- 标题
- 摘要
- 关键词
- 实验方案
- 产品
-
Longitudinal Assessment of Progressive Retinal Pigment Epithelium Disruption in a 26 Year Old A MultiSpectral Imaging Case Study
摘要： Background: Progressive retinal pigment epithelium (RPE) disruption in the absence of drusen or visual disturbances in young people is rarely reported in the literature, except for cases of juvenile macular degenerative diseases, pattern dystrophies or white dot syndromes. In age-related macular degeneration (AMD), RPE disruption typically does not become manifest clinically before age 55. This case report presents a young, healthy 26 year old Caucasian male with asymptomatic progressive RPE disruption in the absence of drusen, as detected by multi-spectral imaging (MSI) technology. Methods: A 26 year old Caucasian male was followed for progressive changes in RPE atrophy and melanin clumping over three visits in a three year period. His dilated fundus examination, fundus photography and optical coherence tomography were within normal limits. Long wavelength MSI revealed progressive RPE changes in the form of RPE atrophy and melanin clumping. MSI fundus auto-fluorescence (FAF) showed corresponding hyperautofluorescence and hypoautofluorescence in the left. Findings: Macular RPE changes can result from phototoxic effects and vary by ethnicity. Functional biomarkers to determine the risk of future vision loss with AMD are frequently sought and include complement factor H and Age-Related Maculopathy Susceptibility 2. FAF, for example is highly indicative of RPE dysfunction and progression. Long wavelength MSI, 620 nm to 740 nm, enhances visualization of the RPE, more specifically atrophy and melanin clumping, which may be indicative of asymptomatic progressive early AMD or retinal dystrophies. Conclusion: This case shows a longitudinal example of progressive RPE disruption in a 26 year old male. This is only one example, but multiple cases of RPE disruption in young people exist. Using MSI to further investigate RPE disruption and progression in a young population may provide a potential biomarker for early AMD, photo toxicity or other retinal dystrophies and degenerations.
关键词： Retinal Pigment Epithelium,Fundus Autofluorescence,Age-related Macular Degeneration,Multi-Spectral Imaging,Progressive retinal pigment epithelium disruption
更新于2025-09-11 14:15:04
-
Photobiomodulation for the treatment of retinal diseases: a review
摘要： Photobiomodulation (PBM), also known as low level laser therapy, has recently risen to the attention of the ophthalmology community as a promising new approach to treat a variety of retinal conditions including age-related macular degeneration, retinopathy of prematurity, diabetic retinopathy, Leber's hereditary optic neuropathy, amblyopia, methanol-induced retinal damage, and possibly others. This review evaluates the existing research pertaining to PBM applications in the retina, with a focus on the mechanisms of action and clinical outcomes. All available literature until April 2015 was reviewed using PubMed and the following keywords: 'photobiomodulation AND retina', 'low level light therapy AND retina', 'low level laser therapy AND retina', and 'FR/NIR therapy AND retina'. In addition, the relevant references listed within the papers identified through PubMed were incorporated. The literature supports the conclusion that the low-cost and non-invasive nature of PBM, coupled with the first promising clinical reports and the numerous preclinical-studies in animal models, make PBM well-poised to become an important player in the treatment of a wide range of retinal disorders. Nevertheless, large-scale clinical trials will be necessary to establish the PBM therapeutic ranges for the various retinal diseases, as well as to gain a deeper understanding of its mechanisms of action.
关键词： low level laser therapy,age-related macular degeneration,retinopathy of prematurity,photobiomodulation,retinal degeneration,amblyopia,far-red to near-infrared,methanol toxicity,retinitis pigmentosa
更新于2025-09-10 09:29:36
-
LONG-TERM VISUAL OUTCOMES AND CLINICAL FEATURES AFTER ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR INJECTION–RELATED ENDOPHTHALMITIS
摘要： Purpose: To determine long-term visual outcomes in patients who developed endophthalmitis after intravitreal anti–vascular endothelial growth factor injections and to correlate visual outcomes with clinical features. Methods: This is a retrospective, multicenter, consecutive case series of patients diagnosed with anti–vascular endothelial growth factor injection–related endophthalmitis who were treated at Mid Atlantic Retina, the Retina Service of Wills Eye Hospital, Philadelphia, PA, and the University of Southern California Roski Eye Institute, Los Angeles, CA. Patients were included if they had at least 1 year of follow-up. Primary outcome was to evaluate long-term visual outcomes up to 5 years of follow-up. The secondary outcome was to determine clinical features (e.g., culture results) that may predict long-term visual acuity outcomes. Results: A total of 56 cases of endophthalmitis from 168,247 anti–vascular endothelial growth factor injections were identi?ed (0.033%, 1/3,004 injections), from which 51 eyes met inclusion criteria. Mean follow-up period was 3.3 years (median 4 years; range 1–5 years). A total of 24 patients (47%) reached a maximum ?nal follow-up of 5 years. Mean Snellen visual acuity at the causative injection visit was 20/102 and decreased to counting ?ngers at diagnosis (P , 0.001). At 6-month follow-up, mean visual acuity improved to 20/644 (P , 0.001) and remained stable up to 5 years (20/480, P = 0.003) follow-up compared with diagnosis. At the ?nal follow-up, 20 eyes had visual acuity that returned to within one line of baseline visual acuity (visual recovery group), whereas 31 patients’ visual acuity was at least one line worse than initial visual acuity (visual deterioration group). The cultures for the visual recovery group were more likely to grow coagulase-negative Staphylococcus, whereas the visual deterioration group primarily grew Streptococcus species, Staphylococcus aureus, and Enterococcus faecalis (P = 0.002, comparing organisms isolated in the visual recovery and deterioration group). Conclusion: Visual outcomes after anti–vascular endothelial growth factor injection– related endophthalmitis seem to reach peak improvement by 6 months and remain stable up to a median of 4-year follow-up. Patients who develop culture-negative endophthalmitis or endophthalmitis secondary to coagulase-negative Staphylococcus are more likely to regain baseline visual acuity compared with cases secondary to Streptococcus species.
关键词： bevacizumab,anti-vascular endothelial growth factor,diabetic macular edema,intravitreal injection,endophthalmitis,a?ibercept,long-term,ranibizumab,neovascular age-related macular degeneration,retinal vein occlusion
更新于2025-09-10 09:29:36
-
Extensive Macular Atrophy with Pseudodrusen Imaged with OCT Angiography
摘要： This report describes the first case of extensive macular atrophy with pseudodrusen (EMAP) imaged with optical coherence tomography angiography (OCTA). A 58-year-old Caucasian man presented with decreased central vision in both eyes. Fundus examination showed large areas of macular atrophy centered on the fovea surrounded by diffuse reticular pseudodrusen. Spectral domain OCT (SDOCT) revealed outer retinal and choriocapillaris atrophy. OCTA demonstrated marked absence of choriocapillaris flow. Extensive macular atrophy with pseudodrusen is a rare clinical entity and a new extreme phenotype of macular degenerations that could shed more light on the role of pseudodrusen and choriocapillaris compromise in the pathogenesis of AMD.
关键词： macular degeneration,OCT angiography,Extensive macular atrophy,pseudodrusen
更新于2025-09-10 09:29:36
-
[IEEE 2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) - Honolulu, HI, USA (2018.7.18-2018.7.21)] 2018 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) - OCT Fluid Segmentation using Graph Shortest Path and Convolutional Neural Network <sup>*</sup>
摘要： Diagnosis and monitoring of retina diseases related to pathologies such as accumulated fluid can be performed using optical coherence tomography (OCT). OCT acquires a series of 2D slices (Bscans). This work presents a fully-automated method based on graph shortest path algorithms and convolutional neural network (CNN) to segment and detect three types of fluid including sub-retinal fluid (SRF), intra-retinal fluid (IRF) and pigment epithelium detachment (PED) in OCT Bscans of subjects with age-related macular degeneration (AMD) and retinal vein occlusion (RVO) or diabetic retinopathy. The proposed method achieves an average dice coefficient of 76.44%, 92.25% and 82.14% in Cirrus, Spectralis and Topcon datasets, respectively. The effectiveness of the proposed methods was also demonstrated in segmenting fluid in OCT images from the 2017 Retouch challenge.
关键词： optical coherence tomography,retinal vein occlusion,fluid segmentation,graph shortest path,convolutional neural network,age-related macular degeneration
更新于2025-09-10 09:29:36
-
Inner Segment Remodeling and Mitochondrial Translocation in Cone Photoreceptors in Age-Related Macular Degeneration With Outer Retinal Tubulation
摘要： PURPOSE. To quantify impressions of mitochondrial translocation in degenerating cones and to determine the nature of accumulated material in the subretinal space with apparent inner segment (IS)-like features by examining cone IS ultrastructure. METHODS. Human donor eyes with advanced age-related macular degeneration (AMD) were screened for outer retinal tubulation (ORT) in macula-wide, high-resolution digital sections. Degenerating cones inside ORT (ORT cones) and outside ORT (non-ORT cones) from AMD eyes and unaffected cones in age-matched control eyes were imaged using transmission electron microscopy. The distances of mitochondria to the external limiting membrane (ELM), cone IS length, and cone IS width at the ELM were measured. RESULTS. Outer retinal tubulation and non-ORT cones lose outer segments (OS), followed by shortening of IS and mitochondria. In non-ORT cones, IS broaden. Outer retinal tubulation and non-ORT cone IS myoids become undetectable due to mitochondria redistribution toward the nucleus. Some ORT cones were found lacking IS and containing mitochondria in the outer fiber (between soma and ELM). Unlike long, thin IS mitochondria in control cones, ORT and non-ORT IS mitochondria are ovoid or reniform. Shed IS, some containing mitochondria, were found in the subretinal space. CONCLUSIONS. In AMD, macula cones exhibit loss of detectable myoid due to IS shortening in addition to OS loss, as described. Mitochondria shrink and translocate toward the nucleus. As reflectivity sources, translocating mitochondria may be detectable using in vivo imaging to monitor photoreceptor degeneration in retinal disorders. These results improve the knowledge basis for interpreting high-resolution clinical retinal imaging.
关键词： ellipsoid,outer retinal tubulation,age-related macular degeneration,histology,photoreceptors,cones,myoid,transmission electron microscopy,Müller cells
更新于2025-09-10 09:29:36
-
Functional optical coherence tomography of retinal photoreceptors
摘要： Age-related macular degeneration (AMD) is the leading cause of severe vision loss and legal blindness. It is known that retinal photoreceptors are the primary target of AMD. Therefore, a reliable method for objective assessment of photoreceptor function is needed for early detection and reliable treatment evaluation of AMD and other eye diseases such as retinitis pigmentosa that are known to cause photoreceptor dysfunctions. Stimulus-evoked intrinsic optical signal (IOS) changes promise a unique opportunity for objective assessment of physiological function of retinal photoreceptor and inner neurons. Instead of a comprehensive review, this mini-review is to provide a brief summary of our recent in vitro and in vivo optical coherence tomography (OCT) studies of stimulus-evoked IOS changes in animal retinas. By providing excellent axial resolution to differentiate individual retinal layers, depth-resolved OCT revealed rapid IOS response at the photoreceptor outer segment. The fast photoreceptor-IOS occurred almost right away ((cid:1) 2 ms) after the onset of retinal stimulation, differentiating itself from slow IOS changes correlated with inner neural and hemodynamic changes. Further development of the functional IOS instruments and retinal stimulation protocols may provide a feasible solution to pursue clinical application of functional IOS imaging for objective assessment of human photoreceptors.
关键词： intrinsic optical signal,photoreceptors,Optical coherence tomography,age-related macular degeneration
更新于2025-09-10 09:29:36
-
New insight into the role of the complement in the most common types of retinopathy-current literature review
摘要： Pathological neovascularisation, which is a critical component of diseases such as age-related macular degeneration (AMD), diabetic retinopathy (DR) and retinopathy of prematurity (ROP), is a frequent cause of compromised vision or blindness. Researchers continuously investigate the role of the complement system in the pathogenesis of retinopathy. Studies have confirmed the role of factors H and I in the development of AMD, and factors H and B in the development of DR. Other components, such as C2, C3, and C5, have also been considered. However, findings on the involvement of the complement system in the pathogenesis of ROP are still inconclusive. This paper presents a review of the current literature data, pointing to the novel results and achievements from research into the role of complement components in the development of retinopathy. There is still a need to continue research in new directions, and to gather more detailed information about this problem which will be useful in the treatment of these diseases.
关键词： diabetic retinopathy,age-related macular degeneration,factors of the complement system,retinopathy of prematurity,single nucleotide polymorphism
更新于2025-09-10 09:29:36
-
Foveal structure during the induction phase of anti-vascular endothelial growth factor therapy for occult choroidal neovascularization in age-related macular degeneration
摘要： Purpose: To evaluate the efficacy of monthly injections of aflibercept and ranibizumab on foveal structure after three months, for the treatment of occult choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Methods: We retrospectively studied 103 eyes with treatment-na?ve neovascular AMD with occult and no classic CNV. Seventy-four of 103 eyes were treated with ranibizumab (intravitreal ranibizumab injection [IVR] group); 29 eyes were treated with aflibercept (intravitreal aflibercept injection [IAI] group). The best-corrected visual acuity and the retinal and choroidal structure at the fovea were evaluated using optical coherence tomography. Results: The total foveal thickness, the height of serous retinal detachments, and subfoveal choroidal thickness were compared with baseline, and the incidence of retinal pigment epithelial elevation significantly decreased in the IAI group compared with the IVR group. In contrast, the thickness of the sensory retina at the fovea significantly decreased in the IVR group when compared with the IAI group. The logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity improved more significantly in the IVR group (?0.085±0.164) than in the IAI group (?0.020±0.125) at 3 months (P=0.017). Conclusion: After intravitreal injection, aflibercept more rapidly reduced subretinal fluid and subfoveal choroidal thickness. In contrast, ranibizumab decreased the sensory retinal thickness compared with aflibercept. The responses of the retinal and choroidal tissue to these anti-VEGF agents may be different during the induction phase for eyes with occult CNV secondary to neovascular AMD.
关键词： occult,neovascular age-related macular degeneration,outer nuclear layer,aflibercept,retinal thickness,ranibizumab
更新于2025-09-10 09:29:36
-
Aflibercept Treatment for Neovascular Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy Refractory to Anti-vascular Endothelial Growth Factor
摘要： Purpose: To report the results of switching treatment to vascular endothelial growth factor (VEGF) Trap-Eye (aflibercept) in neovascular age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) refractory to anti-VEGF (ranibizumab and bevacizumab). Methods: This is a retrospective study involving 32 eyes from 29 patients; 18 were cases of neovascular AMD and 14 were cases of PCV. The best-corrected visual acuity (BCVA) and central macular thickness (CMT) of spectral-domain optical coherence tomography were evaluated. Results: BCVA and CMT improved from 0.58 to 0.55 (p = 0.005) and from 404 to 321 μm (p < 0.001), respectively, after switching to aflibercept. The 14 eyes that received 6 or more aflibercept injections remained stable at 0.81 to 0.81 and 321 to 327 μm (p = 1.0, 0.29), respectively, after 3 aflibercept injections. The 10 eyes that received 3 or more bevacizumab injections after 3 or more aflibercept injections worsened, from 0.44 to 0.47 and from 332 to 346 μm (p = 0.06, 0.05), respectively. The results showed similar improvement of BCVA and CMT in neovascular AMD and PCV. Conclusions: Aflibercept seems to be effective for improvement and maintenance of BCVA and CMT for neovascular AMD and PCV refractory to anti-VEGF. Switching from aflibercept back to bevacizumab treatment may not be a proper strategy.
关键词： Aflibercept,Polypoidal choroidal vasculopathy,Bevacizumab,Macular degeneration,Anti-vascular endothelial growth factor
更新于2025-09-10 09:29:36