Association between the response of intravitreal antivascular endothelial growth factor injection and systemic factors of diabetic macular edema.

BACKGROUND: This study investigated the effects of systemic factors in response to intravitreal injections in patients with macular edema due to non-proliferative diabetic retinopathy (NPDR). METHODS: We retrospectively reviewed the medical records of patients treated with intravitreal injections for macular edema secondary to NPDR between January 2018 and January 2021. The patients were divided into three groups according to the injection response. When patients with diabetic macular edema showed 20µ or more reduction in central retinal thickness compared to baseline, they were classified as responsive group, and if not, they were classified as refractory group. The responsive group was further divided into the complete and incomplete response groups. Patients with complete disappearance of edema at seven months were classified as the complete response group, whereas those in which edema did not disappear were classified as the incomplete response group. The clinical characteristics of each group, including medical history, ophthalmic examination results, and laboratory examination results at the time of diagnosis, were analyzed. RESULTS: Of the 112 eyes (91 patients) that satisfied the inclusion criteria, 89 (77 patients) in the responsive group and 23 (14 patients) in the refractory group were included in the analysis. The responsive group was further divided into the complete (51 eyes) and incomplete (38 eyes) response groups. The refractory group had significantly higher glycated hemoglobin levels and significantly lower estimated glomerular filtration rates than the responsive group (p = 0.026 and p = 0.012, respectively). In the multivariate logistic regression analysis, both factors were found to be significant in predicting the degree of response (all p < 0.05). No factor showed a significant difference between the incomplete and complete response groups(all p > 0.05). CONCLUSIONS: In macular edema caused by NPDR, low glomerular filtration rates and high glycated hemoglobin levels may be used as predictors of poor response to intravitreal injection therapy. In addition to blood glucose control, education should be provided regarding the need for the continuous monitoring of renal function.

Surgical outcomes of adjustment on recessed lateral rectus muscle versus resected medial rectus muscle for intermittent exotropia.

BACKGROUND: To evaluate the effectiveness of resected muscle adjustment compared with the recessed muscle adjustment in patients with intermittent exotropia. METHODS: This retrospective clinical investigation analyzed the data of patients who underwent strabismus surgery with adjustment. Patients who were followed-up for at least one and half year after adjustment were enrolled. They were divided into two groups; patients who underwent adjustment on recessed lateral rectus muscle (LR-Adj group) and adjustment on resected medial rectus muscle (MR-Adj group). Postoperative changes were compared. Surgical success was defined as horizontal deviation < 5 prism diopters (PD) esodeviation and < 10 PD exodeviation on distance measurement at 1.5 years postoperatively. RESULTS: Forty patients were included; LR-Adj group included 21 and MR-Adj group included 19 patients. The mean esodeviation at distance fixation immediately after adjustment was 8.1 ± 5.4 PD in the LR-Adj group and 8.4 ± 4.7 PD in the MR-Adj group (P = 0.843). Postoperative exodrift occurred in both groups, and amount of exodeviation after 1.5 year were not significantly different. For the comparison of the amount of exodrift at near measurement, the amount of exodrift within 1 month after surgery was smaller in the MR-Adj group than that in the LR-Adj group (P = 0.01). Surgical success rates were 81.0% in the LR-Adj group and 84.2% in the MR-Adj group (P = 0.559). CONCLUSIONS: The smaller amount of exodrift in the MR-Adj group may mean that the positional stability of the resected muscle is favorable in the early post-adjustment period. However, there was no significant difference groups in the final exodeviation and surgical success rate between the groups. Resected muscle adjustment was as effective as the conventional recessed muscle adjustment.

Effect and Mechanism of Phosphodiesterase Inhibitors on Trabecular Outflow.

PURPOSE: Phosphodiesterase (PDE) inhibitors increase matrix metalloproteinase (MMP) production by inhibiting re-uptake of adenosine and may potentiate nitric oxide (NO) activity. This study was performed to investigate the effects and mechanisms of PDE inhibitors on trabecular outflow in cultured human trabecular meshwork cells (HTMCs). METHODS: Primary HTMC cultures were exposed to 0, 20, and 50 µM dipyridamole (DPD) or theophylline (TPN). Permeability through the HTMC monolayer was assessed using carboxyfluorescein. The production of NO was assessed using the Griess assay and MMP-2 levels were measured via Western blotting. RESULTS: DPD significantly increased permeability accompanied with increased nitrite concentration and MMP-2 levels (all p < 0.05). TPN increased nitrite but did not affect permeability or MMP-2 levels significantly (p > 0.05). When treated with DPD and TPN together, both permeability and nitrite production were increased; however, MMP-2 levels showed no difference compared to DPD exposure alone (p > 0.05). CONCLUSIONS: DPD increased trabecular permeability accompanied with increased nitrite production and MMP-2 levels. PDE inhibitors may increase trabecular outflow by increasing MMP-2 levels and by potentiating NO activity through cyclic GMP in HTMC.

Antitumor activity of 3,4-dihydroquinazoline dihydrochloride in A549 xenograft nude mice.

In the previous article we have reported that 3,4-dihydroquinazoline 1 is a potent and selective T-type calcium channel blocker that exhibited strong anti-cancer activity in vitro. Compound 1·2HCl was further in vivo evaluated against A549 xenograft in BALB/c nude mice, which exhibited 49% tumor-weight inhibition through intravenous administration of 2 mg/kg of body weight and was more potent than doxorubicin. Moreover, compound 1·2HCl has an oral bioavailability of 98% with LD(50) values of 693 mg/kg (p.o. route) and 40.0 mg/kg (i.v. route) of body weight. In addition, its efficient scale-up synthetic method was developed.