Searching for Biomarkers in Proliferative Diabetic Retinopathy: Amphiregulin and Progranulin.

Objective: Diabetic retinopathy is a common diabetic microvascular problem. Its diagnosis and classification are based on visible changes in clinical fundus examination. However, the discovery of possible vitreous biomarkers in patients with proliferative and nonproliferative diabetic retinopathy may guide both the differentiation and degree of retinopathy. Biomarkers that will be accepted can be also a treatment target. Amphiregulin (AREG) promotes proliferative and regenerative activity and repairs most cell types by binding and activating epidermal growth factor receptors. Progranulin (PGRN) has complex functions in many physiological and pathological processes. Thus, this study aimed to report vitreous AREG and PGRN levels in patients with diabetes and proliferative retinopathy and compare the results with those without diabetes. Methods: Thirty-three eyes of 33 patients with proliferative diabetic retinopathy and 31 eyes of 31 patients without diabetes were included in this study. Vitreous humor samples were collected from all patients at the time of pars plana vitrectomy surgery immediately before the surgical procedure. Vitreous AREG and PGRN values were determined by the ELISA method. Results: The mean AREG and PGRN values were similar in the groups (p=0.427, p=0.459, respectively). Conclusions: The results demonstrated that vitreous AREG and PGRN levels have no significant relationship with proliferative diabetic retinopathy.

Clinical and Optical Coherence Tomography Analysis of Intraretinal Microcysts in Patients with Epiretinal Membrane.

Purpose: To perform clinical and optical coherence tomography analysis of intraretinal microcysts (IRM) in patients undergoing pars plana vitrectomy (PPV) for primary epiretinal membrane (ERM) treatment.Materials and Methods: The files of 137 patients who were operated on by a single surgeon for primary epiretinal membrane treatment in our clinic between September 2017 and January 2020 were retrospectively reviewed. Patients with ERM due to secondary pathology were excluded from the study. Twenty patients with post-operative IRM (group 1) were determined and were included as the study group. To determine the effect of IRMs on visual acuity 20 patients who did not have IRM, had primary ERM and underwent PPV for treatment were included as the control group (group 2). The demographic, clinical, and operative data of the patients were obtained from the hospital database. Retinal analysis of the patients before the operation and at the earliest 6 months after the operation was performed using 6 × 6 mm images taken with the macular cube 512 × 128 protocol on the Cirrus HD-OCT (Carl Zeiss Meditec, Dublin, CA, USA) device in our clinic.Results: Intraretinal microcysts were present in 8 (5.8%) of preoperative 137 patients and 20 (14.6%) of 137 postoperative patients. All 8 patients with preoperative cysts in group 1 also had postoperative IRMs. Excluding patients with preoperative cysts, the postoperative IRM incidence was found to be 12/137 (8.75%). Preoperative (p = .392) and postoperative (p = .978) visions were similar in group 1 and group 2. Preoperative (p = .745) and postoperative retinal thicknesses were similar in both groups (p = .989). The incidence of postoperative (p = .642) IRM was similar in patients who underwent ERM and ERM + internal limiting membrane (ILM) peeling in group 1.Conclusions: Intraretinal microcysts may sometimes be seen before and after ERM surgery. The preoperative cyst presence in ERM patients is an important risk factor for postoperative cyst presence. The peeling of ILM with ERM does not increase the probability of IRM occurrence. The presence of these cysts before and/or after the operation does not affect the visual prognosis and macular thickness in ERM patients.

Red cell distribution width and its association with retinopathy of prematurity.

OBJECTIVE: The aim of this study was to evaluate whether there is a relationship between red cell distribution width (RDW) values and the development of retinopathy of prematurity (ROP) in premature infants. METHODS: This retrospective study was conducted on a total of 159 infants with gestational age (GA) < 35 weeks including 77 infants diagnosed as ROP (patients' group) and 82 infants without ROP (control group) between September 2015 and January 2018. RDW values of the preterm infants were obtained from their medical records (routine postpartum cord blood sample and follow-up venous blood samples taken at first week, second week and first month). The possible relationship between RDW values and clinical features of ROP development was evaluated. RESULTS: The mean GA of all infants was 29.2 ± 2.4 (24-35) weeks, and the mean birth weight was 1268 ± 419 (550-2500) g. The RDW values measured in the first and the second weeks were significantly higher in infants with ROP compared with those wihout ROP (p < .001 for both). There was no statistically significant difference between the groups in terms of cord blood and first month RDW values (p = .719, p = .108, respectively). The first and second week's RDW values of infants with ROP requiring treatment (severe ROP) were significantly higher than those of infants with ROP not requiring treatment (mild ROP) (p = .005, p = .031, respectively), but no statistically significant difference was observed between the groups in terms of cord blood and first month values (p = .114 and p = .371, respectively). CONCLUSION: RDW is an easily accessible and inexpensive marker that may reflect the clinical risk factors for ROP. Follow-up measures of RDW have the potential to help clinicians for the prediction of ROP development in the first 2 weeks postnatally.