Can We Restore Vision? A Cadaveric Study Using Hyaluronidase for Retinal Artery Occlusion
Notice bibliographique
Résumé
Hyaluronidase is very effective in liquefying hyaluronic acid filler gel and reversing vascular occlusion in the face.1 However, blindness with hyaluronic acid occlusion in the retinal artery remains an unsolved problem because of the difficulty of getting the medication around or into the retinal artery.2 There is evidence that hyaluronidase is safe to retinal cells using intravitreous injection for vitreous hemorrhage.3 Despite the grim outlook of this problem, there are 2 recent reports of possible partial blindness reversal with supraorbital notch injection with hyaluronidase.4,5 We therefore set out to see where hyaluronidase goes when it is injected in and around the eye. The authors use video to illustrate 4 injection techniques on 5 human cadaver heads (10 halves). The goal was to see where hyaluronidase diffuses when it is injected with 4 following approaches: inferolateral orbit, supraorbital foramen, infraorbital foramen, and intravitreous. We also attempted to dissolve intravascular hyaluronic acid filler in the retinal vessels after injecting Juvederm-Volbella (Allergan Inc., ON, Canada) mixed 9:1 with methylene blue into each of the 10 angular and/or facial arteries of the 10 head halves. We injected hyaluronidase 1500 iU/ml (York Downs, ON, Canada) mixed 9:1 with dye. Each area was injected until the dye was seen bulging the eyelid fat underneath the skin. Thirty to 40 minutes after the injections, globe dissection was performed in all 10 orbits with enucleation and examination of the retinal neurovascular bundles to see where the hyaluronic acid and hyaluronidase went with their different colored dyes. (See Video 1 [online], which demonstrates lateral orbital injection.) (See Video 2 [online], which demonstrates supraorbital foramen injection.) (See Video 3 [online], which demonstrates infraorbital foramen injection.) (See Video 4 [online], which demonstrates intravitreous injection.) {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 1.","caption":"This Video demonstrates lateral orbital injection.","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_dkw9ds4x"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 2.","caption":"This Video demonstrates supraorbital foramen injection.","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_ldpanlrb"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 3.","caption":"This Video demonstrates infraorbital foramen injection.","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_i3akp07b"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 4.","caption":"This Video demonstrates intra-vitreous injection.","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_jevj71o2"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} We did not get the hyaluronic filler to reach the retinal artery in any of the cadavers as we were not able to get the filler into smaller arteries in this model. Although the colored solution containing hyaluronidase was clearly seen to get into the fat surrounding the retinal neurovascular bundle in the back of the orbit with all 4 of the approaches, we could not see it penetrating the fascia surrounding the retinal vascular bundle and therefore did not get into the fat just adjacent to the retinal artery. We were not able to demonstrate adequate hyaluronidase perivascular or intravascular infiltration in or around the retinal artery with any of the 4 approaches in this cadaver model.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».