ABSTRACT
Natalizumab is a monoclonal antibody licensed for the treatment of relapsing-remitting multiple sclerosis (RRMS). It is known to increase the potential risk of developing progressive multifocal leukoencephalopathy (PML). There is current debate in the literature regarding its association with malignant melanoma. Herein, we report a case of a 55-year old lady with RRMS for whom natalizumab therapy was being considered by her neurologist. Her medical history included a choroidal melanoma which had undergone successful treatment. Additionally, in this case study we discuss the issues regarding malignant melanoma risk and recurrence with natalizumab treatment.
Subject(s)
Choroid Neoplasms/chemically induced , Immunologic Factors/adverse effects , Melanoma/chemically induced , Multiple Sclerosis, Relapsing-Remitting/drug therapy , Natalizumab/adverse effects , Female , Humans , Middle AgedABSTRACT
Here the management of a macular fold complicating retinal reattachment surgery is discussed. The macular fold was repaired by a technique similar to that used in retinal translocation surgery. Direct injection into the macular fold was performed, which caused a linear, rather than the intended concentric, detachment of the retina. Permanent flattening of the macula fold was achieved and the best-corrected Snellen visual acuity was 6/12 at 6 months. The importance of intervention, advantages and disadvantages of this technique and alternative methods of managing such cases are discussed. It may be prudent to consider peripheral, rather than direct, injection into the macular fold to detach the macula in such cases.
Subject(s)
Macula Lutea/surgery , Retinal Detachment/surgery , Retinal Diseases/surgery , Vitrectomy/adverse effects , Adult , Humans , Male , Reoperation , Retinal Diseases/etiology , Treatment Outcome , Visual AcuitySubject(s)
Macular Degeneration , Age Factors , Aged , Angiogenesis Inhibitors/therapeutic use , Aptamers, Nucleotide/therapeutic use , Audiovisual Aids , Fluorescein Angiography , Humans , Laser Therapy , Macular Degeneration/diagnosis , Macular Degeneration/etiology , Macular Degeneration/therapy , Photochemotherapy , Risk FactorsABSTRACT
We have studied the neurotoxicity of amyloid-beta (Abeta) after a single unilateral intravitreal injection. Within the retina apoptotic cells were seen throughout the photoreceptor layer and the inner nuclear layer but not in the ganglion cell layer at 48 h after injection of Abeta(1-42) compared to vehicle control and control peptide. At 5 months, there was a significant reduction in total cell numbers in the ganglion cell layer in Nissl stained retinas. There was glial cell dysfunction with upregulation of glial fibrillary acidic protein and a reduction in the expression of Müller cell associated proteins in the injected retinas. These results suggest an indirect cytotoxic effect of Abeta on retinal neurons and an important role for dysfunction of Müller glia in mediating Abeta neurotoxicity.
