To describe a case of isolated infraorbital mass which had been present for the past 9 years in a young woman. Despite the size, the mass was successfully excised in total.
Corneal perforation is an ocular emergency that requires early intervention to avoid permanent visual loss from endophthalmitis or irreversible structural changes. Although tectonic keratoplasty is the best choice for patching a large perforation, a donor cornea is not always immediately available. Consequently, an alternative material is required while awaiting a donor cornea. We report the use of preserved bovine pericardium as a temporizing graft to maintain the ocular integrity in two patients with corneal perforation.
A 3-year-old girl with facial dysmorphic features suggestive of Cornelia de Lange syndrome was seen in the ophthalmology unit for a right leukocoria. The leukocoria was found to be caused by a large retinoblastoma and the right eye was enucleated. Chromosomal analysis revealed partial chromosome 13q deletion involving band 14 which is associated with a high risk of retinoblastoma. This case shows that patient with chromosome 13q deletion syndrome cannot be diagnosed based on dysmorphic features only. Chromosomal analysis is warranted in all infants with facial dysmorphism suggestive of Cornelia de Lange syndrome so that those with chromosome 13q deletion can be referred early for early detection of retinoblastoma.
Peperomia pellucida (L.) Kunth is a medicinal plant used to manage inflammatory illnesses such as conjunctivitis, and gastrointestinal and respiratory tract disorders in tropical and subtropical regions. However, little is known about its pharmacological mechanism of action against eye diseases. This review aims to critically discuss the phytochemistry, pharmacology and toxicology of P. pellucida as well as its roles in the treatment of cataract, glaucoma and diabetic retinopathy. Recent developments in the uses of P. pellucida for healthcare and nutraceutical products by the pharmaceutical industry are also covered in this review. For this review, a literature search was performed with PubMed, ScienceDirect, SciFinder Scholar and Scopus databases, using relevant keywords. Among the various phytochemicals identified from P. pellucida, β-caryophyllene, carotol, dillapiole, ellagic acid, pellucidin A, phytol and vitexin exhibit strong pharmacological activities within the mitogen-activated protein kinase and nuclear factor-κB signalling pathways in inflammatory eye diseases. The antihypertensive, anti-inflammatory, antioxidant, antihyperglycemic and anti-angiogenic activities displayed by P. pellucida extracts in many in vitro, in vivo and clinical studies suggest its potential role in the management of inflammatory eye diseases. P. pellucida extract was non-toxic against normal cell lines but displayed mild toxicity in animal models. The growing public interest in P. pellucida has inspired the nutraceutical and pharmaceutical industries to process the plant into health products. Although the potential pharmacological mechanisms against eye diseases have been summarized, further studies of the interactions among constituent phytochemicals from P. pellucida within various signalling pathways shall support the use of the plant as an alternative therapeutic source.
This study aims to elucidate the anti-inflammatory mechanism of Peperomia pellucida (L.) Kunth in human retinal pigment epithelial cell line (ARPE-19) as stimulated by high glucose (34 mM and 68 mM), and advanced glycation end product (AGE) under different glucose (17 mM, 34 mM and 68 mM) environments via the nuclear factor kappa B (NF-κB) and peroxisome proliferator activated receptor gamma (PPAR-γ) signalling pathways. The cytotoxicity of P. pellucida in ARPE-19 cells was evaluated with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide assay. The genes and proteins expression of nine pro-inflammatory, angiogenic and antioxidant markers, including glutathione peroxidase (GPx), interleukin 8, matrix metalloproteinase 2, monocyte chemoattractant protein 1, NF-κB, PPAR-γ, receptor for AGE (RAGE), soluble RAGE (sRAGE), and vascular endothelial growth factor in P. pellucida-treated ARPE-19 cells were compared to non-treated control via real-time polymerase chain reaction and western blot. Both P. pellucida methanolic extract (1.5 mg/mL and 3 mg/mL) and ethyl acetate fraction (4 mg/mL) were non-toxic to ARPE-19 cells and demonstrated cytoprotective effect against the high glucose (34 mM) and AGE (17 mM glucose)-induced cellular stress. High glucose and AGE activated the pro-inflammatory signalling in ARPE-19 cells, as evidenced by the increased NF-κB p65 phosphorylation, up-regulation of pro-inflammatory and angiogenic mediators (p<0.05) but reduced GPx, PPAR-γ and sRAGE protein expression. Both P. pellucida methanolic extract (3 mg/mL) and ethyl acetate fraction (4 mg/mL) suppressed (p<0.05) the pro-inflammatory and angiogenic markers expression under high glucose and AGE environment. The main phytochemicals identified in P. pellucida were dillapiole, 2,4,5-trimethoxystyrene, 9-octadecenoic acid, and pheophorbide A-methyl ester which displayed relatively strong binding affinity towards NF-κB p65 and PPAR-γ proteins in molecular docking analysis. This study has demonstrated that P. pellucida is a potential alternative anti-inflammatory source for managing diabetic retinopathy via NF-κB and PPAR-γ signalling.