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Surgical Cystotomy of a Large Iris Pigment Epithelial Cyst with Microinstrumentation.

ABSTRACT: Purpose:Surgical intervention is indicated for large primary iris pigment epithelial cysts that significantly affect vision or compromise adjacent structures. Methods described in the literature include laser photocoagulation, needle aspiration, and complete resection. Methods:We describe a novel surgical technique in which a surgical cystotomy is created for a large, symptomatic iris pigment epithelial cyst using microsurgical instruments for a patient in whom needle aspiration was unsuccessful. Results:The patient's visual symptoms had largely resolved within 1 week postoperatively, no complications were encountered, and there was no clinical or sonographic evidence of cyst recurrence after 14 months. Conclusion:Surgical cystotomy with microinstrumentation may be an effective tool for management of primary iris pigment epithelial cysts, especially as an alternative after needle aspiration fails.

SUBMITTER: Denny MR

PROVIDER: S-EPMC6422127 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Surgical Cystotomy of a Large Iris Pigment Epithelial Cyst with Microinstrumentation.

Denny Matthew R MR Seider Michael I MI

Ocular oncology and pathology 20180725 2

<h4>Purpose</h4>Surgical intervention is indicated for large primary iris pigment epithelial cysts that significantly affect vision or compromise adjacent structures. Methods described in the literature include laser photocoagulation, needle aspiration, and complete resection.<h4>Methods</h4>We describe a novel surgical technique in which a surgical cystotomy is created for a large, symptomatic iris pigment epithelial cyst using microsurgical instruments for a patient in whom needle aspiration w ...[more]

PMID: 30976590

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Project description:During recent Zika epidemics, adults infected with Zika virus (ZIKV) have developed organ-specific inflammatory complications. The most serious Zika-associated inflammatory eye disease is uveitis, which is commonly anterior in type, affecting both eyes and responding to corticosteroid eye drops. Mechanisms of Zika-associated anterior uveitis are unknown, but ZIKV has been identified in the aqueous humor of affected individuals. The iris pigment epithelium is a target cell population in viral anterior uveitis, and it acts to maintain immune privilege within the anterior eye. Interactions between ZIKV and human iris pigment epithelial cells were investigated with infectivity assays and RNA-sequencing. Primary cell isolates were prepared from eyes of 20 cadaveric donors, and infected for 24 hours with PRVABC59 strain ZIKV or incubated uninfected as control. Cytoimmunofluorescence, RT-qPCR on total cellular RNA, and focus-forming assays of culture supernatant showed cell isolates were permissive to infection, and supported replication and release of infectious ZIKV. To explore molecular responses of cell isolates to ZIKV infection at the whole transcriptome level, RNA was sequenced on the Illumina NextSeq 500 platform, and results were aligned to the human GRCh38 genome. Multidimensional scaling showed clear separation between transcriptomes of infected and uninfected cell isolates. Differential expression analysis indicated a vigorous molecular response of the cell to ZIKV: 7,935 genes were differentially expressed between ZIKV-infected and uninfected cells (FDR < 0.05), and 99% of 613 genes that changed at least two-fold were up-regulated. Reactome and KEGG pathway and Gene Ontology enrichment analyses indicated strong activation of viral recognition and defense, in addition to biosynthesis processes. A CHAT network included 6275 molecular nodes and 24 contextual hubs in the cell response to ZIKV infection. Receptor-interacting serine/threonine kinase 1 (RIPK1) was the most significantly connected contextual hub. Correlation of gene expression with read counts assigned to the ZIKV genome identified a negative correlation between interferon signaling and viral load across isolates. This work represents the first investigation of mechanisms of Zika-associated anterior uveitis using an in vitro human cell model. The results suggest the iris pigment epithelium mounts a molecular response that limits intraocular pathology in most individuals.

Dataset Information

Surgical Cystotomy of a Large Iris Pigment Epithelial Cyst with Microinstrumentation.

Publications

Surgical Cystotomy of a Large Iris Pigment Epithelial Cyst with Microinstrumentation.

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