1,721,239 research outputs found
Clinical, Radiographic and Gait Parameters Associated with Medial Arch Pain in the Flexible Pediatric Flatfoot
No full textBinding characteristics of ET receptors in retinal pericytes and effects of high glucose incubation
No full textPurpose. Autoregulation and control of blood flow within the retina is dependent on vascular endothelial release of vasoconstrictors and dilators. The effector cells are the pericytes and vascular smooth muscle cells of the retinal microvascular bed. Many studies show that the responses of these effector cells are affected by diabetes or artificially elevated glucose. In particular, the contractile response of pericytes to endothelin-1 (ET-1) is markedly reduced. ET-1 and related isopeptides exert their effects by binding and activating specific cell surface receptors (ETRs). Pericytes express two subtypes of ETRs, ETA and ETB. The purpose of this study was to assess the dynamics of [I-125]ET-1 binding to ETA and ETB receptors when cultured in normal and high glucose concentrations. Methods. Bovine retinal pericytes (BRP) were exposed to normal (5 mM) or high glucose (25 mM) concentrations for up to 14 days. Displacement of binding and competitive inhibition of binding was carried out in perictye membranes. mRNA expression for ETR subtypes was examined using northern blotting. The expression of G protein alpha subunits (Galpha(s) and Galpha(q)) was detected by western blotting. Results. Highly specific binding of [I-125]ET-1 was seen with BRP membranes. In competition assays, ET-3 was found to displace [I-125]ET-1 binding to BRP membranes in a biphasic manner, indicating the presence of two classes of binding sites. The presence of both ETR subtypes was supported by competition experiments with selective ligands. The expression of Galpha(s) and Galpha(q) subunits decreased in pericytes incubated with 25 mM glucose. Conclusions. No significant differences in binding parameters were evident after culture in high glucose concentrations. However northern blot analysis which confirmed the presence of ETB receptor mRNA did identify an increase in the expression of this receptor
The Royal College of Ophthalmologists Guidelines on AMD: executive summary
No full textAge-related macular degeneration (AMD) is a common condition in older adults. Since publication of the last guidelines in 2009, new data have emerged on the management of AMD and novel solutions have been tested to meet the ongoing challenge of AMD service demands
Optical coherence tomography angiography in paracentral acute middle maculopathy secondary to central retinal vein occlusion
No full textPurpose To report the clinical course and the optical coherence tomography angiography (OCTA) findings of patients presenting with paracentral acute middle maculopathy (PAMM) and central retinal vein occlusion (CRVO). Methods Retrospective case series. Clincal records and multimodal imaging findings of patients presenting with PAMM and CRVO were reviewed. Results Three eyes of three patients (2 males; mean age: 66 years) were included in the study. Mean follow-up was 9 months and images using OCTA (AngioVue OCT angiography system, Optovue, Inc., Fremont, CA, USA) were available at the last follow-up visit. During follow-up, best corrected visual acuity (BCVA) of case 1 was unchanged at 85 ETDRS letters and OCTA revealed a mild attenuation of the perifoveal deep capillary plexus (DCP); in case 2, BCVA changed from 83 to 77 ETDRS letters and OCTA revealed patchy areas of attenuation and pruning of the DCP; in case 3, BCVA decreased from 26 to 8 ETDRS letters and OCTA revealed extensive areas of DCP dropout. Conclusion The natural course of visual acuity in patients with PAMM secondary to CRVO may vary. In these patients, the extent of DCP dropout on OCTA may reflect the extent of visual acuity impairment
Stellate nonhereditary idiopathic foveomacular retinoschisis concomitant to exudative maculopathies
No full textPurpose To report the clinical course of patients presenting with stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) concomitant with exudative maculopathies. Methods Retrospective case series. Multimodal imaging findings, including spectral-domain optical coherence tomography (SD-OCT) were reviewed. Genetic testing for the RS1 gene was performed in one patient. Results We identified two female patients who fit the definition of SNIFR and presented with concomitant neovascular age-related macular degeneration (n-AMD). In both the patients, SD-OCT showed exudative macular features and splitting (bilateral in patient 1, unilateral in patient 2) of the outer plexiform layer (OPL) in the macula with no other evidence of hereditary or an acquired predisposing condition. Genetic testing excluded mutation of RS1 gene in patient 1. The fundi of both the patients showed characteristic signs of active choroidal neovascularization (CNV) and following anti-VEGF treatment, visual acuity improved and CNV-related exudative changes resolved. However, the split along the OPL remained unaltered. Conclusions SNIFR may be associated with n-AMD. It is important to recognise the presence of retinoschisis when there is other exudative pathology as the former may be misinterpreted as intraretinal fluid, prompting unnecessary treatment
Tomographic Biomarkers Predicting Progression to Fibrosis in Treated Neovascular Age-Related Macular Degeneration: A Multimodal Imaging Study
No full textPurpose: To describe the photoreceptor–retinal pigment epithelium (RPE) interface changes and to analyze the relationships between these features and hyperreflective material (HRM) with scarring and atrophy at the macula of patients with neovascular age-related macular degeneration (nAMD). Design: Retrospective single-center observational study. Participants: A total of 150 eyes from 144 patients with naive nAMD were included. Methods: All patients had OCT (HRA-OCT Spectralis, Heidelberg Engineering, Heidelberg, Germany) at baseline and at 1, 3, 6, and 12 months. Macular scar and macular atrophy (MA) were determined on multimodal imaging, including color fundus (CF) and near-infrared imaging at baseline and month 12 (M12). Main Outcome Measures: Change in HRM type (undefined and well-defined) and location, development of fibrotic or nonfibrotic macular scar, MA, and best-corrected visual acuity (BCVA) at M12. Results: At baseline, eyes with fibrin on CF had thicker and wider HRM on OCT that correlated strongly with presence of undefined HRM. The proportion of eyes with undefined HRM fell dramatically by month 1 but well-defined HRM increased. At M12 defined HRM was strongly associated with macular scar (chi-square, 82.1; P < 0.001). Ordinal regression showed that both the thickness and the width of HRM were significant risk factors for development of fibrotic scar (P < 0.001 and P = 0.02) but not nonfibrotic scars (P = 0.67 and P = 0.65). Fibrotic macular scar (P = 0.001) but not nonfibrotic scar (P = 0.129) negatively affected visual acuity at M12. Ordinal regression showed that the risk factors for progression to MA were reticular pseudodrusen and thinner HRM (P = 0.017 and P = 0.028, respectively). MA negatively affected BCVA at M12 (P < 0.001). Conclusion: Our study supports the role of HRM as an important biomarker for the evolution of macular scar and atrophy in patients with nAMD undergoing treatment with anti-VEGF therapies. Undefined HRM can resolve with treatment, whereas well-defined HRM likely contains vascular complexes and fibrotic elements
Orthotic bracing to treat equinus in children with spastic cerebral palsy: Recorded compliance and impact of wearing time
No full textA retrospective study of the real-life utilization and effectiveness of ranibizumab therapy for neovascular age-related macular degeneration in the UK
No full textPurpose: AURA was an international, retrospective, observational study that monitored the real-life use and effectiveness of ranibizumab injections in patients with neovascular age-related macular degeneration (nAMD). This paper reports the findings from the UK.Methods: Patients who started treatment with ranibizumab between January 1, 2009, and August 31, 2009, and had documented follow-up to the end of their treatment and/or monitoring or until August 31, 2011, were retrospectively monitored; the diagnosis and subsequent decision to treat was made by the patient’s own physician. Assessments included the change in visual acuity (standardized letter count) during the first and second years after start of ranibizumab therapy and resource utilization.Results: Four hundred and ten patients from 13 UK centers were analyzed. The mean (standard deviation [SD]) letter score at baseline was 55.0 (17.8). The mean (SD) change in visual acuity from baseline was +6.0 (15.4) letters at year 1 and +4.1 (16.9) at year 2. Most of the patients (86.6%) completed a 3-month loading phase; the visual improvements were numerically higher in these patients. Over 2 years, the mean (SD) number of clinic visits and injections was 18.4 (5.0) and 9.0 (4.7), respectively. Resource use and visual acuity gains were greater than those observed in the global population, which included other countries enrolled in AURA (Canada, France, Germany, Ireland, Italy, the Netherlands, and Venezuela). When patients were stratified according to severity of nAMD (based on letter count at baseline), the mean change in visual acuity score at years 1 and 2 was also higher for the UK than for the global population across all subgroups.Conclusion: Monitoring and treatment rates were high in the UK, resulting in better visual acuity outcomes compared with other included countries. This suggests that translation of clinical study outcomes into real-life settings is achievable, but at the expense of higher resource utilization than is currently the norm in most developed countries
- …
