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27. Optical coherence tomography angiography in unilateral multifocal choroiditis and panuveitis

Author

Lee, Lung-Chi, Huang, Ke-Hao, Chen, Yi-Hao, Lin, Hsin-Ting, Hsu, Chia-Chen, Tai, Ming-Cheng, Liang, Chang-Min, Chen, Jiann-Torng, and Chen, Ching-Long

Subjects
Adult, Choroiditis, genetic structures, Computed Tomography Angiography, Fundus Oculi, multifocal choroiditis and panuveitis, Multifocal Choroiditis, optical coherence tomography angiography, Multimodal Imaging, eye diseases, Retina, Panuveitis, Humans, Female, sense organs, Clinical Case Report, Fluorescein Angiography, Tomography, Optical Coherence, Research Article, idiopathic multifocal choroiditis
Abstract

Rationale: Optical coherence tomography angiography (OCT-A) has the advantage to visualize the microvascular structure of the retina in vivo and was utilized clinically in various neovascular retinal diseases. The OCT-A has also been used to examine the lesion in multifocal choroiditis and panuveitis (MCP). This study aimed to describe a case of MCP and present the disease process of a punched-out lesion in the chorioretina with neovascular activity using OCT-A. Patients concerns: A 32-year-old female Caucasian patient presented with a 2-week history of progressive blurred vision in her right eye with photophobia and a diminished temporal visual field. On presentation, her best corrected visual acuity was 6/60 in the right eye with a prominent anterior uveitis seen under slit lamp examination. Diagnoses: Dilated fundus examination of the right eye showed vitritis and multiple, punched-out yellowish-white lesions over the peripheral retina. Additional multimodal imaging (MMI) were done including fluorescein angiography (FA), indocyanine green angiography (ICGA) and fundus autofluorescence (FAF), which all revealed characteristic findings of MCP. In general, the diagnosis of unilateral MCP was made. Furthermore, one of the punched-out lesions in the right eye was particularly selected and examined under OCT and OCT-A, which revealed a subretinal elevated lesion with high flow signal under OCT-A. Interventions: Treatment with oral prednisolone at 30 mg daily with topical prednisolone acetate 1% every 2 hours were prescribed, which were gradually tapered down within a 2-month course. Outcomes: The patient's best corrected visual acuity of the right eye returned to 6/6 at 2 months after the diagnosis. The flow signal in the OCT-A study of the punched-out lesion had also resolved after steroid treatment. Lessons: The MCP is an uncommon uveitis with multiple inflammatory chorioretinal lesions. Using multimodal imaging technique, physicians can better differentiate these lesions for diagnosis and for further monitoring. Our results demonstrated that these chorioretinal lesions in MCP may display neovascular activities that might not be seen easily using conventional FA or ICGA study. With OCT-A, ophthalmologists could identify and monitor subtle choroidal neovascularization (CNV) changes over these punched-out lesions.

Published
2019

28. Mitomycin C for the prevention of corneal haze in photorefractive keratectomy: a meta‐analysis and trial sequential analysis.

Author

Chang, Yu‐Min, Liang, Chang‐Min, Weng, Tzu‐Heng, Chien, Ke‐Hung, and Lee, Cho‐Hao

Subjects
*PHOTOREFRACTIVE keratectomy, *MITOMYCIN C, *CORNEA, *SEQUENTIAL analysis, *HAZE, *VISUAL acuity
Abstract

Purpose: To evaluate the anti‐haze effect and visual outcome after intraoperative mitomycin C (MMC) use during photorefractive keratectomy (PRK) in myopia or myopic astigmatism patients. Methods: We searched in PubMed, EMBASE, Cochrane Library and Google Scholar comprehensively to obtain studies comparing the clinical effects after PRK with and without MMC published until February 2020. Meta‐analysis of primary outcome (corneal haze rate) and secondary outcomes [predictability, efficacy, safety and corneal endothelial cell density (ECD)] were conducted. We used trial sequential analysis (TSA) in an effort to collect firm evidence supporting our conclusion. Results: Of the included 11 randomized controlled trials, five cohort and one case–control studies, 3536 eyes (2232 and 1304 in the MMC and control groups, respectively) were enrolled for meta‐analysis. The TSA disclosed strong evidence of decline in corneal haze rate in the MMC group compared with that of the control group. In the subgroup analysis of duration, MMC seemed to reduce corneal haze rate in early‐onset and late‐onset haze. Predictability of refraction and visual acuity were greater in the MMC groups, not significantly though. The proportion of patients losing at least two lines of best corrected visual acuity postoperatively in the MMC groups was lower than that in the control groups. The corneal postoperative ECD showed no significant difference between the MMC and control groups. Conclusion: Our meta‐analysis revealed that MMC is an important anti‐haze agent in PRK for reducing both early‐ and late‐onset haze and can also help improving predictability of refraction and subjective postoperative visual acuity. [ABSTRACT FROM AUTHOR]

Published
2021
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36. Resveratrol inhibits transforming growth factor-β2-induced epithelial-to-mesenchymal transition in human retinal pigment epithelial cells by suppressing the Smad pathway

Author

Chen,Ching-Long, Chen,Yi-hao, Tai,Ming-Cheng, Liang,Chang-Min, Lu,Da-Wen, Chen,Jiann-Torng, Chen,Ching-Long, Chen,Yi-hao, Tai,Ming-Cheng, Liang,Chang-Min, Lu,Da-Wen, and Chen,Jiann-Torng

Abstract

Ching-Long Chen,1,2 Yi-Hao Chen,1,2 Ming-Cheng Tai,2 Chang-Min Liang,2 Da-Wen Lu,1,2 Jiann-Torng Chen1,2 1Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan; 2Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan Abstract: Proliferative vitreoretinopathy (PVR) is the main cause of failure following retinal detachment surgery. Transforming growth factor (TGF)-β2-induced epithelial-to-mesenchymal transition (EMT) plays an important role in the development of PVR, and EMT inhibition decreases collagen gel contraction and fibrotic membrane formation, resulting in prevention of PVR. Resveratrol is naturally found in red wine and has inhibitory effects on EMT. Resveratrol is widely used in cardioprotection, neuroprotection, chemotherapy, and antiaging therapy. The purpose of this study was to investigate the effects of resveratrol on TGF-β2-induced EMT in ARPE-19 cells in vitro. We found that resveratrol suppressed the decrease of zona occludens-1 (ZO-1) and caused an increase of alpha-smooth muscle actin expression in TGF-β2-treated ARPE-19 cells, assessed using Western blots; moreover, it also suppressed the decrease in ZO-1 and the increase of vimentin expression, observed using immunocytochemistry. Resveratrol attenuated TGF-β2-induced wound closure and cell migration in ARPE-19 cells in a scratch wound test and modified Boyden chamber assay, respectively. We also found that resveratrol reduced collagen gel contraction – assessed by collagen matrix contraction assay – and suppressed the phosphorylation of Smad2 and Smad3 in TGF-β2-treated ARPE-19 cells. These results suggest that resveratrol mediates anti-EMT effects, which could be used in the prevention of PVR. Keywords: resveratrol, epithelial-to-mesenchymal transition, proliferative vitreoretinopathy, transforming growth factor-β2, retinal pigment epithe

Published
2017

37. Glucosamine inhibits epidermal growth factor-induced proliferation and cell-cycle progression in retinal pigment epithelial cells

Author

Liang, Chang-Min, Tai, Ming-Cheng, Chang, Yun-Hsiang, Chen, Yi-Hao, Chen, Ching-Long, Chien, Ming-Wei, and Chen, Jiann-Torng

Subjects
STAT3 Transcription Factor, Transcriptional Activation, Glucosamine, Glycosylation, Cell Death, Epidermal Growth Factor, Cell Survival, Cell Cycle, Epithelial Cells, Retinal Pigment Epithelium, Endoplasmic Reticulum, Cell Line, carbohydrates (lipids), ErbB Receptors, Stress, Physiological, Cyclins, Humans, Phosphorylation, Extracellular Signal-Regulated MAP Kinases, Endoplasmic Reticulum Chaperone BiP, Proto-Oncogene Proteins c-akt, Cyclin-Dependent Kinase Inhibitor p27, beta Catenin, Research Article, Cell Proliferation
Abstract

Purpose To investigate the effects and mechanisms of glucosamine (GlcN) on the proliferation of retinal pigment epithelial cells in response to epidermal growth factor (EGF). Methods Cell proliferation was measured in the human retinal pigment epithelial cell line (ARPE-19) cells with the 4-[3-(4iodophenyl)-2-(4-nitrophenyl)-2H-5-tetrazolio]-1,3-benzene disulfonate (WST-1) assay and cell counting. The results were confirmed in human donor cells with the carboxyfluorescein diacetate succinimidyl ester cell proliferation assay (CFSE) cell proliferation assay. In ARPE-19 cells, cell-cycle progression was determined by flow cytometry; the protein levels of cell cycle regulators and heat shock protein 90 (Hsp90) were measured by western blotting; the levels and branching of N-glycans were assessed using the L-Phaseolus vulgaris agglutinin lectin-binding assay; and the modulation of N-glycans on EGF receptor (EGFR) was examined by western blotting. Results GlcN inhibited retinal pigment epithelium (RPE) proliferation in a dose-dependent manner. During cell-cycle progression induced by EGF, GlcN caused delays at the G1–S and G2–M transitions without affecting cell viability. GlcN modulated the level and branching of N-glycans on EGFR, suppressed phosphorylation of EGFR, and reduced phosphorylation of extracellular signal-regulated kinases, erine/threonine protein kinase, and the signal transducer and activator of transcription 3 (STAT3). GlcN had only minor effects on the expression of Hsp90, Grp78, and transcription factor CHOP/GADD 153 markers of nonspecific stress in the endoplasmic reticulum. Conclusions GlcN effectively suppressed proliferation of RPE cells in vitro. This effect appeared to be achieved through modification of N-glycans on EGFR. Further research into the role of GlcN as a potential agent for the prevention and treatment of RPE-mediated ocular proliferative disorders, such as proliferative vitreoretinopathy, and other EGF-dependent proliferative cell-growth disorders, is warranted.

Published
2010

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