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Congenital simple hamartoma of the retinal pigment epithelium with depigmentation at the margin in an Indian female.

ABSTRACT: Objective: To report a case of congenital simple hamartoma of the retinal pigment epithelium (CSHRPE) with depigmentation at the margin. Method: Case report. Result: A 40-year-old Indian female was noted to have a small pigmented lesion with a depigmented margin toward the fovea in the right eye. The best-corrected vision was 6/6 in either eye. The optical coherence tomography revealed a highly reflective lesion at the retinal surface causing a shadow effect, suggestive of CSHRPE. Conclusion: Imaging features of a patient with CSHRPE with a crescent-like depigmented area at the margin are presented.

SUBMITTER: Tripathy K

PROVIDER: S-EPMC6637457 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Congenital simple hamartoma of the retinal pigment epithelium with depigmentation at the margin in an Indian female.

Tripathy Koushik K Bandyopadhyay Gopal G Basu Koushik K Vatwani Kishore Kumar KK Shekhar Himanshu H

GMS ophthalmology cases 20190618

Objective: To report a case of congenital simple hamartoma of the retinal pigment epithelium (CSHRPE) with depigmentation at the margin. Method: Case report. Result: A 40-year-old Indian female was noted to have a small pigmented lesion with a depigmented margin toward the fovea in the right eye. The best-corrected vision was 6/6 in either eye. The optical coherence tomography revealed a highly reflective lesion at the retinal surface causing a shadow effect, suggestive of C ...[more]

PMID: 31355121

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Project description:Lipofuscin accumulates with age in the retinal pigment epithelium (RPE) in discrete granular organelles and may contribute to age-related macular degeneration. Because previous studies suggest that lipofuscin contains protein that may impact pathogenic mechanisms, we pursued proteomics analysis of lipofuscin. The composition of RPE lipofuscin and its mechanisms of pathogenesis are poorly understood in part because of the heterogeneity of isolated preparations. We purified RPE lipofuscin granules by treatment with proteinase K or SDS and showed by light, confocal, and transmission electron microscopy that the purified granules are free of extragranular material and associated membranes. Crude and purified lipofuscin preparations were quantitatively compared by (i) LC MS/MS proteomics analyses, (ii) immunoanalyses of oxidative protein modifications, (iii) amino acid analysis, (iv) HPLC of bisretinoids, and (v) assaying phototoxicity to RPE cells. From crude lipofuscin preparations 186 proteins were identified, many of which appeared to be modified. In contrast, very little protein ( approximately 2% (w/w) by amino acid analysis) and no identifiable protein were found in the purified granules, which retained full phototoxicity to cultured RPE cells. Our analyses showed that granules in purified and crude lipofuscin preparations exhibit no statistically significant differences in diameter or circularity or in the content of the bisretinoids A2E, isoA2E, and all-trans-retinal dimer-phosphatidylethanolamine. The finding that the purified granules contain minimal protein yet retain phototoxic activity suggests that RPE lipofuscin pathogenesis is largely independent of associated protein. The purified granules also exhibited oxidative protein modifications, including nitrotyrosine generated from reactive nitrogen oxide species and carboxyethylpyrrole and iso[4]levuglandin E(2) adducts generated from reactive lipid fragments. This finding is consistent with previous studies demonstrating RPE lipofuscin to be a potent generator of reactive oxygen species and supports the hypothesis that such species, including reactive fragments from lipids and retinoids, contribute to the mechanisms of RPE lipofuscin pathogenesis.

Project description:The therapeutic potential of pluripotent stem cells is great as they promise to usher in a new era of medicine where cells or organs may be prescribed to replace dysfunctional tissue. At the forefront are efforts in the eye to develop this technology as it lends itself to in vivo monitoring and sophisticated non-invasive imaging modalities. In the retina, retinal pigment epithelium (RPE) is the most promising replacement cell as it has a single layer, is relatively simple to transplant, and is associated with several eye diseases. However, after transplantation, the cells may transform and cause complications. This transformation may be partially due to incomplete maturation. With the goal of learning how to mature RPE, we compared induced pluripotent stem cell-derived RPE (iPSC-RPE) cells with adult human primary RPE (ahRPE) cells and the immortalized human ARPE-19 line. We cultured ARPE-19, iPSC-RPE, and ahRPE cells for one month, and evaluated morphology, RPE marker staining, and transepithelial electrical resistance (TEER) as quality control indicators. We then isolated RNA for bulk RNA-sequencing and DNA for genotyping. We genotyped ahRPE lines for the top age-related macular degeneration (AMD) and proliferative vitreoretinopathy (PVR) risk allele polymorphisms. Transcriptome data verified that both adult and iPSC-RPE exhibit similar RPE gene expression signatures, significantly higher than ARPE-19. In addition, in iPSC-RPE, genes relating to stem cell maintenance, retina development, and muscle contraction were significantly upregulated compared to ahRPE. We compared ahRPE to iPSC-RPE in a model of epithelial-mesenchymal transition (EMT) and observed an increased sensitivity of iPSC-RPE to producing contractile aggregates in vitro which resembles incident reports upon transplantation. P38 inhibition was capable of inhibiting iPSC-RPE-derived aggregates. In summary, we find that the transcriptomic signature of iPSC-RPE conveys an immature RPE state which may be ameliorated by targeting "immature" gene regulatory networks.

Dataset Information

Congenital simple hamartoma of the retinal pigment epithelium with depigmentation at the margin in an Indian female.

Publications

Congenital simple hamartoma of the retinal pigment epithelium with depigmentation at the margin in an Indian female.

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