography (OCT) central retinal thickness. Systemic factors, such as control of glycated haemoglobin (HbA
1c
), blood pressure and serum lipid estimations, have limited direct influence on DMO management although they remain important considerations to communicate to the primary diabetic physician. A greater understanding is required on how many other factors, in particular psychosocial factors, influence the care of the DMO patient.
Inherited retinal degenerations are a common cause of blindness in Western countries. A mechanism for most retinal degenerations is still unknown; hence, a suitable treatment for most of these ...diseases has yet to be found. Before one can rationally design a treatment, it is necessary to understand the pathway from a gene mutation to the phenotype in patients. Animal models are crucial to understand this process and to develop a treatment. Some naturally occurring animal models are known. However, over the past few years, transgenic engineering has allowed the generation of a rapidly growing number of animal models. In this review, we give an overview of the broad variety of genetic animal models for retinal degeneration.
A case of tamoxifen retinopathy examined with spectral-domain optical coherence tomography (SD-OCT) is presented. The typical refractile deposits are located between ganglion cell layer and inner ...plexiform layer in SD-OCT. A defect on the outer retinal layer with disruption of the photoreceptor layer with sharp edges is seen. The still attached posterior hyaloids gives evidence of other pathomechanism involved in the outer retinal defect than that of macular hole, as suggested in the literature.
OBJECTIVE To describe the morphology of retinal pigment epithelium (RPE) tears secondary to age-related macular degeneration by using high-resolution, spectral-domain optical coherence tomography ...(SD-OCT). METHODS For simultaneous topographic and tomographic in vivo imaging, confocal scanning laser ophthalmoscopy and spectral-domain optical coherence tomography were applied in combination. Retina over the RPE-denuded area was particularly examined for signs of viable photoreceptors. RESULTS A total of 26 patients (28 eyes) were included in the study. The mean (SD) age of patients was 78 (8) years (age range, 62-91 years). In cases with recent RPE tears, external limiting membrane, photoreceptor inner and outer segment junction, and nonatrophic outer nuclear layer could be identified in the retina on the RPE-denuded area. Intact external limiting membrane, photoreceptor inner and outer segment junction, and nonatrophic outer nuclear layer could be seen in 1 patient for up to 325 days after the RPE tear. In fibrotic older RPE tears, these structures were atrophic. CONCLUSIONS In this study, signs for viable photoreceptors could be identified for up to 325 days after an RPE tear using spectral-domain optical coherence tomography. This finding is important to consider in future therapies aimed at rescuing photoreceptors after RPE tears.Arch Ophthalmol. 2011;129(5):575-579-->
The anti-inflammatory drug etanercept may be an effective therapeutic agent in diabetic retinopathy. In order to further evaluate its potential, the pharmacokinetics and safety of this drug after ...intravitreal delivery were investigated.
After intravitreal administration of etanercept in rabbits, clinical examination, electroretinography (ERG), visually evoked potentials (VEP) and histology were evaluated. The pharmacokinetics and distribution of etanercept were analyzed using fluorescence-coupled protein at 0, 2, 4, and 8 weeks after injection in vitreous, retina, and choroid.
No adverse effects and signs of toxicity were found. Etanercept showed peak concentrations after 4 weeks in the retina and choroid.
Intravitreally delivered etanercept is safe and results in high concentrations in the retina and choroid over a long period of time.
Mitochondrial DNA mutations at nucleotide position (np) 3460 in the ND1 gene, np 11778 in the ND4 gene, and np 14484 in the ND6 gene are commonly considered to be associated with the clinical ...features of LHON and account for the majority of LHON cases. Here we report the clinical and molecular genetic findings of a LHON patient with a new mitochondrial DNA mutation at np 11253 in the ND4 gene and spontaneous recovery.
The clinical examination consisted of visual acuity measurements, visual field testing, and ophthalmoscopy over a period of 14 years. Total lymphocyte DNA was analyzed for all common LHON mutations. Because the LHON patient did not harbor any of the common or recently described rare LHON mutations, we performed a sequence analysis of the whole mitochondrial genome.
The patient exhibited typical clinical features of LHON. Molecular genetic analysis did not reveal any of the common LHON mutations. Sequence analysis of the mtDNA of the patient and his unaffected sister and niece was performed and showed a T to C missense mutation at np 11253 in the ND4 gene, leading to a replacement of an evolutionary highly conserved isoleucine by a threonine residue. This mutation introduces a polar group into a hydrophobic domain of the protein and induces a significant change in hydrophobicity of the peptide sequence. The mutation was not found among 100 controls.
The fact that the new mutation at np 11253 is found within a highly conserved region and was not present in any controls implies that this mutation is responsible for LHON in this patient. Interestingly, this point mutation has formerly been reported in the mitochondria of the substantia nigra in an unrelated patient with proven Parkinson's disease.
Zusammenfassung
Zielsetzung
Bestimmung des Forschungs- und Entwicklungsbedarfs, der in den nächsten Jahren (2019–2025) realistischerweise angegangen werden kann, und Beschreibung möglicher ...Forschungswege, um diesen Herausforderungen zu begegnen.
Methoden
Die Ergebnisse eines Konsensusprozesses im European Vision Institute (EVI, Brüssel) werden zusammengefasst. Folgende Themengebiete werden behandelt: Glaukom, Netzhautdystrophien, diabetische Retinopathie, trockenes Auge, Hornhauterkrankungen, Katarakt- und refraktive Chirurgie.
Ergebnisse
Der Forschungsbedarf in den genannten Krankheitsbereichen wird erörtert, realisierbare Forschungsprojekte werden skizziert.
Schlussfolgerungen
Beträchtliche Fortschritte auf dem Gebiet der Augenheilkunde und in den für Patienten relevanten Ergebnissen sind in der nahen Zukunft möglich.
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