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The angopoietin/tyrosine kinase with immunoglobulin and epidermal growth factor homology domains (Ang/Tie) pathway is an emerging key regulator in vascular development and maintenance. Its relevance to clinicians and basic scientists as a... more
The angopoietin/tyrosine kinase with immunoglobulin and epidermal growth factor homology domains (Ang/Tie) pathway is an emerging key regulator in vascular development and maintenance. Its relevance to clinicians and basic scientists as a potential therapeutic target in retinal and choroidal vascular diseases is highlighted by recent preclinical and clinical evidence. The Ang/Tie pathway plays an important role in the regulation of vascular stability, in angiogenesis under physiological and pathological conditions, as well as in inflammation. Under physiological conditions, angiopoietin-1 (Ang-1) binds to and phosphorylates the Tie2 receptor, leading to downstream signalling that promotes cell survival and vascular stability. Angiopoietin-2 (Ang-2) is upregulated under pathological conditions and acts as a context-dependent agonist/antagonist of the Ang-1/Tie2 axis, causing vascular destabilisation and sensitising blood vessels to the effects of vascular endothelial growth factor-A ...
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This is an Editorial and does not have an abstract.
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Research Interests: Chemistry, Ophthalmology, Medicine, Retinal detachment, Retina, and 3 moreRetinal, RhoA, and Fasudil
Research Interests: Tissue Engineering, Medicine, Retinal Pigment Epithelium, Macular Degeneration, Biological Sciences, and 14 moreCell Differentiation, Humans, Mice, Retinitis pigmentosa, Animals, Disease, Retinal Degeneration, Embryonic Stem Cells, Retinal, Rats, Induced Pluripotent Stem Cells, Clinical Trials as Topic, Medical and Health Sciences, and Cell- and tissue-based therapy
Loss of light perception (LP) after open globe injury (OGI) does not necessarily mean the patient will have permanent complete visual loss. Findings that seem to be associated reliably with permanent profound vision loss after OGI include... more
Loss of light perception (LP) after open globe injury (OGI) does not necessarily mean the patient will have permanent complete visual loss. Findings that seem to be associated reliably with permanent profound vision loss after OGI include optic nerve avulsion, optic nerve transection, and profound loss of intraocular contents, which can be identified with CT/MRI imaging albeit with varying degrees of confidence. Eyes with NLP after OGI that undergo successful primary repair with intact optic nerves may be considered for additional surgery, particularly if there is: (1) recovery of LP on the first day after primary repair; (2) treatable pathology underlying NLP status (e.g., extensive choroidal hemorrhage, dense vitreous and subretinal hemorrhage); (3) NLP in the fellow eye. We counsel patients that the chance of recovering ambulatory vision under these circumstances is very low (~5%).
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The aim of this study is to describe the results of pars plana vitrectomy (PPV) for refractory diabetic macular edema (DME). Review of the relevant peer-reviewed scientific literature identified using Medline. The anatomical and... more
The aim of this study is to describe the results of pars plana vitrectomy (PPV) for refractory diabetic macular edema (DME). Review of the relevant peer-reviewed scientific literature identified using Medline. The anatomical and functional outcome of surgery. Vitrectomy with or without internal limiting membrane (ILM) peeling can be beneficial for the treatment of DME that is resistant to laser photocoagulation or sub-Tenon's steroid injection. Visual improvement has been reported in approximately 40-90% of patients, with approximately 85-100% experiencing either improvement or stabilization of vision. Retinal edema decreases or resolves in approximately 70-100% of patients. Complications range in severity with approximately 5-20% of patients developing peripheral retinal breaks, approximately 1-2% developing retinal detachment, approximately 2% developing macular hole, and approximately 10-60% developing cataract. Severe complications such as rubeosis iridis and the fibrinoid syndrome have also been reported. Pars plana vitrectomy can be an effective treatment for diabetic macular edema refractory to laser therapy and/or sub-Tenon's capsule steroid injection.
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Tonic pupil was observed in a 67 year-old patient following a retinal detachment repair with pars plana vitrectomy, endolaser and silicone oil tamponade performed under retrobulbar anesthesia. The probable location of disturbance is the... more
Tonic pupil was observed in a 67 year-old patient following a retinal detachment repair with pars plana vitrectomy, endolaser and silicone oil tamponade performed under retrobulbar anesthesia. The probable location of disturbance is the postganglionic parasympathetic fibers in the short ciliary nerves along their course to the pupil in the suprachoroidal space. A likely explanation for this phenomenon is injury to short ciliary nerves by endolaser treatment.
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Infectious endophthalmitis is a rare but severe complication of septecemia, intraocular surgeries, or penetrating eye trauma. The etiology, prognosis, and management of pediatric endophthalmitis resulting from exogenous and endogenous... more
Infectious endophthalmitis is a rare but severe complication of septecemia, intraocular surgeries, or penetrating eye trauma. The etiology, prognosis, and management of pediatric endophthalmitis resulting from exogenous and endogenous infections are reviewed. Open-globe trauma and glaucoma surgery are the most frequent causes of endophthalmitis in children, whereas endogenous infection is the least common cause. Streptococcus and Staphylococcus species are common bacterial agents in both posttraumatic and postoperative pediatric endophthalmitis, whereas Candida albicans is a commonly reported organism in endogenous endophthalmitis. Additionally, Streptococcus pneumoniae and Haemophilus influenzae appear more likely as pathogens in children than in adults. The clinical manifestations and outcome usually correlate with the virulence of the infecting organism. The visual prognosis of endophthalmitis is generally poor. [J Pediatr Ophthalmol Strabismus 2014;51(3):140–153.]
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The aim of this study was to describe a new technique for transscleral suturing of posterior chamber intraocular lenses (PCIOLs) without intraocular knots. Retrospective noncomparative case series. Twenty-four eyes underwent implantation... more
The aim of this study was to describe a new technique for transscleral suturing of posterior chamber intraocular lenses (PCIOLs) without intraocular knots. Retrospective noncomparative case series. Twenty-four eyes underwent implantation of PCIOLs with this new technique. Suture fixation of PCIOLs was performed in eyes without capsular support. The anatomic and functional outcome of surgery was determined during a follow-up of 2 to 40 months. The PCIOL remained well centered without tilt in 22 of 24 (92%) eyes. The PCIOL was well centered in 16 of 17 (94%) eyes followed for > or =6 months. Complications related to lens suturing were minimal and resolved spontaneously. Final visual outcome depended almost entirely on the underlying health of the retina and optic nerve. This technique eliminates intraocular knots, minimizes operating time with an open globe, and provides excellent lens centration in the absence of capsular support.