Tomasz Choragiewicz

Modified Vitrectomy Technique for Phakic Rhegmatogenous Retinal Detachment with Intermediate Break

Purpose To evaluate the effects of a modification of the traditional 25-gauge pars plana vitrectomy technique in the treatment of uncomplicated macula-on rhegmatogenous retinal detachment (RRD) with intermediate retinal break(s) and marked vitreous traction in the phakic eye. Methods Prospective, noncomparative, and interventional case series. All consecutive phakic eyes with primary uncomplicated macula-on RRD with intermediate retinal break(s) and marked vitreous traction, with at least 1 year of postoperative follow-up, were enrolled. In all eyes, “localized 25-gauge vitrectomy” under air infusion with localized removal of the vitreous surrounding the retinal break(s), in association with laser photocoagulation and air tamponade, was performed. The primary end point was the rate of primary retinal attachment. Secondary end points were cataract progression and assessed by digital Scheimpflug lens photography (mean change of nuclear density units) and the rate of complications. Results Thirty-two phakic eyes were included in the final analysis. At 12 months, the primary outcome of anatomical success was achieved in 94% of eyes. The mean nuclear density units did not change significantly at any time point during the follow-up. After localized vitrectomy, one eye developed an epiretinal membrane, and one eye developed cystoid macular edema; no other significant complications were reported. Conclusions “Localized vitrectomy” has a high anatomical success rate in phakic eyes with primary uncomplicated macula-on RRD with intermediate retinal break(s) and marked vitreous traction, without causing progression of cataract.

Anterograde Transport in Axons of the Retinal Ganglion Cells and its Relationship to the Intraocular Pressure during Aging in Mice with Hereditary Pigmentary Glaucoma

ABSTRACT Purpose: To establish a relationship between impairment of the anterograde axonal transport (AAT) in the axons of the retinal ganglion cells and the intraocular pressure (IOP) during aging in mice with hereditary glaucoma. Methods: Quantitative in vivo approach based on manganese enhanced magnetic resonance imaging was developed in order to evaluate AAT in 3-, 6-, and 14-month old DBA/2J mice that develop age-dependent pigmentary glaucoma or age-matched C57Bl/6 mice that do not develop any retinal disease. Unilateral intravitreous administration of MnCl2 solution was followed 24 h later by MRI performed to obtain spin-lattice relaxation times (T1) for regions of interest encompassing the superior colliculi (SC) and the lateral geniculate nuclei (LGN). From the MRI scans, the estimates of Mn2+ concentrations in SC and LGN contralateral to the injection site, hence the efficiency of AAT in ON, were obtained. IOP and eye morphology was also monitored. Results: In C57Bl/6 mice, AAT to SC was decreasing with age, 30% decrease was noted between 3 and 14 months. The decrease in axonal transport to LGN was less pronounced in this strain. In 3-month-old DBA/2J mice, axonal transport to SC was 30% lower than in 3-month-old C57Bl/6 mice but no significant decrease was noted in 6-month-old animals. However, a decrease of over 95% in axonal transport both to SC and LGN was noted in 14-month-old DBA/2J mice. DBA/2J mice exhibited a sharp increase in IOP at 6 months, which reversed at 14 months but displayed age-dependent elongation of the eyeball and deepening of the anterior chamber. Conclusion: Failure of AAT to SC of DBA/2J mice during development of pigmentary glaucoma does not follow closely changes in IOP and eye morphology. The relationship between IOP and AAT in optic nerve and tract is complex and may reflect preconditioning mechanism.

In vivo biocompatibility of a new cyanine dye for ILM peeling

PurposeTo investigate the biocompatibility of the new cyanine dye: 3,3′-Di-(4-sulfobutyl)-1,1,1′,1′-tetramethyl-di-1H-benz[e]indocarbocyanine (DSS) as a vital dye for intraocular application in an in vivo rat model and to evaluate the effects of this dye on retinal structure and function.MethodsDSS at a concentration of 0.5% was applied via intravitreal injections to adult Brown Norway rats with BSS serving as a control. Retinal toxicity was assessed 7 days later by means of retinal ganglion cell (RGC) counts, light microscopy, optical coherence tomography (OCT), and electroretinography (ERG).ResultsNo significant decrease in RGC numbers was observed. No structural changes of the central retina were observed either in vivo (OCT) or under light microscopy. ERGs detected a temporary reduction of retinal function 7 days after injection; this was no longer evident 14 days after injection.ConclusionsDSS showed good biocompatibility in a well-established experimental in vivo setting and may be usable for intraocular surgery as an alternative to other cyanine dyes. In contrast to indocyanine green, it additionally offers fluorescence in the visual spectrum. Further studies with other animal models are needed before translation into clinical application.