Autologous platelet concentrate in surgery for macular detachment associated with congenital optic disc pit

To evaluate the anatomical and functional results obtained with pars plana vitrectomy (PPV) plus autologous platelet concentrate (APC) as a treatment for macular detachment associated with optic disc pit (ODP). We performed a prospective interventional study of 19 eyes of 19 consecutive patients with posterior macular detachment due to ODP. All patients underwent PPV, posterior hyaloid peeling, fluid-air exchange, injection of 0.05 mL of APC over the ODP and 15% perfluoropropane (C3F8) endotamponade. Postoperative measures included face-up positioning for 2 hours and then avoidance of the face-up position during the ensuing 10 days. All patients underwent complete ophthalmologic examination and optical coherence tomography preoperatively at 1 month, 3 months, 6 months, 9 months, and 12 months postoperatively and then annually. Outcome measures were best corrected visual acuity (BCVA) by logMAR, improvement of quality of vision, macular attachment, and resolution of intraretinal schisis-like separation. Preoperatively, the median BCVA was 0.70 (range: 0.30-1.70) and all patients showed improved visual acuity after surgery; BCVA was 0.22 (range: 0.07-0.52) at 12 months follow-up. All patients showed complete reabsorption of intraretinal fluid (median time: 3.5 months [range: 2-8 months]) and macular attachment at the end of follow-up (median: 60 months [range: 12-144 months]), with stable or improved visual acuity. No reoperations were needed and no major adverse events were recorded. For macular detachment associated with ODP, the combination of PPV, posterior hyaloid peeling, APC, and C3F8 tamponade is a highly effective alternative technique with stable anatomical and functional results

Queratitis por acanthamoeba: estudio retrospectivo

Purpose: To analize the diagnosis and treatment¿s evolution of acanthamoeba keratitis (AK) in our center in recent years. Methods: We have studied 21 cases of AK in which the diagnosis was confirmed by anatomopathological tests. We¿ve studied these variables: age, gender, job, diagnosis date, visual acuity when diagnosed, period of time between starting the symptomatology and specific treatment, contact lenses (CL) wearer and swiming with them, clinical signs, treatment applied and illness evolution. Results: We found that of 21 patients we studied, 17 were CL wearers, 14 of them were soft. The most frequent presumption diagnosis the patient came to our center with was herpetic keratitis in 15 cases. Diagnosis was made in all cases by anatomopathological tests, 9 cases by corneal biopsy and 13 cases by recipient¿s cornea studies in pacients who requiered penetrating keratoplasty. Conclusion: To have the knowledge of this entity and its suspicion in CL wearers is very important to avoid an unfavourably evolution. Early diagnosis and an appropiated treatment can avoid it. Contact lenses wearers should know disinfectant measures in order to avoid risky situations.Objetivo: Analizar la evolución sufrida en el diagnóstico y tratamiento de la queratitis por acanthamoeba en nuestro centro en los últimos 13 años. Métodos: Hemos estudiado 21 casos de dicha patología en los cuales el examen anatomopatológico confirmó el diagnóstico. Se analizan variables como la edad, sexo, ocupación laboral, fecha del diagnóstico, AV en el momento del diagnóstico y AV final, tiempo entre el inicio del cuadro y tratamiento específico, uso de lentes de contacto (LC) y baño con ellas, signos clínicos, tratamiento empleado y evolución del cuadro. Resultados: Hallamos que de 21 pacientes, 17 eran portadores de LC, 14 de las cuales eran hidrofílicas. El diagnóstico de presunción más frecuente con el que el paciente acudió a nuestro servicio fue el de queratitis herpética en 15 casos. El diagnóstico se estableció en todos los casos por estudio anatomopatológico, tanto por biopsia corneal (9 casos) como por estudio del botón corneal en aquellos que requirieron queratoplastia penetrante (QP) (13 casos). Conclusiones: El conocimiento de esta patología y su sospecha en pacientes portadores de LC es fundamental para evitar una evolución desfavorable. El diagnóstico precoz y un tratamiento adecuado pueden evitarlo. El conocimiento por parte de los usuarios de las medidas de desinfección y evitar situaciones de riesgo es básico en la prevención de dicha entidad

Müller glia fused with adult stem cells undergo neural differentiation in human retinal models

Background: Visual impairments are a critical medical hurdle to be addressed in modern society. Müller glia (MG) have regenerative potential in the retina in lower vertebrates, but not in mammals. However, in mice, in vivo cell fusion between MG and adult stem cells forms hybrids that can partially regenerate ablated neurons. Methods: We used organotypic cultures of human retina and preparations of dissociated cells to test the hypothesis that cell fusion between human MG and adult stem cells can induce neuronal regeneration in human systems. Moreover, we established a microinjection system for transplanting human retinal organoids to demonstrate hybrid differentiation. Findings: We first found that cell fusion occurs between MG and adult stem cells, in organotypic cultures of human retina as well as in cell cultures. Next, we showed that the resulting hybrids can differentiate and acquire a proto-neural electrophysiology profile when the Wnt/beta-catenin pathway is activated in the adult stem cells prior fusion. Finally, we demonstrated the engraftment and differentiation of these hybrids into human retinal organoids. Interpretation: We show fusion between human MG and adult stem cells, and demonstrate that the resulting hybrid cells can differentiate towards neural fate in human model systems. Our results suggest that cell fusion-mediated therapy is a potential regenerative approach for treating human retinal dystrophies.Funding: This work was supported by La Caixa Health (HR17-00231), Velux Stiftung (976a) and the Ministerio de Ciencia e Innovación, (BFU2017-86760-P) (AEI/FEDER, UE), AGAUR (2017 SGR 689, 2017 SGR 926