Defensive effect of dexmedetomidine in cecal ligation perforation-induced intense lungs harm by way

Author : Munro Bille | Published On : 16 Oct 2024

The authors present the case of a 73-year-old woman affected by geographic atrophy (GA) in her left eye. During her follow-up, she developed a subretinal hyporeflective space visible on optical coherence tomography (OCT) images. This peculiar OCT sign was recognized to represent a wedge-shaped subretinal hyporeflectivity (WSSH). In contrast to previous reports showing that WSSH develops during the flattening of drusenoid pigment epithelium detachment (PED), the authors found that the WSSH manifestation may be even consecutive to the regression of a large PED and consequent GA appearance. Therefore, the origin of this peculiar OCT finding could be more complex and variegated. [Ophthalmic Surg Lasers Imaging Retina. 2020;51116-118.]. Copyright 2020, SLACK Incorporated.BACKGROUND AND OBJECTIVE To describe a case series of three patients in one family with Von Hippel-Lindau (VHL) disease who presented with vitreoretinal neovascularization and resulting tractional retinal detachments (TRDs). This vitreoretinal phenotype of VHL may benefit from early surgical intervention. PATIENTS AND METHODS Descriptive case series of three patients in one family with VHL disease. A review of the literature regarding surgical intervention for VHL was performed. RESULTS All three patients developed prominent intravitreal neovascularization with fibrovascular growth within the vitreous secondary to a retinal capillary hemangioma. Two subjects with intravitreal neovascularization were treated with laser and cryotherapy but eventually developed a TRD. The final vision in these two patients was light perception and 20/300. The eye that was preemptively treated with vitrectomy to remove the vitreous sustaining the neovascularization had visual acuity of 20/50 after surgery. CONCLUSION Intravitreal neovascularization with fibrovascular proliferation may be an indication for vitrectomy prior to the development of retinal detachment. [Ophthalmic Surg Lasers Imaging Retina. 2020;51109-115.]. Copyright 2020, SLACK Incorporated.BACKGROUND AND OBJECTIVE To study the anatomical and functional outcomes of using epimacular amniotic membrane graft (AMG) to close myopic macular holes (MMHs) in patients with recurrent retinal detachment (RD). PATIENTS AND METHODS Fourteen patients with recurrent MMH-RD were enrolled in a single-arm, prospective study. Pars plana vitrectomy with peeling of any residual internal limiting membrane, preserved AMG was placed over the macular hole (MH) after air-fluid exchange, all patient left on 16% of C2F6. selleckchem RESULTS Fourteen patients (11 females and three males) with an average age of 58.7 years were included; follow-up was 6 months. Thirteen patients (93%) showed retinal reattachment and closure of the hole confirmed by optical coherent tomography. The mean logMAR of best-corrected visual acuity improved to 1.38 compared to 2.2 preoperatively (P less then .002, paired t-test), with no serious intraoperative or postoperative complications. CONCLUSION Epimacular AMG for MMH-RD is a safe and effective treatment for closure of myopic MHs. [Ophthalmic Surg Lasers Imaging Retina. 2020;51101-108.]. Copyright 2020, SLACK Incorporated.BACKGROUND AND OBJECTIVES To quantitatively evaluate diabetic retinopathy (DR) lesions using the authors' validated machine learning algorithms and provide physicians with an automated and precise method to follow the progression of DR and outcome of interventions. PATIENTS AND METHODS Retrospective analyses were conducted of 3,496 color fundus photography images from 19 patients with clinically significant diabetic macular edema receiving conbercept treatment. The modified seven-field fundus images were obtained at baseline and at the third, sixth, and twelfth month visit, whereas the modified two-field fundus images were obtained at the other monthly visits. The area of intraretinal hemorrhage and hard exudate lesions was traced by the authors' validated algorithms. RESULTS The mean central foveal thickness at baseline was 459.9 μm ± 127.5 μm. Mean central foveal thickness was 316.5 μm ± 53.0 μm at the twelfth month visit, which decreased by 143.4 μm when compared with the baseline optical coherence tomogradate lesions during the course of conbercept treatment. The automated system is promising to be a precise and objective method for monitoring the progression of DR and outcomes of interventions in clinical settings. [Ophthalmic Surg Lasers Imaging Retina. 2020;5195-100.]. © 2020 Yu, Wang, Zhou, et al.BACKGROUND AND OBJECTIVE The purpose of this study was to evaluate the difference between widefield confocal scanning laser imaging (WSLO) and widefield broad line fundus (WBLF) imaging in their ability to view the peripheral retina in routine clinical practice. PATIENTS AND METHODS A retrospective chart review identified patients within routine clinical practice who were imaged with a WSLO image and a single and montaged WBLF image. The primary outcome was the number of ultra-widefield quadrants captured utilizing the UWF consensus definitions. Secondary outcomes included the area within each of quadrant and the differences in clinical grading between modalities. RESULTS More vortex ampullae were identified with the WSLO than either single image or montage WBLF image. The WSLO captured 116 of the possible 260 vortex ampullae (45%) in comparison to the WBLF single image (8 of 260; 3%) and WBLF montage (96 of 260; 37%). Only five eyes from WSLO and no images from the WBLF single image met the ultra-widefield consensus definition in routine clinical practice. The average area per individual quadrant acquired by WSLO image was greater than the single or montage WBLF image (781.67 mm2, 433.82 mm2, and 686.03 mm2, respectively; P less then .001). Clinical grading of images found a substantial inter-rater agreement with both technologies (86% on WSLO; 88% on WBLF). CONCLUSIONS Both systems had a low rate of meeting UWF consensus definitions in routine clinical practice. A single WSLO image acquired a greater area than WBLF image in both single-image and montage formats. [Ophthalmic Surg Lasers Imaging Retina. 2020;5189-94.]. Copyright 2020, SLACK Incorporated.BACKGROUND AND OBJECTIVE To describe long-term outcomes and complications after YAG vitreolysis. PATIENTS AND METHODS This is an observational extension study to a previously reported, randomized, controlled study. Thirty-five of 52 patients returned at an average of 2.3 years (range 1.1 to 3.0) after their last YAG vitreolysis treatment to assess long-term efficacy and safety. RESULTS At 2.3 years, 50% of patients felt their symptoms were significantly or completely better, similar to results at 6 months (53%). There was a 59.4% improvement in symptoms, similar to 6 months (54%). The 25-item National Eye Institute Visual Function Questionnaire revealed improvements in near activities, distance vision, mental health, and role difficulties. Adverse events included three eyes with delayed retinal tears, noted 1.4 to 2.8 years after YAG vitreolysis. CONCLUSIONS The efficacy of YAG vitreolysis observed at 6 months was sustained at 2.3 years, with half reporting significant or complete resolution of their floater symptoms. Three patients developed delayed retinal tears not evident at 6 months. A large, long-term randomized controlled trial is needed to determine the true risks of YAG vitreolysis. [Ophthalmic Surg Lasers Imaging Retina. 2020;5185-88.]. Copyright 2020, SLACK Incorporated.BACKGROUND AND OBJECTIVE To report a unique case series of diffuse unilateral subacute neuroretinitis (DUSN) patients imaged with optical coherence tomography angiography (OCTA). PATIENTS AND METHODS In this retrospective case series, multimodal imaging was performed in four patients with DUSN at the time of patient visit. The study patients underwent standard clinical treatment for DUSN. RESULTS The clinical findings were consistent with the diagnosis of DUSN. Cross-sectional OCT showed disruption of outer retinal layers in the foveal area and an irregular structure of the outer plexiform layer. En face OCT revealed hyperreflective spots and a large hyperreflective lesion in the foveal area correspondent to the outer retina disruption seen on cross-sectional OCT. OCTA demonstrated decreased vascular perfusion in both the superficial and deep retinal capillary plexuses along with choriocapillaris preservation. CONCLUSION OCTA may provide a more detailed assessment of the retinal microvascular changes, allowing a more precise anatomical-functional correlation in DUSN. [Ophthalmic Surg Lasers Imaging Retina. 2020;5176-83.]. Copyright 2020, SLACK Incorporated.BACKGROUND AND OBJECTIVE To explore how baseline macular atrophy (MA) affects visual acuity (VA) in patients receiving intravitreal anti-vascular endothelial growth factor (VEGF) injections for neovascular age-related macular degeneration (nAMD). PATIENTS AND METHODS A retrospective, case control series. Patients were grouped into three cohorts based on baseline spectral-domain optical coherence tomography image findings foveal MA, nonfoveal MA, and no MA. Outcomes were assessed at 1, 2, and 3 years following anti-VEGF therapy. RESULTS No differences existed in MA growth between eyes with foveal and nonfoveal MA (0.89 mm2 [95% confidence interval (CI), 0.64-1.14] vs. 0.88 mm2 [95% CI, 0.72-1.05]) after adjusting for baseline lesion sizes at 3 years. Foveal MA patients lost an average of 19.4 ETDRS letters (95% CI, -30.8 to -8.0) after 3 years. Nonfoveal MA patients gained an average of 1.1 ETDRS letters (95% CI, -6.8 to 9.0), and patients without MA averaged a gain of 9.7 ETDRS letters (95% CI, 5.5-14.0). CONCLUSION In patients with nAMD receiving anti-VEGF in routine clinical practice, presence of baseline foveal MA was associated with significant vision loss. [Ophthalmic Surg Lasers Imaging Retina. 2020;5168-75.]. Copyright 2020, SLACK Incorporated.CONTEXT Selenocysteine insertion sequence binding protein 2 (SECISBP2, SBP2) is an essential factor for selenoprotein synthesis. Individuals with SBP2 defects have characteristic thyroid function test (TFT) abnormalities resulting from deficiencies in the selenoenzymes deiodinases. Eight families with recessive SBP2 gene mutations have been reported to date. We report 2 families with inherited defect in thyroid hormone metabolism caused by 4 novel compound heterozygous mutations in the SBP2 gene. CASE DESCRIPTIONS Probands 1 and 2 presented with growth and developmental delay. Both had characteristic TFT with high T4, low T3, high reverse T3, and normal or slightly elevated TSH. The coding region of the SBP2 gene was sequenced and analysis of in vitro translated wild-type and mutant SBP2 proteins was performed. Sequencing of the SBP2 gene identified novel compound heterozygous mutations resulting in mutant SBP2 proteins E679D and R197* in proband 1, and K682Tfs*2 and Q782* in proband 2. In vitro translation of the missense E679D demonstrated all four isoforms, whereas R197* had only 2 shorter isoforms translated from downstream ATGs, and Q782*, K682Tfs*2 expressed isoforms with truncated C-terminus. Reduction in serum glutathione peroxidase enzymatic activity was also demonstrated in both probands. CONCLUSIONS We report 2 additional families with mutations in the SBP2 gene, a rare inherited condition manifesting global selenoprotein deficiencies. Report of additional families with SBP2 deficiency and their evaluation over time is needed to determine the full spectrum of clinical manifestations in SBP2 deficiency and increase our understanding of the role played by SBP2 and selenoproteins in health and disease. Published by Oxford University Press on behalf of the Endocrine Society 2020.