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There is a rise in the number of people who have vision loss due to retinal diseases, and conventional therapies for treating retinal degeneration fail to repair and regenerate the damaged retina. Several studies in animal models and human trials have explored the use of stem cells to repair the retinal tissue to improve visual acuity. In addition to the treatment of age-related macular degeneration (AMD) and diabetic retinopathy (DR), stem cell therapies were used to treat genetic diseases such as retinitis pigmentosa (RP) and Stargardt's disease, characterized by gradual loss of photoreceptor cells in the retina. Transplantation of retinal pigment epithelial (RPE) cells derived from embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) have shown promising results in improving retinal function in various preclinical models of retinal degeneration and clinical studies without any severe side effects. Mesenchymal stem cells (MSCs) were utilized to treat optic neuropathy, RP, DR, and glaucoma with positive clinical outcomes. This review summarizes the preclinical and clinical evidence of stem cell therapy and current limitations in utilizing stem cells for retinal degeneration.
To evaluate the agreement of a home vision screening test compared to standard in-office technician-measured Snellen visual acuity to allow for remote screening and triaging of patients.
In this prospective study, English-speaking patients with in-office ophthalmology appointments from May to August 2020 and visual acuity better than 20/125 were asked to complete a home vision test one week before their scheduled in-office appointment. The home vision test was a modified ETDRS chart displayed in a PDF document that could be printed or viewed on a monitor. The primary outcome was the mean difference between office-based and home visual acuity.
Eighty-two eyes of 45 patients were included in the study with 45 study eyes analyzed. The mean difference between office-based and home visual acuity was -0.02 logMAR (SD 0.15,
=0.28) among study eyes. Of these eyes, 91% demonstrated agreement between the two methods within 0.2 logMAR of the mean difference, and 60% had agreement within 0.1 logMAR of the mean difference. There were no significant demographic or ocular risk factors leading to a greater difference between the tests.
There was good agreement between the home and in-office Snellen tests for patients with vision better than 20/125. The home vision test can be used to remotely determine if there is a significant vision change of >0.2 logMAR or approximately 2 lines of visual acuity.
0.2 logMAR or approximately 2 lines of visual acuity.
The objective of this study is to compare two methods of preoperative planning for placement of intraocular implants traditional paper documentation/electronic scans versus a novel online planning software. The aim was to compare the time required and number of data points manually transcribed with each method and to explore whether differences in surgical accuracy could be identified between the two methods in a small sample of 40 patients.
In this study, preoperative planning was performed twice for all enrolled patients once through the traditional method and once using an online planning software system. The total time spent and number of data points manually transferred were recorded for each method.
Of the 40 patients enrolled, the mean total surgical planning time was 239 ± 190 seconds for the traditional method vs 63 ± 31 seconds with the online planning software (P<0.00001). The mean number of data points transcribed was 7.2 ± 7.2 for the traditional method vs 0.9 ± 1.7 with the online planning software (P<0.0000001). No statistically significant differences were noted in terms of accuracy of prediction of the spherical equivalent surgical outcome.
In comparison to traditional methods, a significant reduction in time required for surgical planning and the manual transcription of data points was noted when a comprehensive online surgical planning software was used. This has important implications for the efficiency and likely the safety of surgical planning.
In comparison to traditional methods, a significant reduction in time required for surgical planning and the manual transcription of data points was noted when a comprehensive online surgical planning software was used. This has important implications for the efficiency and likely the safety of surgical planning.
This paper aimed to present daily-practice recommendations for the management of diabetic macular edema (DME) patients based on available scientific evidence and the clinical experience of the consensus panel.
A group of Spanish retina experts agreed to discuss different aspects related with the clinical management of DME patients.
Panel was mainly focused on therapeutic objectives in DME management; definition terms; and role of biomarkers as prognostic and predictive factors to intravitreal treatment response. The panel recommends to start DME treatment as soon as possible in those eyes with a visual acuity less than 20/25 (always according to the retina unit capacity). Naïve patient was defined, in a strict manner, as a patient who, up to that moment, had never received any treatment. A refractory DME patient may be defined as the one who did not achieve a complete resolution of the disease, regardless of the treatment administered. Different optical coherence tomography biomarkers, such as disorganization of the retinal inner layers, hyperreflective dots, and cysts, have been identified as prognostic factors.
This document has sought to lay down a set of recommendations and to identify key issues that may be useful for the daily management of DME patients.
This document has sought to lay down a set of recommendations and to identify key issues that may be useful for the daily management of DME patients.
To describe the outcomes of descemet stripping automated endothelial keratoplasty (DSAEK) in congenital hereditary endothelial dystrophy (CHED) and to evaluate the role of microscope integrated optical coherence tomography (Mi-OCT) during the surgery.
Retrospective data analysis.
A retrospective study from the medical records of all those patients who were diagnosed with CHED and underwent DSAEK at our centre from 2015 were evaluated. All patients underwent Mi-OCT-guided standard DSAEK procedure. Intra-operative difficulties, visual outcomes and graft survival were recorded.
A total of 48 eyes of 29 patients with a mean age of 9.87 ± 8.2 years and mean follow-up of 17.3 months were evaluated. Thirty-nine eyes underwent primary DSAEK and 9 eyes underwent PKP. Three eyes who underwent PKP had failed graft for which they underwent DSAEK. The mean preoperative Snellen's visual acuity was 1.71 ± 0.66 and the mean preoperative central corneal thickness was 1.10 ± 0.174 mm. Intraoperatively, all the grafts were attached which was confirmed using Mi-OCT. Graft detachment was seen in the immediate postoperative period in 10.4% (4 eyes) of primary DSAEK, out of which DM scoring was not performed in 2 eyes. Following DSAEK, cornea cleared at four-week follow-up in 89.7% eyes and in all the eyes the cornea cleared at six-week follow-up.
Primary DSAEK could be a preferred option over PKP for CHED with early presentation and in those eyes with failed primary PKP. Mi-OCT is a very useful tool in these eyes for various intraoperative procedures, thereby improving the outcomes of the procedure.
Primary DSAEK could be a preferred option over PKP for CHED with early presentation and in those eyes with failed primary PKP. Mi-OCT is a very useful tool in these eyes for various intraoperative procedures, thereby improving the outcomes of the procedure.Understanding the generation, growth, and dynamics of bubbles as they absorb or release dissolved gas in reactive flows is crucial for optimizing the efficiency of electrochemically gas-evolving systems like alkaline water electrolysis or hydrogen production. To better model these bubbly flow systems, we use a coupled level set and volume of fluid approach integrated with a one-fluid transport of species model to study the dynamics of stationary and rising bubbles in reactive two-phase flows. To accomplish this, source terms are incorporated into the continuity and phase conservation equations to allow the bubble to grow or shrink as the species moves through the interface. Verification of the hydrodynamics of the solver for non-reactive systems demonstrates the requisite high fidelity interface capturing and mass conservation necessary to incorporate transport of species. learn more In reactive systems where the species impacts the bubble volume, the model reproduces the theoretically predicted and experimentally measured diffusion-controlled growth rate (i.e., R(t) ∝ t 0.5). The model is then applied to rising bubbles to demonstrate the impact of transport of species on both the bubble velocity and shape as well as the concentration field in its wake. This improved model enables the incorporation of electric fields and chemical reactions that are essential for studying the physicochemical hydrodynamics in multiphysics systems.
The objective of this study was to assess the pharmacy professionals' understanding and viewpoints on drug information center (DIC) services and differences, if any, with pharmacologist's survey conducted earlier.
An electronic cross-sectional knowledge, practice, and attitude survey was carried out. A questionnaire in the form of the hyperlink was sent to pharmacy professionals through e-mail, Facebook messenger, and WhatsApp. Factors linked to pharmacy professionals' vision in expanding countrywide DIC services were studied with logistic regression in R.
A total of 125 pharmacy professionals responded. The participant believing in the published literature as a standard reference for establishing and running the DIC services; participants identifying more challenges in the day-to-day DIC functioning; and participants believing in the ability of DIC in reducing morbidity, mortality, and cost of care had 4.76 (95% confidence interval [CI] = 0.97-6.44), 4.24 (95% CI = 0.97-6.44), and 2.43 (95% CI = 0.97-6sal of published literature and due modifications in graduate and postgraduate curricula. A collaborative approach between pharmacists and pharmacologists is needed to improve the quality of drug information services and evidence-based medicine practice in low-resource countries like India.
Acute-on-chronic liver failure (ACLF), which develops in patients with underlying alcoholic liver disease (ALD), is characterized by acute deterioration of liver function and organ failures are secondary to that. The clear understanding of metabolic pathways perturbed in ALD-ACLF patients can greatly decrease the mortality and morbidity of patients through predicting outcome, guiding treatment, and monitoring response to treatment. The purpose of this study was to investigate the metabolic disturbances associated with ACLF using nuclear magnetic resonance (NMR)-based serum metabolomics approach and further to assess if the serum metabolic alterations are affected by the severity of hepatic impairment.
The serum-metabolic profiles of 40 ALD-ACLF patients were compared to those of 49 age and sex-matched normal-control (NC) subjects making composite use of both multivariate and univariate statistical tests.
Compared to NC, the sera of ACLF patients were characterized by significantly decreased serum levels of several amino acids (except methionine and tyrosine), lipid, and membrane metabolites suggesting a kind of nutritional deficiency and disturbed metabolic homeostasis in ACLF.
