The Antiangiogenic Properties of Adipose-Derived Mesenchymal Stem/Stromal Cells in Corneal Neovascularization in a Rabbit Model.

The purpose was to study the anti-angiogenic effect of adipose-derived mesenchymal stem/stromal cells (ADMSCs) on experimentally induced corneal injuries. Corneal neovascularization (NV) was induced by incising and subsequently suturing the corneal surface in 32 New Zealand rabbits. Following suturing, the rabbits were randomly allocated into 2 groups, and received either phosphate-buffered saline (PBS) (control) or ADMSCs, both administered via three different routes. Digital images of the cornea were obtained two weeks post-incision to measure the area of neovascularized cornea. Tumor necrosis factor (TNF) was immunohistochemically assessed in the both groups. The corneal tissue was evaluated for vascular endothelial growth factor (VEGF). The extent of corneal NV in all eyes was assessed photographically by an independent observer. Fourteen days after the incisions, the degree of corneal NV was substantially decreased in the ADMSC-treated group (1.87 ± 0.9 mm2, 1.4 % ± 0.67 % of corneal surface) compared to the control and PBS-treated group (4.66 ± 1.74 mm2, 3.51 % ± 1.31 %, p < 0.001). ADMSCs significantly decreased injury-induced corneal NV in New Zealand rabbits two weeks post-treatment. This strategy has potential for use in the control of corneal NV in vivo.

Optical coherence tomography-guided classification of epiretinal membranes.

To study and classify epiretinal membranes (ERMs) based on spectral domain optical coherence tomography (SD-OCT) findings. One hundred and twelve patients with ERMs were examined clinically and underwent OCT examination. The anatomical structure of the macula and vitreoretinal interface was studied. ERMs were classified in two categories: A, with posterior vitreous detachment (PVD) (91 cases), and B, with the absence of PVD (21 cases). Category A was divided into two subcategories: A1, without contraction of the ERM (37 cases), and A2, with the presence of membrane contraction (54 cases). A2 was further subdivided into A2.1, with retinal folding (15 cases), A2.2, with edema (23 cases), A2.3, with cystoid macular edema (9 cases), and A2.4, with lamellar macular hole (7 cases). Category B was divided in two subcategories: B1, without vitreomacular traction (VMT) (4 cases), and B2, with the presence of VMT (17 cases). Category B2 was subdivided into B2.1, with edema (9 cases), B2.2, presenting retinal detachment (5 cases), and B2.3, with schisis (3 cases). OCT classification of ERMs provides useful information on the anatomical structure of the retina, and the accurate estimation of vitreoretinal interface.

Bilateral herpes simplex keratitis presenting as peripheral ulcerative keratitis.

PURPOSE: To report a case of bilateral Herpes simplex keratitis (HSK) masquerading as peripheral ulcerative keratitis (PUK). METHODS: A case of a 47-year-old female complaining of painful red eyes with a history of arthritis and anterior uveitis attacks with positive antinuclear antibodies (ANA). Biomicroscopy revealed PUK, stromal infiltrations and bilateral central corneal epithelial erosions. Slit-lamp examination disclosed +3 anterior chamber cells in both eyes. RESULTS: Blood testing was positive for ANA. Herpes simplex virus (HSV) antigen was identified in both eyes using polymerase chain reaction (PCR). The management included topical prednisolone and acyclovir, as well as systemic valacyclovir. Improvement of epithelial corneal defects, PUK, and visual acuity was achieved gradually during the follow-up period. CONCLUSIONS: Bilateral herpetic keratitis presenting as PUK is an extremely rare manifestation of herpetic disease. PUK can pose a diagnostic dilemma in cases with immune system dysregulation. Excluding infectious agents is mandatory for appropriate treatment.

24-Hour variation of optical coherence tomography-measured retinal thickness in diabetic macular edema.

PURPOSE: To investigate 24-hour variation in retinal thickness in patients with diabetic macular edema (DME) using optical coherence tomography (OCT). METHODS: Fifty-three eyes of 53 diabetic patients with clinically significant macular edema and central subfield thickness (CST) >225 µm, 36 eyes of 36 healthy individuals (normal controls), and 22 eyes of 22 diabetic patients without macular pathology (diabetic controls) underwent 5 OCT measurements at 7 am, 10 am, 3 pm, 8 pm, and 1 am. Visual acuity, blood pressure, blood glucose, and body temperature were measured as well. RESULTS: The CST (p<0.0005), total macular volume (p<0.0005), and visual acuity (p<0.0005) showed significant variation in patients. The CST (450 µm at 7 am) reached a minimum at 3 pm (absolute change of -49 µm, relative change of -17%) before increasing again. Thickening changes were higher in more thickened retinas (p<0.0005, p=0.024, absolute and relative change, respectively). Visual acuity was worse in the morning (0.38 logMAR) and improved to a maximum at 8 pm (0.30 logMAR) (p<0.0005). Blood pressure, blood glucose, and body temperature did not vary over time. CONCLUSIONS: The 24-hour variation of retinal thickness is observed in a large proportion of patients with DME, with a decrease from morning to afternoon. Time of examination should be taken into account when managing such patients.

Pupillometric characteristics in patients with choroidal neovascularization due to age-related macular degeneration.

PURPOSE: To study the pupillary light reflex in patients with choroidal neovascularization due to age-related macular degeneration (AMD). METHODS: The study included 15 patients with AMD and 15 control subjects. A full recording of the pupil's reaction to light was registered and the following eight parameters were measured and reported: baseline pupil (R1), latency (T1), minimum pupil radius (R2), amplitude (AMP), maximum constriction velocity (VCmax), maximum constriction acceleration (ACmax), time for maximum velocity (T2), and time for maximum constriction (T3). RESULTS: All variables measured presented alterations in the AMD group and a number of them were significantly reduced in the AMD group. CONCLUSIONS: The presence of neovascular AMD significantly affects the pupil's response to light stimulus when compared to normal subjects.

Ectopia lentis et pupillae: report of a unilateral case and surgical management.

PURPOSE: To report a case of clinically unilateral congenital ectopia lentis et pupillae (ELeP) and discuss its surgical management. DESIGN: Interventional case report. METHODS AND RESULTS: A 37-year-old female was referred to our service for surgical management of unilateral ectopia pupillae for aesthetic reasons. On presentation the visual acuity of the affected eye was 20/400. Ultrasound exam did not show any crystalline lens dislocation, and therefore the case was considered a very rare variable of the ELeP syndrome. We proceeded to surgical correction of the pupillary ectopia. At the 3-month follow-up the patient's visual acuity was 20/30. CONCLUSIONS: Although the clinical features and the genetic aspects of ELeP are documented in the older ophthalmic literature, this entity has received relatively little attention. Surgical correction of this rare disorder can be attempted for aesthetic and functional reasons.

Perfluorocarbon liquid utilization in primary vitrectomy repair of retinal detachment with multiple breaks.

PURPOSE: To evaluate the efficacy of pars plana vitrectomy in conjunction with intraoperative perfluoro-n-octane (PFO) use as initial treatment of retinal detachment (RD) with multiple breaks located at various distances from the ora serrata. METHODS: Twenty-two consecutive eyes (15 phakic, 2 aphakic, and 5 pseudophakic) presenting with RD with multiple breaks and tears underwent primary pars plana vitrectomy, PFO retinal reattachment, transcleral cryopexy or endolaser treatment of breaks, PFO/air exchange, and final injection of 18% perfluoropropane (C3F8). Scleral buckles were not used. The mean follow-up period was 29 months. RESULTS: Temporary PFO utilization attached the posterior retina and facilitated the safe removal of vitreous at its base and around the retinal tears. Intraoperative complications included new breaks (3 eyes), enlargement of breaks (2 eyes), and a small bubble of subretinal PFO (1 eye). Postoperatively, the retina remained attached during follow-up in 19 eyes. Cataract developed or progressed in 13 phakic eyes. CONCLUSIONS: Pars plana vitrectomy in conjunction with intraoperative PFO utilization is effective as initial treatment of RDs with multiple breaks. The main limitation of this technique is the postoperative progressive cataract formation in phakic eyes.