Ultrasound Biomicroscopy Research Articles

Generating Synthesized Ultrasound Biomicroscopy Images from Anterior Segment Optical Coherent Tomography Images by Generative Adversarial Networks for Iridociliary Assessment.

IntroductionThe aim of this study was to investigate the feasibility of generating synthesized ultrasound biomicroscopy (UBM) images from swept-source anterior segment optical coherent tomography (SS-ASOCT) images using a cycle-consistent generative adversarial network framework (CycleGAN) for iridociliary assessment on a cohort presenting for primary angle-closure screening.MethodsThe CycleGAN architecture was adopted to synthesize high-resolution UBM images trained on the SS-ASOCT dataset from the department of ophthalmology, Xinhua Hospital. The performance of the CycleGAN model was further tested in two separate datasets using synthetic UBM images from two different ASOCT modalities (in-distribution and out-of-distribution). We compared the ability of glaucoma specialists to assess the image quality of real and synthetic images. UBM measurements, including anterior chamber, iridociliary parameters, were compared between real and synthetic UBM images. Intra-class correlation coefficients, coefficients of variation, and Bland–Altman plots were used to assess the level of agreement. The Fréchet Inception Distance (FID) was measured to evaluate the quality of the synthetic images.ResultsThe whole trained dataset included anterior chamber angle images, of which 4037 were obtained by SS-ASOCT and 2206 were obtained by UBM. The image quality of real versus synthetic SS-ASOCT images was similar as assessed by two glaucoma specialists. The Bland–Altman analysis also suggested high consistency between measurements of real and synthetic UBM images. In addition, there was fair to excellent agreement between real and synthetic UBM measurements for the in-distribution dataset (ICC range 0.48–0.97) and the out-of-distribution dataset (ICC range 0.52–0.86). The FID was 21.3 and 24.1 for the synthetic UBM images from the in-distribution and out-of-distribution datasets, respectively.ConclusionWe developed a CycleGAN model to translate UBM images from non-contact SS-ASOCT images. The CycleGAN synthetic UBM images showed fair to excellent reproducibility when compared with real UBM images. Our results suggest that the CycleGAN technique is a promising tool to evaluate the iridociliary and anterior chamber in an alternative non-contact method.

Uveal Melanoma

Uveal melanoma, a malignant proliferation of melanocytes in the uvea, is the most common primary tumor of the eye in adults. The purpose of this review is to discuss the risk factors, clinical presentation, diagnosis, prognosis, and management, while providing information about novel viewpoints and tools for diagnosis and treatment of uveal melanoma. Blue-light exposure, BAP1 polymorphisms, complete monosomy 3, and history of ocular melanocytosis are the greatest risk factors for the development of uveal melanoma. Uveal melanoma can first present either on routine eye exam or upon presentation with flashes, floaters, and visual field defects. Diagnosis of uveal melanoma is made with anterior segment ocular coherence tomography or ultrasound biomicroscopy. Fine-needle biopsy of the lesion often follows diagnosis, with gene expression profiling being the best prognostic indicator for uveal melanoma. The gold standard for treatment of uveal melanoma is plaque brachytherapy. Other treatment possibilities for uveal melanoma include enucleation, charged-particle radiation therapy, transpupillary thermotherapy and photodynamic thermotherapy. Uveal melanoma may be fatal if untreated and subsequently metastasizes. Hopefully, earlier detection methods including the use of circulating tumor cells, circulating tumor DNA, and circulating MicroRNA and subsequent treatment using novel targeted therapies like high-intensity focused ultrasound, iontophoresis and electrochemotherapy would be crucial to improving prognosis in the future.

A prediction model for sulcus-to-sulcus diameter in myopic eyes: a 1466-sample retrospective study

BackgroundTo establish and verify the accuracy and reliability of a sulcus-to-sulcus diameter (STS) prediction model.MethodsIn this retrospective study, the prediction formula was established with the data from 1466 eyes from 733 subjects from July 2020 to April 2021 and verified with the data from 278 eyes from 139 subjects between May 2021 and June 2021. Each subject was measured with a Pentacam, IOLMaster 700, OPD-Scan III, and ultrasound biomicroscope. The prediction formulas were established with multiple linear regression, and intergroup correlation coefficients (ICCs) and Bland–Altman tests were used to assess the agreement between the predicted and actual STS (actual STS was measured by UBM).ResultsThe explanatory variables relevant to the horizontal STS (STSH) were the Pentacam white-to-white diameter (WTWP; standardized partial regression coefficient [β] = 0.330; p < 0.001), the flat K value (β = -0.211; p < 0.001), and the anterior corneal diameter (ACD) (β = 0.178; p < 0.001). The corresponding multiple regression equation was : STSH (mm) = 8.061 + 0.510 × WTWP − 0.090 × Flat K value + 0.430 × ACD. The explanatory variables relevant to the vertical STS (STSV) were the WTWP (β = 0.435; p < 0.001), the steep K value (β = -0.271; p < 0.001), and the ACD (β = 0.187; p < 0.001). The corresponding multiple regression equation was : STSV (mm) = 8.540 + 0.492 × WTWP − 0.075 × Steep K value + 0.329 × ACD. The bias of the predicted to the actual STSH was − 0.021, with 95% limits of agreement (95% LoA) from − 0.499 to 0.457. The bias of the predicted to the actual STSV was 0.057, with 95% LoA from − 0.462 to 0.575. The ICC was 0.883 between the predicted and actual STSH and 0.859 between the predicted and actual STSV.ConclusionsThe Pentacam-measured WTW, the K value and the ACD are important for predicting the STS diameter. The prediction model has good accuracy and reliability.Trial registrationNot applicable.

Classifications of Qualitative Characteristics on Angle Configurations via Ultrasound Biomicroscopy in Acute Primary Angle Closure.

PurposeTo study the classifications of qualitative characteristics on the angle configurations in the acute primary angle closure (APAC) and fellow eyes by ultrasound biomicroscopy (UBM).MethodsA total of 131 patients (262 eyes) were researched retrospectively. The qualitative parameters from UBM images were classified into iris form (IF), ciliary body configuration (CBC), basal iris thickness (BIT), iris convexity (IC), iris insert (II), iris angulation (IA), ciliary body size (CBS) and ciliary body position (CBP). Comparative analyses between the APAC (case group) and fellow (control group) eyes were performed.ResultsThere were significant differences in IF, CBC, IC, II, CBS, CBP between the case group and control group in all quadrants (P<0.001). The IA of the case group and control group presented significant difference in all quadrants (P=0.001). However, there was not a significant difference in BIT between the case group and control group in all quadrants (P=0.495). The case group had fewer parallelogram-like and mushroom-like and more cone-like and hook-like CBCs than the control group (P<0.001).ConclusionMultiple ciliary body configurations can influence the stability of the lens and the anatomic configuration of the anterior chamber angle indirectly. New qualitative classification system of UBM may be more intuitionistic and refined to reflect the angle configurations to help clinical practice.

Uveitis-glaucoma-hyphema syndrome secondary to an in-the-bag intraocular lens with capsular fibrosis

A patient developed pseudoexfoliative glaucoma and hyphema syndrome with an appropriately placed, in-the-bag single-piece lens. Ultrasound biomicroscopy showed a Soemmering ring, extensive fibrotic bands tethering the capsule to the ciliary body, and localized ciliary body traction. An anterior chamber washout, peeling of the fibrotic bands, and capsular phimosis correction were performed. Uveitis-glaucoma-hyphema syndrome may be caused by a nontilted in-the-bag lens, precipitated by the formation of tractional fibrotic bands, a Soemmering ring, and a predisposition to zonular laxity from pseudoexfoliative syndrome. Surgical peeling of the capsular fibrosis may be the most important factor in preventing recurrent hyphema.

Anterior Ocular Biometrics as Measured by Ultrasound Biomicroscopy.

Background: High frequency ultrasonography (ultrasound biomicroscopy; UBM) is an ophthalmic diagnostic tool that can be used to measure the depth of the anterior segment (ASD), the anterior chamber angle (ACA), as well as thicknesses of the iris and the ciliary body (CB). Methods: The anterior segment dimensions and thicknesses were measured by Sonomed 35-MHz. Results: Measurements for 95 eyes from 52 adults were analyzed. The mean and median ASD and ACA were 2.91, 2.92 ± 0.41 mm and 34.1, 34.3 ± 12.1 degrees, respectively. The angle superiorly was wider than inferiorly (p = 0.04). At the root of the iris, the mid of the iris, and the juxtapupillary edge of the iris, the iris thicknesses (median, mean) were 0.40, 0.41 ± 0.1, 0.50, 0.51 ± 0.1, and 0.70, 0.71 ± 0.1 mm, respectively. The thicknesses of CB and CB together with the ciliary processes (median, mean), were 0.70, 0.71 ± 0.15 mm and 1.36, 1.41 ± 0.15 mm, respectively. The upper quadrant of both the iris and the CB was significantly thicker than the lower quadrant (p = 0.04). Conclusions: Our biometric measurements for the anterior segment can be used as normative data for anterior segment depth and angle and iris and ciliary body thickness in normal eyes.

Metastatic tumor of the ciliary body manifesting as phacomorphic glaucoma: A clinical case

Introduction: Metastatic ciliary body tumor is a relatively rare tumor with a poor prognosis. Ciliary body tumors manifest as closed angle glaucoma, secondary glaucoma (phacomorphic glaucoma (PG), neovascular glaucoma), chronic uveitis, and cataract. The diverse manifestation of symptoms leads to diagnostic errors. Case presentation: This article presents a clinical case of a man aged 59 years with PG of the left eye. Ultrasound biomicroscopy revealed: a mushroom-shaped mass on the ciliary body penetrating toward the posterior chamber, with indistinct boundaries. Metastatic tumor of ciliary body had clinical manifestation as PG in this patient. Conclusion: All types of secondary glaucoma and acute attack of primary closed angle glaucoma should be carefully examined for intraocular tumor. Incorrect choice of treatment tactics for such patients can lead to common complications such as metastasis.

Unilateral Diffuse Uveal Melanocytic Proliferation

An 83-year-old woman presented with accumulations of pigment in the anterior chamber of her right (Fig A) but not left eye (Fig B). Fundus examinations, gonioscopy, B-scan ultrasonography (Fig C), and ultrasound biomicroscopy failed to identify an intraocular tumor. An iris biopsy revealed a proliferation of melanocytes without atypia (Fig D), which were intensively immunoreactive for Melan A (Fig E). A diagnosis of unilateral diffuse uveal melanocytic proliferation was established. Later, the patient revealed she had a small cutaneous melanoma removed from her back 50 years prior.

Современные методы визуализации угла передней камеры глаза в диагностике и лечении глаукомы

Purpose. To analyze the literature reflecting the main modern methods of visualizing the angle of the anterior chamber of the eye, which are used in patients with glaucoma. Material and methods. To perform the review, a search was carried out for literature sources on the Pubmed, Scopus and Elibrary reference databases for the period up to 2022 inclusive using the following keywords: anterior camera angle, gonioscopy, electronic gonioscopy, optical coherence tomography, ultrasound biomicroscopy and the same phrases in Russian. Results. The variety of clinical and morphological forms of glaucoma, the wide prevalence, frequency of occurrence and steady growth of this disease require timely diagnostics, as well as dynamic monitoring of the results of conservative and surgical treatment in patients with glaucoma. Despite the importance of such a diagnostic method as gonioscopy, ophtalmologists still do not use it sufficiently, the frequency of its application during the first visit to the doctor for glaucoma varies from 17.96 to 45.9%. There are also additional instrumental methods of examination of patients with glaucoma that allow an objective assessment of the structures of the eye anterior segment: automated gonioscopy, optical coherence tomography of the eye anterior segment and ultrasound biomicroscopy. These methods can be used both for the primary diagnosis of glaucoma and its dynamic observation, as well as for choosing surgical treatment tactics and monitoring its results thanks to high-precision visualisation and image documentation. Each of them has its own characteristics, advantages and disadvantages, depending on the specifics of the disease and the presence of concomitant ocular pathology, which are described in this article. Conclusion. Taking into account the variety of clinical forms of glaucoma and the insufficient equipment of medical institutions, especially primary care, it can be concluded that it is necessary to improve diagnostic algorithms. Methods such as electronic gonioscopy, optical coherence tomography of the eye anterior segment and ultrasound biomicroscopy will make the diagnostic process more accurate and informative, help to correctly diagnose and determine treatment tactics for both primary care physicians and surgeons. The possibility of documenting the results obtained and creating a system for their analysis can contribute to the founding of a generalized database, which will greatly simplify and accelerate the process of providing care to patients with glaucoma. Key words: glaucoma, anterior chamber angle, gonioscopy, electronic gonioscopy, optical coherence tomography, ultrasound biomicroscopy

Ultrasound biomicroscopy of the equine iridocorneal angle.

The iridocorneal angle (ICA) is the major pathway of aqueous humour outflow from the anterior chamber of the eye. Ultrasound biomicroscopy (UBM) has been utilised to characterise the morphology of this drainage pathway in numerous species. UBM may allow for early recognition of aqueous humour outflow obstructions in horses, allowing for earlier recognition of risk for glaucoma, a vision-threatening and painful disease. UBM morphology of the normal equine ICA has yet to be described. To determine the ultrasonographic morphology of the equine ICA by UBM in standing sedated horses. In vivo experimental study. Thirty healthy adult horses underwent UBM of the ICA at four locations (superior, temporal, inferior, nasal) of each eye utilising standing sedation, topical anaesthesia and auriculopalpebral perineural anaesthesia. Anatomic structures were defined on ultrasound images through comparison to published histologic photomicrographs of the equine ICA. Ultrasound imaging of the ICA at all four locations was easily performed in standing, sedated horses. High-resolution images of the ICA allowed for identification of the pectinate ligament, corneoscleral trabecular meshwork (TM), uveal TM and supraciliary TM. Pupil size was midrange in all eyes, but was not strictly controlled. Lighting conditions not controlled. Various breeds included. In vivo UBM of the equine ICA is feasible and provides high-resolution images of the structures of the aqueous humour outflow pathway.

Uveal Effusion Syndrome: Clinical Characteristics, Outcome of Surgical Treatment, and Histopathological Examination of the Sclera.

PurposeIn this study, we aimed to investigate clinical characteristics and histopathology and evaluate surgical outcomes of quadrantic lamellar-sclerectomy with sclerostomy for uveal effusion syndrome (UES).DesignRetrospective, cohort study.ParticipantsOverall, 106 eyes of 66 patients diagnosed with UES were treated at the Beijing Tongren Hospital between January 1, 2001 and June 26, 2021.MethodsPatients were examined by routine ophthalmologic examinations, fluorescein and indocyanine green angiography (FFA/ICGA); axial length determination; color Doppler ultrasound (CDU); ultrasound biomicroscopy (UBM), optical coherence tomography (OCT), and optical coherence tomographic angiography (SD/SS-OCTA). Quadrantic lamellar-sclerectomy with sclerostomy was performed at the equator in all patients and histopathological examination of the excised sclera was analyzed in all samples.Main Outcome MeasuresThe reattachment of the choroid and retina with resolution of the serous fluid, best corrected visual acuity (BCVA), choroidal thickness, and recurrence of ciliochoroidal detachment were the main outcome measures.ResultsTwo subgroups were identified: (1) type 1 (nanophthalmic eye), wherein the eyeball was small (average axial length 15.83 ± 1.45 mm) with high hypermetropia (average 12.6 diopters) and (2) type 2 (non-nanophthalmic eye), wherein the eyeball size was normal (average axial length 23.45 ± 1.68 mm) with or without refractive error, combined with or without systemic symptoms. Histopathologically, types 1 and 2 demonstrated similarly abnormal sclera with the disorganization of collagen fiber bundles and deposits of proteoglycans in the matrix. Quadrantic lamellar-sclerectomy with sclerostomy was effective in both types 1 and 2, inducing post-operative resolution of the subretinal fluid accumulation and increasing the useful BCVA. The choroidal thickness was significantly different before and after surgery (P < 0.05). Approximately 98.1% of cases attained permanent reattachment within 6 months after one operation through this procedure. The single operation success rate was 96.2%, and success with one or two operations was 100%.ConclusionsUES is caused by abnormalities of the sclera and increased resistance to transscleral fluid outflow, combined with increased choroidal thickness. Quadrantic lamellar-sclerectomy with sclerostomy is an effective treatment for UES that can rescue correct the useful visual acuity.

Accommodative movements of the choroid in the optic nerve head region of human eyes, and their relationship to the lens

The ciliary muscle (CM) powers the accommodative response, and during accommodation the CM pulls the choroid forward in the region of the ora serrata. Our goal was to elucidate the accommodative movements of the choroid in the optic nerve region in humans and to determine whether these movements are related to changes in the lens dimensions that occur with aging, in the unaccommodated and accommodated state.Both eyes of 12 human subjects (aged 18–51 yrs) were studied. Homatropine (1 drop/5%) was used to relax the ciliary muscle (unaccommodated or “resting” eye) and pilocarpine was used to induce the maximum accommodative response (2 drops/4%) (accommodated eye). Images of the fundus and choroid were collected in the region of the optic nerve (ON) via Spectralis OCT (infrared and EDI mode), and choroidal thickness was determined. Ultrasound biomicroscopy (UBM; 50 MHz, 35 MHz) images were collected in the region of the lens/capsule and ciliary body. OCT and UBM images were collected in the resting and accommodated state.The unaccommodated choroidal thickness declined significantly with age (p = 0.0073, r = 0.73) over the entire age range of the subjects studied (18–51 years old). The choroidal thickness was significantly negatively correlated with lens thickness in the accommodated (p = 0.01) and the unaccommodated states (p = 0.005); the thicker the lens the thinner the choroid.Choroid movements around the optic nerve during accommodation were statistically significant; during accommodation the choroid both thinned and moved centrifugally (outward/away from the optic nerve head). The accommodative choroid movements did not decline significantly with age and were not correlated with accommodative amplitude.Measurement of the choroidal thickness is possible with the Spectralis OCT instrument using EDI mode and can be used to determine the accommodative changes in choroidal thickness. The choroidal thickness decreased with age and during accommodation. It may be that age-related choroidal thinning is due to changes in the geometry of the accommodative apparatus to which it is attached (i.e., ciliary muscle/lens complex) such that when the lens is thicker, the choroid is thinner. Accommodative decrease in choroidal thickness and stretch of the retina/choroid may indicate stress/strain forces in the region of the optic nerve during accommodation and may have implications for glaucoma.

Biometric and Structural Ocular Manifestations of Anterior Megalophthalmos.

ObjectiveThe aim of this study was to examine the biometric ocular manifestations and structural ocular features of anterior megalophthalmos (AM).MethodsFifteen patients with AM (30 eyes) from the Eye & ENT Hospital of Fudan University were included. The age-matched control group consisted of 30 participants (30 eyes) who underwent Pentacam HR and IOLMaster 700 measurements for one normal eye. Data on demographics, biometric manifestations, and genotypes were carefully compared.ResultsA total of 15 patients with AM and 30 control patients were enrolled. There were no differences in age (37.27 ± 19.1 vs. 31.43 ± 19.69 years, P = 0.249) between these two groups. AM eyes were characterized by premature cataracts (11/30, 36.67%) and zonular weakness with lens subluxation (22/30, 73.33%) compared with the control group. Notably, 20 of the 30 AM eyes (66.67%) had significant posterior iris bowing, and 16 of the 30 AM eyes (53.33%) showed an enlarged ciliary ring on ultrasound biomicroscopy (UBM). Mean corneal curvature was lower in the AM eyes (42.01 ± 2.06 D vs. 43.14 ± 1.38 D, P = 0.023). There was no significant difference in corneal pachymetry and central endothelial cell count between the AM and control groups. Significant differences were found in terms of the anterior chamber and white-to-white (WTW) among the Pentacam HR and IOLMaster 700 in patients with AM (P < 0.05). The difference was 0.53 ± 0.48 mm and 0.36 ± 0.14 mm, respectively (P < 0.001).ConclusionThe results of this cohort study conclude the biometric and structural ocular manifestations in Chinese cohorts. Posterior iris bowing (66.67%) and lens subluxation (73.33%) are the most characteristic findings in patients with AM with anatomical abnormalities of megalocornea and a deep anterior chamber, although corneal biometric manifestations of AM included flatter cornea and lower total corneal astigmatism. The knowledge of ocular manifestations of AM is important for diagnosis and preparation for the operation in advance to avoid intraoperative and postoperative complications. Significant differences were found in the anterior chamber and WTW values between the Pentacam HR and IOLMaster 700. Thus, we suggest that various examinations should be carefully considered before determining an AM diagnosis.

Spontaneous Regression of Presumed Iris Melanocytoma

A 45-year-old man was referred for a unilateral pigmented iris lesion. Examination of the right eye showed a visual acuity of 20/20 and intraocular pressure of 14 mmHg. On slit-lamp biomicroscopy, a darkly pigmented, elevated lesion was observed in the peripheral iris (Fig A). Ultrasound biomicroscopy revealed a solid lesion in the peripheral iris with a thickness of 1.6 mm (Fig B). The mass was presumed to be an iris melanocytoma. Four years later, a divet developed centrally, and the thickness of the lesion decreased to 0.9 mm (Fig C–D).

Correlation of Levator-Muller's Complex Thickness on Ultrasound Biomicroscopy to Botulinum Toxin A Injection in Thyroid-Related Upper Eyelid Retraction.

To study the thickness of levator palpebra superioris-Muller's muscle complex (LMC) on ultrasound biomicroscopy (UBM) and to correlate with the clinical response to botulinum toxin A (BTA) injection in patients with inactive-stage of thyroid-related upper eyelid retraction (UER). We also studied the correlation of clinical parameters, preinjection with postinjection values. This was a prospective, interventional study. Patients with thyroid-related UER who underwent subconjunctival injection of BTA were recruited. Demographic data and clinical details were evaluated. UBM (50 MHz) was done to measure the thickness of LMC. Patient's satisfaction was graded at each follow-up. Follow-up was done at 1week, 1 month, and 3 months' time intervals. A total of 13 patients were recruited and 26 eyes were divided into two groups; group 1 included eyes with UER (n=17), and group 2 included eyes without UER (n=9). There was a statistically significant reduction in margin reflex distance 1 (MRD1) after BTA injection at 1-week, 1-month, and 3-months follow-up with maximum reduction at 1 month. The mean LMC thickness of 26 eyes was 0.96 mm which was found to be significantly more than normal controls. On comparison of mean LMC thickness with the amount of UER and reduction in MRD1, we did not find a significant difference. Patients with TED have significantly thicker LMC on UBM than controls. Further studies are needed with a larger sample size on the correlation of UBM features of levator aponeurosis with response to BTA injection.

Agreement analysis of Lenstar with other four techniques of biometry before cataract surgery.

To test whether some biometry measurements provided by the Lenstar LS900 compared well with the AL-Scan, Pentacam rotating Scheimpflug camera, Ultrasound Biomicroscopy (UBM) and Tomey EM-3000. Two hundred and one patients having routine cataract surgery had standard preoperative assessment. In this clinical study, the axis length (AL) and lens thickness (LT) were taken by Lenstar LS900 and AL-Scan; anterior chamber depth (ACD) was taken by Lenstar LS900, A-Scan, Pentacam and UBM; central corneal thickness (CCT) was taken by Lenstar LS900, Pentacam and Tomey EM-3000. The results were compared using a Wilcoxon-Mann-Whitney U test and Pearson correlation calculations. Agreement was assessed through intraclass correlation coefficients and Bland-Altman plots. The highest correlation was found between Lenstar and AL-Scan for AL (r = 0.975; P < 0.001). For LT measurements, the correlation between these two devices was also good (r = 0.699; P < 0.001). Excellent correlations were showed between Lenstar and Pentacam or UBM for ACD (r = 0.948, 0.704, respectively, both P < 0.001), but not between Lenstar and AL-Scan (r = 0.453, P < 0.001). The correlations of CCT between Lenstar and Pentacam or Tomey EM-3000 were both excellent (r = 0.817, 0.882, respectively, both P < 0.001). In phakic eyes of cataract patients, measurements of AL, LT, ACD and CCT from Lenstar LS900 yielded results that correlated very well with other clinical instruments.

Pigmented paravenous retinochoroidal atrophy with acute angle-closure glaucoma and posterior subcapsular cataract: a case report

BackgroundPigmented paravenous retinochoroidal atrophy (PPRCA) is a rare fundus disease characterized by the presence of osteoblast-like pigment, atrophy of retinal pigment epithelium (RPE), and choroid deposition along the large retinal veins.Case presentationA 55-year-old Chinese female presented with right eye distention and bilateral vision loss. Osteocyte-like pigmentation and retinal choroidal atrophy distributed along the large retinal veins were seen in the fundus of bilateral eyes. The atrophy in the left eye was more severe compared to the right eye. The patient also presented with bilateral acute angle-closure glaucoma (AACG) and posterior subcapsular cataract (PSC) accompanied with anterior segmental manifestations, similar to the complications of retinitis pigmentosa (RP). The patient underwent ultrasound biomicroscopy (UBM), Humphrey field analyser (HFA), optical coherence tomography (OCT), fundus autofluorescence (FAF), fluorescein fundus angiography (FFA), electroretinogram (ERG), and electrooculography (EOG), all of which confirmed the aforementioned diagnose.ConclusionPPRCA is a rare disease of unknown etiology. The patient in this case presented with complications similar to those of RP, and the two conditions may share a genetic basis. Further studies are needed to confirm this relationship.

The P2X7 Receptor Promotes Colorectal Inflammation and Tumorigenesis by Modulating Gut Microbiota and the Inflammasome.

Background: Given the role of the P2X7 receptor (P2X7R) in inflammatory bowel diseases (IBD), we investigated its role in the development and progression of colitis-associated colorectal cancer (CA-CRC). Methods: CA-CRC was induced in P2X7R+/+ and P2X7R−/− mice with azoxymethane (AOM) combined with dextran sodium sulfate (DSS). In a therapeutic protocol, P2X7R+/+ mice were treated with a P2X7R-selective inhibitor (A740003). Mice were evaluated with follow-up video endoscopy with endoluminal ultrasound biomicroscopy. Colon tissue was analyzed for histological changes, densities of immune cells, expression of transcription factors, cytokines, genes, DNA methylation, and microbiome composition of fecal samples by sequencing for 16S rRNA. Results: The P2X7R+/+ mice displayed more ulcers, tumors, and greater wall thickness, than the P2X7R−/− and the P2X7R+/+ mice treated with A740003. The P2X7R+/+ mice showed increased accumulation of immune cells, production of proinflammatory cytokines, activation of intracellular signaling pathways, and upregulation of NLRP3 and NLRP12 genes, stabilized after the P2X7R-blockade. Microbial changes were observed in the P2X7R−/− and P2X7R+/+-induced mice, partially reversed by the A740003 treatment. Conclusions: Regulatory mechanisms activated downstream of the P2X7R in combination with signals from a dysbiotic microbiota result in the activation of intracellular signaling pathways and the inflammasome, amplifying the inflammatory response and promoting CA-CRC development.

Clinical characteristics and surgical treatment of idiopathic uveal effusion syndrome

To investigate the clinical characteristics of idiopathic uveal effusion syndrome (IUES) and to identify effective surgical modalities for its treatment. This retrospective analysis included clinical data of 33 eyes from 26 patients with IUES at Beijing Tongren Hospital. Records of eye examinations, ocular ultrasound, ocular ultrasound biomicroscopy (UBM), and follow-up surgical treatment were reviewed and analyzed. Of 26 patients, 17 (65.4%) were male and 9 (34.6%) were female. The average age of disease onset was 46.8y (range: 22-64y). Seven patients (26.9%) showed retinal detachment in both eyes at presentation. B-ultrasound showed the presence of retinal detachment in one eye or both eyes. All patients had binocular ciliary leakage and detachment. Eyes with retinal detachment underwent four-quadrantic partial-thickness sclerectomy and sclerostomy. Subretinal fluid resolution was achieved within 6mo. Recurrence was observed in three eyes and was resolved with re-operation. Ophthalmic ultrasound and UBM, among others, can be helpful in the diagnosis of IUES. Sclerectomy and sclerostomy are surgical modalities that can successfully treat the disease. Some patients may experience recurrence after surgery; reoperation remains safe and effective for them. Long-term follow-up is essential in such settings.

Оптимизация объема предоперационной диагностики у пациентов с персистирующей сосудистой фетальной сетью

Purpose. To optimize the scope of preoperative diagnostics in patients with persistent fetal vascular network. Material and methods. The Kaluga branch underwent surgical treatment of 30 patients with various manifestations of persistent fetal vascular network from 2015 to 2020. The age of the patients was from 3 months to 8.5 years. At the stage of preoperative diagnostics, additional research methods was used: fluorescence angiography (FAG), ultrasound color duplex scanning (UCDS), ultrasound biomicroscopy (UBM). Results. A complex of diagnostic measures made it possible to develop the most individualized plan for surgical treatment. In 16 patients, the anterior type of the disease was determined – phacoaspiration with IOL implantation was performed according to the standard technique, if necessary, a “dry vitrectomy” was carried out with the removal of the posterior lens capsule and adjacent parts of the vitreous body. In 11 patients (11 eyes) with a mixed type, phacoaspiration of the lens with IOL implantation and simultaneous 3-port 27g vitrectomy was performed according to the standard technique; tamponade of the vitreous cavity was not carried out. In 10 patients (30%) in the period from 6 months to 1.5 years after the first intervention the reoperation was required. In 27 patients (90%), the transparency of the optical surroundings was restored. Complete retinal attachment was observed in 22 patients (73%). For 3 to 6 months after surgery in 5 patients (17%), traction retinal attachment occurred. In 3 patients (10%), retinal attachment was not achieved despite repeated interventions. Conclusion. A differential approach to each patient based on preoperative multimodal diagnosis made it possible to expand the indications for surgical treatment and achieve satisfactory anatomical and functional results. Keywords: persistent vascular fetal network, complex of preoperative diagnostics, fluorescent angiography, ultrasound color duplex scanning, ultrasound biomicroscopy.