New Insights into Ocular Complications of Human Immunodeficiency Virus Infection

HIV/AIDS continues to be a major global public health issue, affecting multiple organs, such as the eyes. With the advent of Highly Active Antiretroviral Therapy (HAART), the incidence has dropped but HIV ocular complications still remain a major cause of vision impairment in HIVpositive individuals. Since modern medical interventions nowadays can change this previously fatal infection into a chronic disease and enable people living with HIV for relatively long and healthy lives, recent studies update the incidence of HIV-related ocular manifestations, which has reached 70% among HIV patients. The primary ocular disorders induced by HIV are various and the clinical ocular findings are similar, which may be a problem to diagnose in the setting of disease. In our discussion, these complications are classified by etiology, for example noninfectious microvasculopathy resulting from direct invasion of the HIV, HIV-associated opportunistic infections caused by a virus, such as cytomegalovirus and varicella-zoster virus, fungus for example, candida and cryptococcus, bacteria like mycobacterium, parasites, such as toxoplasma and pneumocystis, and other pathogens, and infiltration lesions like lymphoma and Kaposi sarcoma. In order to get a better understanding of HIV ocular complications, we focus on HIV-related ocular complications in the HAART era with an emphasis on current incidence, clinical manifestations, ocular examination findings, differential diagnosis, treatment, and prognosis. In addition, we discuss the possibility of virus reservoir in the eyes, which makes HIV-related oculopathy still ubiquitous even after successful systemic treatment. </jats:sec

Associations Between the Retinal/Choroidal Microvasculature and Carotid Plaque in Patients with CHD: An Optical Coherence Tomography Angiography Study

Abstract Background To investigate the associations between retinal/choroidal microvasculature and carotid plaque in patients with CHD assessed by optical coherence tomography angiography (OCTA). Methods This study included 127 CHD patients with and 79 without carotid plaque. Each patient had both OCTA taken and digitized to determine retinal/choroidal thickness, vessel density and flow area and carotid ultrasound for carotid plaque size and stability measurement. SCP, DCP, out retina and choriocapillaris vessel density, out retina and choriocapillaris flow area, and full retina thickness were analyzed in the fovea centered 6 × 6 mm area. The association between OCTA measurements and carotid plaque characteristics in patients with CHD were evaluated. Results The duration of hypertension and DM was significantly longer in CHD patients with carotid plaque than that without (p &lt; 0.001). The mean values for vessel density SCP and DCP (except fovea zone), and choriocapillaris nasal zone were significantly lower in plaque group (p &lt; 0.05). Negative correlations between the carotid plaque width and vessel density SCP and DCP (except fovea zone) (p &lt; 0.05) were also found in this study. Conclusions In patients with CHD, carotid plaque, a risk factor and marker of atherosclerosis and stenosis, is significantly and independently associated with retinal and choroidal microvascular changes by OCTA.</jats:p

Isolation and Characterization of Primary Retinal Microglia From the Human Post-mortem Eyes for Future Studies of Ocular Diseases

Microglia, the primary resident immunocytes in the retina, continuously function as immune system supervisors in sustaining intraocular homeostasis. Microglia relate to many diseases, such as diabetic retinopathy, glaucoma, and optic nerve injury. To further investigate their morphology and functions in vitro, a reliable culture procedure of primary human retinal microglia is necessary. However, the culture condition of microglia from the adult retina is unclear. Researchers created several protocols, but most of them were carried out on rodents and newborns. This study describes a protocol to isolate and characterize human primary retinal microglia from human post-mortem eyes. The whole procedure started with removing the retinal vessels, mechanical separation and enzymatic dissociation, filtration, and centrifugation. Then, we cultured the cell suspensions on a T-75 flask for 18 days and then shook retinal microglia from other retinal cells. We found numerous retinal microglia grow and attach to Müller cells 10 days after seeding and increase rapidly on days 14–18. Iba1 and P2RY12 were used to qualify microglia through immunofluorescence. Moreover, CD11b and P2RY12 were positive in flow cytometry, which helps to discriminate microglia from other cells and macrophages. We also observed a robust response of retinal microglia in lipopolysaccharide (LPS) treatment with proinflammatory cytokines. In conclusion, this study provides an effective way to isolate and culture retinal microglia from adult human eyes, which may be critical for future functional investigations.</jats:p

Influence of menopausal status on retinal and choroidal thickness using SS-OCT

Abstract Background To evaluate the influence of menopausal status on retinal and choroidal thickness. Methods Ninety-five postmenopausal study group and ninety-five age-matched premenopausal control group were recruited randomly. The thickness of the retina and choroid was measured by swept-source optical coherence tomography (SS-OCT). Results The postmenopausal group showed significantly decreased choroidal thickness in the inner temporal (p = 0.038) and inner superior (p = 0.036) sectors, as compared to the premenopausal group. Conclusions This study revealed that choroidal thickness measured by SS-OCT was significantly thinner in postmenopausal women than control group. We speculate that the decrease in choroidal thickness in postmenopausal women indicate a reduced estrogen-dependent vasodilatory effect in ophthalmic vessels. Trial registration: Participants enrolled in the research signed informed consent and the study was approved by the institutional ethics committee of Huashan Hospital affiliated with Fudan University (protocol number: KY2016-274).</jats:p

The impact of serum BNP on retinal perfusion assessed by an AI-based denoising optical coherence tomography angiography in CHD patients

Background: To investigate the correlation between retinal vessel density (VD) parameters with serum B-type natriuretic peptide (BNP) in patients with coronary heart disease (CHD) using novel optical coherence tomography angiography (OCTA) denoising images based on artificial intelligence (AI). Methods: OCTA images of the optic nerve and macular area were obtained using a Canon-HS100 OCT device in 176 patients with CHD. Baseline information and blood test results were recorded. Results: Retinal VD parameters of the macular and optic nerves on OCTA were significantly decreased in patients with CHD after denoising. Retinal VD of the superficial capillary plexus (SCP), deep capillary plexus (DCP) and radial peripapillary capillary (RPC) was strongly correlated with serum BNP levels in patients with CHD. Significant differences were noted in retinal thickness and retinal VD (SCP, DCP and RPC) between the increased BNP and normal BNP groups in patients with CHD. Conclusion: Deep learning denoising can remove background noise and smooth rough vessel surfaces. SCP,DCP and RPC may be potential clinical markers of cardiac function in patients with CHD. Denoising shows great potential for improving the sensitivity of OCTA images as a biomarker for CHD progression

Endophthalmitis caused by Mycobacterium houstonense: case report

Abstract Background Mycobacterium houstonense is rapidly growing mycobacteria (RGM) that belongs to M. fortuitum group. So far, there have been few associated reports of human diseases induced by M. houstonense worldwide. Case presentation We present a delayed-onset postoperative endophthalmitis caused by M. houstonense after glaucoma drainage implant (GDI) surgery. The ocular infection lasted for 2 months without appropriate treatment that developed into endophthalmitis and the patient underwent an emergency enucleation. Conclusion Implant erosion and a delay in diagnosis of ocular infection could lead to irreversible damage as observed in our case. Ophthalmologists should be alert for ocular RGM infection, and prompt laboratory diagnosis with initiation of effective multidrug therapy might prevent loss of vision. </jats:sec

Choroidal and retinal thickness in patients with vitamin C deficiency using swept-source optical coherence tomography

Abstract Background To investigate the effects of vitamin C on central retinal thickness and choroidal thickness. Methods A total of 69 patients diagnosed with vitamin C deficiency and 1:1 age- and gender-matched 69 healthy individuals with normal serum vitamin C were included in this study. Demographic characteristics of the individuals were collected. All patients underwent a comprehensive ophthalmic examination. Subfoveal choroidal thickness and retinal thickness were measured using a swept-source optical coherence tomography (SS-OCT). Results The average retinal thickness was 269.07 ± 13.51 μm in the vitamin C deficiency group and 276.92 ± 13.51 μm in the control group. The average choroidal thickness was 195.62 ± 66.40 μm in the in the vitamin C deficiency group and 238.86 ± 55.08 μm in the control group. There was a significant decrease in both average choroidal thickness and retinal thickness in vitamin C deficiency group compared with normal individuals (p < 0.001, and = 0.001 respectively). Conclusion The central retinal and choroidal thickness were thinner in vitamin C deficiency group compared with normal individuals. These findings suggested that vitamin C deficiency might play an important role in retinal and choroidal diseases