Bevacizumab and Triamcinolone for Branch Vein Occlusion

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Promises of stem cell therapy for retinal degenerative diseases

With the development of stem cell technology, stem cell-based therapy for retinal degeneration has been proposed to restore the visual function. Many animal studies and some clinical trials have shown encouraging results of stem cell-based therapy in retinal degenerative diseases. While stem cell-based therapy is a promising strategy to replace damaged retinal cells and ultimately cure retinal degeneration, there are several important challenges which need to be overcome before stem cell technology can be applied widely in clinical settings. In this review, different types of donor cell origins used in retinal treatments, potential target cell types for therapy, methods of stem cell delivery to the eye, assessments of potential risks in stem cell therapy, as well as future developments of retinal stem cells therapy, will be discussed

Prevention of age-related macular degeneration

Age-related macular degeneration (AMD) is one of the leading causes of blindness in the developed world. Although effective treatment modalities such as anti-VEGF treatment have been developed for neovascular AMD, there is still no effective treatment for geographical atrophy, and therefore the most cost-effective management of AMD is to start with prevention. This review looks at current evidence on preventive measures targeted at AMD. Modalities reviewed include (1) nutritional supplements such as the Age-Related Eye Disease Study (AREDS) formula, lutein and zeaxanthin, omega-3 fatty acid, and berry extracts, (2) lifestyle modifications, including smoking and body-mass-index, and (3) filtering sunlight, i.e. sunglasses and blue-blocking intraocular lenses. In summary, the only proven effective preventive measures are stopping smoking and the AREDS formula

Autophagic Upregulation Is Cytoprotective in Ischemia/Reperfusion-Injured Retina and Retinal Progenitor Cells

The cytoprotective versus cytotoxic role of macroautophagy in ocular ischemia/reperfusion injuries remains controversial and its effects under hyperglycemia are unclear. We investigated the involvement of autophagy in in vitro and in vivo normoglycemic and hyperglycemic models of retinal ischemia/reperfusion injury. Retinal ischemia (2 h) and reperfusion (2 or 22 h) was induced in wild-type and type I diabetic Ins2Akita/+ mice using a middle cerebral artery occlusion model. R28 retinal precursor cells were subjected to CoCl2-induced hypoxia with or without autophagic inhibitor NH4Cl. Autophagic regulation during ischemia/reperfusion was assessed through immunohistochemical detection and Western blotting of microtubule-associated protein 1A/1B-light chain 3 (LC3) and lysosomal associated membrane protein 1 (LAMP1). Effect of autophagic inhibition on cell viability and morphology under hypoxic conditions was also evaluated. Upregulation of autophagic markers in the inner retinae was seen after two hours reperfusion, with tapering of the response following 22 h of reperfusion in vivo. LC3-II turnover assays confirmed an increase in autophagic flux in our hypoxic in vitro model. Pharmacological autophagic inhibition under hypoxic conditions decreased cell survival and induced structural changes not demonstrated with autophagic inhibition alone. Yet no statistically significant different autophagic responses in ischemia/reperfusion injuries were seen between the two glycemic states

Predisposing Factors, Microbial Characteristics, and Clinical Outcome of Microbial Keratitis in a Tertiary Centre in Hong Kong: A 10-Year Experience

Purpose. To study the risk factors, microbial profile, antibiotic susceptibility pattern, and outcome for microbial keratitis over the past 10 years in a tertiary center in Hong Kong. Methods. All cases with corneal scraping performed in Queen Mary Hospital, Hong Kong from January 2004 to December 2013 were included. Clinical outcome was defined as poor if the final visual acuity (VA) was abnormal or worse than presenting VA, a major complication occurred, or therapeutic keratoplasty was required. Results. 347 scrapes were performed in the 10-year period growing 130 microorganisms (32.3% culture positive rate). Contact lens use was the commonest risk factor. The commonest isolates were coagulase-negative Staphylococcus and Pseudomonas aeruginosa. Fluoroquinolone susceptibility was tested in 47 Gram-negative bacteria with 93.6% susceptibility (100% for Pseudomonas). 90.7% of cases had good visual outcome. Multivariate logistic regression showed age (p=0.03), trauma (p=0.006), and ulcer size >3 mm (p=0.039) to be independently associated with poor outcome. Conclusion. There was no shifting trend in the isolate distribution or emergence of resistant strains in our study. Contact lens wear was the commonest risk factor, with Pseudomonas being the most frequent isolate in this group. It remained 100% susceptible to fluoroquinolones and 97% cases had good visual outcome