PurposeTo evaluate the efficacy of the different diagnostic tests for vitreoretinal lymphoma (VRL).MethodsA cohort of 150 patients with a presumed diagnosis of VRL. Vitrectomy samples were analysed for cytology, monoclonality [polymerase chain reaction (PCR)] and cytokine levels, and anterior chamber taps were analysed for cytokine levels. Vitreoretinal lymphoma (VRL) was diagnosed after confirming the clinical suspicion with vitreal or brain cytology.ResultsVitreoretinal lymphoma (VRL) was diagnosed in 78 patients. Vitreal cytology was positive for 53/132 patients (40.2%), 36/53 had positive cytology from both the eye and the brain. Additional 25 patients had positive brain cytology. Vitreal PCR for monoclonality was positive for 32/91 patients (35.2%). Vitreal cytokine levels of interleukin (IL)‐10/IL‐6 were >1 for 47/110 patients (43.1%). For cytology, PCR and cytokine analysis, the respective sensitivity was 73.6%, 46.0% and 81.4%, and the accuracy of the tests was 85.6%, 60.4% and 80.9%, respectively. All three tests were available for 79 patients. In this subset, for cytology, PCR and cytokine analysis the respective sensitivity was 79.5%, 41.0% and 82.1%, respectively, and the accuracy of the tests was 89.9%, 60.8% and 81.0%, respectively.ConclusionCytokines analysis has an important role in the diagnosis of VRL. We suggest analysing cytokines levels in all cases suspected of VRL along with cytology and PCR analysis.
Purpose of reviewWith limited access of more than half the world's population to corneal transplantation, regenerative medicine may represent a promising alternative. This review explores the main advancements achieved in cell-based therapies for corneal epithelium, stroma, and endothelium during 2021--2022. Recent findingsMultiple surgical techniques have been developed for epithelial limbal stem cell replacement. Recent studies aimed to gain greater understanding and characterization of these techniques. Though no clear superiority could be demonstrated, simple limbal epithelial transplantation seems to have the most clinical and cost effectiveness. For stromal disease, autologous adipose-derived stem cells have shown favorable results. For endothelial dysfunction, the validity of intracameral cultivated allogeneic endothelial cell injection and Descemetorrhexis without endothelial keratoplasty, as well as the benefits of adjunctive rho-associated kinase inhibitors, were emphasized. SummaryA plethora of innovative cell-based regenerative therapies for corneal diseases have been developed in past years. While recent literature solidifies our knowledge, most studies are still in preliminary or preclinical stages. Though showing great promise, these approaches will require larger studies with betterdefined endpoints to establish their benefits over currently available treatments.
Background: Over the past decade, Penetrating Keratoplasty (PKP) graft failure has been increasingly managed by Descemet Membrane Endothelial Keratoplasty (DMEK). Moreover, Anterior Segment Optical Coherence Tomography (AS-OCT) is becoming as essential modality for perioperative evaluation. Our aim is to share important surgical considerations and modifications based on preoperative evaluation using AS-OCT and, consequently, present our clinical and surgical outcomes of DMEK performed for secondary PKP graft failure. Methods:A retrospective review of medical records was performed for patients who underwent DMEK due to failed PKP in Hadassah Medical Center during 2018-2019. Collected data included demographic characteristics, PKP graft size measured by AS-OCT, corneal donor endothelial cell density (ECD), intra-operative surgical method adjustments, postoperative complications, visual acuity in Snellen (VA), central pachymetry and postoperative ECD.Results: 16 patients (9 males) and 16 eyes were included. The study period was 18 months. Mean age at performing DMEK was 63 years. All patients underwent preoperative AS-OCT and case-based surgical plan was obtained. Before DMEK, mean VA and central pachymetry were 0.04 and 685 µm, respectively. At last follow up, they significantly improved to 0.3 (p-value = 0.001) and 542 µm (p-value = 0.008) respectively. Postoperatively, 93.75% of the grafts were attached. Graft failure rate was 6.25% due to late decompensation. Graft detachment rate and rebubbling rate were 18.75% respectively. Conclusion:A suitable case-based preoperative evaluation by AS-OCT may play a vital role in DMEK for failed PKP. Consequently, it utilizes obtaining a suitable surgical plan which may increase success rates and decrease complications rates along with accelerating visual recovery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.