Plastic vs. glass: the effect of the synthetic material in contact with DMEK tissue during staining on endothelial cell loss.

PURPOSE: Endothelial cell loss (ECL) during Descemet membrane endothelial keratoplasty (DMEK) graft preparation has been shown to affect graft survival and the need for re-grafting. The purpose of this study was to quantitatively assess the impact of the plastic and glass mediums in contact with DMEK donor tissue during intra-operative graft staining on ECL. METHODS: Retrospective study that included patients who underwent DMEK surgery between January 2019 and June 2021 at Hôpital Maisonneuve-Rosemont and the Jewish General Hospital in Montreal, Canada. DMEK grafts were stained with 0.06% Trypan blue ophthalmic solution (VisionBlue®, Dutch Ophthalmic, USA, Exeter, NH) for 120 s in either a plastic or glass medium prior to delivery into the recipient's eye. The ECL was compared between the two groups 12-30 months post-operatively. RESULTS: ECL at 12-30 months was significantly less in the eyes that had received grafts stained in a plastic medium compared to those stained in a glass medium. Graft survival and re-bubbling was higher in the glass group however this difference was not statistically significant. CONCLUSION: Staining of the DMEK graft in a plastic medium caused less ECL compared to the glass medium.

Sphingolipids and ceramides in human aqueous humor.

PURPOSE: To determine the differential profiles of sphingomyelin, sphingoid base, sphingoid base-1-phosphate and ceramide lipid species and their quantitative differences between control and glaucomatous aqueous humor (AQH) derived from human donors. METHODS: AQH from control and primary open-angle glaucoma donors was collected and subjected to lipid extraction using suitable modifications of the Bligh and Dyer method. Proteins were estimated using Bradford's method. Lipids were identified and ratiometrically quantified in a two-step process using precursor ion scan or neutral loss scan (NLS) with appropriate class-specific lipid standards on a TSQ Quantum Access Max mass spectrometer following established procedures. Primary human trabecular meshwork cells and video microscopic imaging were used to assess changes in cell shape and motility upon exposure to 20 pmol of Cer(d18:0/18:1(9Z)) in 10% dimethyl sulfoxide (vehicle). RESULTS: We identified several species of sphingomyelin, sphingoid base, sphingoid base-1-phosphate, and ceramides that were common between control and glaucomatous AQH. Some unique lipid species in these classes were also identified in controls but not in glaucoma and vice versa. We found exposure to 20 pmol of Cer(d18:0/18:1(9Z)) resulted in changes in the trabecular meshwork cell shape and observed motility changes compared to vehicle-only control. CONCLUSIONS: Most lipids belonging to the sphingomyelin, sphingoid base, sphingoid base-1-phosphate, and ceramide species were common between control and primary open-angle glaucoma donors. However, some sphingolipids and ceramides were found to be uniquely present in control but absent in the glaucomatous AQH and vice versa. Identification of unique lipid species present or absent in the pathophysiological context may contribute further insight into glaucoma pathology.

The Association Between Vitamin D Serum Level and COVID-19 Patients' Outcomes in a Tertiary Center in Saudi Arabia: A Retrospective Cohort Study.

Vitamin D deficiency has been associated with the risk for immune-mediated inflammatory reactions in various respiratory infections. Our study investigated the association between vitamin D deficiency and coronavirus disease 2019 (COVID-19) patients' outcomes. We included 545 patients who were admitted to a tertiary center in Jeddah, Saudi Arabia from March 2020 to July 2021 with a vitamin D serum test result at the time of infection or prior to disease onset. The data were extracted retrospectively using a data collection sheet. Our primary outcomes were intensive care unit (ICU) admission and in-hospital mortality. The cut-off values for vitamin D were <25, 25-49, and 50-250 for deficient, suboptimal, and optimal levels respectively. Our result revealed that there is no association between vitamin D serum levels deficiency and ICU admission (OR=1.08, p=0.75) or in-hospital mortality (OR=1.74, p=0.97). ICU admission and in-hospital mortality percentages in patients with vitamin D deficiency were 14.1% and 6.4%, respectively. In comparison, percentages for patients with optimal levels were 16.67% and 6.15% for ICU admission and in-hospital mortality, respectively. Smoking was not associated with ICU admission (p=0.05) or in-hospital mortality (p=0.38). Our study does not support a relationship between vitamin D deficiency and COVID-19 patients' outcomes. Future studies should be directed toward conducting randomized clinical trials to determine whether vitamin D has an effective role in reducing COVID-19 severity.

In vivo quantification of cochlin in glaucomatous DBA/2J mice using optical coherence tomography.

The expression of cochlin in the trabecular meshwork (TM) precedes the clinical glaucoma symptoms in DBA/2J mice. The ability to quantify cochlin in the local tissue (TM) offers potential diagnostic and prognostic values. We present two (spectroscopic and magnetomotive) optical coherence tomography (OCT) approaches for in vivo cochlin quantification in a periodic manner. The cochlin-antibody OCT signal remains stable for up to 24 hours as seen at 3.5 hours after injection allowing for repeated quantification in the living mouse eyes.

A comparison of trabecular meshwork sphingolipids and ceramides of ocular normotensive and hypertensive states of DBA/2J mice.

PURPOSE: To determine the differential profiles of sphingomyelin, sphingoid base, sphingoid base-1-phosphate, and ceramide and their quantitative differences between trabecular meshwork (TM) derived from normotensive and hypertensive intraocular pressure states of DBA/2J mice. METHODS: Normotensive and hypertensive state TM were collected from mice and analyzed. Lipid extraction was performed using the Bligh and Dyer method, and the protein concentrations were determined using the Bradford method. The lipids were identified and quantified using appropriate standards with a TSQ Quantum Access Max triple quadrupole mass spectrometer applying class-specific lipid identification settings. RESULTS: The comparative profiles of sphingomyelin, sphingoid base, sphingoid base-1-phosphate, and ceramide between normotensive and hypertensive TM showed several species unique to a phase and as well common between states. CONCLUSION: The presence or absence of several sphingolipids and ceramides in the normotensive or hypertensive states may contribute to better understanding of the glaucomas.

Human trabecular meshwork sphingolipid and ceramide profiles and potential latent fungal commensalism.

PURPOSE: We determined the profiles of sphingomyelin, sphingoid base, sphingoid base-1-phosphate, and ceramide, and their quantitative differences between control and glaucomatous trabecular meshwork (TM) derived from human donors. METHODS: Control and primary open angle glaucoma (POAG) TM samples were collected from cadaver donors. In addition, POAG TM surgical specimens also were procured. Lipid extraction was performed using suitable modifications of the Bligh and Dyer method. Protein concentrations were determined using Bradford's method. Lipids, identified using standardized class-specific lipid mass spectrometry, were quantified using a two-step ratiometric process. Gomori methenamine silver (GMS) staining was performed for detection of presence of Fusarium in the anterior eye tissue sections. PCR analyses were performed for detection of Fusarium species in the donor TM samples. RESULTS: Several species of sphingomyelin, sphingoid base, sphingoid base-1-phosphate, and ceramide were common between control and POAG TM. Only a subset of species in some of these classes were identified uniquely either in controls or in POAG TM. Several lipid species of fungal origin (many from Fungi imperfecti, Fusarium species) were found to be common between control and POAG TM. The GMS staining and PCR analyses showed presence of DNA belonging to Fusarium species suggesting latent commensalism. CONCLUSIONS: Most sphingolipids and ceramides (except a few unique to a specific donor TM group) were found to be common in the control and POAG TM. Latent commensalism by Fusarium was suggested by identification of Fusarium-specific lipids, which was supported further by PCR amplification and sequencing of DNA.