Clinical outcomes and epidemiology of intraocular foreign body injuries in Cork University Hospital, Ireland: an 11-year review.

BACKGROUND/AIMS: To describe the epidemiology, outcomes, and prognostic factors of intraocular foreign body (IOFB) injuries at a tertiary ophthalmic referral centre in Cork University Hospital, Ireland. METHODS: A retrospective review of 23 eyes with IOFB that presented to Cork University Hospital (CUH) from January 2009 to December 2019 was performed. The mechanism and characteristics of IOFB injury were all noted. This data was collated and analysed to ascertain the epidemiology of IOFB injury in CUH and to describe the prognostic factors affecting visual outcome following IOFB injury. RESULTS: There was a 100% male prevalence. The mean age was 37.4 years. The majority of IOFBs were metal in nature and were acquired by hammering, often while working and frequently in the absence of personal protective equipment (PPE). The route of entry for the IOFB was via the cornea in 70% of cases. Fifty-two percent of cases were clinically detectable and 43% of cases were only identifiable on CT (computed tomography) imaging. Eighty-seven percent of cases underwent surgery on the same day as presentation. There was no incidence (0%) of endophthalmitis. Seventeen percent of cases developed post-operative retinal detachment (RD). The mean pre-operative VA was 0.79 LogMAR (6/38 Snellen equivalent-SE) compared to a mean VA of 0.58 LogMAR (6/24 SE) following surgery. CONCLUSIONS: This review provides important epidemiological data for IOFB injuries in Ireland. It also adds some useful information to the literature in relation to prognostic factors and lens status post IOFB injury.

Diet and risk factors for age-related maculopathy.

BACKGROUND: Evidence continues to accumulate that oxidative stress is etiologically important in the pathogenesis of age-related maculopathy (ARM) and that appropriate antioxidants of dietary origin may protect against this condition. OBJECTIVE: Risk factors for ARM may be classed as established or putative. We report a study designed to investigate whether such risk factors are associated with a dietary lack of antioxidants relevant to retinal health. DESIGN: Dietary, anthropometric, and sociodemographic details relating to 828 healthy Irish subjects aged 20-60 y were recorded in a cross-sectional fashion and analyzed for associations between risk factors for ARM and dietary intake of relevant nutrients. RESULTS: Of the established risk factors for ARM, increasing age was associated with a relative lack of dietary zeaxanthin (P < 0.05) and tobacco use with a relative lack of dietary vitamin C (P < 0.05). Of the putative risk factors for ARM, alcohol consumption was associated with a relative lack of dietary alpha-linoleic acid (P < 0.05), and female sex was associated with a relative lack of dietary zinc (P < 0.05). CONCLUSIONS: We showed that several variables related to risk for ARM are associated with a relative dietary lack of key nutrients. Our finding that age, the most important and universal risk factor for ARM, is associated with a relative lack of dietary zeaxanthin, is an important finding that warrants further investigation.

The relationships between macular pigment optical density and its constituent carotenoids in diet and serum.

PURPOSE: Lutein (L) and zeaxanthin (Z) are two dietary carotenoids that accumulate at the macula, where they are collectively known as macular pigment (MP). There is a biologically plausible rationale, with some supporting evidence, that MP may protect against age-related maculopathy (ARM). This study was undertaken to investigate the relationship between dietary intake of L and Z, serum concentrations of these carotenoids, and MP optical density in 828 healthy Irish subjects. METHODS: Dietary intake of L and Z was assessed with a validated food-frequency questionnaire, and serum concentrations of these carotenoids were quantified by high-performance liquid chromatography. MP optical density was measured psychophysically, using heterochromatic flicker photometry. Demographic data, lifestyle data, and general health status, were also recorded by questionnaire, with particular attention directed toward risk-factors (established and putative) for ARM. RESULTS: The relationships between MP optical density, serum concentrations of L (and Z), and dietary intake of L (and Z) were positive and statistically significant when analyzed for the entire study group (r = 0.136-0.303; P < 0.01 for all). Subjects with a clinically confirmed family history of ARM, current heavy cigarette smokers, subjects aged more than 53 years, and subjects with a body mass index (BMI) >27, did not demonstrate a positive and significant relationship between MP optical density and serum concentrations of Z (r = 0.041, r = 0.001, r = 0.074 and r = 0.082, respectively; P > 0.05 for all). However, there was a positive and significant relationship between MP optical density and serum concentrations of L in the presence of all these risk factors (r = 0.165 to 0.257), except for current heavy smokers (r = 0.042; P > 0.05). CONCLUSIONS: For subjects at increased risk of ARM (e.g., subjects with a clinically confirmed family history of ARM, current heavy cigarette smokers, subjects aged > 53 years and subjects with a BMI > 27) retinal capture and/or retinal stabilization of Z appears to be compromised, whereas retinal uptake and/or stabilization of L appears to be compromised in current heavy smokers only. Given the lack of MP in association with risk for ARM, the findings indicate that a retina predisposed to this condition may have an impaired ability to accumulate circulating Z.

Macular carotenoids and age-related maculopathy.

Lutein (L) and zeaxanthin (Z) are concentrated at the macula, where they are collectively known as macular pigment (MP), and where they are believed to play a major role in protecting retinal tissues against oxidative stress. Whilst the exact pathogenesis of age-related maculopathy (ARM) remains unknown, the disruption of cellular processes by oxidative stress may play an important role. Manipulation of dietary intake of L and Z has been shown to augment MP, thereby raising hopes that dietary supplementation with these carotenoids might prevent, delay, or modify the course of ARM. This article discusses the scientific rationale supporting the hypothesis that L and Z are protective against ARM, and presents the recent evidence germane to this theory.