Meningothelial Cells React to Elevated Pressure and Oxidative Stress

BACKGROUND: Meningothelial cells (MECs) are the cellular components of the meninges enveloping the brain. Although MECs are not fully understood, several functions of these cells have been described. The presence of desmosomes and tight junctions between MECs hints towards a barrier function protecting the brain. In addition, MECs perform endocytosis and, by the secretion of cytokines, are involved in immunological processes in the brain. However, little is known about the influence of pathological conditions on MEC function; e.g., during diseases associated with elevated intracranial pressure, hypoxia or increased oxidative stress. METHODS: We studied the effect of elevated pressure, hypoxia, and oxidative stress on immortalized human as well as primary porcine MECs. We used MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) bioreduction assays to assess the proliferation of MECs in response to treatment and compared to untreated control cells. To assess endocytotic activity, the uptake of fluorescently labeled latex beads was analyzed by fluorescence microscopy. RESULTS: We found that exposure of MECs to elevated pressure caused significant cellular proliferation and a dramatic decrease in endocytotic activity. In addition, mild oxidative stress severely inhibited endocytosis. CONCLUSION: Elevated pressure and oxidative stress impact MEC physiology and might therefore influence the microenvironment of the subarachnoid space and thus the cerebrospinal fluid within this compartment with potential negative impact on neuronal function

'Spontaneous' periocular hemorrhage and macrohematuria

PURPOSE: To report on a 19-year-old man with 'spontaneous' periocular hemorrhage and macrohematuria as the first signs of a bone-marrow-infiltrating rhabdomyosarcoma of the left superior rectus muscle. PROCEDURES: Clinical eye examination, magnetic resonance imaging, laboratory workup and bone marrow biopsy were performed. RESULTS: Magnetic resonance imaging showed a mass lesion in the left superior rectus muscle. While funduscopy had initially been normal, optic disc swelling, retinal hemorrhage and vitreous cell infiltration could be seen in the further course of disease. Laboratory work-up showed macrohematuria, thrombocytopenia and decreased concentration levels of plasma fibrinogen. Thromboplastin time was decreased. A bone marrow biopsy revealed small cell infiltration; using immunohistochemistry, a rhabdomyosarcoma was diagnosed. Unfortunately, the patient died few months later, in spite of chemotherapy. CONCLUSION: 'Spontaneous' periocular hemorrhage and macrohematuria were the first signs of a bone-marrow-infiltrating rhabdomyosarcoma in this young and otherwise healthy patient

Unilateral Optic Disc Swelling with Inhomogeneous Cerebrospinal Fluid Compositon Between the Spinal Theca and the Subarachnoid space (SAS) of the Left Optic Nerve

We report the case of a patient with unilateral optic disc swelling and inhomogeneous cerebrospinal fluid (CSF) composition between the spinal theca and the SAS of the left optic nerve

Papilledema revisited : is its pathophysiology really understood?

The term 'papilledema' is used to describe swelling of the optic disc that is thought or known to be associated with increased intracranial pressure (ICP) transmitted to the subarachnoid space (SAS) surrounding the optic nerve (ON). In most cases, the diagnosis of increased ICP is confirmed by lumbar puncture, the results of which are believed to represent the pressure in all of the cerebrospinal fluid (CSF) spaces. Until recently, all CSF spaces were thought to communicate freely and that CSF pressure and composition in one location were the same throughout the central nervous system (CNS) unless there was an acquired structural disturbance. However, the concept of continuous CSF flow and pressure throughout the CNS does not explain why some patients with elevated ICP do not develop papilledema, why some patients have highly asymmetrical papilledema, or why some patients with papilledema have normal ICP during 24-hour monitoring. In addition, CSF sampling during lumbar puncture and during ON sheath fenestration demonstrates an increased concentration of lipocalin-like prostaglandin D synthase, a substance toxic to astrocytes, in the SAS of the ON compared with that in the lumbar CSF space, and also a difference in CSF dynamics between the lumbar and ON SAS in some patients with papilledema. We therefore suggest that papilledema does not result from raised ICP alone but in some cases by compartmentation of the SAS of the ON, leading to a toxic milieu around the nerve

Reliability of Cyclotorsion measurements using Scanning Laser Ophthalmoscopy imaging in healthy subjects: the CySLO study

Background/aimsTo evaluate inter-rater and intra-rater reliability of objective cyclotorsion measurements obtained in healthy subjects using the Heidelberg Spectralis spectral domain—optical coherence tomography (SD-OCT) device.MethodsIn this prospective methodological study, 32 healthy subjects (14 men, 18 women; aged 21–64 years) were enrolled, 31 right eyes were examined and their foveo-papillary angles (FPAs) were measured. The retinal nerve fibre layer (RNFL) programme by Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany) was used to measure cyclotorsion based on the in-built algorithm for the measurement of the FPA on the scanning laser ophthalmoscopy (SLO) image. Repeated scans of the fixating and non-fixating right eye without and with eye tracker each were obtained by three different examiners.ResultsThe mean FPA measured overall by all three examiners was 6.6°±2.8°. The inter-rater reliability of the measured FPAs using the linear mixed effects model is estimated as rhointer=0.8803. The intra-rater reliability is estimated as rhointra=0.9589.ConclusionsRepeatability of objective cyclotorsion measurements within and between observers using the Heidelberg Spectralis OCT is very high. SD-OCT/SLO imaging is a reliable imaging technique to measure and study cyclotorsion.Clinical trial numberNCT02631369, Results.</jats:sec

Following prevalence of myopia in a large Swiss military cohort over the last decade: where is the European "myopia boom"?

Purpose Myopia prevalence is increasing globally, with the highest rates found in Asia. Data from European countries is scarce. We aimed to investigate whether the prevalence of myopia is rising in our meridians. Methods Data from male military conscripts for the recruitment period of 2008–2017 were retrospectively analyzed. Year of recruitment, conscripts’ birth year, visual acuity, refractive status (spherical equivalent), and spectacle wear (yes/no) were available. Results The dataset contained data of a total of 355,657 male conscripts, who had been recruited in the years 2008 to 2017. The mean number of conscripts per year was 35,566 (MD = 35,440, SD = 1249), reaching a minimum number of 33,998 conscripts in 2017 and a maximum of 37,594 in 2011. Mean age at recruitment was 19.7 years (MD = 19.0 years, SD = 1.1 years). Overall, the number of conscripts wearing spectacles remained stable over the observation time; on average 29.6% (n = 10,540; MD = 10,472; SD = 492) of conscripts wore glasses at recruitment. Of 21.8% (n = 77,698) of conscripts, data on the refractive status was available: The mean spherical equivalent for both right and left eyes was -2.3D (MD = -2 D, SD = 2.4 D). No decrease in mean spherical equivalent per recruitment year was noted over the observation period. Estimated myopia prevalence reached an average of 27.5% (SD = 0.8%) and did not increase during the observation period. Conclusion In summary, no change in spherical equivalent refractive errors of male Swiss army conscripts was found for the years 2008–2017. Equally, the percentage of spectacle wearers (MN = 29.6%) and estimated myopia prevalence (MN = 27.5%) did not significantly increase during the observation time.ISSN:1435-702XISSN:0721-832

Dental Malposition in Patients with Congenital Superior Oblique Muscle Palsy (.pdf)

Patients with congenital superior oblique palsy tend to adopt a head tilt to the contralateral side to maintain binocular single vision. Facial asymmetries as a consequence of a long-standing head tilt have been reported previously. The aim of this study was to analyze the effect of habitual head tilt due to congenital superior oblique palsy on dental occlusion

Cyclotorsion Measurement on Scanning Laser Ophthalmoscopy Imaging Compared With Fundus Photography in Patients With Fourth Nerve Palsy and Healthy Controls

Background: The purpose of the study is to evaluate the agreement of the foveopapillary angle (FPA) on conventional fundus photography (c-FPA) with the FPA on scanning laser ophthalmoscopy (SLO) imaging (SLO-FPA) in patients with fourth nerve palsy and healthy controls (HCs). Methods: The FPA was measured in both eyes of 25 patients and 25 HCs in synedra View (c-FPA) and with the integrated algorithm of the Heidelberg Spectralis OCT (SLO-FPA). The primary endpoint was the agreement of both measurements. Furthermore, we evaluated the influence of the eye tracker, the influence of fixation on objective torsion, and the FPA cutoff between patients and HCs.Results: The mean SLO-FPA in patients (6/25 acquired palsies) was 11.3 ± 3.6° and 6.4 ± 2.1° in HCs. The mean c-FPA was 11.4 ± 4.0° and 5.8 ± 2.2°, respectively. The Bland–Altman plot of c-FPA vs SLO-FPA in patients and HCs shows no systematic bias (mean of −0.28°). Limits of agreement were −6.58 and 6.02°. Using the eye tracker had no systematic effect. There was no evidence for an immediate shift of torsion with change of fixation (24/25 patients and 23/25 HCs). Discrimination between patients and HCs by the SLO-FPA is very good with an area under the curve = 0.92 (95% confidence interval: 0.84–0.99). Conclusions: SLO-FPA measurement allows convenient and consistent assessment of objective cyclotorsion. There was no systematic bias in the difference between SLO-FPA and traditional c-FPA; thus, SLO-FPA is a valuable alternative to the commonly used c-FPA. Using the eye tracker is recommended for proper centering of the ring scan

Cyclotorsion Measurement on Scanning Laser Ophthalmoscopy Imaging Compared With Fundus Photography in Patients With Fourth Nerve Palsy and Healthy Controls

Background: The purpose of the study is to evaluate the agreement of the foveopapillary angle (FPA) on conventional fundus photography (c-FPA) with the FPA on scanning laser ophthalmoscopy (SLO) imaging (SLO-FPA) in patients with fourth nerve palsy and healthy controls (HCs). Methods: The FPA was measured in both eyes of 25 patients and 25 HCs in synedra View (c-FPA) and with the integrated algorithm of the Heidelberg Spectralis OCT (SLO-FPA). The primary endpoint was the agreement of both measurements. Furthermore, we evaluated the influence of the eye tracker, the influence of fixation on objective torsion, and the FPA cutoff between patients and HCs.Results: The mean SLO-FPA in patients (6/25 acquired palsies) was 11.3 ± 3.6° and 6.4 ± 2.1° in HCs. The mean c-FPA was 11.4 ± 4.0° and 5.8 ± 2.2°, respectively. The Bland–Altman plot of c-FPA vs SLO-FPA in patients and HCs shows no systematic bias (mean of −0.28°). Limits of agreement were −6.58 and 6.02°. Using the eye tracker had no systematic effect. There was no evidence for an immediate shift of torsion with change of fixation (24/25 patients and 23/25 HCs). Discrimination between patients and HCs by the SLO-FPA is very good with an area under the curve = 0.92 (95% confidence interval: 0.84–0.99). Conclusions: SLO-FPA measurement allows convenient and consistent assessment of objective cyclotorsion. There was no systematic bias in the difference between SLO-FPA and traditional c-FPA; thus, SLO-FPA is a valuable alternative to the commonly used c-FPA. Using the eye tracker is recommended for proper centering of the ring scan

Lipocalin-like Prostaglandin D Synthase (L-PGDS)concentration in aqueous humour in patients with open-angle Glaucoma

PURPOSE:: To report on the concentration of lipocalin-like prostaglandin D synthase (L-PGDS) in the aqueous humour (AH) in patients with open-angle glaucoma (OAG). PATIENTS AND METHODS:: Prospective assessment in 20 patients (13 female, 7 male, mean age 74±10.6 y) who underwent surgery for OAG. AH was sampled and analyzed for L-PGDS concentration. AH from 26 patients (11 female, 15 male, 72.4±14.4 y) without glaucoma who underwent cataract surgery, served as control subjects. RESULTS:: The L-PGDS concentration in the AH sampled from the anterior chamber in the OAG group (5.9±2.4 mg/L) was significantly (P<0.001) higher than in the control group (3.3±1.3 mg/L). There were no significant differences between the concentrations of L-PGDS between the left and the right eye or between genders. CONCLUSIONS:: L-PGDS concentration in the AH of patients with OAG was significantly elevated compared with its concentration in the AH of nonglaucomatous eyes. As L-PGDS is a biologically pluripotent protein, its possible role in glaucoma warrants further examination