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Pesquisa : Distrofia and Endotelial and De and Fuchs [Palavras]
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[PMID]:29338061
[Au] Autor:Okumura N; Matsumoto D; Fukui Y; Teramoto M; Imai H; Kurosawa T; Shimada T; Kruse F; Schlötzer-Schrehardt U; Kinoshita S; Koizumi N
[Ad] Endereço:Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan.
[Ti] Título:Feasibility of cell-based therapy combined with descemetorhexis for treating Fuchs endothelial corneal dystrophy in rabbit model.
[So] Source:PLoS One;13(1):e0191306, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Corneal transparency is maintained by the corneal endothelium through its pump and barrier function. Severe corneal endothelial damage results in dysregulation of water flow and eventually causes corneal haziness and deterioration of visual function. In 2013, we initiated clinical research of cell-based therapy for treating corneal decompensation. In that study, we removed an 8-mm diameter section of damaged corneal endothelium without removing Descemet's membrane (the basement membrane of the corneal endothelium) and then injected cultured human corneal endothelial cells (CECs) into the anterior chamber. However, Descemet's membrane exhibits clinically abnormal structural features [i.e., multiple collagenous excrescences (guttae) and thickening] in patients with Fuchs endothelial corneal dystrophy (FECD) and the advanced cornea guttae adversely affects the quality of vision, even in patients without corneal edema. The turnover time of cornea guttae is also not certain. Therefore, we used a rabbit model to evaluate the feasibility of Descemet's membrane removal in the optical zone only, by performing a small 4-mm diameter descemetorhexis prior to CEC injection. We showed that the corneal endothelium is regenerated both on the corneal stroma (the area of Descemet's membrane removal) and on the intact peripheral Descemet's membrane, based on the expression of function-related markers and the restoration of corneal transparency. Recovery of the corneal transparency and central corneal thickness was delayed in areas of Descemet's membrane removal, but the cell density of the regenerated corneal endothelium and the thickness of the central corneal did not differ between the areas with and without residual Descemet's membrane at 14 days after CEC injection. Here, we demonstrate that removal of a pathological Descemet's membrane by a small descemetorhexis is a feasible procedure for use in combination with cell-based therapy. The current strategy might be beneficial for improving visual quality after CEC injection as a treatment for FECD.
[Mh] Termos MeSH primário: Terapia Baseada em Transplante de Células e Tecidos
Transplante de Córnea
Distrofia Endotelial de Fuchs/terapia
[Mh] Termos MeSH secundário: Idoso
Animais
Terapia Combinada
Lâmina Limitante Posterior/cirurgia
Modelos Animais de Doenças
Epitélio Posterior/patologia
Estudos de Viabilidade
Feminino
Distrofia Endotelial de Fuchs/patologia
Distrofia Endotelial de Fuchs/cirurgia
Seres Humanos
Masculino
Coelhos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180117
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191306


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[PMID]:28742620
[Au] Autor:Ampazas P; Droutsas K; Giallouros E; Schroeder FM; Sekundo W
[Ad] Endereço:*Department of Ophthalmology, Philipps University of Marburg, Marburg, Germany; and †First Department of Ophthalmology, National and Kapodistrian University of Athens-Faculty of Medicine, Athens, Greece.
[Ti] Título:Comparison of 5% Sulfur Hexafluoride Versus 100% Air Tamponade in Descemet Membrane Endothelial Keratoplasty.
[So] Source:Cornea;36(10):1189-1194, 2017 Oct.
[Is] ISSN:1536-4798
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To compare the rebubbling rate and clinical outcomes of Descemet membrane endothelial keratoplasty (DMEK) with 5% sulfur hexafluoride (SF6) gas versus 100% air as a tamponade for graft attachment. METHODS: Retrospective, comparative, interventional case series including 368 consecutive pseudophakic eyes with Fuchs endothelial dystrophy or pseudophakic bullous keratopathy that underwent DMEK in a tertiary referral center between October 2010 and August 2015 using either air (group 1, 191 eyes) or 5% SF6 (group 2, 177 eyes) as a tamponade. The rebubbling rate, complications, best-corrected distance visual acuity (BCVA), manifest refraction, and endothelial cell density were analyzed before and at 1 week, 1, 3, 6, 12, 24, and 36 months after surgery. RESULTS: The rebubbling rate was 20.4% (39/191, group 1) versus 6.8% (12/177, group 2; P < 0.001). Complications included cystoid macular edema (n = 5, group 1, and n = 10, group 2; P = 0.14) and 1 case of presumed allograft rejection (n = 1, group 2). The follow-up period was 12 ± 8 months for group 1 and 6 ± 4 months for group 2. BCVA (logarithm of the minimum angle of resolution) had improved after 12 months from 1.43 ± 0.63 to 0.18 ± 0.26 (group 1, P < 0.001) and from 1.8 ± 0.63 to 0.18 ± 0.17 (group 2, P < 0.001). The percentage of eyes with BCVA ≥0.2 logarithm of the minimum angle of resolution at 12 months was 70.9% (90/127, group 1) and 78.4% (40/51, group 2; P = 0.3). Endothelial cell loss at 12 months after DMEK was 44 ± 18% (group 1) versus 33 ± 15% (group 2, P = 0.07). CONCLUSIONS: The use of a tamponade with 5% SF6 yielded a significantly lower incidence of graft detachment requiring surgical reintervention with no detrimental effect on graft endothelial cells. Thus, routine use of 5% SF6 for a graft tamponade in DMEK is recommended.
[Mh] Termos MeSH primário: Ar
Perda de Células Endoteliais da Córnea/prevenção & controle
Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior
Tamponamento Interno/métodos
Rejeição de Enxerto/prevenção & controle
Hexafluoreto de Enxofre/administração & dosagem
Aderências Teciduais
[Mh] Termos MeSH secundário: Idoso
Contagem de Células
Feminino
Distrofia Endotelial de Fuchs/cirurgia
Seres Humanos
Masculino
Refração Ocular/fisiologia
Estudos Retrospectivos
Doadores de Tecidos
Acuidade Visual/fisiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
WS7LR3I1D6 (Sulfur Hexafluoride)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1097/ICO.0000000000001299


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[PMID]:28742617
[Au] Autor:Dimitry MES; Lewis AD; Zacharaki F; Chandran M; Robson D; Menon G; Poole TRG
[Ad] Endereço:The Eye Dept, Frimley Park Hospital, Frimley Health NHS Foundation Trust, Surrey, United Kingdom.
[Ti] Título:Simple Single-Pass Technique for Ultrathin Descemet Stripping Automated Endothelial Keratoplasty: A Pilot Study.
[So] Source:Cornea;36(10):1178-1183, 2017 Oct.
[Is] ISSN:1536-4798
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To assess intraoperative and postoperative graft thickness (GT) after donor deturgescence for ultrathin Descemet stripping automated endothelial keratoplasty and to evaluate visual outcomes, endothelial cell density, and patient satisfaction at 1 year. METHODS: Prospective interventional case series of patients with Fuchs endothelial dystrophy, Fuchs endothelial dystrophy and cataract, and pseudophakic bullous keratopathy (n = 12 grafts). The donor cornea was allowed to thin out by simple evaporation on an artificial anterior chamber, to the required precut thickness, before a single microkeratome pass. GT after microkeratome cut, at 1 week, 1, 3, 6, and 12, months was measured. Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity, Pelli-Robson contrast sensitivity, endothelial cell density, and score on the visual function questionnaire (VFQ-25) were assessed. RESULTS: Mean intraoperative postmicrokeratome cut GT was 78.9 ± 33.3 µm. Mean GT at 1 week, 1, 3, 6, and 12 months was 70.7, 70.9, 62.8, 66.5, and 58.9 µm, respectively. Mean initial donor corneal thickness was 647 ± 67 µm, and mean precut thickness was 526 ± 4.5 µm (mean thinning time: 17 min). Best-corrected visual acuity at 1 week, 1, 3, 6, and 12 months was 68.8, 76.9, 76.3, 76.9, and 78.6 letters with 9-letter gain at 12 months (P = 0.02). Mean endothelial cell loss at 3, 6, and 12 months was 36.8% ± 6.75%, 37.2% ± 8%, and 37.9% ± 9.75% loss, respectively. At 1 year, 83.3% of patients achieved ≥20/40 (6/12) and 66.7% of patients achieved ≥20/32 (6/9.5). VFQ-25 testing showed an improvement in the visual function. CONCLUSIONS: This pilot study demonstrates a simple graft deturgescence technique that reproducibly creates ultrathin grafts without donor wastage.
[Mh] Termos MeSH primário: Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/métodos
Distrofia Endotelial de Fuchs/cirurgia
[Mh] Termos MeSH secundário: Idoso
Sensibilidades de Contraste/fisiologia
Paquimetria Corneana
Epitélio Posterior/patologia
Epitélio Posterior/transplante
Feminino
Seres Humanos
Período Intraoperatório
Masculino
Meia-Idade
Projetos Piloto
Período Pós-Operatório
Estudos Prospectivos
Doadores de Tecidos
Tomografia de Coerência Óptica
Acuidade Visual/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.1097/ICO.0000000000001273


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[PMID]:29196769
[Au] Autor:Eghrari AO; Vahedi S; Afshari NA; Riazuddin SA; Gottsch JD
[Ad] Endereço:Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.
[Ti] Título:CTG18.1 Expansion in TCF4 Among African Americans With Fuchs' Corneal Dystrophy.
[So] Source:Invest Ophthalmol Vis Sci;58(14):6046-6049, 2017 Dec 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: Studies of Fuchs' dystrophy have largely focused on individuals of European origin. Characterization of disease among African Americans is required to ensure prognostic factors and therapeutic approaches are applicable across diverse patient populations. Methods: We assessed all self-reported black and white patients aged older than 40 years at a tertiary care institution with a diagnosis of cataract over a 3-year period for concurrent diagnosis of Fuchs' dystrophy. Affected patients in a longitudinal cohort were invited to provide a blood sample from which we extracted genomic DNA. The CTG18.1 trinucleotide repeat length was determined using a two-step, triplet repeat primed PCR protocol. Expansion was defined as >40 CTG repeats. Demographic information, including race, was documented. Results: Of 59,365 self-reported black and white adults who presented for cataract evaluation, the odds ratio of presenting with Fuchs' dystrophy among black compared to white patients was 0.6992 (95% confidence interval [CI], 0.6210-0.7872). A total of 60 black and 549 white patients with Fuchs' corneal dystrophy enrolled in the longitudinal study, of which 21 (35.0%) black and 343 (62.5%) white patients demonstrated trinucleotide repeat expansion, a significant difference (P = 7.7 × 10-5). In a multivariable linear regression model, repeat expansion but not race was significantly associated with mean clinical grading of severity. Conclusions: Black patients with Fuchs' dystrophy were less likely than white patients to demonstrate CTG18.1 allele expansion. The data contribute to our understanding of population differences in clinical presentation, and highlight the need for considering diversity of patient populations in clinical research.
[Mh] Termos MeSH primário: Afroamericanos
DNA/genética
Distrofia Endotelial de Fuchs/genética
Predisposição Genética para Doença
Polimorfismo Genético
Fator de Transcrição 4/genética
[Mh] Termos MeSH secundário: Alelos
Seguimentos
Distrofia Endotelial de Fuchs/diagnóstico
Distrofia Endotelial de Fuchs/etnologia
Genótipo
Seres Humanos
Incidência
Reação em Cadeia da Polimerase
Estudos Retrospectivos
Autorrelato
Fatores de Tempo
Fator de Transcrição 4/metabolismo
Expansão das Repetições de Trinucleotídeos
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (TCF4 protein, human); 0 (Transcription Factor 4); 9007-49-2 (DNA)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171203
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-21661


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[PMID]:28456826
[Au] Autor:Gabbay IE; Bahar I; Nahum Y; Livny E
[Ad] Endereço:Department of Ophthalmology, Rabin Medical Center, 39 Jabotinsky St., 49100, Petach Tikva, Israel. igabbay@gmail.com.
[Ti] Título:Comparison of Descemet stripping under continuous air flow, manual air injection and balanced salt solution for DMEK: a pilot study.
[So] Source:Graefes Arch Clin Exp Ophthalmol;255(8):1605-1611, 2017 Aug.
[Is] ISSN:1435-702X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Descemet's membrane endothelial keratoplasty (DMEK) involves removal of the recipient's Descemet membrane (DM) prior to transplanting the donor's DM. When using balanced salt solution (BSS) or ophthalmic viscosurgical devices (OVDs), visualization of the host's DM during its stripping may be inadequate and may result in Descemet remnants and could lead to sub-optimal surgical results. Previous articles described excellent visualization when utilizing air injection but this requires repeated air injection into the anterior chamber (AC). We present a pilot study that compares different techniques under which DM stripping can be performed: with continuous automated air infusion, with manual air infusion, and with BSS. METHODS: We retrospectively compared video footage of DM stripping with BSS, with continuous air and with manual injection of air into the AC to determine DM stripping duration and the number of times the surgeon had to insert and retrieve a surgical instrument from the AC. RESULTS: Thirty videos of 10 consecutive cases of the three DM stripping techniques were evaluated. DM stripping duration was 3.26 (±1.32), 3.92 (±1.2) and 12.9 (±3.98) minutes for BSS, continuous air flow, and manual air injection, respectively. Frequency of instrument retrieval (FIR) was 3.6 (±1.71), 1.5 (±0.71) and 15.1 (±3.28) for BSS, continuous air flow, and manual air injection, respectively. Continuous air flow and BSS were both statistically different than manual air injection into the AC (p < 0.05), but did not differ from one another statistically. CONCLUSION: DM stripping during posterior lamellar surgery is imperative for favorable post-operative results and prevention of complications. Performing this step under air in the AC contributes to better visualization and an efficient surgery.
[Mh] Termos MeSH primário: Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior/métodos
Distrofia Endotelial de Fuchs/cirurgia
Cloreto de Sódio/administração & dosagem
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Ar
Câmara Anterior
Feminino
Seguimentos
Distrofia Endotelial de Fuchs/diagnóstico
Seres Humanos
Injeções
Masculino
Meia-Idade
Projetos Piloto
Estudos Retrospectivos
Acuidade Visual
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Nm] Nome de substância:
451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE
[do] DOI:10.1007/s00417-017-3675-0


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[PMID]:28886202
[Au] Autor:Mootha VV; Hansen B; Rong Z; Mammen PP; Zhou Z; Xing C; Gong X
[Ad] Endereço:Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas, United States.
[Ti] Título:Fuchs' Endothelial Corneal Dystrophy and RNA Foci in Patients With Myotonic Dystrophy.
[So] Source:Invest Ophthalmol Vis Sci;58(11):4579-4585, 2017 Sep 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: The most common cause of Fuchs' endothelial corneal dystrophy (FECD) is an intronic CTG repeat expansion in TCF4. Expanded CUG repeat RNA colocalize with splicing factor, muscleblind-like 1 (MBNL1), in nuclear foci in endothelium as a molecular hallmark. Myotonic dystrophy type 1 (DM1) is a neuromuscular disorder caused by a CTG repeat expansion in the 3'-untranslated region (UTR) of DMPK. In this study, we examine for RNA-MBNL1 foci in endothelial cells of FECD subjects with DM1, test the hypothesis that DM1 patients are at risk for FECD, and determine prevalence of TCF4 and DMPK expansions in a FECD cohort. Methods: Using FISH, we examined for nuclear RNA-MBNL1 foci in endothelial cells from FECD subjects with DM1. We examined 13 consecutive unrelated DM1 patients for FECD using slit-lamp and specular microscopy. We genotyped TCF4 and DMPK repeat polymorphisms in a FECD cohort of 317 probands using short-tandem repeat and triplet repeat-primed PCR assays. Results: We detected abundant nuclear RNA foci colocalizing with MBNL1 in endothelial cells of FECD subjects with DM1. Six of thirteen DM1 patients (46%) had slit-lamp and specular microscopic findings of FECD, compared to 4% disease prevalence (P = 5.5 × 10-6). As expected, 222 out of 317 (70%) FECD probands harbored TCF4 expansion, while one subject harbored DMPK expansion without prior diagnosis of DM1. Conclusions: Our work suggests that DM1 patients are at risk for FECD. DMPK mutations contribute to the genetic burden of FECD but are uncommon. We establish a connection between two repeat expansion disorders converging upon RNA-MBNL1 foci and FECD.
[Mh] Termos MeSH primário: Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos/genética
Distrofia Endotelial de Fuchs/genética
Distrofia Miotônica/genética
Miotonina Proteína Quinase/genética
RNA Nuclear
Proteínas de Ligação a RNA/genética
Fatores de Transcrição/genética
[Mh] Termos MeSH secundário: Adulto
Idoso
Epitélio Posterior/metabolismo
Epitélio Posterior/patologia
Feminino
Distrofia Endotelial de Fuchs/patologia
Técnicas de Genotipagem
Seres Humanos
Hibridização in Situ Fluorescente
Masculino
Meia-Idade
Distrofia Miotônica/patologia
Reação em Cadeia da Polimerase
Processamento de RNA
Lâmpada de Fenda
Fator de Transcrição 4
Expansão das Repetições de Trinucleotídeos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Basic Helix-Loop-Helix Leucine Zipper Transcription Factors); 0 (DMPK protein, human); 0 (MBNL1 protein, human); 0 (RNA, Nuclear); 0 (RNA-Binding Proteins); 0 (TCF4 protein, human); 0 (Transcription Factor 4); 0 (Transcription Factors); EC 2.7.11.1 (Myotonin-Protein Kinase)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.17-22350


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[PMID]:28832669
[Au] Autor:Kuot A; Hewitt AW; Snibson GR; Souzeau E; Mills R; Craig JE; Burdon KP; Sharma S
[Ad] Endereço:Department of Ophthalmology, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
[Ti] Título:TGC repeat expansion in the TCF4 gene increases the risk of Fuchs' endothelial corneal dystrophy in Australian cases.
[So] Source:PLoS One;12(8):e0183719, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Fuchs' endothelial corneal dystrophy (FECD) is a progressive, vision impairing disease. Common single nucleotide polymorphisms (SNPs) and a trinucleotide repeat polymorphism, thymine-guanine-cytosine (TGC), in the TCF4 gene have been associated with the risk of FECD in some populations. We previously reported association of SNPs in TCF4 with FECD risk in the Australian population. The aim of this study was to determine whether TGC repeat polymorphism in TCF4 is associated with FECD in the Australian population. In 189 unrelated Australian cases with advanced late-onset FECD and 183 matched controls, the TGC repeat polymorphism located in intron 3 of TCF4 was genotyped using a short tandem repeat (STR) assay. The repeat length was verified by direct sequencing in selected homozygous carriers. We found significant association between the expanded TGC repeat (≥ 40 repeats) in TCF4 and advanced FECD (P = 2.58 × 10-22; OR = 15.66 (95% CI: 7.79-31.49)). Genotypic analysis showed that 51% of cases (97) compared to 5% of controls (9) were heterozygous or homozygous for the expanded repeat allele. Furthermore, the repeat expansion showed stronger association than the most significantly associated SNP, rs613872, in TCF4, with the disease in the Australian cohort. This and haplotype analysis of both the polymorphisms suggest that considering both the polymorphisms together rather than either of the two alone would better predict susceptibility to FECD in the Australian population. This is the first study to report association of the TGC trinucleotide repeat expansion in TCF4 with advanced FECD in the Australian population.
[Mh] Termos MeSH primário: Fatores de Transcrição de Zíper de Leucina e Hélice-Alça-Hélix Básicos/genética
Distrofia Endotelial de Fuchs/genética
Predisposição Genética para Doença
Fatores de Transcrição/genética
Expansão das Repetições de Trinucleotídeos
[Mh] Termos MeSH secundário: Alelos
Austrália
Estudos de Casos e Controles
Seres Humanos
Íntrons
Polimorfismo Genético
Fator de Transcrição 4
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Basic Helix-Loop-Helix Leucine Zipper Transcription Factors); 0 (TCF4 protein, human); 0 (Transcription Factor 4); 0 (Transcription Factors)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170824
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183719


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[PMID]:28739420
[Au] Autor:Fuest M; Ang M; Htoon HM; Tan D; Mehta JS
[Ad] Endereço:Singapore Eye Research Institute, Singapore; Department of Ophthalmology, RWTH Aachen University, Aachen, Germany.
[Ti] Título:Long-term Visual Outcomes Comparing Descemet Stripping Automated Endothelial Keratoplasty and Penetrating Keratoplasty.
[So] Source:Am J Ophthalmol;182:62-71, 2017 Oct.
[Is] ISSN:1879-1891
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To compare 5-year visual acuity and refraction outcome in Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK) for Fuchs endothelial dystrophy (FED) or bullous keratopathy (BK) in Asian eyes. DESIGN: Prospective interventional case series. METHODS: We analyzed 828 consecutive cases of DSAEK (423) or PK (405) for FED and BK from the Singapore Cornea Transplant Registry performed from 1991 to 2011. Our main outcome measures were best spectacle-corrected visual acuity (BSCVA) with astigmatism (cylinder) and spherical equivalent (SE) over 5 years of follow-up. RESULTS: Mean age was 67.5 ± 11.5 years (50.1% male, 49.9% female) and majority was Chinese (76.6%, n = 634) in our multiracial Asian population. DSAEK eyes had significantly better BSCVA (P < .001-.037) with lower SE (P < .001-.017) and cylinder (P < .001), independent of surgical indication, compared to PK over 5 years. DSAEK was superior to PK over 5 years (P < .001-.026) in FED, but only over 3 years in BK (P < .001-.031). DSAEK in FED eyes had significantly better BSCVA compared to BK eyes (P = .006 at 4-year follow-up). DSAEKs with preoperative BSCVA < 1.3 logMAR had significantly better visual outcomes than cases with ≥ 1.3 logMAR (P < .001-.042). PKs had significantly higher postoperative refractive correction than DSAEKs, with no significant influence of the surgery indication. CONCLUSIONS: In our study cohort, DSAEK provided significantly better long-term BSCVA and lower astigmatism than PK over 5 years of follow-up. Visual outcomes of DSAEK for FED were better than BK. In some analyses for years 1-3, analysis of covariance adjustment indicated that this DSAEK-associated better long-term BSCVA was independent of better preoperative vision in DSAEK eyes.
[Mh] Termos MeSH primário: Ceratoplastia Endotelial com Remoção da Lâmina Limitante Posterior
Distrofia Endotelial de Fuchs/cirurgia
Ceratoplastia Penetrante
Refração Ocular/fisiologia
Acuidade Visual/fisiologia
[Mh] Termos MeSH secundário: Idoso
Doenças da Córnea/fisiopatologia
Doenças da Córnea/cirurgia
Feminino
Seguimentos
Distrofia Endotelial de Fuchs/fisiopatologia
Seres Humanos
Masculino
Estudos Prospectivos
Sistema de Registros
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE


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[PMID]:28727885
[Au] Autor:Okumura N; Kitahara M; Okuda H; Hashimoto K; Ueda E; Nakahara M; Kinoshita S; Young RD; Quantock AJ; Tourtas T; Schlötzer-Schrehardt U; Kruse F; Koizumi N
[Ad] Endereço:Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan.
[Ti] Título:Sustained Activation of the Unfolded Protein Response Induces Cell Death in Fuchs' Endothelial Corneal Dystrophy.
[So] Source:Invest Ophthalmol Vis Sci;58(9):3697-3707, 2017 Jul 01.
[Is] ISSN:1552-5783
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Purpose: The unfolded protein response (UPR) is believed to play a role in the pathogenesis of Fuchs' endothelial corneal dystrophy (FECD). The purpose of this study was to investigate whether unfolded proteins accumulate in the corneal endothelium in FECD and if they are involved in triggering cell death. Methods: Descemet's membranes with corneal endothelial cells (CECs) were obtained during keratoplasty, and expression of aggresomes, type 1 collagen, fibronectin, and agrin was evaluated. Endoplasmic reticulum (ER) stress of immortalized human CECs from non-FECD subjects and from FECD patients (iHCEC and iFECD, respectively) were evaluated. The effect of MG132-mediated aggresome formation on the UPR and intrinsic pathway and the effect of mitochondrial damage on UPR were also examined. The effect of CHOP knockdown on the ER stress-mediated intrinsic pathway was also evaluated. Results: Aggresome formation was higher in iFECD than in iHCEC and was colocalized with type 1 collagen, fibronectin, and agrin. GRP78, phosphorylated IRE1, PERK, and CHOP showed higher activation in iFECD than in iHCEC. MG132-mediated aggresome formation upregulated ER stress sensors, the mitochondrial membrane potential drop, cytochrome c release to the cytoplasm, and activation of caspase-9 and -3. By contrast, staurosporine-mediated mitochondrial damage did not induce ER stress. Knockdown of CHOP attenuated the ER stress-induced cleavage of caspase-9, which is caused by intrinsic pathway activation. Conclusions: Excessive synthesis of extracellular matrix proteins induced unfolded protein accumulation in FECD. Prolonged ER stress-mediated cell death, occurring via the intrinsic apoptotic signaling pathway, therefore might be associated with the pathogenesis of FECD.
[Mh] Termos MeSH primário: Apoptose
Epitélio Posterior/metabolismo
Proteínas da Matriz Extracelular/metabolismo
Distrofia Endotelial de Fuchs/patologia
Agregação Patológica de Proteínas/patologia
Resposta a Proteínas não Dobradas/fisiologia
[Mh] Termos MeSH secundário: Agrina/metabolismo
Células Cultivadas
Colágeno Tipo I/metabolismo
Lâmina Limitante Posterior/metabolismo
Lâmina Limitante Posterior/patologia
Retículo Endoplasmático/metabolismo
Retículo Endoplasmático/patologia
Fibronectinas/metabolismo
Distrofia Endotelial de Fuchs/metabolismo
Proteínas de Choque Térmico/metabolismo
Seres Humanos
Imuno-Histoquímica
Potencial da Membrana Mitocondrial/fisiologia
Meia-Idade
Estresse Oxidativo
Agregação Patológica de Proteínas/metabolismo
Reação em Cadeia da Polimerase em Tempo Real
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Agrin); 0 (Collagen Type I); 0 (Extracellular Matrix Proteins); 0 (Fibronectins); 0 (Heat-Shock Proteins); 0 (molecular chaperone GRP78)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170728
[Lr] Data última revisão:
170728
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1167/iovs.16-21023


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[PMID]:28726355
[Au] Autor:Price FW; Price MO
[Ad] Endereço:Price Vision Group, Indianapolis.
[Ti] Título:Combined Cataract/DSEK/DMEK: Changing Expectations.
[So] Source:Asia Pac J Ophthalmol (Phila);6(4):388-392, 2017 Jul-Aug.
[Is] ISSN:2162-0989
[Cp] País de publicação:China
[La] Idioma:eng
[Ab] Resumo:Endothelial keratoplasty (EK) has revolutionized corneal transplant surgery by providing rapid visual recovery and improved visual outcomes. In parts of the world with Fuchs endothelial dystrophy, many patients may present with both cataracts and corneal degeneration requiring surgery. Other forms of endothelial decompensation may also present with cataracts. The staging or combination of transplant surgery and cataract surgery depend on both the abilities of the surgeon and the surgical techniques being considered. We currently use phacoemulsification to remove cataracts and routinely perform both cataract surgery and EK with topical anesthesia. The decision to perform either combined or staged cataract and transplant surgery depends upon the examination of the eye including assessment of the anterior chamber depth and the status of the anterior surface of the cornea, which affects the ability to reliably assess keratometry. Additional considerations include the type of lens implant to use, the desired refractive outcome, and the patient's preference about whether to undergo 1 or 2 surgical procedures per eye.
[Mh] Termos MeSH primário: Catarata/complicações
Transplante de Córnea/métodos
Distrofia Endotelial de Fuchs/complicações
Facoemulsificação/métodos
Acuidade Visual
[Mh] Termos MeSH secundário: Distrofia Endotelial de Fuchs/cirurgia
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.22608/APO.2017127



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