V M Asensio-Sánchez

To measure erythropoietin (Epo) levels in the vitreous body from patients with proliferative diabetic retinopathy (PDR). Undiluted vitreous samples were obtained from 44 patients who had not undergone prior vitreous or intraocular surgery. Patients were divided into two groups: A (n= 24) patients with PDR and B (n= 20) patients with retinal detachment, preretinal macular membranes and macular holes. Epo was determined using radioimmunoassay. Epo vitreous concentration in group A was 512 mU/mL (range 120-880) and in group B was 25.1 mU/mL (range 5.2-201) (p< 0.001). These results show that the concentration of Epo in the vitreous body was significantly higher in patients with PDR than in the control group.

We examined the influence of non-ophthalmic parameters as risk factors of clinically significant macular edema (CSME). The authors reviewed clinical records of all clinically significant macular edema between 1995 and 2005. The association between the presence of CSME and HgbA1c, onset and duration of diabetes, blood pressure, body mass index, lipid status, sex, tobacco smoking and urinary albumin excretion was evaluated. 208 eyes met the study criteria. Patients ranged in age from 14 to 82 years (mean, 66 years) and had 8 to 64 years (mean, 47.5 years) of history of diabetes. Significant risk factors for CSME were older age, high levels of HgbA1c, high values of blood pressure, tobacco smoking, high cholesterol and LDL-cholesterol and high levels of proteinuria and microalbuminuria. Independent on the type of diabetes, patients with long standing diabetes have a high risk to develop diabetic maculopathy, but other closely-related risk factors are hypertension, hyperglycemia, lipids, tobacco smoking and renal status.

Helicobacter pylori (HP) gastric infection has been implicated as an important factor in occlusive arterial pathology. Nowadays, it is suspected that central serous chorioretinopathy (CSC) is due to a multifocal vascular occlusive disease of the choriocapillaris. The aim of this study was to determine the relation between gastric HP infection and CSC. We evaluated a group of 16 patients with CSC and 20 controls. HP infection was assessed by the 13C-urea breath test (UBT). Clinical CSC diagnosis was confirmed by fundus biomicroscopy and fluorescein angiography. Out of 16 patients with CSC, 11 (68.75%) were males and 5 (31.25%) females, with a mean age of 46.3 years. HP infection was positive in 11 patients (68.75%) and negative in 5 (31.25%). Men were HP-positive (HP+) in 72.7% of cases, compared to women who were HP+ in 60% of cases. The difference in prevalence of HP between the CSC-group (68.75%) and the control-group (30%) was found to be statistically significant (p< 0.05). HP+ patients had more gastric pain than HP negative (HP-) patients (72.73% vs 20%). These results indicate a possible statistical association between Helicobacter pylori gastric infection and CSC. HP should thus be considered a risk factor in CSC patients.