T. Panagiotoglou

The use of intravitreal etanercept in diabetic macular oedema.

The aim of this pilot study was to investigate the effect of intravitreal administration of etanercept in refractory diabetic macular edema. Seven patients diagnosed with diabetic macular edema, refractory to previous treatment, were enrolled. They all received 2 consecutive intravitreal injections of 2.5 mg (0, 1 ml) of Etanercept (Enbrel), with a two-week interval. In all patients visual acuity assessment, fundoscopy and fluorescein angiography were performed prior to the first injection, weekly for the first month, as well as 2 and 3 months following the first injection. No adverse reactions or adverse events were noticed in any patient. Analysis of the data indicates a trend for improvement of visual acuity, a slight worsening of hard exudates and fluorescein leakage, while hemorrhages remained stable, 3 months after initiation of therapy. However, no statistical significance has been reached. This small pilot study did not reveal any improvement in the clinical course of patients with refractory diabetic macular edema after the intravitreal injection of etanercept. Further research is warranted in order to obtain conclusive results concerning the role of anti-TNF therapy in diabetic macular edema.

Atorvastatin for Diabetic Macular Edema in Patients with Diabetes Mellitus and Elevated Serum Cholesterol

BACKGROUND AND OBJECTIVE To determine the efficacy of atorvastatin in reducing hard exudates and diabetic macular edema. PATIENTS AND METHODS An uncontrolled clinical case series included 18 eyes with diabetic maculopathy and an elevated baseline lipid profile. All patients were treated with atorvastatin. Ophthalmologic evaluation, including fundus photography and fluorescein angiography, was performed at presentation and repeated at 3, 6, and 12 months. Hard exudates, hemorrhages, and fluorescein leakage at 12 months were evaluated and compared with baseline findings. RESULTS Eighteen subjects with diabetic maculopathy received atorvastatin, and a significant decrease in total cholesterol and low-density lipoprotein cholesterol was seen (P < .05). Hard exudates and fluorescein leakage were decreased. No evidence of an association between change in hemorrhage status and treatment was found. CONCLUSION Oral atorvastatin therapy in patients with diabetes mellitus and dyslipidemia seems to reduce the severity of hard exudates and fluorescein leakage in diabetic maculopathy and could be useful as an adjuvant therapy in the management of diabetic macular edema.

Endophthalmitis After Cataract Extraction: Incidence, Treatment, and Outcome in Crete, Greece, During Period 2000-2008

Purpose: To report the incidence, microbial spectrum, and outcome of cataract operation related endophthalmitis cases from 2000 to 2008 in the Department of Ophthalmology, University Hospital of Heraklion, Crete. Methods: Retrospective, observational case series collected from the files of the University Eye Clinic of Heraklion. Results: From 2000 to 2008, 23 eyes of 23 patients with endophthalmitis after cataract surgery were reported. Vitreous specimens were obtained in all cases. Twelve were cultured positive, 8 with gram-positive bacteria, and 4 with gram-negative bacteria. Ten patients were treated medically, 13 surgically, and 2 finally underwent enucleation of the affected globe. Fourteen (60.8%) eyes of the total 23 managed in our hospital, achieved a final visual acuity of 1/10 or better and 9 lower than 1/10. Five eyes ended up with no light perception. Conclusions: We provide an overview of cataract operation related endophthalmitis cases managed in our clinic during the past 9 years.

Ocular Rigidity and Outflow Facility in Nonproliferative Diabetic Retinopathy

Purpose. To compare ocular rigidity (OR) and outflow facility (C) in patients with nonproliferative diabetic retinopathy (NPDR) and control subjects. Methods. Twenty-four patients with NPDR (NPDR group) and 24 controls (control group) undergoing cataract surgery were enrolled. NPDR group was further divided into patients with mild NPDR (NPDR1-group) and patients with moderate and/or severe NPDR (NPDR2-group). After cannulation of the anterior chamber, a computer-controlled device was used to infuse saline and increase the intraocular pressure (IOP) in a stepping procedure from 15 to 40 mmHg. Ocular rigidity and outflow facility coefficients were estimated from IOP and volume recordings. Results. Ocular rigidity was 0.0205 μL−1 in NPDR group and 0.0202 μL−1 in control group (P = 0.942). In NPDR1-group, OR was 0.017 μL−1 and in NPDR2-group it was 0.025 μL−1 (P = 0.192). Outflow facility was 0.120 μL/min/mmHg in NPDR-group compared to 0.153 μL/min/mmHg in the control group at an IOP of 35 mmHg (P = 0.151). There was no difference in C between NPDR1-group and NPDR2-group (P = 0.709). Conclusions. No statistically significant differences in ocular rigidity and outflow facility could be documented between diabetic patients and controls. No difference in OR and C was detected between mild NPDR and severe NPDR.