Predictors and Outcomes of Vitrectomy and Silicone Oil Injection in Advanced Diabetic Retinopathy

PURPOSE: To evaluate visual and anatomical results and identify factors that influence vitrectomy and silicone oil (SO) injection outcomes in proliferative diabetic retinopathy (PDR). METHODS: This retrospective study included 236 eyes with PDR that were undergoing vitrectomy and SO injection with >3-month follow-up. The primary outcomes were final best-corrected visual acuity (BCVA) and retinal attachment rate. RESULTS: At the final visit (mean, 88 ± 58 weeks), complete, partial, and no retinal attachment were observed in 86.9%, 10.6%, and 2.5% of patients, respectively. A total of 155 eyes had experienced SO removal, while 81 had SO in place. The mean initial BCVA was 1.9 ± 0.7 logarithm of the minimum angle of resolution (logMAR) and significantly improved to 1.7 ± 0.8 logMAR (p = 0.001). Initial macular detachment (adjusted odds ratio [AOR], 0.25), development of iatrogenic break (AOR, 0.25), and use of heavy SO (AOR, 0.13) were independently associated with a lower risk of final retinal attachment, and SO removal was associated with a higher incidence (AOR, 7.55). Better baseline BCVA was associated with a higher risk of final BCVA ≥20 / 200. CONCLUSIONS: Despite an encouraging outcome based on anatomical data in advanced PDR treated with vitrectomy and SO, the functional prognosis was not satisfying for patients. Eyes with better vision at baseline had a more favorable prognosis, whereas eyes with initial macular detachment, intraoperative iatrogenic break, or heavy SO showed more unfavorable outcomes. In selected cases, extending the time of SO use did not worsen the prognosis.

Homeostasis status between prooxidants and antioxidants as a potent marker in Iranian preeclamptic patients

To measure the plasma oxidant, lipid peroxidation and antioxidants, ascorbate, to magnify the prooxidants and antioxidants status as a marker of pre-eclampsia. Included in the study were 50 preeclamptic and 100 normotensive pregnant women of singleton gestations in their third trimester, presented in Allavi Hospitals in Ardabil province of Iran from August 2004 to April 2005. Among these patients plasma malonaldehyde [MDA] and vitamin C concentration were analyzed. Blood samples [5 ml] were collected aseptically in heparin bulb. Spectrophotometric methods were employed to determine the plasma concentrations of vitamin C. The Statistical Package for Social Sciences software was used to analyze the data. In preeclampsia, significant increase in prooxidant MDA was observed as compared to controls. A significant fall in antioxidants vitamin C was noted in preeclampsia as compared to control. The MDA showed a significant balance to the level of vitamin C. Administration of regular nutritive supplementation containing reducing systems like vitamin C should help in maintaining the equilibrium during normal pregnancy and theoretically in preeclampsia too but to what extent they help in clinical practice is still being investigated