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  • Preretinal abnormal tissue before and after pars plana vitrectomy in macula-on rhegmatogenous retinal detachment: a multimodal imaging studyThis link opens in a new windowJan 3, 2025
    Purpose

    To quantitatively explore preretinal abnormal tissue (PAT) in macula-on rhegmatogenous retinal detachment (RRD) before and after surgery.

    Methods

    In this case-series study, PAT was detected by en-face optical coherence tomography images with custom slabs in eyes that underwent pars plana vitrectomy and SF6 for macula-on RRD.

    Main outcome measures were PAT area at baseline, 3-month and 6-month follow-up, and its relative change. Associations between PAT and foveal avascular zone (FAZ) at superficial capillary plexus (SCP), RRD area, retinal tear (RT) area and endolaser area were investigated.

    Results

    36 macula-on eyes RRD were included in the analysis. Significant PAT growth was registered from baseline until 6 months (p<0.001). Baseline PAT area correlated with RT area (r=0.54, p=0.001). Significant correlation between relative change in PAT and relative change in FAZ SCP was found. The multivariable regression model showed a statistically significant association between Endolaser area (cm2) and relative changes in PAT (p=0.004).

    Conclusions

    Our study found that despite good retinal reattachment, PAT proliferates over months with vascular changes. Endolaser area has a major influence on PAT growth, without impact on best-corrected visual acuity. Additional knowledge about pathophysiological mechanisms of growth could help understanding which surgical approach may limit PAT extension and future secondary epiretinal membrane.

  • Genome-wide association study of anterior uveitisThis link opens in a new windowDec 27, 2024
    Background/aims

    The purpose of this study is to define genetic factors associated with anterior uveitis through genome-wide association study (GWAS).

    Methods

    In this GWAS meta-analysis, we combined data from the FinnGen, Estonian Biobank and UK Biobank with a total of 12 205 anterior uveitis cases and 917 145 controls. We performed a phenome-wide association study (PheWAS) to investigate associations across phenotypes and traits. We also evaluated genetic correlations of anterior uveitis.

    Results

    We identified six anterior uveitis-associated loci. Genome-wide significant (p<5 x 10–8) associations were identified for the first time at three loci (innate immunity activator (INAVA), nucleotide-binding domain, leucine-rich repeat family, pyrin domain containing 3 and nitric oxide synthase 2). We detected associations at three loci previously reported to be associated with uveitis (endoplasmic reticulum aminopeptidase 1 (ERAP1), the trinucleotide repeat containing 18 (TNRC18) and the HLA region) and also replicated associations at two loci previously associated with acute anterior uveitis (IL23R and HDAC2-AS2). In PheWAS, we further detected that lead single nucleotide polymorphisms (SNPs) at three of the anterior uveitis-associated loci (ERAP1, INAVA and TNRC18) are associated with other immunity-related phenotypes, including ankylosing spondylitis and inflammatory bowel disease. Additionally, we detected a moderate genetic correlation between anterior uveitis and inflammatory bowel disease (rg=0.39, p=8 x 10–5).

    Conclusion

    We identified six anterior uveitis-associated loci, including three novel loci with genome-wide significance. Our findings deepen our understanding of the genetic basis of anterior uveitis and the genetic connections between anterior uveitis and immune-related disorders, providing a foundation for further research and potential therapeutic interventions.

  • Predictors of cytomegalovirus corneal endotheliitis postcorneal transplantationThis link opens in a new windowDec 22, 2024
    Purpose

    This study was designed to investigate risk factors for the development of cytomegalovirus (CMV) corneal endotheliitis following corneal transplantation.

    Methods

    We retrospectively analysed 1225 corneal transplants for bullous keratopathy between 2011 and 2021. 31 cases who were administered the treatment of CMV corneal endotheliitis preoperatively were excluded, and 1194 cases were analysed for risk factors for the development of CMV corneal endotheliitis following corneal transplantation.

    Results

    Among 1194 cases, 15 cases (1.26%) occurred CMV corneal endotheliitis after corneal transplantation. Coin-shaped lesion or keratoprecipitates were observed in 100% of cases. Postoperatively, the mean onset of CMV corneal endotheliitis was 9.9±12.2 months, with 12 eyes (80.0%) within the first 12 months. Multivariate analysis adjusted for potential confounding factors revealed a gender (male, OR (8.42, 95% CI: 2.19 to 56.00), the previous history of anterior uveitis (OR: 25.31, 95% CI: 8.22 to 95.19) and the previous history of glaucoma (OR: 6.25, 95% CI: 1.17 to 115.90) were significantly associated with the development of postoperative CMV corneal endotheliitis. The maternal proportion Ryan multiple comparison tests revealed that dual previous history with glaucoma and anterior uveitis significantly enhanced the development of postoperative CMV corneal endotheliitis (p<0.001).

    Conclusions

    CMV corneal endotheliitis developed postcorneal transplantation with coin-shaped lesions. Careful postoperative follow-up, especially within the first 12 months after surgery, is necessary for patients with a history of glaucoma or anterior uveitis.

  • CMV corneal endotheliitisThis link opens in a new windowDec 22, 2024

    When corneal endotheliitis was first reported by Khodadoust and Attarzadeh in 1982, it was thought to be caused by an autoimmune process.1 The clinical presentation was similar to corneal allograft rejection due to the presence of linear corneal keratic precipitates (KPs). PCR testing in a patient with a similar clinical presentation in Japan led to discovery of the herpes simplex virus.2 Later, Koizumi et al detected cytomegalovirus (CMV) DNA in a case of corneal endotheliitis.3 CMV endotheliitis is a unique entity. The pathogenesis of CMV corneal endotheliitis is unknown. The clinical presentation is characterised by KPs and local corneal oedema eventually leading to corneal endothelial cell damage and bullous keratopathy. The diagnosis is confirmed by the presence of CMV DNA in the anterior chamber. The response to treatment is variable with the use of topical ganciclovir and systemic ganciclovir or valganciclovir. It is important...

  • Prognosis for patients with metastatic conjunctival melanomaThis link opens in a new windowDec 18, 2024

    Conjunctival melanoma is a rare ocular cancer, and despite recent advances in the early detection of metastasis and the availability of new drugs such as immune checkpoint inhibitors and Braf-directed targeted therapy that have demonstrated efficacy for the treatment of metastatic conjunctival melanoma,1 it remains a significant cause of morbidity and mortality worldwide. Jain et al report on 29 patients with metastatic conjunctival melanoma.2 These 29 patients represent about 10% of the 288 patients with conjunctival melanoma included in this retrospective review based on data pooled from 10 international centres from a wide geographic area of the world. ‘Metastasis’ is defined as ‘M1’ per the American Joint Commission on Cancer (AJCC) definition and as such only addresses distant (hematogenous) metastasis. In other words, the stated primary objective of the report is to focus on patients who developed hematogenous distant metastasis although the authors provide some information...

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