María José Blanco

Comparative study of incomplete posterior vitreous detachment as a risk factor for proliferative vitreoretinopathy

Abstract · Background: Abnormal vitreoretinal relationships have recently been implicated in many vitreoretinal disorders. Sites of abnormal vitreoretinal adherences are likely to exist in eyes predisposed to rhegmatogenous retinal detachment (RD), causing either retinal tears or incomplete posterior vitreous detachment (PVD). The present study was designed in two parts to identify the risk for preoperative and postoperative proliferative vitreoretinopathy (PVR) due to incomplete PVD. · Methods: We prospectively evaluated the vitreoretinal relationships using high-resolution kinetic echography in 102 consecutive eyes of 100 patients with rhegmatogenous RD. In the first part, a case-control study was conducted to compare the vitreous status in patients with preoperative PVR (cases) with that in patients with non-PVR-complicated RD (controls). During the second part, patients with noncomplicated RD (65 eyes) who were operated on by a simple retinal attachment procedure were followed up for a mean period of 6.6 months to compare the recurrence of RD due to postoperative PVR according to their vitreous status. · Results: Patients with PVR on study entry had a higher prevalence of partial PVD (28 of 32 eyes, 87%) than did controls (25 of 70 eyes, 35%). The statistical significance of this difference was independent of all other variables studied. After a mean follow-up period of 6.6 months, the incidence of recurrence of RD associated with postoperative PVR was 33% in the eyes with incomplete PVD, compared with 4.9% in the eyes without incomplete PVD. · Conclusions: Our results support the notion that the occurrence of incomplete PVD in RD is a significant risk factor for preoperative and postoperative PVR.

Serum DJ-1/PARK 7 is a potential biomarker of choroidal nevi transformation.

PURPOSE There is substantial evidence that intraocular melanomas arise from benign nevi in the uveal tract. Previous studies performed by the authors revealed that uveal melanoma cells secrete the oncoprotein DJ-1/PARK7 into the extracellular environment and circulation. The aim of this study was to determine whether circulating DJ-1 serum levels correlate with known clinical risk factors of nevi growth. METHODS Standardized ultrasonography, optical coherence tomography, and eye fundus examinations were used to evaluate the clinical risk factors of nevi growth. These clinical risk factors (including nevi size, distance of margins to the optic disc, detection of acoustic hollowness, presence of ocular symptoms, orange pigment, subretinal fluid, and absence of drusen) were examined in 53 consecutive patients from January 2009 to February 2011. Serum levels of DJ-1/PARK7 in these patients and in healthy age- and sex-matched controls (n = 32) were analyzed using ELISA. RESULTS Within the choroidal nevi group, DJ-1 serum levels were higher in those with symptoms (P < 0.033), with a nevus thickness greater than 1.5 mm (P < 0.001), a large basal diameter greater than 8 mm (P < 0.001), and the presence of acoustic hollowness (P < 0.001), compared to those patients without these risk factors. Similar significant differences were found when these at risk nevi subgroups were compared to healthy persons. CONCLUSIONS Elevated serum levels of DJ-1 are associated with choroidal nevi transformation risk factors. Therefore, DJ-1 appears to be a promising factor for predicting the growth of choroidal nevi and may be a potential biomarker of malignancy.

Relationship between macular bending and foveoschisis in myopic patients.

Purpose To investigate factors associated with myopic foveoschisis and macular bending and to determine how the presence of macular bending affects the development of myopic foveoschisis. Methods In a prospective study of 194 eyes of 105 patients with high myopia, we performed complete ophthalmic examinations, optical coherence tomography (OCT), and A-scan ultrasounds. Patients were divided into three groups according to the OCT results. Group 1 consisted of 25 eyes (17 patients) with myopic foveoschisis; group 2 consisted of 36 eyes (20 patients) with macular bending; and group 3 consisted of 135 eyes (68 patients) without macular bending, foveoschisis, or other diseases. Macular bending was defined as a smooth macular elevation observed upon OCT in patients with pathologic myopia. Age, sex, spherical equivalence, axial length (AXL), and OCT findings were obtained and compared to identify factors that are related to myopic foveoschisis and macular bending. Moreover, using the whole data set, we evaluated and correlated myopic foveoschisis with the presence or absence of macular bending to determine whether this bulge in the macular area influences the development of myopic foveoschisis. Results In group 1, all eyes presented posterior staphyloma and two factors were independently associated with a higher risk of having myopic foveoschisis: internal limiting membrane detachment (p < 0.001) and retinal arteriolar traction (p < 0.001). In group 2, only retinal arteriolar traction (p < 0.009) was independently associated with macular bending. Furthermore, macular bending was significantly correlated as a protective factor against myopic foveoschisis (adjusted odds ratio, 0.116; 95% confidence interval, 0.019 to 0.701; p < 0.019); the AXL of patients with the same spherical equivalence and macular bending was significantly shorter than that of patients without macular bending (p = 0.005). Conclusions Intraocular and extraocular wall factors were associated with myopic traction maculopathy, which plays an important role in its pathogenesis. Moreover, macular bending might be a key factor in preventing myopic foveoschisis by decreasing AXL.

160Thr mutation in the rhodopsin gene associated with retinitis pigmentosa.

Mutations in the rhodopsin gene were studied in 23 unrelated Spanish patients with sporadic retinitis pigmentosa (RP). A codon 160 Thr C→A transition was found in 4 of the 23 patients vs. none of the 159 controls (p < 0.001) suggesting that this mutation may be an informative marker in RP.

ME20-S as a Potential Biomarker for the Evaluation of Uveal Melanoma.

PURPOSE We previously identified the presence of the melanocyte-specific secreted (ME20-S) glycoprotein in secretomes of uveal melanoma (UM) cultures. The aim of this study was to test for the presence and levels of ME20-S in the serum of patients with choroidal nevi and UM and correlate these levels with individual clinical data. METHODS Serum ME20-S levels were determined by ELISA in 111 patients distributed into four categories (53 choroidal nevi, 30 untreated UM, 11 10-year disease-free [DF] UM, 17 hepatic metastatic UM) and 32 age- and sex-matched controls. ME20-S levels were correlated with individual clinical data. RESULTS The UM and the metastatic groups showed significantly higher levels of serum ME20-S than the other groups (P < 0.001). ME20-S levels in the DF patients did not differ from those in the control group. In addition, log-transformed serum ME20-S levels showed a positive correlation with the thickness of the lesion mass in UM patients (regression coefficient 0.0689, 95% confidence interval 0.0689-0.1123, R2 = 27.1%). CONCLUSIONS Elevated ME20-S serum levels are associated with tumor size and advanced stages of UM while low levels are characteristic of DF patients. ME20-S might be a promising serum marker for UM and useful for monitoring metastatic disease.