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The Role of Vitamin A in Retinal Diseases.
Sajovic, J, Meglič, A, Glavač, D, Markelj, Š, Hawlina, M, Fakin, A
International journal of molecular sciences. 2022;(3)
Abstract
Vitamin A is an essential fat-soluble vitamin that occurs in various chemical forms. It is essential for several physiological processes. Either hyper- or hypovitaminosis can be harmful. One of the most important vitamin A functions is its involvement in visual phototransduction, where it serves as the crucial part of photopigment, the first molecule in the process of transforming photons of light into electrical signals. In this process, large quantities of vitamin A in the form of 11-cis-retinal are being isomerized to all-trans-retinal and then quickly recycled back to 11-cis-retinal. Complex machinery of transporters and enzymes is involved in this process (i.e., the visual cycle). Any fault in the machinery may not only reduce the efficiency of visual detection but also cause the accumulation of toxic chemicals in the retina. This review provides a comprehensive overview of diseases that are directly or indirectly connected with vitamin A pathways in the retina. It includes the pathophysiological background and clinical presentation of each disease and summarizes the already existing therapeutic and prospective interventions.
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The gut microbiota in retinal diseases.
Bringer, MA, Gabrielle, PH, Bron, AM, Creuzot-Garcher, C, Acar, N
Experimental eye research. 2022;:108867
Abstract
The gut microbiota is a complex ecosystem that inhabits the gastrointestinal tract and consists of archaea, fungi, viruses, and bacteria, with bacteria being dominant. From birth onwards, it coevolves dynamically together with the host. The composition of the gut microbiota is under the influence of a complex interplay between both host and environmental factors. Scientific advances in the past few decades have shown that it is essential in maintaining homeostasis and tipping the balance between health and disease. In addition to its role in food digestion, the gut microbiota is implicated in regulating multiple physiological processes in the host gut mucosa and in distant organs such as the brain. Persistent imbalance between gut microbial communities, termed "dysbiosis," has been associated with several inflammatory and metabolic diseases as well as with central nervous system disorders. In this review, we present the state of the art of current knowledge on an emerging concept, the microbiota-retina axis, and the potential role of its disturbance in the development of retinopathies. We also describe several microbiota-targeting strategies that could constitute preventive and therapeutic tools for retinopathies.
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3.
New Insights Into Immunological Therapy for Retinal Disorders.
Takeda, A, Yanai, R, Murakami, Y, Arima, M, Sonoda, KH
Frontiers in immunology. 2020;:1431
Abstract
In the twentieth century, a conspicuous lack of effective treatment strategies existed for managing several retinal disorders, including age-related macular degeneration; diabetic retinopathy (DR); retinopathy of prematurity (ROP); retinitis pigmentosa (RP); uveitis, including Behçet's disease; and vitreoretinal lymphoma (VRL). However, in the first decade of this century, advances in biomedicine have provided new treatment strategies in the field of ophthalmology, particularly biologics that target vascular endothelial growth factor or tumor necrosis factor (TNF)-α. Furthermore, clinical trials on gene therapy specifically for patients with autosomal recessive or X-linked RP have commenced. The overall survival rates of patients with VRL have improved, owing to earlier diagnoses and better treatment strategies. However, some unresolved problems remain such as primary or secondary non-response to biologics or chemotherapy, and the lack of adequate strategies for treating most RP patients. In this review, we provide an overview of the immunological mechanisms of the eye under normal conditions and in several retinal disorders, including uveitis, DR, ROP, RP, and VRL. In addition, we discuss recent studies that describe the inflammatory responses that occur during the course of these retinal disorders to provide new insights into their diagnosis and treatment.
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4.
Mitochondrial Dysfunction as a Novel Target for Neuroprotective Nutraceuticals in Ocular Diseases.
Huang, CP, Lin, YW, Huang, YC, Tsai, FJ
Nutrients. 2020;(7)
Abstract
The eyes require a rich oxygen and nutrient supply; hence, the high-energy demand of the visual system makes it sensitive to oxidative stress. Excessive free radicals result in mitochondrial dysfunction and lead to retinal neurodegeneration, as an early stage of retinal metabolic disorders. Retinal cells are vulnerable because of their coordinated interaction and intricate neural networks. Nutraceuticals are believed to target multiple pathways and have shown neuroprotective benefits by scavenging free radicals and promoting mitochondrial gene expression. Furthermore, encouraging results demonstrate that nutraceuticals improve the organization of retinal cells and visual functions. This review discusses the mitochondrial impairments of retinal cells and the mechanisms underlying the neuroprotective effects of nutraceuticals. However, some unsolved problems still exist between laboratory study and clinical therapy. Poor bioavailability and bioaccessibility strongly limit their development. A new delivery system and improved formulation may offer promise for health care applications.
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5.
Optical Coherence Tomography Angiography: Review of Current Technical Aspects and Applications in Chorioretinal Disease.
Wang, JC, Miller, JB
Seminars in ophthalmology. 2019;(4):211-217
Abstract
Optical coherence tomography angiography (OCT-A) has enabled fast, non-invasive, high-resolution visualization of vasculature within the eye. In the past few years, it has become increasingly utilized for a range of disorders including age-related macular degeneration, diabetic retinopathy, retinal vein occlusions, and uveitis among others. This article reviews technical aspects of OCT-A, its applications in chorioretinal disease, and known limitations of the technology.
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6.
An FP's guide to AI-enabled clinical decision support.
Halamka, J, Cerrato, P
The Journal of family practice. 2019;(9):486;488;490;492
Abstract
To better understand the capabilities and challenges of artificial intelligence and machine learning, we look at the role they can play in screening for retinopathy and colon cancer.
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7.
Crystalline retinopathy: Unifying pathogenic pathways of disease.
Kovach, JL, Isildak, H, Sarraf, D
Survey of ophthalmology. 2019;(1):1-29
Abstract
Crystalline retinopathies may be associated with different etiologies including genetic, toxic, degenerative, idiopathic, and iatrogenic causes. We outline the various types of crystalline retinopathies and summarize their associated etiologies, pathogenesis, clinical presentations, multimodal imaging findings, and management strategies.
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8.
Autoimmune Retinopathy.
Tsang, SH, Sharma, T
Advances in experimental medicine and biology. 2018;:223-226
Abstract
The autoimmune retinopathies (AIRs) are a group of inflammatory-mediated retinopathies that present with unexplained visual loss (both central and peripheral), visual field defects, usually a ring scotoma, photoreceptor dysfunction as evident on electroretinography (ERG), and circulating autoantibodies against retinal antigens. The fundus may be normal or may show vascular attenuation, retinal atrophy with or without pigmentary changes or waxy pallor of the optic disc, and no or minimal inflammatory cells.
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9.
Intravitreal gas for symptomatic vitreomacular adhesion: a synthesis of the literature.
Neffendorf, JE, Simpson, ARH, Steel, DHW, Desai, R, McHugh, DA, Pringle, E, Jackson, TL
Acta ophthalmologica. 2018;(7):685-691
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Abstract
Symptomatic vitreomacular adhesion (sVMA) is defined as visual loss secondary to foveal damage from vitreomacular traction (VMT) and includes isolated VMT, impending macular hole (MH), and full-thickness MH with persisting vitreous attachment. Management options include pars plana vitrectomy (PPV), intravitreal ocriplasmin, intravitreal gas injection or observation. This synthesis of the literature aimed to assess the safety and efficacy of intravitreal gas for sVMA. Articles describing patients with VMT or MH treated with intravitreal expansile gas were selected by systematic literature review using MEDLINE, EMBASE, and the Cochrane Database of Controlled Trials (CENTRAL) up to September 2016. The main outcomes at 1 month and final review were logarithm of the minimum angle of resolution (logMAR) visual acuity (VA), anatomical success (absence of both VMT and MH, without PPV) and adverse events (AEs). The intended comparator was observation. Nine of 106 identified articles were eligible, and none were randomized controlled trials. The mean VA of 91 eyes improved from 0.55 (Snellen equivalent 6/21) to 0.48 (6/18) logMAR at 1 month and to 0.35 (6/13) logMAR at final review. The mean VA at final review, prior to a vitrectomy, was 0.42 (6/16). Anatomic success was 48% at 1 month and 57% at final review. The reported AEs comprised retinal detachment in two highly myopic eyes. Intravitreal gas injection can relieve sVMA. Larger controlled studies are needed to determine safety and efficacy relative to observation, ocriplasmin, or vitrectomy.
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10.
Four decades of ocular renin-angiotensin and kallikrein-kinin systems (1977-2017).
Igić, R
Experimental eye research. 2018;:74-83
Abstract
This review offers a contemporary history of the renin-angiotensin (RAS) and kallikrein-kinin (KKS) systems with emphasis on how these complex systems affect the eye. It describes the types of communication (cross-talk) between the two systems and evaluates their potential role in the development of diabetic retinopathy, diabetic macular edema, age-related macular degeneration, glaucoma, and uveitis. In addition to detailing the important physiological actions of components of the RAS and KKS, possibilities are suggested for new therapeutic avenues in the treatment of common ocular diseases. Historical notes indicate the major events in this research area, marking four decades from the first publication on the discovery of renin and angiotensin converting enzyme in the eye to the present time.