Inadvertent steroid injection into the crystalline lens.
Ontology highlight
ABSTRACT:
SUBMITTER: Alam MS
PROVIDER: S-EPMC5488069 | biostudies-other | 2017
REPOSITORIES: biostudies-other
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Project description:Custom high-resolution high-speed anterior segment spectral domain optical coherence tomography (OCT) was used to characterize three-dimensionally (3-D) the human crystalline lens in vivo. The system was provided with custom algorithms for denoising and segmentation of the images, as well as for fan (scanning) and optical (refraction) distortion correction, to provide fully quantitative images of the anterior and posterior crystalline lens surfaces. The method was tested on an artificial eye with known surfaces geometry and on a human lens in vitro, and demonstrated on three human lenses in vivo. Not correcting for distortion overestimated the anterior lens radius by 25% and the posterior lens radius by more than 65%. In vivo lens surfaces were fitted by biconicoids and Zernike polynomials after distortion correction. The anterior lens radii of curvature ranged from 10.27 to 14.14 mm, and the posterior lens radii of curvature ranged from 6.12 to 7.54 mm. Surface asphericities ranged from -0.04 to -1.96. The lens surfaces were well fitted by quadrics (with variation smaller than 2%, for 5-mm pupils), with low amounts of high order terms. Surface lens astigmatism was significant, with the anterior lens typically showing horizontal astigmatism ([Formula: see text] ranging from -11 to -1 µm) and the posterior lens showing vertical astigmatism ([Formula: see text] ranging from 6 to 10 µm).
| S-EPMC3470006 | biostudies-other
Project description:Custom Spectral Domain Optical Coherence Tomography (SD-OCT) provided with automatic quantification and distortion correction algorithms was used to measure anterior and posterior crystalline lens surface elevation in accommodating eyes and to evaluate relationships between anterior segment surfaces. Nine young eyes were measured at different accommodative demands. Anterior and posterior lens radii of curvature decreased at a rate of 0.78 ± 0.18 and 0.13 ± 0.07 mm/D, anterior chamber depth decreased at 0.04 ± 0.01 mm/D and lens thickness increased at 0.04 ± 0.01 mm/D with accommodation. Three-dimensional surface elevations were estimated by subtracting best fitting spheres. In the relaxed state, the spherical term accounted for most of the surface irregularity in the anterior lens (47%) and astigmatism (70%) in the posterior lens. However, in accommodated lenses astigmatism was the predominant surface irregularity (90%) in the anterior lens. The RMS of high-order irregularities of the posterior lens surface was statistically significantly higher than that of the anterior lens surface (x2.02, p<0.0001). There was significant negative correlation in vertical coma (Z3 (-1)) and oblique trefoil (Z3 (-3)) between lens surfaces. The astigmatic angle showed high degree of alignment between corneal surfaces, moderate between corneal and anterior lens surface (~27 deg), but differed by ~80 deg between the anterior and posterior lens surfaces (including relative anterior/posterior lens astigmatic angle shifts (10-20 deg).
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Project description:To develop an age-dependent mathematical model of the isolated ex-vivo human crystalline lens shape to serve as basis for use in computational modeling.Profiles of whole isolated human lenses (n=27) aged 6 to 82, were measured from shadow-photogrammetric images. Two methods were used to analyze the lenses. In the two curves method (TCM) the anterior and posterior surfaces of the lens were fit to 10th-order even polynomials and in the one curve method (OCM) the contour of one half-meridional section of the lens was fit to 10th-order polynomials. The age-dependence of the polynomial coefficients was assessed. The analysis was used to produce an age-dependent polynomial model of the whole lens shape.The root mean squared errors for the fits ranged from 11 to 70 microm for the OCM, 9 to 27 microm for the posterior surface of the TCM and 8 to 134 microm for the anterior surface of the TCM. The coefficients of the OCM did not display a significant trend with age. The 2nd-, 6th- and 10th-order coefficients of the anterior surface of the TCM decreased with age while the 8th-order coefficient increased. For the posterior surface of the TCM, the 8th-order coefficient significantly decreased with age and the 10th-order coefficient increased. The age-dependent equations of both the models provide a reliable model from age 20 to 60. The OCM model can be used for lenses older than 60 as well.The shape of the whole human crystalline lens can be accurately modeled with 10th-order polynomial functions. These models can serve to improve computational modeling, such as finite element (FE) modeling of crystalline lenses.
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Project description:PurposeA distinct subset of genes, so-called "late fiber genes," is expressed in cells bordering the central, organelle-free zone (OFZ) of the lens. The purpose of this study was to identify additional members of this group.MethodsFiber cells were harvested from various layers of the lens by laser micro-dissection and subjected to microarray, in situ hybridization, and Western blot analysis.ResultsExpression of Livin, a member of the inhibitor of apoptosis protein (IAP) family encoded by Birc7, was strongly upregulated in deep cortical fiber cells. The depth-dependent distribution of Livin mRNA was confirmed by quantitative PCR and in situ hybridization. The onset of Livin expression coincided with loss of organelles from primary fiber cells. Livin expression peaked at 1 month but was sustained even in aged lenses. Antibodies raised against mouse Livin labeled multiple bands on immunoblots, reflecting progressive proteolysis of the parent molecule during differentiation. Mice harboring a floxed Birc7 allele were generated and used to conditionally delete Birc7 in lens. Lenses from knockout mice grew normally and retained their transparency, suggesting that Livin does not have an indispensable role in fiber cell differentiation.ConclusionsBirc7 is a late fiber gene of the mouse lens. In tumor cells, Livin acts as an antiapoptotic protein, but its function in the lens is enigmatic. Livin is a RING domain protein with putative E3 ubiquitin ligase activity. Its expression in cells bordering the OFZ is consistent with a role in organelle degradation, a process in which the ubiquitin proteasome pathway has been implicated previously.
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Project description:PurposeTo analyze the age dependence of the longitudinal modulus of the crystalline lens in vivo using Brillouin scattering data in healthy subjects.MethodsBrillouin scans were performed along the crystalline lens in 56 eyes from 30 healthy subjects aged from 19 to 63 years. Longitudinal elastic modulus was acquired along the sagittal axis of the lens with a transverse and axial resolution of 4 and 60 ?m, respectively. The relative lens stiffness was computed, and correlations with age were analyzed.ResultsBrillouin axial profiles revealed nonuniform longitudinal modulus within the lens, increasing from a softer periphery toward a stiffer central plateau at all ages. The longitudinal modulus at the central plateau showed no age dependence in a range of 19 to 45 years and a slight decrease with age from 45 to 63 years. A significant intersubject variability was observed in an age-matched analysis. Importantly, the extent of the central stiff plateau region increased steadily over age from 19 to 63 years. The slope of change in Brillouin modulus in the peripheral regions were nearly age-invariant.ConclusionsThe adult human lens showed no measurable age-related increase in the peak longitudinal modulus. The expansion of the stiff central region of the lens is likely to be the major contributing factor to age-related lens stiffening. Brillouin microscopy may be useful in characterizing the crystalline lens for the optimization of surgical or pharmacological treatments aimed at restoring accommodative power.
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Project description:In a cataract surgery, the opacified crystalline lens is replaced by an artificial intraocular lens (IOL). To optimize the visual quality after surgery, the intraocular lens to be implanted must be selected preoperatively for every individual patient. Different generations of formulas have been proposed for selecting the intraocular lens dioptric power as a function of its estimated postoperative position. However, very few formulas include crystalline lens information, in most cases only one-dimensional. The present study proposes a new formula to preoperatively estimate the postoperative IOL position (ELP) based on information of the 3-dimensional full shape of the crystalline lens, obtained from quantitative eye anterior segment optical coherence tomography imaging. Real patients were measured before and after cataract surgery (IOL implantation). The IOL position and the postoperative refraction estimation errors were calculated by subtracting the preoperative estimations from the actual values measured after surgery. The proposed ELP formula produced lower estimation errors for both parameters -ELP and refraction- than the predictions obtained with standard state-of-the-art methods, and opens new avenues to the development of new generation IOL power calculation formulas that improve refractive and visual outcomes.
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Project description:The synthesis of quinolinic acid from tryptophan is a critical step in the de novo biosynthesis of nicotinamide adenine dinucleotide (NAD+) in mammals. Herein, the nonheme iron-based 3-hydroxyanthranilate-3,4-dioxygenase responsible for quinolinic acid production was studied by performing time-resolved in crystallo reactions monitored by UV-vis microspectroscopy, electron paramagnetic resonance (EPR) spectroscopy, and X-ray crystallography. Seven catalytic intermediates were kinetically and structurally resolved in the crystalline state, and each accompanies protein conformational changes at the active site. Among them, a monooxygenated, seven-membered lactone intermediate as a monodentate ligand of the iron center at 1.59-Å resolution was captured, which presumably corresponds to a substrate-based radical species observed by EPR using a slurry of small-sized single crystals. Other structural snapshots determined at around 2.0-Å resolution include monodentate and subsequently bidentate coordinated substrate, superoxo, alkylperoxo, and two metal-bound enol tautomers of the unstable dioxygenase product. These results reveal a detailed stepwise O-atom transfer dioxygenase mechanism along with potential isomerization activity that fine-tunes product profiling and affects the production of quinolinic acid at a junction of the metabolic pathway.
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Project description:To report the therapeutic efficacy and results of an accidentally injected intralenticular sustained-release dexamethasone implant (Ozurdex) in a patient with macular edema secondary to diabetic macular edema. Dexamethasone intravitreal implant is an approved formulation in the management of macular edema. The most common adversarial effects are an elevation of intraocular pressure (IOP) and cataract, but the unintentional injection of the dexamethasone implant into the lens is a particularly rare event.We report a case of a 72-year-old man treated for resistant Diabetic macular edema (DME) with dexamethasone intravitreal implant (Ozurdex, Allergan, Inc., Irvine, CA, USA) in which the technique was complicated by accidental implantation into the lens body and review the management. The patient underwent phacoemulsification of the lens, removal of the Ozurdex, intravitreal Avastin injection, and implant of a one-piece lens in the posterior capsule.
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Project description:Background and purposeInadvertent subdural contrast injections can occur during any myelogram. Currently, there are no guidelines defining when residual subdural iodinated contrast will be cleared and no longer interfere with subsequent procedure and imaging. We investigated the time to resolution of subdural contrast using a 2-day lateral decubitus digital subtraction myelogram and associated CT myelogram data in patients undergoing evaluation for spontaneous intracranial hypotension.Materials and methodsRetrospective review of 63 patients with lateral decubitus digital subtraction myelograms from September 4, 2018, to October 1, 2019, was performed. Patients with 2-day lateral decubitus digital subtraction myelograms on 2 consecutive days, with or without a same-day CT myelogram on day 1 and with a same-day CT myelogram on day 2, were included. Patients with next-day CT covering at least the abdomen and pelvis after either-day injection were also included. In cases of subdural injection, next-day CT scans were evaluated for residual subdural contrast.ResultsOf 49 included patients, 5 had subdural injection on day 1, with the second-day CT myelogram available for review. One of these 5 patients had subdural injections on 2 different days and subsequently had chest/abdomen/pelvis CTA a day after the second subdural injection. In all 6 cases of subdural injections, there was complete resolution of subdural contrast on the next-day CT, with the shortest time to resolution of approximately 20.5 hours (range, 20.5-28.5 hours).ConclusionsOur study suggests that resolution of inadvertently injected subdural contrast occurs within 1 day, and the myelogram can be reattempted as early as the next day.
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Project description:Background: Epidural steroid injection (ESI) has been used in managing chronic radicular pain. Regarding various techniques of ESI, the synergistic effect of caudal ESI (CESI) on transforaminal ESI (TFESI) in chronic lumbosacral radicular pain in prospective randomized controlled trial has not been determined. Methods: A total of 54 eligible patients with lumbosacral radicular pain were randomly allocated to undergo TFESI plus CESI (TC group) or TFESI alone (T group). The effective response to treatment was predefined by at least a 30% reduced verbal numerical rating scale (VNRS) from baseline between group comparison and the functional outcomes as measured by improved Oswestry Disability Index by least 15 points from baseline. All participants were evaluated using a single blinded outcome assessor before the procedure and at 1, 3 and 6 months after the procedure. P <0.05 was considered as statistically significant. Results: Average VNRS reduced significantly from baseline after receiving procedure at 1, 3 and 6 months in both groups (P-value <0.05). The TC group exhibited more effective and showed significant pain relief compared with the T group at 3 months (P=0.01). However, no statistical difference was observed between sub group analysis in pain relief and insignificant difference between group comparisons of functional outcomes. Conclusions: A treatment combining TFESI and CESI showed significant pain relief over TFESI alone at 3 months. No effect was found concerning functional evaluation. Registration: Thai Clinical Trials Registry ID TCTR20171101002 01/11/2017F.
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