Epidemiology and prognosis factors in open globe injuries in the Federal District of Brazil.

OBJECTIVE: To identify the epidemiological profile and prognostic factors of open globe injuries that require emergency surgical treatment. DESIGN: Retrospective cohort study. SUBJECTS: Patients with OGI who underwent publicly funded emergency surgical treatment in the Federal District from 2014 to 2018. METHODS: Data were collected by reviewing electronic medical records through a questionnaire and tabulated. The statistical analysis was performed in SPSS Statistics 26.0.0.0 (p ≤ 0.05). RESULTS: A total of 359 records were included, corresponding to 336 eyes of 334 patients (294 males and 40 females). The average age was 32.7 years. The affected eye was the right eye in 165 cases, the left eye in 166 cases, and both eyes in 3 cases. The average time between injury and hospitalization was 75.7 h, and the time between injury and surgery averaged 173.7 h. The injury types were as follows: 197 penetrating; 109 rupture; 19 IOFB; 11 perforating. The injuries were in the following zones: 181 zone I; 82 zone II; 70 zone III. The OTS grades were as follows: 57 were classified as grade 1; 101 were grade 2; 142 were grade 3; 28 were grade 4; and 8 were 5. The most commonly performed surgeries were corneal suture, corneoscleral suture, and evisceration. The most common clinical features were traumatic cataract, herniated iris and hyphema. The following were risk factors for poor prognosis: zone III, time between trauma and surgery > 72 h, rupture injury, retinal detachment, disorganization of the eyeball, endophthalmitis, uveal prolapse, OTS classification 1 or 2, and low initial visual acuity. The following factors predicted a good prognosis: initial VA > 1/200, penetrating injury, OTS 4 and zone II. CONCLUSIONS: The high frequency of many of these factors may explain the high rate of severe visual loss found. Injury localization in zone II was identified as a previously unrecognized protective factor against severe visual loss.

The impact of mass spectrometry application to screen new proteomics biomarkers in Ophthalmology.

INTRODUCTION: In the search for molecular markers that aid in the early diagnosis and treatment of various human diseases, many studies have focused on changes in genes, their transcripts and protein products. Recent advances in proteomic methodologies, such as mass spectrometry (MS), generate new opportunities to obtain relevant information on normal and abnormal processes that occur in many important cell pathways. The human eye is a highly specialized and compartmentalized organ, and the interpretation of molecular biomarkers helps to evaluate its cellular structure, providing a broader molecular understanding that corroborates in the pathophysiology of ophthalmological diseases, with marked improvements in their diagnosis, prognosis and treatment. This review summarizes the most important protein biomarkers in Ophthalmology screened by MS tools. CONCLUSION: The use of translational medicine techniques (as MS), integrating basic and clinical research, still transforms scientific findings, from laboratory researches to clinical applications, from the bedside into the community.

Novel Possible Protein Targets in Neovascular Age-Related Macular Degeneration: A Pilot Study Experiment.

Age-related macular degeneration (AMD) is among the world's leading causes of blindness. In its neovascular form (nAMD), around 25% of patients present further anatomical and visual deterioration due to persistence of neovascular activity, despite gold-standard treatment protocols using intravitreal anti-VEGF medications. Thus, to comprehend, the molecular pathways that drive choroidal neoangiogenesis, associated with the vascular endothelial growth factor (VEGF), are important steps to elucidate the mechanistic events underneath the disease development. This is a pilot study, a prospective, translational experiment, in a real-life context aiming to evaluate the protein profiles of the aqueous humor of 15 patients divided into three groups: group 1, composed of patients with nAMD, who demonstrated a good response to anti-VEGF intravitreal injections during follow-up (good responsive); group 2, composed of patients with anti-VEGF-resistant nAMD, who demonstrated choroidal neovascularization activity during follow-up (poor/non-responsive); and group 3, composed of control patients without systemic diseases or signs of retinopathy. For proteomic characterization of the groups, mass spectrometry (label-free LC-MS/MS) was used. A total of 2,336 proteins were identified, of which 185 were distinctly regulated and allowed the differentiation of the clinical conditions analyzed. Among those, 39 proteins, including some novel ones, were analyzed as potential disease effectors through their pathophysiological implications in lipid metabolism, oxidative stress, complement system, inflammatory pathways, and angiogenesis. So, this study suggests the participation of other promising biomarkers in neovascular AMD, in addition to the known VEGF.