Eicosanoid Profiles in the Vitreous Humor of Patients with Proliferative Diabetic Retinopathy.

Proliferative diabetic retinopathy is a potentially blinding sequela of uncontrolled diabetes that involves a complex interaction of pro-angiogenic and inflammatory pathways. In this study, we compared the levels of pro-angiogenic arachidonic acid-derived mediators in human vitreous humor obtained from eyes with high-risk proliferative diabetic retinopathy versus controls. The results indicated that lipoxygenase and cytochrome P450-derived eicosanoids were elevated (5-HETE, 12-HETE, 20-HETE, and 20-COOH-AA), and there appeared to be no differences in levels measured in eyes with tractional retinal detachments versus those without. These results provide further insight into the pathogenesis of this disease and for the development of future potential therapeutic agents that target arachidonic acid metabolites to treat diabetic retinopathy.

Severe ocular trauma in the emergency room.

UNLABELLED: To assess the nature, severity, and mechanisms of ocular trauma in the emergency room at an academic teaching hospital. METHODS: Individual review of patients' records involving ocular trauma in the emergency room. Severe intraocular trauma was defined as any injury that required intraocular surgery, any traumatic optic neuropathy, or total destruction of the eye. RESULTS: Of 519 patients in 2010 seen in the emergency room for ocular trauma, 52 patients (10%) had severe ocular trauma. Contusions (17) were the most common injury, followed closely by penetrating lacerations (16) and ruptures (16). In addition, 33 of these 52 patients (63.5%) had a full-thickness open globe injury, with physical assault as the most common etiology. CONCLUSION: The most common severe ocular traumas seen in the emergency room were contusions, penetrating lacerations, and ruptures. Penetrating lacerations and ruptures were the most common causes of open eye wall injuries.

Factors affecting wound leakage in 23-gauge sutureless pars plana vitrectomy.

PURPOSE: To evaluate risk factors for sclerotomy leakage in 23-gauge sutureless pars plana vitrectomy in 219 patients. METHODS: Nested case-control study involving 48 patients with wound leaks (visible on-table sclerotomy leakage requiring sutures) and 171 control subjects without wound leaks. Patients received either a conventional sclerotomy incision at 45°, which was then changed to 90° midincision, or an extremely oblique sclerotomy incision (OSI) at 10°, which was then changed to 30° midincision. Risk factors studied included age, gender, laterality, surgical duration, sclerotomy incision (OSI vs. conventional sclerotomy incision), preoperative diagnosis (macular vs. nonmacular), history of vitrectomy, and primary surgeon (attending vs. supervised resident). RESULTS: Multivariate logistic regression analysis found significant (P ≤ 0.05) protective factors for wound leakage including OSI, macular preoperative diagnosis, no previous vitrectomy, and female gender. Surgical duration at least 45 minutes was considered a borderline risk factor. CONCLUSION: Using an extremely OSI versus a conventional sclerotomy incision reduces the incidence of wound leakage postoperatively because of its self-sealing effect. Other factors that contribute to wound leakage, such as increased surgical duration and nonmacular diagnosis, may be indirect measurements of extensive trocar rotation, causing wound leakage despite the use of an OSI.