Peripheral retinal neovascularization in a patient with obstructive sleep apnea.

Purpose: To describe a case of peripheral retinal neovascularization and its possible etiological connection to comorbid obstructive sleep apnea. Observations: In this case report we describe a diabetic patient with obstructive sleep apnea who presented with bilateral peripheral retinal neovascularization but in the absence of any other evidence of diabetic retinopathy. Aside from confirmed nocturnal hypoxia and reasonably controlled diabetes mellitus, etiological investigation was otherwise unrevealing. Conclusions and Importance: In the absence of typical findings for diabetic retinopathy, nocturnal hypoxia due to obstructive sleep apnea may be a contributing factor in the development of peripheral retinal neovascularization. There may be a role for more vigilant OSA screening in patients with peripheral retinal neovascularization as treatment with positive airway pressure devices may reduce the retinal hypoxic burden.

Epidemiology of Persistent Postsurgical Pain Manifesting as Dry Eye-Like Symptoms After Cataract Surgery.

PURPOSE: To evaluate the epidemiology of persistent postsurgical pain (PPP) manifesting as dry eye (DE)-like symptoms 6 months after surgery. METHODS: This single-center study included 119 individuals whose cataract surgeries were performed by a single surgeon at the Bascom Palmer Eye Institute and who agreed to participate in a phone survey 6 months after surgery. Patients were divided into 2 groups: the PPP group was defined as those with a Dry Eye Questionnaire-5 score ≥6 and without PPP as those with a Dry Eye Questionnaire-5 score <6 at 6 months after cataract surgery. RESULTS: Mean age of the study population was 73 ± 8.0 years; 55% (n = 66) were female. PPP was present in 34% (n = 41) of individuals 6 months after surgery. Factors associated with an increased risk of PPP were female sex [odds ratio (OR) = 2.68, 95% confidence interval (CI) = 1.20-6.00, P = 0.01], autoimmune disorder (OR = 13.2, CI = 1.53-114, P = 0.007), nonocular chronic pain disorder (OR = 4.29, CI = 1.01-18.1, P = 0.06), antihistamine use (OR = 6.22, CI = 2.17-17.8, P = 0.0003), antireflux medication use (OR = 2.42, CI = 1.04-5.66, P = 0.04), antidepressant use (OR = 3.17, CI = 1.31-7.68, P = 0.01), anxiolytic use (OR = 3.38, CI = 1.11-10.3, P = 0.03), and antiinsomnia medication use (OR = 5.28, CI = 0.98-28.5, P = 0.047). PPP patients also reported more frequent use of artificial tears (P < 0.0001), higher ocular pain levels (P < 0.0001), and greater neuropathic ocular pain symptoms, including burning (P = 0.001), wind sensitivity (P = 0.001), and light sensitivity (P < 0.0001). CONCLUSIONS: PPP in the form of persistent DE-like symptoms is present in approximately 34% of individuals 6 months after cataract surgery. The frequency of PPP after cataract surgery is comparable to that of other surgeries including laser refractive surgery, dental implants, and genitourinary procedures.

Epidemiology of Persistent Dry Eye-Like Symptoms After Cataract Surgery.

PURPOSE: To evaluate the frequency and risk factors for persistent postsurgical pain (PPP) after cataract surgery, defined as mild or greater dry eye (DE)-like symptoms 6 months after surgery. METHODS: This single-center study included 86 individuals who underwent cataract surgery between June and October 2016 and had DE symptom information available 6 months after surgery. Patients were divided into 2 groups: controls were defined as those without DE symptoms 6 months after surgery (defined by a Dry Eye Questionnaire 5 (DEQ5) score <6), cases were defined as those with mild or greater DE-like symptoms 6 months after surgery (DEQ5 ≥6). RESULTS: Mean age of the study population was 71 ± 8.6 years; 95% (n = 82) were men. DE-like symptoms were reported in 32% (n = 27) of individuals 6 months after cataract surgery; 10% (n = 8) reported severe symptoms (DEQ5 ≥12). Patients with DE-like symptoms after cataract extraction also had higher ocular pain scores and specific ocular complaints (ocular burning, sensitivity to wind and light) compared with controls with no symptoms. A diagnosis of nonocular pain increased the risk of DE-like symptoms after cataract surgery (odds ratio 4.4, 95% confidence interval 1.58-12.1, P = 0.005). CONCLUSIONS: Mild or greater PPP occurred in approximately 1/3 of individuals after cataract surgery. Prevalence of severe PPP is in line with that of refractive surgery, dental implants, and genitourinary procedures.

Lipid Sample Preparation for Biomedical Research.

We describe here a step-by-step protocol for extraction of lipids from tissue/cell samples for biomedical research. The protocol described here works well for biological samples that contain lipids, which are less than 2% of weight compared to total wet weight of tissue or cells. The protocols described here are suitable and incremental modification of previously published protocols. These protocols have been developed based on our experience with different tissues and cells, and yield estimates determined using class-specific mass spectrometry either using direct infusion or after chromatographic separation.