Comprehensive expression analysis of prostanoid enzymes and receptors in the human endometrium across the menstrual cycle

Prostanoids are well-described primary mediators of inflammatory processes and are essential for the normal physiological function of the female reproductive system. The aim of this study was to determine the temporal expression of the prostanoid biosynthetic enzymes (PTGS1, PTGS2, PTGES, PTGES2, PTGES3, AKR1B1, AKR1C3, CBR1, HPGDS, PTGDS, PTGIS, TBXAS1 and HPGD) and the prostanoid receptors (PTGER1, PTGER2, PTGER3, PTGER4, PTGFR, PTGDR, GPR44, PTGIR and TBXA2R) in the human endometrium throughout the menstrual cycle. The analysis identified PTGFR to have a distinct expression profile compared with other components of the prostanoid system, as expression is maximal during the proliferative phase. Immunohistochemical analysis for PTGER1 suggests a dual function for this receptor depending on its temporal (proliferative versus secretory) and spatial (nuclear versus cell membrane) expression. The expression profiles of the PGF2α synthases identified AKR1B1 and CBR1 as the likely regulators of PGF2α production during the menstrual phase. Immunohistochemical analysis for AKR1B1, CBR1 and AKR1C3 suggest expression to be in the glandular epithelium and vasculature. This study represents the first comprehensive analysis of the components of prostanoid biosynthetic and signalling pathway in the human endometrium. The expression profiles described have the potential to identify specific prostanoid components that may be dysregulated in inflammatory-associated disorders of the endometrium

Surgery for epimacular membrane: impact of retinal internal limiting membrane removal on functional outcome

PURPOSE: To examine eyes that underwent vitrectomy and peeling of epimacular membrane and to correlate the functional results with the presence or absence of an internal limiting membrane (ILM) in the histologic specimens. METHODS: Seventy-one eyes underwent vitrectomy and peeling of an epimacular membrane. These membranes were examined with a transmission electron microscope. Best-corrected visual acuities were recorded before macular surgery, 1 month after surgery, and at the final examination and were compared between group 1 (ILM removed) and group 2 (ILM not removed). The age, gender, status of the lens preoperatively, type of epimacular membrane (idiopathic or secondary), intraoperative and postoperative complications, and elapsed time between vitrectomy and cataract operation were recorded. All 71 eyes were pseudophakic at the final examination. The mean follow-up was 21 months. RESULTS: Long segments of ILM were found in the specimens from 55 (77%) of the cases. Final visual acuities were better in group 1 (ILM removed) than in group 2 (ILM not removed, P = 0.004). The visual gain was 3.1 lines on the Early Treatment of Diabetic Retinopathy Study chart in group 1 and 0.9 lines in group 2. At the last examination, a recurrent epimacular membrane was observed in 5 (9%) eyes of group 1 and 9 (56%) eyes of group 2. CONCLUSION: ILM removal during surgery for epimacular membrane is associated with better final vision and a lower risk of recurrent epimacular membrane

Baerveldt aqueous shunt implantation into the ciliary sulcus

Purpose: Aqueous shunt implantation into the anterior chamber is associated with corneal decompensation in up to a third of eyes. Intracameral tube position may affect corneal endothelial cell loss. The authors set out to examine the efficacy and safety of Baerveldt shunt implantation into the ciliary sulcus combined with surgical peripheral iridectomy (SPI). Methods: One hundred eyes prospectively underwent Baerveldt shunt implantation into the cilliary sulcus combined with SPI, leaving a short intracameral tube length (1-2mm). Pre and post operative measures recorded included patient demographics, visual acuity, IOP, number of glaucoma medications (GMs) and all complications. Pre-existing corneal decompensation was recorded. Success was defined as IOP≤21mmHg and 20% reduction in IOP from baseline with or without GMs. Results: Mean age was 65.4 years (±20.4years). Mean follow-up was 10.8 months. Preoperatively IOP was 25.7mmHg (± 9.9mmHg), GMs were 2.9 (±1.2) and VA was 0.4 (±0.3). At one year postoperatively there was a significant drop in IOP (mean= 13.3mmHg (± 5.0mmHg); p<0.001) and number of GMs (mean= 1.3 (±1.4); p<0.001); and no significant change in VA (mean= 0.4 (±0.3); p=0.93). The success rate at one year was 83%. Complications were minor and non sight threatening (10%), there were no cases of postoperative corneal decompensation, tube blockage or iris/corneal-tube contact. Conclusions: The results demonstrate that placement of Baerveldt shunts into the ciliary sulcus with SPI is a safe and efficacious method of IOP reduction in comparison with standard shunt positioning in the anterior chamber. The intracameral tube position combined with SPI avoided tube-iris contact and corneal decompensation. Sulcus placement of aqueous shunts should be considered in pseudophakic eyes

New Tonopen XL: comparison with the Goldmann tonometer

PURPOSE: To compare the intraocular pressure (IOP) values obtained using a Goldmann tonometer (Haag-Streit) with those obtained with the new Tonopen XL (Mentor), which has certain differences compared with first- and second-generation models. METHODS: The IOPs of 104 patients were assessed by Goldmann tonometer and Tonopen XL tonometer. Goldmann measurements was done first in 145 eyes and Tonopen measurements were done first in 53 eyes. Four observers measured the IOP. Observers A, B and C used the Goldmann tonometer first and then the Tonopen XL, while observer D used the Tonopen XL first and then the Goldmann tonometer. The results were analysed by descriptive analysis and, when the distribution of the data was normal, paired t-test and Pearson's r coefficient were used to compare and correlate IOP measurements between Goldmann and Tonopen measurements. When the distribution of the data was non-normal, the Wilcoxon matched-pair test and Spearman coefficient were used. The agreement between Goldmann and Tonopen values was also calculated. ANOVA test was used to compare the difference obtained by 'Goldmann minus Tonopen' measurements among the three different observers. RESULTS: A statistically significant difference (p < 0.0001) was found between the IOP readings obtained by Goldmann tonometer and the Tonopen XL and a significant correlation was found between the Goldmann values and Tonopen XL values (p < 0.001). When the Goldmann IOP was more than 20 mmHg the Tonopen XL measurements were lower than the Goldmann values. Also in this group this difference was statistically significant. No significant difference was found between Goldmann values and Tonopen values among the three observers, even though a significant difference was found between Goldmann values and Tonopen values for observer B. When the values obtained by first the Goldmann tonometer and then the Tonopen XL were compared with those obtained by first the Tonopen XL and then the Goldmann tonometer, no significant difference was found between the two groups. CONCLUSION: The new Tonopen XL provides similar results to the Goldmann tomometer in 62% of the cases and was slightly less accurate than the Goldmann tonometer for extreme values, just like the previous Tonopen. Nevertheless the precision is good enough for the purpose of adequate screening