Ido Eldar

Molecular and histological changes following central retinal artery occlusion in a mouse model

The aim of this study was to characterize the molecular and histological changes that occur in the retina following central retinal artery occlusion (CRAO) in a mouse model. CRAO was induced in 60 mice by laser photoactivation of intravenously injected rose bengal. Mice were sacrificed at 3, 6, 12, and 24h and 7 and 21 days after CRAO induction for molecular analysis (5-13 mice/time point) and histological and apoptosis studies (3-4 mice/time point). Fundus examination and fluorescein angiography were also performed at various points. Retinal mRNA was analyzed for expression of T-cell antigen 1 (Thy-1), vascular endothelial growth factor (VEGF), heme oxygenase-1 (HO-1), and hypoxia-induced factor 1 alpha (HIF-1 alpha) using real-time polymerase chain reaction. The results showed that at 6-24h following CRAO induction, the retina was edematous, with interrupted blood perfusion. Fluorescein angiography showed reperfusion at 6h, and TdT-mediated dUTP nick end-labeling (TUNEL) assay revealed an increase in apoptotic cells in the first 24h. On histological sections, nuclear loss in the inner retinal layers was maximal on day 21. Thy-1 expression decreased to 30% of baseline (P<or=0.002). VEGF expression increased in the first 3h and gradually decreased thereafter, reaching 75% of baseline on day 21 (P<or=0.005). HO-1 was upregulated at all time points, with a peak at 12h. No change was noted in HIF-1 alpha expression at any time. In conclusion, CRAO in mice causes cell apoptosis in the inner layers of the retina, with a significant cell loss and a decrease in Thy-1 expression by 21 days. These changes are accompanied by a rise in expression of the ischemia-related protein HO-1 to a peak at 12h, with levels remaining above control values at day 21. Given the similarity of the mouse model to human CRAO, these findings may have implications for the future clinical management of CRAO.

Timing intra-Fallopian transfer procedures.

With the gradual decline in the use of zygote intra-Fallopian transfer (ZIFT), current practice is to offer ZIFT almost exclusively to patients with repeated implantation failure (RIF). For practical reasons, the procedure is sometimes deferred by 1 day and embryo intra-Fallopian transfer (EIFT) is performed. The aim of the present study was to compare the reproductive outcome of ZIFT versus EIFT. In a retrospective analysis, 176 patients who failed in 7.65 +/- 3.7 previous IVF cycles underwent 200 ZIFT and 73 EIFT procedures. Implantation and live birth rates were compared for both groups. Patients in both groups were found comparable for demographic and clinical parameters. Similar numbers of oocytes were retrieved and fertilized in both groups, and 5.2 +/- 1.2 zygotes/embryos were transferred. Implantation and live birth rates (10.5 and 26.5% versus 10.9 and 24.7% for ZIFT and EIFT respectively) were comparable. It is concluded that tubal transfer of zygotes and day-2 cleavage stage embryos are equally effective.

Effect of Dexamethasone Eyedrops on Blood Glucose Profile

Purpose: To evaluate the effect of dexamethasone eyedrops on blood glucose. Methods: Two hundred eighty-five patients who underwent cataract surgery were prospectively randomized to receive treatment with topical dexamethasone or diclofenac for 1 month. A capillary blood sample was collected before surgery, immediately after, 1 week later, and 1 month later. Results: A significant increase in blood glucose levels was noted only in the diabetic dexamethasone group, from 170 ± 55.5 (mg/dl) before surgery to 229 ± 76.8 (mg/dl) 1 month later (p = 0.05, 95% confidence interval of −13 to −83.2). The latter level was significantly higher than the 1-month level in the diabetic patients treated with diclofenac drops (198.4 ± 66.5 mg/dl, p = 0.038). Conclusions: Postoperative dexamethasone eyedrops have a greater effect on the blood glucose profile of diabetic petients than on nondiabetic patients. Clinicians should be alerted to this risk and may initiate appropriate follow-up in this patient subgroup.

The effects of an external nasal dilator on labor

Background The aim of this study was to assess the effect of an external nasal dilator on several variables characterizing labor in both mother and fetus. Methods One hundred and fifty primigravida women in active labor were randomized to wear, throughout labor, either a dilator spring-loaded nasal strip or a placebo device. Data were obtained during labor and compared between the groups. After delivery, the satisfaction rate was assessed. Results No differences were found between the study and the control group regarding rate of induction or augmentation of labor as well as Montevideo units reached, frequency of rupture of membranes, duration of the active phase and second stage of labor, usage of epidural analgesia, normal fetal heart pattern, meconium-stained amniotic fluid, and neonatal well being. Length of maternal and neonatal hospitalization also did not differ between the groups. Satisfaction rate was significantly higher in parturient women wearing nasal strips with a dilator spring than in parturient women wearing a placebo spring (P < 0.0001). Conclusion Nasal strips do not change the course but ameliorate the quality of labor by improving the ease of breathing. Nasal dilators sustain the respiratory effort associated with the long process of labor and may control the switch from nasal to oronasal breathing during delivery.

Photodynamic Therapy for Pseudophakic Eyes Compared to Eyes With Cataract

BACKGROUND AND OBJECTIVE Verteporfin photodynamic therapy (vPDT) plays a role in the treatment of chorioretinal conditions. The purpose of this study was to compare vPDT outcomes between cataractous and pseudophakic eyes. PATIENTS AND METHODS In this prospective study of consecutive patients with choroidal neovascularization (CNV) secondary to neovascular age-related macular degeneration (nAMD) treated with vPDT, cataract and pseudophakic eyes were compared for number and timing of vPDT treatments, duration of follow-up, angiographic features, and changes in best-corrected visual acuity (BCVA). RESULTS Overall, 103 eyes (n = 95) were included in the final analysis; 44 eyes in the cataract group and 59 eyes in the pseudophakic group. No significant difference in change in BCVA (P = .19) or leakage-free CNV lesions (P = .58) was found between the groups. CONCLUSIONS In this study of vPDT for nAMD, there was no significant difference between eyes with cataract and pseudophakic eyes. It seems that cataract does not clinically alter the effect of vPDT. [Ophthalmic Surg Lasers Imaging Retina. 2016;47:1132-1136.].

C-reactive protein levels do not correlate with retinal artery occlusion but with atherosclerosis

PurposeTo determine C-reactive protein (CRP) levels in acute retinal artery occlusion (RAO) and their association with atherosclerotic risk factors.MethodsCRP levels in 16 patients with RAO were compared with levels in 16 age-matched controls at risk of atherosclerosis and 16 young volunteers. Repeated CRP testing was performed 6 years later.ResultsElevated CRP levels (>3 mg/l) and risk factors for atherosclerosis were detected in seven patients in the study group (44%) and nine at-risk controls (56%). On follow-up, CRP levels were reduced in all seven retested patients. Six patients died of vascular events within 5 years, of whom four had high CRP levels during RAO.ConclusionsCRP level correlates with atherosclerosis but it is not significantly elevated in patients with RAO.