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Retinal Disease and Metabolism
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Topic review
Updated time: 05 Apr 2021
Submitted by: Menaka Thounaojam
Definition: Bile acids (BAs) are amphipathic sterols primarily synthesized from cholesterol in the liver and released in the intestinal lumen upon food intake. BAs play important roles in micellination of dietary lipids, stimulating bile flow, promoting biliary phospholipid secretion, and regulating cholesterol synthesis and elimination. Emerging evidence, however, suggests that, aside from their conventional biological function, BAs are also important signaling molecules and therapeutic tools. In the last decade, the therapeutic applications of BAs in the treatment of ocular diseases have gained great interest.
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Topic review
Updated time: 07 May 2021
Submitted by: Mohamed Al-Shabrawey
Definition: Bone morphogenetic proteins (BMPs) play an important role in bone formation and repair. Recent studies underscored their essential role in the normal development of several organs and vascular homeostasis in health and diseases. Elevated levels of BMPs have been linked to the development of cardiovascular complications of diabetes mellitus. However, their particular role in the pathogenesis of microvascular dysfunction associated with diabetic retinopathy (DR) is still under-investigated.
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Topic review
Updated time: 10 May 2021
Submitted by: Jackson Scharf
Definition: The advent of optical coherence tomography angiography (OCTA) has facilitated remarkable advancements in our ability to image the blood vessels of the retina and choroid. This is particularly true of the choriocapillaris (CC), the blood vessel bed that feeds the outer retina. OCTA has more clearly defined the integral role of the CC in age-related macular degeneration (AMD), the leading cause of vision loss people over 50 years old. OCTA imaging shows that the choriocapillaris is impaired in intermediate and advanced non-neovascular AMD, and the severity of impairment may predict the advancement of disease. In advanced non-neovascular AMD, the choriocapillaris is severely impaired underneath the area of geographic atrophy, and the level of impairment surrounding geographic atrophy can predict the rate of atrophy enlargement. Macular neovascularization, harmful new blood vessels that grow in neovascular AMD, can be readily identified and classified using OCTA. It is still unclear however if neovascularization features with OCTA can predict the lesion’s level of activity. However, the choriocapillaris surrounding macular neovascularization is impaired while the more peripheral choriocapillaris is spared, implying that choriocapillaris disease may drive the growth of these new blood vessels. With continued innovation in OCTA image acquisition and analysis methods, new discoveries in AMD are set to follow.
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Topic review
Updated time: 11 Nov 2020
Submitted by: Gideon Nkrumah
Definition: Central serous chorioretinopathy (CSCR) is a chorioretinal disease affecting mostly middle-age males. It is marked by the serous detachment of the neurosensory layer at the macula. This review of the literature provides a framework of the current characteristic/relevant imaging findings of CSCR. Although the pathogenesis of CSCR is unclear, the choroid plays a major role and its changes are fundamental to the diagnosis and treatment of CSCR. Choroidal imaging has advanced the diagnosis of CSCR. This has led to numerous imaging biomarkers like CVI, CT, and hyperreflective dots for early detection and possible prognostication of CSCR. More techniques like wide-field scans and en face imaging are being employed to characterize the choroid in CSCR.
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Topic review
Updated time: 14 Feb 2021
Submitted by: francesco petrillo
Definition: Exogenous fungal endophthalmitis (EXFE) represents a rare complication after penetrating ocular trauma of previously unresolved keratitis or iatrogenic infections, following intraocular surgery such as cataract surgery.
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Topic review
Updated time: 28 Jun 2021
Submitted by: Yonathan Garfias
Definition: Angiogenesis is the new formation of vessels. Physiologically, it is essential for tissue repair; while its aberrant presentation, it may produce pathological disorders, such as Proliferative Diabetic Retinoptahy, Age Related Macular Degeneration, among many others.
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Topic review
Updated time: 09 Mar 2021
Submitted by: Regina Rodrigo
Definition: Inherited retinal dystrophies (IRDs) are a group of retinal disorders that cause progressive and severe loss of vision because of retinal cell death, mainly photoreceptor cells. IRDs include retinitis pigmentosa (RP), the most common IRD. IRDs present a genetic and clinical heterogeneity that makes it difficult to achieve proper treatment. The progression of IRDs is influenced, among other factors, by the activation of the immune cells (microglia, macrophages, etc.) and the release of inflammatory molecules such as chemokines and cytokines. Upregulation of tumor necrosis factor alpha (TNFα), a pro-inflammatory cytokine, is found in IRDs. This cytokine may influence photoreceptor cell death. Different cell death mechanisms are proposed, including apoptosis, necroptosis, pyroptosis, autophagy, excessive activation of calpains, or parthanatos for photoreceptor cell death. Some of these cell death mechanisms are linked to TNFα upregulation and inflammation. Therapeutic approaches that reduce retinal inflammation have emerged as useful therapies for slowing down the progression of IRDs.
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Topic review
Updated time: 13 Dec 2020
Submitted by: Arnaud MARTEL
Definition: Intraocular solid malignancy biopsy is usually not performed due to the risk and fear of extraocular extension. Recently, liquid biopsy has gained in popularity in this field. Liquid biopsy allows the diagnosis of intraocular malignancies as well as its monitoring in retinoblastoma. Liquid biopsy may help the clinican to better understand the metastatic spread, especially in uveal melanoma.
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Topic review
Updated time: 09 Jul 2021
Submitted by: Elsa Chan
Definition: Glaucoma is a heterogeneous group of disorders unified by loss of retinal ganglion cells (RGCs) and their axons, resulting in a characteristic phenotype consisting of an excavated optic nerve head with corresponding visual field defects. The pathogenesis of glaucoma is incompletely understood with multiple pathophysiological factors and pathways postulated to be causative, such as mechanical, vascular, and immunological factors, leading to the final result of apoptotic death of RGCs. Increasingly it is becoming apparent that these factors do not contribute to glaucoma independently, but rather they can be viewed as a continuum in which each factor contributes to the damage of retinal ganglion cell axons.
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Topic review
Updated time: 05 May 2021
Submitted by: Sadanand Pandey
Definition: Retinoblastoma is a rare type of cancer, and its treatment, as well as diagnosis, is challenging, owing to mutations in the tumor-suppressor genes and lack of targeted, efficient, cost-effective therapy, exhibiting a significant need for novel approaches to address these concerns. For this purpose, nanotechnology has revolutionized the field of medicine with versatile potential capabilities for both the diagnosis, as well as the treatment, of retinoblastoma via the targeted and controlled delivery of anticancer drugs via binding to the overexpressed retinoblastoma gene. Nanotechnology has also generated massive advancements in the treatment of retinoblastoma based on the use of surface-tailored multi-functionalized nanocarriers.
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