Abstract: Primary vitreoretinal lymphoma (PVRL), as a subset of primary central nervous system lymphoma (PCNSL), is a rare and fatal ocular malignancy. Most PVRL masquerades as chronic posterior uveitis, which makes the clinical diagnosis challenging. Vitreous cells, subretinal lesions and imaging techniques are essential for clinical diagnosis. Importantly, cytopathology/histopathology identification of malignant cells is the gold standard for the diagnosis of PVRL. In addition, molecular detection of immunoglobulin heavy chain (IgH) or T cell receptor (TCR) gene rearrangements, immunophenotyping for cell markers, and cytokine analysis of interleukine-10 elevation are often used as adjunct procedures. Current management of PVRL involves local radiation, intravitreal chemotherapy (methotrexate and rituximab), with or without systemic chemotherapy depending on the involvement of non-ocular tissues. In cases with concomitant PCNSL, systemic high-dose methotrexate/rituximab based therapy in conjunction with local therapy, whole brain radiotherapy and/or autologous stem cell transplantation is considered. Although PVRL normally responds well to initial treatment, high rates of relapse and CNS involvement usually lead to poor prognosis and limited survival. A professional team of medical experts in ophthalmologists, ocular pathologists, neuro-oncologists and hemato-oncologists is essential for optimizing patient management.
Background: To explore the safety and effectiveness of Sclera patch grafts in the management of scleral defects.
Methods: This is a retrospective uncontrolled study. Medical records were retrospectively reviewed for 8 eyes of 8 patients with sclera patch grafts. Two patients had necrotizing scleritis, 2 patients had scleral melting/perforation secondary to thermal burns, 4 patients had scleral staphyloma secondary to surgery. Sclera was reconstructed with allogenic sclera patch grafts, 6 in 8 patients combined autologous conjunctival pedicle flap, 1 patient combined partial medial rectus translocation, 1 patient combined autologous pedicle tenon graft, simultaneously. Treatment outcomes were evaluated using structural integrity, best corrected visual acuity (BCVA), scleritis remission, sclera rejection and melt, and ocular symptoms.
Results: Eight patients were reviewed. In all of these cases, satisfactory anatomic and functional outcomes were achieved. In the at least half a year follow-up, the BCVA of all the eight patients were no worse than that of preoperative. No eye pain, foreign body sensation and other discomforts showed in all the patients, except one woman, who showed sclera rejection and melt 1 month postoperative. In addition, one patient showed high intraocular pressure (28 mmHg), which can be controlled by a kind of medicine.
Conclusions: In this series, sclera patch grafts is an effective method for management scleral defects in the at least half a year following-up. Attention should be paid to the sclera patch rejection and melt post operatively.
Background: To settle the fundamentals of a numerical procedure that relates retinal ganglion-cell density and threshold sensitivity in the visual field. The sensitivity of a generated retina and visual pathways to virtual stimuli are simulated, and the conditions required to reproduce glaucoma-type defects both in the optic-nerve head (ONH) and visual fields are explored.
Methods: A definition of selected structural elements of the optic pathways is a requisite to a translation of clinical knowledge to computer programs for visual field exploration. The program is able to generate a database of normalized visual fields. The relationship between the number of extant receptive fields and threshold sensitivity is plotted for background sensitivity and corresponding automated perimetry. A solution in two planes to the 3D distribution of axons in the ONH is proposed. Visual fields with induced damage in the optic disc are comparable in pattern and quantity to glaucomatous records.
Results: The two-level simulation of the ONH facilitates the analysis of optic-cup/retinal defects. We can generate the virtual optic pathways tailored to the age and morphology of the patient’s eye, and it is possible to reproduce glaucomatous damage by “reverse engineering” engineering. The virtual cortical model renders a quantitative relationship between visual defect and neural damage.
Conclusions: A two-level computing of the retina/optic nerve facilitates the analysis of neuroretinal defects and can be incorporated to automatic perimeters to facilitate visual field analysis.
Abstract: Tea is the second most popular beverage worldwide after water. Green tea has the highest nutraceutical values with well-established general health benefits and wide safety margins. Natural polyphenols found in green tea, including (+)-catechin (C), (–)-epicatechin (EC), (+)-gallocatechin (GC), (–)-epigallocatechin (EGC), (–)-epicatechin-3-gallate (ECG), (–)-gallocatechin-3-gallate (GCG) and (–)-epigallocatehin-3-gallate (EGCG). They have many potent biological properties and therapeutic effects in human health and diseases. These small molecules have high bioavailability and specific therapeutic potential in eye tissues. Recently some researchers studied the metabolomic responses to the green tea. In this talk, summary of these studies will be reviewed and its potential applications in the ocular research will be discussed.
Abstract: As a complex disease, myopia is the most common eye disease worldwide. Many myopia susceptibility genes or variants have been successfully identified in the past years by genome-wide genetic association studies (GWAS), which focus mainly on the single-nucleotide polymorphisms. Little attention has been paid to examine the role of copy number variations (CNVs) in refractive error and myopia. This study adopted a systematic strategy to investigate the role of CNVs in high myopia. In the discovery phase, a pilot GWAS suggests putative CNVs for follow-up. Multiplex ligation-dependent probe amplification was then used to quantify the copy number of 89 CNV segments in 737 case-control samples in the second phase and then 24 top-ranking CNVs in a second group of 1,029 case-control samples in the final validation phase. This validation phase identified 22 significant CNVs. Further work is needed to examine the role of these few CNVs in myopia development.
Abstract: Encapsulated-cell therapy (ECT) is an attractive approach for continuously delivering freshly synthesized therapeutics to treat sight-threatening posterior eye diseases, circumventing repeated invasive intravitreal injections and improving local drug availability clinically. Composite collagen-alginate (CAC) scaffold in ECT contains an interpenetrating network that integrates the physical and biological merits of its constituents, including biocompatibility, mild gelling properties and availability. An injectable CAC system that supported the growth of HEK293 cells with sustainable glial-derived neurotrophic factor (GDNF) delivery has been developed. Continuous GDNF delivery was detected in culture and in healthy rat eyes for at least 14 days. The gels were well tolerated with no host tissue attachment and contained living cell colonies. Most importantly, gel implantation in dystrophic Royal College of Surgeons rat eyes for 28 days retained photoreceptors while those gels containing higher initial cell number yielded better photoreceptor rescue effect. This rescue effect is clinically relevant as photoreceptor death is a common pathology in many retinal diseases. Moreover, since cells including autologous cells can be genetically engineered to secrete various therapeutic agents, CAC gel offers a flexible system design and is a potential treatment option for other chronic neurodegenerative diseases.
