Ophthalmology Commons^™

Poppers Maculopathy Due To Alkyl Nitriteinfused Candle: A Case Report, Tori Sayers, Murtaza K. Adam

School of Medicine Publications

Recreational inhalation of alkyl nitrites (“poppers”) is associated with a characteristic toxic maculopathy presumably due to ischemic changes in the central macula. Alkyl nitrite candles are available for purchase online and do not appear to be regulated. We report a unique retrospective case of vision loss following second-hand inhalation of vapor from a “poppers” candle in which a 29-year-old Hispanic male with no previous medical history presented with acute bilateral vision loss after attending a party at a nightclub. The patient denied sungazing, exposure to lasers, and a family history of inherited retinal disease. History was significant for use of …

Extrapulmonary Small Cell Carcinoma Presenting As Bilateral Papilledema, Hyponatremia, Encephalitis, Seizures, Crmp5-Igg Reactivity, And Prominent Anterior Tubular Perivascular Spaces, Ramsis Benjamin, Drew Thomas, Nina Mourao, J. Judd Fite, Brianna Woodliff, Shubhank Goyal

School of Medicine Publications

Background: Paraneoplastic syndromes that affect both the optic disc and the brain parenchyma typically harbor antibodies directed toward CV2/collapsin response-mediator protein 5 (anti-CRMP5), amphiphysin, Ma antigen 2 (Ma2/Ta), and Yo. The most common cancers linked to anti-CRMP5 antibodies include small-cell lung carcinoma (SCLC), followed by thymoma, renal cell carcinoma, and thyroid papillary carcinoma. A long-held belief explains papilledema as related to increased pressure within the subarachnoid space or the microvascular capillaries, but intracranial pressures within the normal standard range may exist in a person with a paraneoplastic syndrome and papilledema. The glymphatic system, a central waste-clearance conduit, may play a …

Vegf In Diabetic Retinopathy And Age-Related Macular Degeneration, Andrew Callan, Justin Z. Heckman, Giani Tah, Samantha Lopez, Laura Valdez, Andrew Tsin

School of Medicine Publications

Vascular endothelial growth factor (VEGF) plays a key role in angiogenesis throughout the human body, influencing countless physiological and pathological processes, including tumor growth, preeclampsia, and retinal diseases such as diabetic retinopathy (DR) and age-related macular degeneration (AMD). In DR, VEGF promotes retinal neovascularization and intraretinal fluid accumulation, leading to complications like diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR). Regular intravitreal anti-VEGF injections are commonly used to manage PDR and DME, though repeated treatments are often required, and efficacy can be limited. AMD, a major cause of vision loss in older adults, is characterized by either dry or …

Novel Methods Of Identifying Individual And Neighborhood Risk Factors For Loss To Follow-Up After Ophthalmic Screening, Noah Heilenbach, Titilola Ogunsola, Ceyhun Elgin, Dustin Fry, Mina Iskander, Yara Abazah, Ahmed Aboseria, Rahm Alshamah, Jad Alshamah, Gladys Maestre

School of Medicine Publications

Précis

Residence in a middle-class neighborhood correlated with lower follow-up compared to residence in more affluent neighborhoods. The most common explanations for not following up were the process of making an appointment and lack of symptoms.

Purpose:

To explore which individual and neighborhood-level factors influence follow-up as recommended after positive ophthalmic and primary care screening in a vulnerable population using novel methodologies.

Participants

and Methods: From 2017 to 2018, 957 participants were screened for ophthalmic disease and cardiovascular risk factors as part of the Real-Time Mobile Teleophthalmology study. Individuals who screened positive for either ophthalmic or cardiovascular risk factors were …

Neuro-Ophthalmology Diseases In Elderly, Aishwarya Gatiganti

School of Medicine Publications

It is well understood that as the body begins to age, its ability to adapt and sustain itself decreases. The eyes are not immune to this effect, and the complex interplay between the eyes and the brain deteriorates insidiously over time. There has been a notable increase in the elderly population, and diseases such as the ones described above need to be at the forefront of an ophthalmologist's mind when treating this population. Neuro-ophthalmology diseases in the elderly are not well known to general practitioners but should be included in the differential due to the potential of rapid deterioration and …

Diabetic Retinopathy And The Role Of Vegf, Aishwarya Gatiganti, Laura Valdez, Andrew Tsin Ph.D.

School of Medicine Publications

Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population. It works by disrupting the neural and vascular components in the retina and leads to loss of neural interaction/function, vascular permeability, and angiogenesis. It can be classified into two general stages: non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). DR can also lead to vascular leakage and cause diabetic macular edema (DME), the most common cause of vision loss in DR (Duh, Sun et al. 2017). There are currently a wide range of therapies, but they are limited in their efficacy and side effects. None of …

Nutrigenetic Reprogramming Of Oxidative Stress, Joseph Ryu, Huzeifa Gulamhusein, Jin Kyun Oh, Joseph H. Chang, Jocelyn Chen, Stephen H. Tsang

School of Medicine Publications

Retinal disorders such as retinitis pigmentosa, age-related retinal degeneration, oxygen-induced retinopathy, and ischemia-reperfusion injury cause debilitating and irreversible vision loss. While the exact mechanisms underlying these conditions remain unclear, there has been a growing body of evidence demonstrating the pathological contributions of oxidative stress across different cell types within the eye. Nuclear factor erythroid-2-related factor (Nrf2), a transcriptional activator of antioxidative genes, and its regulator Kelch-like ECH-associated protein 1 (Keap1) have emerged as promising therapeutic targets. The purpose of this review is to understand the protective role of the Nrf2-Keap1 pathway in different retinal tissues and shed light on the …

Real-Time Mobile Teleophthalmology For The Detection Of Eye Disease In Minorities And Low Socioeconomics At-Risk Populations, Lama A. Al-Aswad, Cansu Yuksel Elgin, Vipul Patel, Deborah Popplewell, Kalashree Gopal, Dan Gong, Zach Thomas, Devon Joiner, Cha-Kai Chu, Gladys E. Maestre

School of Medicine Publications

Purpose: To examine the benefits and feasibility of a mobile, real-time, community-based, teleophthalmology program for detecting eye diseases in the New York metro area.

Design: Single site, nonrandomized, cross-sectional, teleophthalmologic study.

Methods: Participants underwent a comprehensive evaluation in a Wi-Fi-equipped teleophthalmology mobile unit. The evaluation consisted of a basic anamnesis with a questionnaire form, brief systemic evaluations and an ophthalmologic evaluation that included visual field, intraocular pressure, pachymetry, anterior segment optical coherence tomography, posterior segment optical coherence tomography, and nonmydriatic fundus photography. The results were evaluated in real-time and follow-up calls were scheduled to complete a secondary questionnaire form. Risk …

Involvement Of Tgfβ Signaling Pathway In Oxidative Stress And Diabetic Retinopathy, Reanna Rodriguez, Kristine L. Lowe, Megan Keniry, Andrew Tsin

School of Medicine Publications

Diabetic Retinopathy (DR) is a leading cause of blindness in the U.S. However, not much is known of underlying molecular mechanism and how oxidative stress contributes to its development. In the present study, we investigated the involvement of TGFβ signaling pathway on the effect of oxidative stress on VEGF secretion and viability of retinal cells. VEGF is the hallmark that exacerbates DR progression in prolonged diabetes. Some major concerns that have arisen are the underlying effects of antioxidants in elevating VEGF secretion in diabetes. In this study, we evaluated how hypoxia (or low oxygen) impacts viability and VEGF secretion using …

Diabetic Retinopathy: Targeting Bigh3 To Develop Novel Molecular Therapies, Reanna Rodriguez, Anjalee Choudhury, Daniela Gonzalez, Cristian Mercado, Andrew Tsin

School of Medicine Publications

Diabetic retinopathy (DR) is a complication of diabetes due to damage of blood vessels in the retina. Aside from being a major cause of blindness in the world, DR also has a significant impact on quality of life. Although there are methods to delay the progression of DR, there are no existing therapeutic regimens for early intervention. Thus, it is critical to develop cost-effective therapies towards preventing DR development.

Recent Advances On Visual Cycle Protein Research And Progress On Clinical Translation, Xin Yee Ooi, Rujman Khan, Anjalee Choudhury, Francisco Xavier Elisarraras, Jeff Grigsby, Brandi Obregon, Andrew T C Tsin

School of Medicine Publications

Since the publication of our previous paper, Visual cycle proteins: Structure, function, and roles in human retinal disease (Tsin, et.al, JBC 293:13016, 2018) there has been significant progress on multiple topics discussed in this paper. In the present communication, we further explore research advances on two visual cycle proteins: DES1 and IRBP. In addition, we emphasize the progress of clinical translation of other visual cycle protein research, including the breakthrough of FDA-approved gene therapy for Leber’s congenital amaurosis, and additional gene therapies at different stages of clinical trials for various retinal diseases such as retinitis pigmentosa, diabetic retinopathy, and Stargardt’s …

Keratoconus In A Patient With Alport Syndrome: A Case Report, Majid Moshirfar, David F. Skanchy, Aaron T. Gomez, Yasmyne C. Ronquillo, Benjamin Buckner, Phillip C. Hoopes

School of Medicine Publications

BACKGROUND Known ocular manifestations of Alport syndrome include features such as anterior lenticonus and fleck retinopathy. Reports of keratoconus in such patients are limited. We report tomographic findings consistent with keratoconus in a patient with Alport syndrome.

CASE SUMMARY A 52-year-old female was referred to our ophthalmology clinic with decreased vision and increased tearing. She was diagnosed with stage III Alport syndrome two years prior. Upon examination she was found to have average keratometries of 48 D bilaterally with tomographic evidence of keratoconus.

CONCLUSION Although a rare presentation, concurrent Alport syndrome and keratoconus should be considered when reviewing the ocular …

Expression Of Integrin And Tgfbi In Human Retinal Pericytes, Andrew T C Tsin, Brenda Su, Laura Valdez, Edgar Serrato

School of Medicine Publications

Purpose: The aim for this study is to investigate the expression of integrin α3, β1 and TGF-β induced protein (TGFBI) and the secretion of TGFBI by primary culture of human retinal pericytes (pHRP). Evidence suggests that chronic diabetes associate with HRP apoptosis leading to the development of diabetic retinopathy.

Methods: pHRP (Cell Systems) were cultured in complete media (15mM glucose) in a humidified, 5% CO2, 37°C condition. Cells were seeded at passage 6 to 8 into a 24 well-plate with coverslips or P10 dishes. Cells (85% confluence) media were then replaced by DMEM media with euglycemic glucose (5.5mM) or hyperglycemic …

Eyelid Cosmetic Enhancements And Their Associated Ocular Adverse Effects, Maliha Masud, Majid Moshirfar, Tirth J. Shah, Aaron T. Gomez, Michele R. Avila, Yasmyne C. Ronquillo

School of Medicine Publications

Numerous cosmetic enhancements and augmentations to the natural appearance of the periorbital area are readily available today. Due to the increasing popularity of these cosmetic procedures, it is important for ophthalmologists to be aware of their potential risks, complications and adverse effects. The aim of this literature review was to introduce some of the most common ocular cosmetic enhancements and provide a comprehensive overview of their associated adverse effects reported in various medical journals. PubMed, Embase, and Google Scholar were used to identify articles related to the following ocular cosmetic procedures; eyelash extensions, permanent eyelid tattooing, and eyelash dyeing. The …

Ophthalmic Manifestations Of Congenital Zika Syndrome In Colombia And Venezuela, Juan B. Yepez, Felipe A. Murati, Michele Petitto, Carlos F. Peñaranda, J. Fernando Arevalo, Gladys E. Maestre

School of Medicine Publications

IMPORTANCE The ocular manifestations and sequelae of Zika virus infection are not well known. Recently, the World Health Organization changed the declaration of Zika as a public health emergency and designated the viral outbreak and related microcephaly clusters as a long-term program of work. This change indicates the urgent need to evaluate and document ophthalmic manifestations in patients for timely management of this disease. In addition, confirmation whether the public health problem in Brazil extends to other regions in South America is needed.

OBJECTIVE To report the ocular manifestations of congenital Zika syndrome with microcephaly in Colombia and Venezuela.

DESIGN, …

Horner's Syndrome Secondary To Neuroblastoma, Roberto A. Cruz, T. K. Tran, Nicky R. Holdeman, Christian Cajavilca, Rosa A. Tang

School of Medicine Publications

Horner’s syndrome is classically characterized by a triad of miosis, partial ptosis and anhidrosis. The etiology is due to an interruption in the sympathetic innervation to the eye. A prompt diagnosis is crucial, given that Horner’s syndrome could be a manifestation of a life-threatening condition. A thorough case history and clinical evaluation must be employed to arrive at the diagnosis. An important means for confirming Horner’s syndrome is pharmacological testing, which is also used to localize the level where the sympathetic chain is compromised. Following the diagnosis and localization of the lesion, an algorithm should be followed to determine the …