- Safety and Efficacy of a Trans-Eyelid Facial Rejuvenation Surgery Combining Partial Repositioning of Orbital Fat and Midface Lift in Chinese Patients: A Prospective Case Series. [Journal Article]
- AOAnn Otol Rhinol Laryngol 2019 May 27; :3489419850845
- CONCLUSIONS: To conclude, the combined partial orbital fat repositioning and midface lift via sub-ciliary approach is a successful treatment option for facial rejuvenation with no major complications.
- StatPearls: Anatomy, Head and Neck, Eye Arteries [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- The branches of the ophthalmic artery comprise the entire arterial supply to the eye. Most commonly the ophthalmic artery branches off of the internal carotid artery, distal to the cavernous sinus, t…
The branches of the ophthalmic artery comprise the entire arterial supply to the eye. Most commonly the ophthalmic artery branches off of the internal carotid artery, distal to the cavernous sinus, then travels through the optic canal. The ophthalmic artery has multiple branches which separate into two categories: orbital branches and optical branches. The orbital arteries include the ciliary arteries, retinal artery, and muscular arteries.: Long Posterior Ciliary Arteries: The long posterior ciliary arteries (1 to 2) travel near the optic nerve and pierce the posterior sclera to supply the choroid and ciliary muscle before joining the major arterial circle of the iris. The major arterial circle of the iris distributes branches to the iris and ciliary body. Short Posterior Ciliary Arteries: The number of short posterior ciliary arteries vary per individual, often ranging between 6 to 12 arteries that branch off the ophthalmic artery as it crosses the optic nerve medially. These arteries supply the ciliary processes and optic disk. The arterioles form the choroid. The perpendicular terminal arterioles supply choriocapillaris, the blood supply to Bruch’s membrane and outer retina.. Anterior Ciliary Arteries: Anterior ciliary arteries (7 in number) branch from the muscular arteries and run with the extraocular muscles. The anterior ciliary arteries supply the rectus muscles, conjunctiva, and sclera before joining the long posterior ciliary arteries to form the major arterial circle of the iris. Each rectus muscle receives supply by two anterior ciliary arteries, except the lateral rectus which receives blood supply from only one anterior ciliary artery. Central Retinal Artery: It is the first branch of the ophthalmic artery. It is a terminal branch supplying the inner layer of the retina, and its occlusion can cause sudden visual loss. It travels inferiorly and within the optic nerve sheath to supply the inner two-thirds of the retina. The artery further divides into superior and inferior arcades, which form the blood-retina barrier. Muscular branches: The two muscular branches of the ophthalmic artery that supply extraocular muscles include the medial and lateral muscular branches. The medial artery being larger than the lateral muscular branch.
- Factors Within the Endoneurial Microenvironment Act to Suppress Tumorigenesis of MPNST. [Journal Article]
- FCFront Cell Neurosci 2018; 12:356
- Background: Deciphering avenues to adequately control malignancies in the peripheral nerve will reduce the need for current, largely-ineffective, standards of care which includes the use of invasive…
Background: Deciphering avenues to adequately control malignancies in the peripheral nerve will reduce the need for current, largely-ineffective, standards of care which includes the use of invasive, nerve-damaging, resection surgery. By avoiding the need for en bloc resection surgery, the likelihood of retained function or efficient nerve regeneration following the control of tumor growth is greater, which has several implications for long-term health and well-being of cancer survivors. Nerve tumors can arise as malignant peripheral nerve sheath tumors (MPNST) that result in a highly-aggressive form of soft tissue sarcoma. Although the precise cause of MPNST remains unknown, studies suggest that dysregulation of Schwann cells, mediated by the microenvironment, plays a key role in tumor progression. This study aimed to further characterize the role of local microenvironment on tumor progression, with an emphasis on identifying factors within tumor suppressive environments that have potential for therapeutic application. Methods: We created GFP-tagged adult induced tumorigenic Schwann cell lines (iSCs) and transplanted them into various in vivo microenvironments. We used immunohistochemistry to document the response of iSCs and performed proteomics analysis to identify local factors that might modulate divergent iSC behaviors. Results: Following transplant into the skin, spinal cord or epineurial compartment of the nerve, iSCs formed tumors closely resembling MPNST. In contrast, transplantation into the endoneurial compartment of the nerve significantly suppressed iSC proliferation. Proteomics analysis revealed a battery of factors enriched within the endoneurial compartment, of which one growth factor of interest, ciliary neurotrophic factor (CNTF) was capable of preventing iSCs proliferation in vitro. Conclusions: This dataset describes a novel approach for identifying biologically relevant therapeutic targets, such as CNTF, and highlights the complex relationship that tumor cells have with their local microenvironment. This study has significant implications for the development of future therapeutic strategies to fight MPNSTs, and, consequently, improve peripheral nerve regeneration and nerve function.
- NEUROTROPHIC KERATOPATHY AFTER RETINAL DETACHMENT SURGERY COMBINED WITH ENDOLASER PHOTOCOAGULATION. [Journal Article]
- RCRetin Cases Brief Rep 2018 Oct 08
- CONCLUSIONS: Neurotrophic keratopathy may occur after pars plana vitrectomy. The possible mechanism is long ciliary nerve damage related to the extensive endolaser photocoagulation.
- Cortical AAV-CNTF Gene Therapy Combined with Intraspinal Mesenchymal Precursor Cell Transplantation Promotes Functional and Morphological Outcomes after Spinal Cord Injury in Adult Rats. [Journal Article]
- NPNeural Plast 2018; 2018:9828725
- Ciliary neurotrophic factor (CNTF) promotes survival and enhances long-distance regeneration of injured axons in parts of the adult CNS. Here we tested whether CNTF gene therapy targeting corticospin…
Ciliary neurotrophic factor (CNTF) promotes survival and enhances long-distance regeneration of injured axons in parts of the adult CNS. Here we tested whether CNTF gene therapy targeting corticospinal neurons (CSN) in motor-related regions of the cerebral cortex promotes plasticity and regrowth of axons projecting into the female adult F344 rat spinal cord after moderate thoracic (T10) contusion injury (SCI). Cortical neurons were transduced with a bicistronic adeno-associated viral vector (AAV1) expressing a secretory form of CNTF coupled to mCHERRY (AAV-CNTFmCherry) or with control AAV only (AAV-GFP) two weeks prior to SCI. In some animals, viable or nonviable F344 rat mesenchymal precursor cells (rMPCs) were injected into the lesion site two weeks after SCI to modulate the inhibitory environment. Treatment with AAV-CNTFmCherry, as well as with AAV-CNTFmCherry combined with rMPCs, yielded functional improvements over AAV-GFP alone, as assessed by open-field and Ladderwalk analyses. Cyst size was significantly reduced in the AAV-CNTFmCherry plus viable rMPC treatment group. Cortical injections of biotinylated dextran amine (BDA) revealed more BDA-stained axons rostral and alongside cysts in the AAV-CNTFmCherry versus AAV-GFP groups. After AAV-CNTFmCherry treatments, many sprouting mCherry-immunopositive axons were seen rostral to the SCI, and axons were also occasionally found caudal to the injury site. These data suggest that CNTF has the potential to enhance corticospinal repair by transducing parent CNS populations.
- Evolution of Glaucoma Surgery in the Last 25 Years. [Review]
- RMRambam Maimonides Med J 2018 Jul 30; 9(3)
- Glaucoma is a chronic neurodegenerative optic nerve disease. Treatment is intended to prevent the development and progression of optic nerve damage by lowering intraocular pressure (IOP). Current the…
Glaucoma is a chronic neurodegenerative optic nerve disease. Treatment is intended to prevent the development and progression of optic nerve damage by lowering intraocular pressure (IOP). Current therapy options include topical/systemic drugs that increase aqueous humor outflow or decrease its production, laser therapy that targets the trabecular meshwork and ciliary body, and incisional surgery. Trabeculectomy as well as glaucoma drainage devices are often performed, given their high efficacy in lowering IOP. However, the significant risk profile with potential sight-threatening complications has motivated glaucoma experts to create alternative surgeries to treat glaucoma. Minimally invasive glaucoma surgery (MIGS) is defined by: micro-invasive approach, minimal tissue trauma, high safety profile, and rapid recovery. The new devices might promote an earlier transition from medical/laser therapy to surgery, and therefore decrease the side effects associated with long-term use of topical medications as well as deal with the limited adherence of patients to their regimens. This review presents the surgical options available for glaucoma patients and their evolution over the past 25 years.
- Disease Modification Through Trophic Factor Delivery. [Review]
- MMMethods Mol Biol 2018; 1780:525-547
- Huntington's disease (HD) is characterized by a significant loss of striatal neurons that project to the globus pallidus and substantia nigra, together with loss of cortical projection neurons in var…
Huntington's disease (HD) is characterized by a significant loss of striatal neurons that project to the globus pallidus and substantia nigra, together with loss of cortical projection neurons in varying regions. Mutant huntingtin is suggested to drive the pathogenesis partially by downregulating corticostriatal brain-derived neurotrophic factor (BDNF) levels and signaling. Neurotrophic factors are endogenous peptides that promote the survival and maintenance of neurons. BDNF and other neurotrophic factors have shown neuroprotective benefits in various animal models of neurodegeneration, and are interesting candidates to protect the cell populations that are destined to die in HD. In an attempt to enhance the delivery of neurotrophic factors, several methods have been established to deliver long-term neurotrophic factor gene therapy to human target tissues. This chapter discusses two alternative approaches that have been shown to have potential to deliver neurotrophic factors as a neuroprotective gene therapy for HD. The methods are (1) ex vivo approach where encapsulated cells engineered to express neurotrophic factor are inserted into brain parenchyma or ventricle, and (2) in vivo viral vector therapy, in which viral vector is injected into desired brain area to express gene of interest in the host cells.
- Ocular involvement in neurolymphomatosis. [Case Reports]
- AJAm J Ophthalmol Case Rep 2018; 10:148-151
- CONCLUSIONS: Our patient is only the second histological demonstration of ciliary nerve involvement by NL, and the first, to our knowledge, of primary NL spreading secondarily from the ciliary nerves into the choroid. Our patient demonstrates that NL, though rare, should be included in the differential diagnosis of ocular cranial nerve palsies and ophthalmoplegia.
- StatPearls: Horner Syndrome [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Horner syndrome is a rare condition classically presenting with partial ptosis (drooping or falling of upper eyelid), miosis (constricted pupil) and facial anhidrosis (loss of sweating) due to a disr…
Horner syndrome is a rare condition classically presenting with partial ptosis (drooping or falling of upper eyelid), miosis (constricted pupil) and facial anhidrosis (loss of sweating) due to a disruption in the sympathetic nerve supply. It is primarily acquired following damage to the sympathetic nerve supply, but rare cases of congenital forms have been seen. Treatment is centered around identification and appropriate management of the underlying secondary cause. The syndrome has several names such as Bernard-Horner syndrome (French-speaking countries), Horner syndrome (English speaking countries), oculosympathetic palsy and Von Passow syndrome (Horner syndrome in association with iris heterochromia). The syndrome was first described by Francois Pourfour du Petit in 1727 when considering results from an animal experiment involving resection of intercostal nerves and subsequent changes seen in the ipsilateral eye and face. It was outlined more thoroughly by the French physiologist, Claude Bernard in 1852, followed by several physicians who offered different interpretations. The condition was formally described and later named after a Swiss ophthalmologist Johann Friedrich Horner in 1869.  Anatomy Understanding the sympathetic innervation of the eye is vital to understanding the features of this syndrome. The nerve supply is constituted by three different neurons, starting from the posterolateral hypothalamus and ending as the long ciliary nerves to supply the iris dilator and superior tarsal muscles (Muller muscle). The first-order neurons originate from the hypothalamus and descend through the midbrain and pons uncrossed, terminating at the C8-T2 level of the spinal cord in the intermediolateral cell columns (ciliospinal center of Budge). Second-order preganglionic neurons exit at the T1 level of the spinal cord to enter the cervical sympathetic chain where the fibers ascend to synapse in the superior cervical ganglion at C3-C4 level. Third-order, postganglionic fibers, branch off into the sudomotor and vasomotor fibers which follow the external carotid artery and innervate the sweat glands and blood vessels of the face. The remaining fibers ascend along the internal carotid artery in the carotid plexus to eventually enter the cavernous sinus where they join the abducens nerve (CN VI). The fibers then exit the cavernous sinus to enter the orbit via the superior orbital fissure along with the ophthalmic branch (V1) of the trigeminal nerve (CN V) as the long ciliary nerves.
New Search Next
- Proton Beam Irradiation: A Safe Procedure in Postequatorial Extraocular Extension From Uveal Melanoma. [Journal Article]
- AJAm J Ophthalmol 2018; 191:49-53
- CONCLUSIONS: This study shows that posterior EOE can safely be treated by proton beam therapy, even if the optic nerve is infiltrated. MRI enables safe detection of optic nerve invasion.