MicroRNA Expression in the Aqueous Humor of Patients with Diabetic Macular Edema.

We identified and compared secreted microRNA (miRNA) expression in aqueous humor (AH) and plasma samples among patients with: type 2 diabetes mellitus (T2D) complicated by non-proliferative diabetic retinopathy (DR) associated with diabetic macular edema (DME) (DME group: 12 patients); T2D patients without DR (D group: 8 patients); and non-diabetic patients (CTR group: 10 patients). Individual patient AH samples from five subjects in each group were profiled on TaqMan Low Density MicroRNA Array Cards. Differentially expressed miRNAs identified from profiling were then validated in single assay for all subjects. The miRNAs validated in AH were then evaluated in single assay in plasma. Gene Ontology (GO) analysis was conducted. From AH profiling, 119 mature miRNAs were detected: 86 in the DME group, 113 in the D group and 107 in the CTR group. miRNA underexpression in the DME group was confirmed in single assay for let-7c-5p, miR-200b-3p, miR-199a-3p and miR-365-3p. Of these four, miR-199a-3p and miR-365-3p were downregulated also in the plasma of the DME group. GO highlighted 54 validated target genes of miR-199a-3p, miR-200b-3p and miR-365-3p potentially implied in DME pathogenesis. Although more studies are needed, miR-200b-3p, let-7c-5p, miR-365-3p and miR-199a-3p represent interesting molecules in the study of DME pathogenesis

Central Retinal Vein Occlusion and Prothrombotic Factors

Retinal vein occlusion (RVO) is an important cause of visual loss. Known risk factors are hypertension, diabetes mellitus, hyperlipidaemia, open angle glaucoma and abnormalities of haemostatic factors and blood viscosity. The aim of our study was to identify any relationships between RVO and fibrinolytic-coagulative pattern in patients affected either by metabolic disorders or not Methods: 50 patients (22 male, 28 female) affected by RVO underwent a study of metabolic, coagulative and fibrinolytic parameters. All patients were not submitted to any previous ocular theraphy before the episode of RVO. After a complete ophtalmologic evaluation, blood was collected to perform various laboratory tests: Enzymatic-colorimetric: glicaemia, total-cholesterol (TC), HDL-cholesterol (HDL-C), Tryglicerides (TG), Antitrombin III (ATIII), Protein C and S (PC, PS), Alpha-2-antiplasmin (A2P), Plasminogen (PL). ELISA: D-dimer (DD), tissue plasminogen activator and inhibitor (t-PA, PAI-1), thrombin activable fibrinolysis inhibitor (TAFI), Soluble P and E selectin (sP-sel, sE-sel), vonWillebrand factor (vWF), fragment 1+2 (F1+2), lipoprotein (a) [lp(a)]. Coagulative: Protein C resistance (APCR), Factor VII and VIII (VII, VIII). HPLC: Homocysteine. Our data show a decreased fibrinolytic power in 43/50 subjects (86%) (ELT 318±36 min, PAP 107±19 ug/l). PAI-1 was 21.4±4.2 UI/l in the general population with differences between diabetic and dyslipidaemic subjects and not-metabolic patients. 1 patients suffered from low ATIII levels (60%), none had PC, PS deficiency or APCR. 2 not-metabolic subjects had increased Lp (a) and impairment of fibrinolysis. Hyper Hc (21.6±3.1umol/l) was detected in 4 subjects TAFI and sP-sel were increased in patients (4) with type IIa hyperlipidemia. sE-sel and vWF were particularly increased in dysmetabolic subjects (diabetes and Hyper TG or low HDL-C). A prothrombotic state involving defects in coagulative and fibrinolytic factors has been previously associated with the onset of RVO. Our data show that a fibrinolytic impairment is the most common feature in such patients regardless dysmetabolic or not associated diseases. Moreover mechanisms leading to fybrinolysis alterations vary between subjects in order to associated metabolic conditions. Defects in anticoagulant natural proteins or platelet hyperactivity are very rare conditions detected in our population. Such data suggest that the fibrinolytic system may be an important target of acute treatment and profilaxys in RVO affected patients

Peptidergic innervation of mesenteric lymphatics in guinea pigs: an immunocytochemical and pharmacological study.

By immunocytochemistry, substance P immunoreactive (SP-IR) and vasoactive intestinal peptide immunoreactive (VIP-IR) nerve fibers were examined in guinea pig mesenteric lymph collectors. The immunoreactive nerve fibers, located in the adventitia of lymphatics, were few and were irregularly distributed along the vessel wall. These fibers appeared to be more numerous and more evenly distributed along the corresponding artery and vein walls within the same area. SP immunoreactivity in the vascular nerves was depleted in guinea pigs injected with capsaicin but was unaffected by the injection of 6-hydroxydopamine. By contrast, VIP-IR nerve fibers were unaffected by both treatments. It is concluded that SP-IR nerve fibers in the lymphatics are likely to be of sensory origin and that VIP containing nerves in the lymph collectors are distinct from SP-containing and noradrenergic nerves. It is also suggested that lymph collectors possess a complex although limited innervation pattern not only of autonomic nerve fibers containing classic neurotransmitters but also of peptidergic nerve fibers of a different origin with a vasomotor and/or sensory action

Congenital Optic Pit and Argon Laser Photocoagulation

Congenital Optic Pit of the papilla (CPP) is a monolateral little hole located in the inferior temporal portion of the optic nerve CPP is characterized by a spherical shape involving 1/3 of the optic nerve surface and has a deep face with pigmented base The most important complication is retinal detachment, in particular macular detachment. The origin of subretinal fluid is unknown. We observed 2 cases, both females, 18 and 25 years old, one complicated by macular detachment. We treated macular detachment with argon laser photocoagulation applying spots around the detached retina and achieved improvement of visual acuity. Most important diagnostic feature in CPP seems to be retinal angiography, demonstrating hyperfluorescence of CPP and macular detachment

Neonatal retinoblastoma

Purpose: To identify patients with retinoblastoma diagnosed at the age of 1 month and describe their clinical features and treatment outcome. Methods: A retrospective study of 715 cases of retinoblastoma diagnosed and treated at the Retinoblastoma Referral Center University of Siena between 1980 and 2018 has been performed. Results: Thirty‐!ve patients diagnosed within the !rst month of life have been identi!ed. The majority of them had a bilateral form; among the unilateral ones some of them developed metachronous tumors in the fellow eye. Family history was positive in most of them. The follow‐up range was 1 to 37 years. Management included early enucleation, systemic chemotherapy, bridge chemotherapy followed by intraarterial chemotherapy and focal treatments. None of them developed metastatic disease or second tumors. Conclusions: Family history prompted early diagnosis in most cases. However, early diagnosis does not always mean early stage of the disease and better prognosis

Coagulative, fibrinolytic and metabolic pattern in patients with central retinal vein occlusion.

Central retinal vein occlusion (CRVO) is an important cause of visual loss. Many risk factors have been associated with CRVO onset at various ages. Among them diabetes mellitus, hypertension, immunologic disorders, increase in blood viscosity and coagulation, decrease of fibrinolysis have been reported in many subjects. The aim of our study was to detect the metabolic, coagulative and fibrinolytic pattern in 54 patients (26 men, 28 women, mean age 50.4 ± 12.3) affected by CRVO. We excluded from the study patients with other ocular disorders. A fibrinolytic impairment is the most common feature in our population. It occurs either in dysmetabolic or in nonmetabolic subjects. Such data suggest a prominent role of the fibrinolytic system in the pathogenesis of CRVO

Photostimulation with subthreshold yellow micropulsed laser for chronic residual subfoveal rhegmatogenous retinal detachment after surgery

Purpose The aim of this pilot study, the first of this kind, was to evaluate the safety and efficacy of Subthreshold Yellow Micropulsed Laser (SML) to treat eleven patients with chronic residual subfoveal Retinal Detachment (RD) after surgery to repair Rhegmatogenous Retinal Detachment (RRD). Methods Eleven eyes with residual subfoveal RD after surgery, dating from eight to sixteen months before treatment have been evaluated. Evaluation included visual acuity, Amsler test, ophthalmoscopy, Autofluorescence (AF) and Spectral-Domain Optical Coherence Tomography (SD-OCT). Results After treatment we recorded improved visual acuity and Amsler test, disappearance of subfoveal detachment by ophthalmoscopy, reduced retinal pigment epithelial distress by AF and restored macular retinal profile without neuroretinal alterations by SD-OCT evaluation in nine eyes. Conclusions Photostimulation with SML, selective for the Retinal Pigment Epithelium (RPE), is proved to be painless, effective and safe. The possibility to reabsorb subretinal liquid by foveal and parafoveal RPE photostimulation, without neuroretinal damage, opens new prospects for the therapy of this pathology. If further studies confirm the results of the present pilot study, SML treatment can be considered the first and only non invasive option for chronic residual RD after retinal surgery to repair RRD