Background To study the epidemiology of ocular trauma requiring hospital admission in children under 18 years in age. Methods This retrospective cohort study included pediatric patients with ocular injuries at the Ophthalmology Department of the Clinical Hospital Centre, Split, Croatia, from 2000 to 2015, classified according to the Birmingham Eye Trauma Terminology. Results There were 353 children hospitalized, 82% of boys (mean age 11 years) and 18% of girls (mean age 10 years). The majority of traumas occurred in the outside environment (70%, n = 249), followed by occurrences at home (17%, n = 60), and at a school/nursery (8%, n = 28). Final visual acuity was 6/18 or better in 286 (96%) patients with closed globe injury and in 26 (49%) patients with open globe injury. Severe impairment of vision was found in 12 (4.4%) patients in the closed globe injury group and 26 (49%) patients in the open globe injury group. A statistically significant difference was found between final visual acuity and initial visual acuity in all patients (χ2 = 12.8; P < 0.001). Conclusion The majority of pediatric eye injuries are happening in the outside environment and are preventable. Implementation of well–established safety precautions would greatly reduce this source of visual disability in children.

Aim To determine if preoperative treatment with a topical non-steroidal anti-inflammatory drug (NSAID) lowers the concentration of intraocular interleukin (IL)-12 and the incidence of postoperative macular edema in patients with non-proliferative diabetic retinopathy undergoing cataract surgery.Methods A total of 55 patients were randomized to diclofenac (n = 27) or placebo (n = 28). Patients receiving diclofenac started preoperative treatment with 0.1% topical diclofenac four times a day 7 days before cataract surgery and the therapy was discontinued 30 days after surgery. Patients in the control group were administered placebo 7 days preoperatively and a standard postoperative therapy with 0.1% topical dexamethasone four times a day for 30 days after surgery. All patients received postoperative antibiotic prophylaxis with tobramycin eye drops four times daily for 30 days. Seven days before the cataract surgery, on the day of surgery, and 1, 7, 30, and 90 days after surgery, central foveal thickness (CFT) was measured with optical coherence tomography (OCT) and the aqueous humor was sampled at the beginning of cataract surgery for the analysis of IL-12 concentration. Due to loss to follow-up and insufficient aqueous humor samples, the data of 3 patients treated with diclofenac and 8 patients receiving placebo were not analyzed.Results The aqueous humor IL-12 concentration was significantly lower in the diclofenac group than in the placebo group (t = -2.85, p = 0.007). The diclofenac group had a significantly smaller increase in CFT after phacoemulsification (F = 13.57, p< 0.001).Conclusion Patients preoperatively treated with diclofenac had significantly lower intraocular levels of IL-12 and a lower increase in CFT, which indicates that a combination of preoperative and postoperative treatment with a topical NSAID may lower the incidence of postoperative macular edema in patients with diabetic retinopathy.

BACKGROUND:Eye development is a consequence of numerous epithelial-to-mesenchymal interactions between the prospective lens ectoderm, outpocketings of the forebrain forming optic vesicles, and surrounding mesenchyme. How different cell types forming eye structures differentiate from their precursors, and which factors coordinate complex human eye development remains largely unknown. Proper differentiation of photoreceptors is of special interest because of their involvement in the appearance of degenerative retinal diseases.METHODS:Here we analyze the spatiotemporal expression of neuronal markers nestin, protein gene product 9.5 (PGP9.5), and calcium binding protein (S100), proliferation marker (Ki-67), markers for cilia (alpha-tubulin), and cell stemness marker octamer-binding transcription factor 4 (Oct-4) in histological sections of 5-12 -week human eyes using immunohistochemical and immunofluorescence methods.RESULTS:While during the investigated developmental period nestin shows strong expression in all mesenchymal derivatives, lens, optic stalk and inner neuroblastic layer, PGP9.5 and S100 expression characterizes only neural derivatives (optic nerve and neural retina). PGP9.5 is co-localized with nestin and S100 in the differentiating cells of the inner neuroblastic layer. Initially strong proliferation in all parts of the developing eye gradually ceases, especially in the outer neuroblastic layer. Proliferating Ki-67 positive cells co-localize with nestin in the retina, lens, and choroid. Strong Oct-4 and alpha-tubulin immunoreactivity in the retina and optic nerve gradually decreases, while they co-localize in outer neuroblastic and nerve fiber layers.CONCLUSIONS:The described expression of investigated markers indicates their importance in eye growth and morphogenesis, while their spatially and temporally restricted pattern coincides with differentiation of initially immature cells into specific retinal cell lineages. Alterations in their spatiotemporal interplay might lead to disturbances of visual function.