Search Results (68)

(1) Background: Ocular emergencies account for 1.5–3% of emergency department (ED) visits and require urgent diagnosis to prevent serious complications. Ultrasonography is a crucial, non-invasive diagnostic tool for these conditions but traditionally lacks portability and integration with modern electronic smart devices. The purpose of this study was to assess the accuracy and performance of a new handheld ultrasound device in comparison to a conventional cart-based sonographic machine in patients attending to the ED for vitreo-retinal diseases. (2) Methods: three specialists in ophthalmology, with at least 4-year experience in vitreo-retinal diseases and eye ultrasound, evaluated images of 50 eyes with both portable and traditional ultrasound probes. Each specialist made the diagnosis based on the images captured with both probes and then rated their overall image quality and confidence of diagnosis with a five-point Likert scale. The concordance of diagnosis between the two probes was evaluated. (3) Results: The sample comprised 42 patients. Twenty (40%) healthy eyes and thirty eyes with the following vitreo-retinal interface conditions were examined: 12 retinal detachment (24%), 8 vitreous hemorrhage (16%), and 10 posterior vitreous detachment (20%). The overall accuracy of the two devices appeared to be comparable (70.7% vs. 69.3%). The Butterfly iQ+ probe showed similar sensitivity in retinal detachment diagnosis (91.7% vs. 94.4% of the Accutome B-scan Pro), while it showed poor performance in diagnosing posterior vitreous detachment (sensitivity = 27.2%); (4) Conclusions: The Butterfly iQ+ device demonstrated high sensitivity in the diagnosis of retinal detachment. Significant adjustments are still needed to improve the resolution of the vitreous body. Full article

A 54-year-old, one-eyed Caucasian male was admitted to the Ophthalmology Clinic due to a gradual deterioration of vision in the right eye for approximately two weeks. The patient denied any trauma or viral infection during this time. On the day of admission, the patient’s best corrected visual acuity (BCVA) in the right eye was 0.5 on the Snellen scale. The patient’s left eye had been atrophied for several years, with no light perception and no visibility of the fundus due to previous trauma and multiple surgeries. Ophthalmologic examination of the anterior segment and vitreous body of both eyes showed no signs of inflammation. Fundus examination of the right eye revealed scattered inflammatory foci, creamy-yellow and round, visible in all sectors. Laboratory tests, imaging studies, optical coherence tomography (OCT) angiographies, OCTs of the macula and optic nerve head, fluorescein angiographies (FAs), electroretinograms (ERGs), and visual field tests were performed. These examinations led to a diagnosis of a disease resembling birdshot-like chorioretinopathy. Immunogenetic testing of the patient did not reveal the presence of human leukocyte antigen (HLA)-A29. Dermatological and immunological consultations were conducted, and a differential diagnosis was made. Due to the reduced visual acuity (VA) observed and the inability to assess the left eye, a high-dose corticosteroid therapy was initiated, which was gradually tapered, along with the application of an immunosuppressive drug. The course of the disease was typical for birdshot chorioretinopathy, with chronic periods of remissions and exacerbations. The patient’s clinical improvement was only achieved after co-administration of general corticosteroids at a dose of 0.5–1 mg/kg/day, mycofenolate mofetil, and periocular (sub-Tenon’s) triamcinolone. Full article

This suspect case focuses on investigating the presence of halite (NaCl) crystals on the clothing of a deceased individual to determine whether they resulted from immersion in seawater or residual absorption after immersion (i.e., the crystals were left on the clothing after contact with the victim’s wet body). Thirteen clothing samples were collected from various garments worn by the victim and were subjected to optical stereomicroscopy, Scanning Electron Microscopy (SEM), coupled with Energy Dispersive Spectroscopy (EDS), and Simultaneous Thermal Analysis (STA). Optical stereomicroscopy revealed numerous white-colored, vitreous, and greasy luster microcrystals dispersed between fabric fibers, with higher concentrations observed near the hem seams and metal rivets. These microcrystals exhibited predominantly cubic and irregular morphologies. Additionally, sandy particles and organic elements, such as plant fragments and micro seashells, were detected, indicative of coastal environment exposure. SEM-EDS analysis confirmed the presence mainly of sodium and chlorine in stoichiometric ratios consistent with halite, with crystals exhibiting amorphous, needle-shaped, or cubic morphologies. Furthermore, STA analysis identified weight loss events attributed to organic decomposition and halite decomposition at high temperatures, corroborating SEM-EDS findings. The distribution and characteristics of halite crystals, along with other trace elements, support the hypothesis of immersion in seawater while wearing clothing. Specifically, the higher concentrations of halite crystals near thicker fabric portions and metal rivets suggest slower drying rates and longer evaporation times, indicative of immersion rather than residual absorption after swimming. This finding not only helps in determining the victim’s exposure to seawater but also establishes a methodology for distinguishing between different sources of halite residue on clothing. Overall, the comprehensive mineralogical characterization of halite crystals on clothing samples, using best practices of forensic mineralogy, provides valuable forensic insights related to the circumstances that led to the victim’s death. This approach aided investigators in reconstructing the sequence of events, enhancing the accuracy of forensic reconstructions. Moreover, this study contributes to the broader field of forensic geoscience by demonstrating the practical applications of mineralogical analysis in criminal investigations, potentially guiding future research and improving investigative techniques in similar cases. Full article

Anti-VEGF agents, e.g., bevacizumab, are used in retinal surgery, while their interaction with silicone oils and novel hydrogels remains unclear. This study examines the in vitro pharmacokinetics of bevacizumab in silicone oil-filled eyes compared to various hydrogel replacements and the porcine vitreous body as well as its impact on the interface tension of silicone oils. An in vitro model filled with light or heavy silicone oil, porcine vitreous bodies, or hydrogels (alginate and polyethylene glycol (PEG)-based) was equilibrated with a balanced salt solution. Monitoring of bevacizumab in the aqueous phase was conducted for up to 24 h, and its effect on interfacial tension was studied. Significant differences in bevacizumab partitioning were observed across endotamponades after 24 h. In silicone oils, bevacizumab was found exclusively in the aqueous phase, while in the other endotamponades, it accumulated in the gel phase (96.1% in porcine vitreous body, 83.5% in alginate, and 27.6% in PEG-based hydrogel). Bevacizumab significantly reduced interfacial tension (40 to 8 mN/m), possibly enhancing silicone oil emulsification. The type of endotamponade heavily influenced the bevacizumab concentration in the aqueous. The vitreous body and replacement hydrogels likely serve as a drug reservoir, highlighting the need for in vivo studies to explore these interactions prior to clinical application. Full article

Background: Endotamponade of the vitreous body with silicone oil is a common procedure, being the basis of many vitreoretinal surgeries. However, emulsification may happen, which is a clinically relevant adverse event of silicone oil use. Methods: This review provides a thorough analysis of the emulsification process. It focuses on describing factors affecting this event as well as its possible subsequent complications. Results: The viscosity of silicone oil, the duration of emulsification, the status of the lens and many other factors have an influence on the onset and intensity of emulsification. This phenomenon carries several risks for operated eyes such as increased intraocular pressure, keratopathy or structural changes to the retina. Conclusions: The use of modern imaging techniques, especially optical coherence tomography, enables faster detection of the emulsification process. This allows for an adequate clinical response and more accurate follow-up of the patient. Full article

Nitrate (NO₃⁻) obtained from the diet is converted to nitrite (NO₂⁻) and subsequently to nitric oxide (NO) within the body. Previously, we showed that porcine eye components contain substantial amounts of nitrate and nitrite that are similar to those in blood. Notably, cornea and sclera exhibited the capability to reduce nitrate to nitrite. To gain deeper insights into nitrate metabolism in porcine eyes, our current study involved feeding pigs either NaCl or Na¹⁵NO₃ and assessing the levels of total and ¹⁵N-labeled NO₃⁻/NO₂⁻ in various ocular tissues. Three hours after Na¹⁵NO₃ ingestion, a marked increase in ¹⁵NO₃⁻ and ¹⁵NO₂⁻ was observed in all parts of the eye; in particular, the aqueous and vitreous humor showed a high ¹⁵NO₃⁻ enrichment (77.5 and 74.5%, respectively), similar to that of plasma (77.1%) and showed an even higher ¹⁵NO₂⁻ enrichment (39.9 and 35.3%, respectively) than that of plasma (19.8%). The total amounts of NO₃⁻ and NO₂⁻ exhibited patterns consistent with those observed in ¹⁵N analysis. Next, to investigate whether nitrate or nitrite accumulate proportionally after multiple nitrate treatments, we measured nitrate and nitrite contents after supplementing pigs with Na¹⁵NO₃ for five consecutive days. In both ¹⁵N-labeled and total nitrate and nitrite analysis, we did not observe further accumulation of these ions after multiple treatments, compared to a single treatment. These findings suggest that dietary nitrate supplementation exerts a significant influence on nitrate and nitrite levels and potentially NO levels in the eye and opens up the possibility for the therapeutic use of dietary nitrate/nitrite to enhance or restore NO levels in ocular tissues. Full article

Glaucoma is a multifactorial pathology involving the immune system. The subclinical immune response plays a homeostatic role in healthy situations, but in pathological situations, it produces imbalances. Optical coherence tomography detects immune cells in the vitreous as hyperreflective opacities and these are subsequently characterised by computational analysis. This study monitors the changes in immunity in the vitreous in two steroid-induced glaucoma (SIG) animal models created with drug delivery systems (microspheres loaded with dexamethasone and dexamethasone/fibronectin), comparing both sexes and healthy controls over six months. SIG eyes tended to present greater intensity and a higher number of vitreous opacities (p < 0.05), with dynamic fluctuations in the percentage of isolated cells (10 µm²), non-activated cells (10–50 µm²), activated cells (50–250 µm²) and cell complexes (>250 µm²). Both SIG models presented an anti-inflammatory profile, with non-activated cells being the largest population in this study. However, smaller opacities (isolated cells) seemed to be the first responder to noxa since they were the most rounded (recruitment), coinciding with peak intraocular pressure increase, and showed the highest mean Intensity (intracellular machinery), even in the contralateral eye, and a major change in orientation (motility). Studying the features of hyperreflective opacities in the vitreous using OCT could be a useful biomarker of glaucoma. Full article

Whereas Picasso’s work in ceramics, wood and bronze is rather well known, the body of his sculptures in glass remains an object of little research. In fact, as a thorough analysis reveals, they rarely find mention in publications or catalogues on Picasso and seldom are included in exhibitions or retrospectives on the great Spanish artist. This may on the one hand be attributed to a still prevailing perception of glass as a medium for industrial, functional or everyday purposes—hence discounting the material in terms of artistic output—while on the other to controversies of authorship, related to the question of ideation versus creation. Unlike ceramics or bronze, the realisation of blown glass sculpture hinges on the involvement of the maestro vetraio as the mediator between thought and form—thus resulting in a distancing between artwork and artist conditioned by the nature of the medium. Against this background, the paper aims at a better understanding of Picasso’s vision of sculpture through an examination of his creations in the vitreous medium. On these grounds, a closer look at Picasso’s works in glass is meant to highlight his unique ‘hand’ in terms of idiom, line and form. Full article

Due to the scarcity of literature data on the DNA content of different human tissues, this study aimed to isolate DNA from different tissues and fluids of the human body together with the determination of its content in the samples studied. Material was collected and tests were performed between 1990 and 2010, during autopsies performed for prosecutor’s offices in the Department of Forensic Medicine. Goiter and thyroid cancer tissues were obtained from the Department of General Surgery, Gastroenterology and Endocrinology of Wroclaw Medical University. Isolated samples were measured spectrophotometrically, yielding an R 260/280 nm between 1.5 and 1.6. In some cases (when a sufficiently pure preparation could not be obtained), isolation was continued using the silica-based commercial QIAquick PCR Purification Kit (Qiagen). If the sampling tissues showed signs of decomposition such as bad odour or colour, the results were calibrated by Real-Time PCR, using the Quantifiler DNA assay (Thermo Fisher Scientific, Applied Biosystems). The results have shown that the maximum amount of genetic material was obtained from hair roots, adrenal glands, gonads and lymph nodes. The lowest DNA content per gram or milliliter of tissue or body fluid was found in adipose tissue, blood, saliva, bile, sweat, tears and the vitreous body of the eye. The presented findings indicate the best sources of high-quality DNA from the human body: gonads, kidneys, muscle (including heart), blood and bones (after decalcification). Full article

The current study reports the use of silver (Ag) and samarium (Sm) as dopants to improve the properties of standard bioglass in terms of biological performance. This experiment considers thin films of doped bioglass obtained by pulsed laser deposition (PLD) and spin coating (SC). For both methods, some parameters were gradually varied, as the main objective was to produce a bioglass that could be used in biomedical fields. In order to study the morphology, the phase composition and other properties, the samples obtained were subjected to multiple analyses, such as thermal analysis, scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), Fourier-transform infrared (FT-IR), Raman spectroscopy, and x-ray diffraction (XRD). Furthermore, the in vitro bioactivity of the samples, as assessed through simulated body fluid (SBF) immersion, as well as immunocytochemistry and evaluation of actin filaments, assessed through fluorescence microscopy, are reported. The results confirmed the formation of the designed vitreous target employed as the source of material in the PLD experiments only at sintering temperatures below 800 °C; this vitreous nature was preserved in the grown film as well. The presence of Ag and Ce dopants in the parent glassy matrix was validated for all stages, from powder, to target, to PLD/SC-derived coatings. Additionally, it was demonstrated that the surface topography of the layers can be adjusted by using substrates with different roughness or by modulating the processing parameters, such as substrate temperature and working pressure in PLD, rotation speed, and number of layers in SC. The developed material was found to be highly bioactive after 28 days of immersion in SBF, but it was also found to be a potential candidate for inhibiting the growth of Gram-negative bacteria and a suitable support for cell growth and proliferation. Full article

Mitochondrial autophagy plays a contributary role in the pathogenesis of retina degeneration (RD). ZYAN1 is a novel proline hydroxylase domain (PHD) inhibitor that can enhance the expression of hypoxia-inducible factor 1-alpha (HIF-1α). This study investigated whether ZYAN1 could alleviate progressive photoreceptor loss and oxidative damage in a pharmacologically induced RD model via the modulation of mitophagy. ZYAN1 was injected into the vitreous body of the RD model, and the retinal autophagy level was analyzed. The therapeutic effects of ZYAN1 were evaluated via a function examination, a morphological assay, in situ reactive oxygen species (ROS) detection, and an immunofluorescence assay. It was shown that the thickness of the outer nuclear layer (ONL) increased significantly, and visual function was efficiently preserved via ZYAN1 treatment. The mitochondria structure of photoreceptors was more complete in the ZYAN1-treated mice, and the number of autophagosomes also increased significantly. Membrane disc shedding and ROS overproduction were alleviated after ZYAN1 treatment, and the axonal cilia were more structurally intact. A Western blot analysis showed that the expression levels of the autophagy-related proteins LC3-B, Beclin-1, and ATG5 increased significantly after ZYAN1 treatment, while the expression of P62 was down-regulated. Moreover, the expression levels of HIF-1α and BNIP3 were up-regulated after ZYAN1 treatment. Therefore, an intravitreal injection of ZYAN1 can act as part of the pharmacologic strategy to modulate mitophagy and alleviate oxidative stress in RD. These findings enrich our knowledge of RD pathology and provide insights for the discovery of a therapeutic molecule. Full article

To treat certain vitreoretinal diseases, the vitreous body, a hydrogel composed of mostly collagen and hyaluronic acid, must be removed. After vitrectomy surgery, the vitreous cavity is filled with an endotamponade. Previously, pre-clinical hydrogel-based vitreous body substitutes either made from uncrosslinked monomers (1st generation), preformed crosslinked polymers (2nd generation), or in situ gelating polymers (3rd generation) have been developed. Forward light scattering is a measure of Stray light induced by optical media, when increased, causing visual disturbance and glare. During pinhole surgery, the hydrogels are injected into the vitreous cavity through a small 23G-cannula. The aim of this study was to assess if and to what extent forward light scattering is induced by vitreous body replacement hydrogels and if Stray light differs between different generations of vitreous body hydrogel replacements due to the different gelation mechanisms and fragmentation during injection. A modified C-Quant setup was used to objectively determine forward light scattering. In this study, we found that the 1st and 3rd generation vitreous body replacements show very low stray light levels even after injection (2.8 +/− 0.4 deg²/sr and 0.2 +/− 0.2 deg²/sr, respectively) as gel fragmentation and generation of interfaces is circumvented. The 2nd generation preformed hydrogels showed a permanent increase in stray light after injection that will most likely lead to symptoms such as glare when used in patients (11.9 +/− 0.9 deg²/sr). Stray light of the 2nd generation hydrogels was 3- and 2-fold increased compared to juvenile and aged vitreous bodies, respectively. In conclusion, this significant downside in the forward light scattering of the 2nd generation hydrogels should be kept in mind when developing vitreous body replacement strategies, as any source of stray light should be minimized in patients with retinal comorbidities. Full article

The main method of treatment and prevention of endophthalmitis is a combination of intravitreal and topical administration of antibiotics, such as cefuroxime moxifloxacin or vancomycin. However, this method is ineffective due to the rapid elimination of the drug. This problem can be solved with the help of intravitreal in situ injection systems, which are injected with a syringe into the vitreous body and provide prolonged action of the drug at the focus of inflammation. Under the influence of temperature, the liquid drug undergoes a phase transition and turns into a gel after injection. This ensures its prolonged action. The study aimed to develop an intravitreal in situ cefuroxime delivery system for the treatment of endophthalmitis based on a thermosensitive biodegradable composition of poloxamer 407 and hyaluronic acid. A combination of poloxamer Kolliphor^® P407, Kolliphor^® P188, and PrincipHYAL^® hyaluronic acids of different molecular weights was used as a delivery system. The potency of cefuroxime solid dispersion with polyvinylpyrrolidone-10000, polyethylene glycol-400, and polyethylene glycol-1500 in a 1:2 ratio was studied for prolonged action compared to cefuroxime substance. The experimental formulations were studied for the parameters of gelation temperature in a long-term test (4 months), pH, and release of cefuroxime using dialysis bags. To study the distribution parameter in the vitreous body, an in vitro model (1/13) was developed, which was a hollow agar sphere filled with 1% (w/v) polyacrylate gel. For the superior formulations, a HET-CAM test (chorioallantoic membrane test) was performed to determine the absence of irritant effects. According to the study results, a formulation containing a solid dispersion of cefuroxime:PEG-400 (1:2), the matrix of which contained 18% (w/v) Kolliphor^® P407 poloxamer, 3% (w/v) Kolliphor^® P188 poloxamer, and 0.5% (w/v) hyaluronic acid (1400–1800), was selected. This sample had an average gelation temperature of 34.6 °C, pH 6.7 ± 0.5, and a pronounced prolonged effect. Only 7.6% was released in 3 h of the experiment, whereas about 38% of cefuroxime was released in 72 h. No irritant effect on the chorioallantoic membrane was observed for any formulations studied. Full article

Introduction: Epiretinal membrane (ERM) is a relatively common condition affecting the macula. When symptoms become apparent and compromise a patient’s quality of vision, the only therapeutic approach available today is surgery with a vitrectomy and peeling of the ERM. Angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACE-Is) reduce the effect of angiotensin II, limit the amount of fibrosis, and demonstrate consequences on fibrinogenesis in the human body. Case Description and Materials and Methods: A rare case of spontaneous ERM resolution with concomitant administration of ARB is reported. The patient was set on ARB treatment for migraines and arterial hypertension, and a posterior vitreous detachment was already present at the first diagnosis of ERM. The scientific literature addressing the systemic relationship between ARB, ACE-Is, and fibrosis in the past 25 years was searched in the PubMed, Medline, and EMBASE databases. Results: In total, 38 and 16 original articles have been selected for ARBs and ACE-Is, respectively, in regard to fibrosis modulation. Conclusion: ARBs and ACE-Is might have antifibrotic activity on ERM formation and resolution. Further clinical studies are necessary to explore this phenomenon. Full article

Our aim was to assess the therapeutic efficacy of a modified single-arm suture technique on traumatic cyclodialysis cleft with vitreoretinal injury. The procedure involved fixing a detached ciliary body using a single-armed 10-0 polypropylene suture under the assistance of a 29-gauge needle. Patients with a traumatic cyclodialysis cleft combined with an anterior and posterior segment injury who underwent modified internal cyclopexy together with vitreoretinal surgery were enrolled in this study. Ultrasound biomicroscopy (UBM) was used to diagnose and evaluate the cyclodialysis and anterior segment injury. B-scan ultrasonography was performed to assess the condition of the vitreous, retina and choroid. The surgical time and successful rate for repairing the cyclodialysis cleft were recorded. Preoperative and postoperative best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were documented for assessment. The study included 20 eyes. The extent of the cyclodialysis cleft was from 30° to 360°. Besides a traumatic cyclodialysis cleft, the included cases also combined this with vitreous hemorrhages, retinal detachment, macular holes, choroid avulsion, and suprachoroidal hemorrhage. All the clefts were anatomically closed in one surgery. The average surgical time for fixing the cyclodialysis cleft was 2.68 ± 0.54 min/30° cleft. A significant improvement in LogMAR BCVA was observed from 2.94 ± 0.93 preoperatively to 1.81 ± 1.11 at the 6-month follow-up. IOP was elevated from 10.90 ± 6.18 mmHg preoperatively to 14.45 ± 2.35 mmHg at the 6-month follow-up. The modified single-armed suture technique was proved to be an effective method to fix the traumatic cyclodialysis cleft, which could facilitate the use of the procedure to repair chorioretinal disorders. It improved the BCVA and maintained the IOP with less postoperative complications. Full article