Indian Journal of Ophthalmology Jul 2020
American Journal of Ophthalmology Case... Jun 2018Congenital ectropion uvea is a rare anomaly, which is associated with open, but dysplastic iridocorneal angles that cause childhood glaucoma. Herein, we present 3 cases...
Congenital ectropion uvea is a rare anomaly, which is associated with open, but dysplastic iridocorneal angles that cause childhood glaucoma. Herein, we present 3 cases of angle-closure glaucoma in children with congenital ectropion uvea.
Three children were initially diagnosed with unilateral glaucoma secondary to congenital ectropion uvea at 7, 8 and 13 years of age. The three cases showed 360° of ectropion uvea and iris stromal atrophy in the affected eye. In one case, we have photographic documentation of progression to complete angle closure, which necessitated placement of a glaucoma drainage device 3 years after combined trabeculotomy and trabeculectomy. The 2 other cases, which presented as complete angle closure, also underwent glaucoma drainage device implantation. All three cases had early glaucoma drainage device encapsulation (within 4 months) and required additional surgery (cycloablation or trabeculectomy).
CONCLUSIONS AND IMPORTANCE
Congenital ectropion uvea can be associated with angle-closure glaucoma, and placement of glaucoma drainage devices in all 3 of our cases showed early failure due to plate encapsulation. Glaucoma in congenital ectropion uvea requires attention to angle configuration and often requires multiple surgeries to obtain intraocular pressure control.
Journal of Cellular and Molecular... Aug 2013The potential of stem cell (SC) therapies for eye diseases is well-recognized. However, the results remain only encouraging as little is known about the mechanisms...
The potential of stem cell (SC) therapies for eye diseases is well-recognized. However, the results remain only encouraging as little is known about the mechanisms responsible for eye renewal, regeneration and/or repair. Therefore, it is critical to gain knowledge about the specific tissue environment (niches) where the stem/progenitor cells reside in eye. A new type of interstitial cell-telocyte (TC) (www.telocytes.com) was recently identified by electron microscopy (EM). TCs have very long (tens of micrometres) and thin (below 200 nm) prolongations named telopodes (Tp) that form heterocellular networks in which SCs are embedded. We found TCs by EM and electron tomography in sclera, limbus and uvea of the mouse eye. Furthermore, EM showed that SCs were present in the anterior layer of the iris and limbus. Adhaerens and gap junctions were found to connect TCs within a network in uvea and sclera. Nanocontacts (electron-dense structures) were observed between TCs and other cells: SCs, melanocytes, nerve endings and macrophages. These intercellular 'feet' bridged the intercellular clefts (about 10 nm wide). Moreover, exosomes (extracellular vesicles with a diameter up to 100 nm) were delivered by TCs to other cells of the iris stroma. The ultrastructural nanocontacts of TCs with SCs and the TCs paracrine influence via exosomes in the epithelial and stromal SC niches suggest an important participation of TCs in eye regeneration.
Topics: Animals; Electron Microscope Tomography; Limbus Corneae; Mice; Mice, Inbred C57BL; Stem Cells; Uvea
The Pan African Medical Journal 2016Congenital iris ectropion is a rare condition; non-progressive anomaly characterised by the presence of iris pigment epithelium on the anterior surface of the iris...
Congenital iris ectropion is a rare condition; non-progressive anomaly characterised by the presence of iris pigment epithelium on the anterior surface of the iris stroma and is frequently associated with anterior iris insertion, dysgenesis of the drainage angle and glaucoma. This paper describes unusual case of bilateral case of congenital iris ectropion in adult patient with pupillary abnormality, normal anterior chamber angle structure and with no evidence of glaucoma.
Topics: Anterior Chamber; Botswana; Ectropion; Humans; Iris; Male; Pigment Epithelium of Eye; Uvea; Young Adult
American Journal of Ophthalmology Mar 2022To determine the visual outcomes and effectiveness of glaucoma surgeries in congenital ectropion uvea.
To determine the visual outcomes and effectiveness of glaucoma surgeries in congenital ectropion uvea.
Retrospective interventional case series.
Surgeries and examination findings were collected on 11 eyes of 8 patients with congenital ectropion uvea at 2 academic sites from 2001 to 2021. Visual outcomes, surgical success (intraocular pressure [IOP]: 5-20 mm Hg, no additional IOP-lowering surgery, no visually devastating complications), and survival rates of glaucoma surgeries were assessed.
Glaucoma in bilateral congenital ectropion uvea was diagnosed at an earlier age (0.02 ± 0.01 years) than unilateral disease (8.9 ± 5.3 years, P = .002). All eyes required glaucoma surgery with 91% requiring multiple surgeries (3.5 ± 2.1, median 3 surgeries per eye). Trabeculotomy (8 eyes) showed 13% success rate. Although none of the 4 eyes that underwent trabeculectomy with mitomycin C needed repeat trabeculectomy, glaucoma drainage device placement, or cycloablation, 75% required bleb revision surgery. Glaucoma drainage devices (7 eyes) had a 57% success rate with 3 eyes requiring subsequent cycloablation (2) or trabeculectomy (1). At the final follow-up (8.5 ± 6.6 years, median: 7.9 years), all eyes achieved IOP control, and IOP was lower compared with presentation (13.2 ± 2.6 mm Hg vs 32.9 ± 9.9 mm Hg, P = .002). Best-corrected logarithm of the minimum angle of resolution visual acuity at the final follow-up was 0.2 ± 0.2.
Bilateral congenital ectropion uvea presents with glaucoma earlier than unilateral cases. The majority of eyes required multiple glaucoma surgeries. Angle surgery was less effective than trabeculectomy or glaucoma drainage devices. IOP control was obtained in all eyes and affected individuals had good visual outcomes.
Indian Journal of Ophthalmology Jun 2016
Indian Journal of Ophthalmology Nov 2017
Lassa Virus Targeting of Anterior Uvea and Endothelium of Cornea and Conjunctiva in Eye of Guinea Pig Model.Emerging Infectious Diseases May 2019Lassa virus (LASV), a hemorrhagic fever virus endemic to West Africa, causes conjunctivitis in patients with acute disease. To examine ocular manifestations of LASV, we...
Lassa virus (LASV), a hemorrhagic fever virus endemic to West Africa, causes conjunctivitis in patients with acute disease. To examine ocular manifestations of LASV, we histologically examined eyes from infected guinea pigs. In fatal disease, LASV immunostaining was most prominent in the anterior uvea, especially in the filtration angle, ciliary body, and iris and in and around vessels in the bulbar conjunctiva and peripheral cornea, where it co-localized with an endothelial marker (platelet endothelial cell adhesion molecule). Antigen was primarily associated with infiltration of T-lymphocytes around vessels in the anterior uvea and with new vessel formation at the peripheral cornea. In animals that exhibited clinical signs but survived infection, eyes had little to no inflammation and no LASV immunostaining 6 weeks after infection. Overall, in this model, LASV antigen was restricted to the anterior uvea and was associated with mild chronic inflammation in animals with severe disease but was not detected in survivors.
Topics: Animals; Biopsy; Conjunctivitis; Disease Models, Animal; Endothelium, Corneal; Female; Guinea Pigs; Immunohistochemistry; Iritis; Keratitis; Lassa virus; Male; Polymerase Chain Reaction; RNA, Viral
Advanced Biomedical Research 2021Usher syndrome is a heterogeneous genetic disease that is the most common cause of hereditary blindness-deafness. This syndrome is the most prevalent syndrome associated...
Usher syndrome is a heterogeneous genetic disease that is the most common cause of hereditary blindness-deafness. This syndrome is the most prevalent syndrome associated with retinitis pigmentosa. A 25-year-old man referred to us with hearing loss and vision diminution since childhood which has gradually worsened. Visual acuity of both eyes was 20/100. Slit lamp examination of the left eye revealed endothelial stellate keratic precipitates, mild anterior chamber reaction, iris heterochromia, ectropion of uvea, and mild posterior subcapsular cataract. There were also no crypts and abnormal vessels in the left eye iris. His intraocular pressure was 14 mmHg in the right eye and 18 mmHg in the left one. Funduscopy demonstrated waxy pallor optic nerve, marked arterial narrowing, and retinal bone spicule pigment formation in both eyes. We report for the first time a very rare association between Usher syndrome, Fuchs heterochromic uveitis (FHU), and ectropion uvea. To our knowledge, no association has been reported between ectropion uvea, FHU, and Usher syndrome.
Expression of toll-like receptor 4 in uvea-resident tissue macrophages during endotoxin-induced uveitis.Molecular Vision 2009To investigate the dynamics and distribution of toll-like receptor 4 (TLR4)-positive cells and resident tissue macrophages in the uvea during endotoxin-induced uveitis...
To investigate the dynamics and distribution of toll-like receptor 4 (TLR4)-positive cells and resident tissue macrophages in the uvea during endotoxin-induced uveitis (EIU) in Wistar rats.
Wistar rats (n=40) received a footpad injection of 200 microg of Vibrio cholera lipopolysaccharide (LPS), and the intensity of anterior segment inflammation was evaluated after the LPS injection. Ten rats each were killed 6, 12, 24 and 48 h after injection. Ten normal Wistar rats were killed as controls (0 h). The iris-ciliary body complex and choroids from each eye were removed and subdivided into segments. Immunohistochemical localization of TLR4 and a resident tissue macrophage marker, cluster of differentiation 163 (CD163), was performed on whole mount isolated iris-ciliary body complexes and choroids. TLR4+ and CD163+ cells in the iris were manually counted, and the cell density (cells/mm(2)) was calculated. The distribution patterns and phenotypes of cells expressing these two proteins were further characterized by double-labeled immunofluorescence studies.
The iris-ciliary body complex did not express TLR4 in normal rats. TLR4+ cells were detectable in the iris stroma 6 h after injection, and the number significantly increased (p<0.001 by one-way ANOVA) 12, 24, and 48 h after injection. The morphology of TLR4+ cells hardly changed 12-48 h after injection. CD163 was expressed in the uvea in all rats. During the inflammatory response phase (0-48 h after injection), the proportion of CD163+ tissue macrophages having a round morphology increased (p<0.001 by one-way ANOVA) concurrently with a decrease in the proportion of dendritiform CD163+ cells. These changes occurred mainly in the macrophages located in the stroma bordering the iris endothelial layer. Double-labeling immunofluorescence demonstrated the co-expression of TLR4 and CD163 in round stroma cells with TLR4 located at the cell membrane and CD163 in the cytoplasm. TLR4+ cells could not be detected in choroids in any of the rats.
The results of the present study indicate that TLR4 expression increased in the iris and iris tissue macrophages expressed TLR4 during EIU. This has significant implications for the understanding of ocular inflammation and for interpreting the potential role of Gram-negative bacteria in the pathogenesis of acute anterior uveitis.
Topics: Animals; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Cell Count; Cell Shape; Choroid; Ciliary Body; Endotoxins; Immunohistochemistry; Iris; Lipopolysaccharides; Macrophages; Male; Rats; Rats, Wistar; Receptors, Cell Surface; Toll-Like Receptor 4; Uvea; Uveitis