Ocular Injuries From Drive-by Paintball Shootings.

PURPOSE: To characterize ocular injuries from drive-by paintball shootings with a focus on the severity of injuries sustained, clinical management, and visual outcomes. DESIGN: Retrospective, interventional case series. METHODS: Setting: University practice and emergency department. PATIENT POPULATION: Patients evaluated by the ophthalmology service for paintball injuries. OBSERVATION PROCEDURE: Age, sex, eye laterality, mechanism of injury, initial best-corrected visual acuity (BCVA), and initial diagnosis. MAIN OUTCOME MEASURES: Clinical intervention(s), BCVA at last follow-up visit, and severity of injuries with a focus on ruptured globes. RESULTS: Twenty patients suffered unilateral ocular injuries from drive-by paintball shootings between January 2020 and December 2021. The median follow-up interval was 7.1 weeks (range: 3 days to 11.4 months). The average patient age at presentation was 36.6 years (range: 13-64 years). Fourteen patients (70%) had an initial BCVA of counting fingers or worse. Six patients (30%) suffered a ruptured globe injury requiring surgical repair, of whom 3 (15%) underwent subsequent evisceration. Twelve patients (60%) suffered ocular injuries requiring surgical intervention. Fifteen ocular surgeries were performed on 9 patients (45%) at our institution with 3 patients referred to outside providers for definitive surgical management due to insurance. BCVA at last follow-up visit was no light perception in 5 patients. CONCLUSIONS: The severity of injury after paintball-induced ocular trauma is higher in this case series than what has previously been reported in the literature. Paintball guns can cause devastating ocular injury when used as an assault weapon, and their use in unregulated settings bears further scrutiny.

Coffee, Tea, and Mammographic Breast Density in Premenopausal Women.

Studies have investigated the associations of coffee and tea with mammographic breast density (MBD) in premenopausal women with inconsistent results. We analyzed data from 375 premenopausal women who attended a screening mammogram at Washington University School of Medicine, St. Louis, MO in 2016, and stratified the analyses by race (non-Hispanic White (NHW) vs. Black/African American). Participants self-reported the number of servings of coffee, caffeinated tea, and decaffeinated tea they consumed. Volpara software was used to determine volumetric percent density (VPD), dense volume (DV), and non-dense volume (NDV). We used generalized linear regression models to quantify the associations of coffee and tea intake with MBD measures. Coffee: ≥1 time/day (ß = 1.06; 95% CI = 0.93-1.21; p-trend = 0.61) and caffeinated tea: ≥1 time/day (ß = 1.01; 95% CI = 0.88-1.17; p-trend = 0.61) were not associated with VPD. Decaffeinated tea (≥1 time/week) was positively associated with VPD in NHW women (ß = 1.22; 95% CI = 1.06-1.39) but not in African American women (ß = 0.93; 95% CI = 0.73-1.17; p-interaction = 0.02). Coffee (≥1 time/day) was positively associated with DV in African American women (ß = 1.52; 95% CI = 1.11-2.07) but not in NHW women (ß = 1.10; 95% CI = 0.95-1.29; p-interaction = 0.02). Our findings do not support associations of coffee and caffeinated tea intake with VPD in premenopausal women. Positive associations of decaffeinated tea with VPD, with suggestions of effect modification by race, require confirmation in larger studies with diverse study populations.