The role of trimethylamine-N-oxide level in the diagnosis of diabetic retinopathy and the differential diagnosis of diabetic and nondiabetic retinopathy

Abstract

To evaluate the clinical course and management of infectious interface keratitis after Descemet membrane endothelial keratoplasty. Methods: A total of 352 cases that had undergone Descemet membrane endothelial keratoplasty were retrospectively reviewed. Patients with infectious interface keratitis during follow-up were analyzed. The microbiological analyses, time to infection onset, clinical findings, follow-up duration, treatment, and post-treatment corrected distance visual acuity were recorded. Results: IIK was detected in eight eyes of eight cases. Three fungal and three bacterial pathogens were identified in all cases. All patients received medical treatment according to culture sensitivity. Antifungal treatment was initiated in two cases with no growth on culture, with a preliminary diagnosis of fungal interface keratitis. Intrastromal antifungal injections were performed in all patients with fungal infections. The median time to infection onset was 164 days (range: 2-282 days). The postoperative infectious interface keratitis developed in the early period in two cases. The mean follow-up duration was 13.4 ± 6.2 months (range: 6-26 months). Re-Descemet membrane endothelial keratoplasty was performed in two patients (25%) and therapeutic penetrating keratoplasty in four patients (50%) who did not recover with medical treatment. The final corrected distance visual acuity was 20/40 or better in five patients (62.5%). Conclusions: The diagnosis and treatment of infectious interface keratitis following Descemet membrane endothelial keratoplasty are challenging. Early surgical intervention should be preferred in the absence of response to medical treatment. Better graft survival and visual acuity can be achieved with therapeutic penetrating keratoplasty and re-Descemet membrane endothelial keratoplasty in patients with infectious interface keratitis.

Advances in fecal microbiota transplantation for the treatment of diabetes mellitus

“…Previous studies have shown that the circulating levels of TMAO are significantly elevated under diabetic conditions in both human and animal models. Researchers have also found that TMAO is closely associated with adverse events such as diabetes-related retinopathy, coronary heart disease, and kidney disease ( Zhang et al., 2021 ; Yakar et al., 2022 ; Huang et al., 2023 ; Yu et al., 2024 ). Jiang et al.…”

Role of the Gut Microbiome in the Development of Atherosclerotic Cardiovascular Disease

“…Furthermore, Pasteurellaceae bacteria are significantly lower in patients with diabetic retinopathy as compared to patients without this complication [ 105 ]. Plasma TMAO levels are also significantly increased in individuals with diabetic retinopathy, and its levels are associated with the incidence of this microvascular complication [ 106 , 107 ]. These data highlight the importance of the intestinal microbiome and suggest that dysbiosis could play an important role in the development of diabetic complications.…”

Diabetes-associated neutrophil NETosis: pathogenesis and interventional target of diabetic complications

“…Ruboxistaurin can further gain mild beneficial effects on visual loss in clinics (65).Hydrogen sulfide (H2S) is an endogenous signaling molecule that attenuates NETosis and accelerates diabetic wound healing by blocking ROS-mediated activation of MAPK ERK1/2 and p38 (66), suggesting that adding H2S precusor and cystathionine g-Lyase(H2S synthetase) activator might become a future drug target to prime diabetic wound to heal. Other NETosis-related compounds have been investigated in several disease model other than diabetes (see in Supplementary Table 2) (67)(68)(69)(70)(71)(72)(73)(74)(75)(76)(77)(78)(79)(80)(81)(82).…”