The primary objectives of this study were to determine if erythropoietin (EPO) is neuroprotective to the photoreceptors in the retinal degeneration slow (rds) mouse in the absence of an increase in hematocrit and to determine if deglycosylated EPO (DEPO) is less neuroprotective. We performed subretinal injections of 10U EPO, DEPO or hyperglycosylated EPO (HEPO) in postnatal day 7 rds mice. Whole eye EPO levels were quantified by ELISA at specified time points post-injection. TUNEL analysis, hematocrit, and immunohistochemistry were performed at postnatal day 20. Half of the amount of EPO measured immediately after injection was detected less than one hour later. Twenty four hours later, EPO levels were 1000 times lower than the amount originally detected. Uninjected rds mice contained 36±2 TUNEL-positive cells/mm retina and PBS injected mice contained 17±3 TUNEL-positive cells/mm retina. EPO, DEPO, and HEPO treated rds retinas contained 5±2, 9±2, and 3±1 TUNEL-positive cells/mm retina, respectively. The hematocrit was 43% in control and 41% in treated rds mice Previous studies have shown neuroprotection of the retina by treatment with as little as 24–39mU EPO/mg total protein in the eye. In this study, we detected 40mU/mg EPO in the eye 11 hours after injecti on of 10U EPO. Treatment with all forms of EPO tested was neuroprotective to the photoreceptors without a concomitant increase in hematocrit.
Purpose To describe 2 year clinical outcomes for a retrospective study group of patients undergoing photocoagulation and focal laser treatment for diabetic retinopathy (DR)or maculopathy at an eye institution in Singapore.
Methods Retrospective study
Results 150 consecutive eyes were recruited.The mean age was 59.3 years old with 46% males and 54% females.Majority were type 2 diabetics (146 out of 150) with mean HBA1c of 8.4 %. Indication for pan retinal laser photocoagulation (PRP) was severe non proliferative DR and indication for macula laser was clinically significant macular edema(CSME). For patients with only PRP performed, the mean change in log mar visual acuity (VA) at 2 yrs was +0.121 +/‐0.46. DR status at 2 yrs was stable in 90.6% of the patients and the macula was unremarkable in 86.8% of the patients. In patients requiring only macula laser, there was improvement in log mar VA at 2 years, with a mean change of ‐0.085 +/‐ 0.18. Diabetic status was stable in 91.3% of the patients and the macula was dry in 95.7% of the patients. In patients undergoing both PRP and macula laser , there was improvement in VA with a mean log mar VA change of ‐0.095 +/‐0.45. DR status at 2 years was stable in 92% of the patients and the macula was dry in 88% of the patients.Complications of laser treatment include epiretinal membrane (5.3%), cystoid macular edema(0.7%)and scar creep(0.7%).0.9% of the patients developed CSME after commencing PRP.
Conclusion There is an overall improvement in visual acuity in DR patients undergoing laser treatment. Most patients had stable DR at 2 yrs and there were few complications of the laser.
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