Arginine resulted in worsened mucosal injury, disruption of the actin cytoskeleton, decreased tissue ATP and enhanced permeability compared with glutamine which appeared protective. The immune-enhancing agent arginine results in breakdown of gut barrier function which may have important implications for critically injured patients.
Age-related macular degeneration (AMD) can have devastating effects on vision, especially in its neovascular form. In the last decade, the use of intravitreal pharmacotherapy targeted to vascular endothelial growth factor (VEGF) has significantly improved the visual outcomes in patients with neovascular AMD. Although we have become accustomed to these unprecedented improvement outcomes, maintaining good visual results with anti-VEGF therapy requires tremendous effort, time and cost, typically involving monthly clinic visits and intravitreal injections. The introduction of aflibercept, an anti-VEGF drug that targets all isoforms of VEGF as well as placenta growth factor, has shown promise throughout recent clinical trials as an equally effective treatment for neovascular AMD that requires less frequent dosing than either ranibizumab or bevacizumab. Based on clinical trial results, the U.S. Food and Drug Administration approved aflibercept in November 2011 for use in neovascular AMD, giving patients the hope of alleviating some of the burden associated with treatment.
Purpose: The purpose of this study was to compare images of the retina and choroid obtained with Spectralis 1050-nm spectral-domain optical coherence tomography (SD-OCT) with and without enhanced depth imaging (EDI) to the commercially available 870-nm SD-OCT with and without EDI.Methods: Full-length 308 line scans were obtained with both 870-and 1050-nm Spectralis OCT instruments, with and without EDI. Two trained retina physicians masked to wavelength and EDI status assessed the ability to visualize the vitreoretinal interface and full-thickness choroid, and subfoveal choroidal thickness (SFCT) was measured.Results: Included in the study were 21 eyes. The vitreoretinal interface was visualized best with 870-nm OCT without EDI and was diminished with 1050-nm OCT. Graders preferred 1050 nm with EDI over 870 nm with EDI in qualitative comparisons of the choroid; 1050 nm without EDI was slightly preferred over 870 nm with EDI but was not statistically significant. SFCT measurements correlated well among the imaging modalities except for 870 nm without EDI.Conclusions: SD-OCT with EDI at 870 nm provides good visualization of both the vitreoretinal interface and choroid, whereas 1050-nm SD-OCT with or without EDI provides more choroidal detail at the expense of visualization of the vitreoretinal interface.
Intraocular foreign bodies (IOFBs) can complicate globe trauma and are associated with a high incidence of severe vision loss. Occult IOFBs present a particular challenge as they are not diagnosed promptly and tend to present with advanced complications, including endophthalmitis and retinal detachment. In this report, we present three cases of occult nonmetallic IOFBs presenting as fulminant uveitis, and we also review the literature.
We report two rare cases of biopsy proven Immunoglobulin G4-related sclerosing orbital inflammation (IgG4SOI). The first case had intracranial involvement which, to our knowledge, is the first IgG4SOI case with serum cerebrospinal fluid abnormalities and the second case had an unusual presentation of a compressive optic neuropathy and systemic lymphadenopathy.
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