In a double-blind randomized clinical trial, 79 non-insulin-dependent diabetic subjects with early retinopathy and open-angle glaucoma received orally either three 500-mg capsules of Doxium® (calcium dobesilate) daily for 6 months (41 patients) or three placebo capsules daily for the same period (38 patients). At the end of the study statistically significant differences in the Doxium group compared with the placebo group were recorded: intraocular pressure, visual field defects, surface area of retinal hemorrhages, and whole blood and plasma viscosity were reduced (p < 0.001). Coefficient of outflow facility and serum albumin concentration were increased (p < 0.001 and p < 0.02, respectively). These results suggest that increased whole blood viscosity is a risk factor for diabetic retinopathy and for glaucomatous optic nerve damage. They further suggest that Doxium reduces blood hyperviscosity and lowers intraocular pressure, with a beneficial effect on retinal state and visual fields.

50 patients with diabetes mellitus of 2–7 years’ duration were divided by a random method into 2 equal groups, one of which received 1,500 mg of Doxium (calcium dobesilate) daily for 3 months, the other group receiving a placebo. All the patients had diabetic retinopathy, open-angle glaucoma, raised intraocular pressure, and hyperviscosity of whole blood, plasma, and aqueous humor. 10 patients in each group underwent operation for glaucoma. At the end of the trial the state of the retina, the visual acuity, and the visual fields had improved, and the intraocular pressure and the 3 viscosity values had fallen to a statistically significant extent in the Doxium group compared with the initial status and with the placebo group. These results are consistent with Doxium’s known action in reducing capillary fragility, microvascular hyperpermeability, and blood viscosity.

Age-related macular degeneration (AMD) is characterized by irreversible damage of photoreceptors in the central posterior part of the retina, called the macula and is the most common cause of vision loss in those aged over 50. A growing body of evidence shows that cumulative long-term exposure to UV radiation may be harmful to the retina and possibly leads to AMD irrespective of age. In spite of many research efforts, cellular and molecular mechanisms leading to UV-induced retinal damage and possibly retinal diseases such as AMD are not completely understood. In the present study we explored damage mechanisms accounting for UV-induced retinal phototoxicity in the rats exposed to UVA and UVB irradiation using a proteomics approach. Our study showed that UV irradiation induces profound changes in the retinal proteomes of the rats associated with the disruption of energy homeostasis, oxidative stress, DNA damage response and structural and functional impairments of the interphotoreceptor matrix components and their cell surface receptors such as galectins. Two small leucine-rich proteoglycans, biglycan and lumican, were identified as phototoxicity biomarkers associated with UV-induced disruption of interphotoreceptor matrix (IPM). In addition, UVB induced activation of Src kinase, which could account for cytoskeletal rearrangements in the retina was observed at the proteomics level. Pharmacological intervention either to target Src kinase with the aim of preventing cytoskeletal rearrangements in the retinal pigment epithelium (RPE) and neuronal retina or to help rebuild damaged IPM may provide fresh avenues of treatment for patients suffering from AMD.

A case of a 9-year-old boy with a transorbital toy-arrow injury to the brain is presented. At admission he was in coma (Glasgow Coma Scale of 6) with right hemiparesis and had a completely prolapsed left eye. Computerized tomography revealed intracranial haemorrhage and fracture of the orbital wall, which were treated conservatively. His left eye was enucleated due to massive injury. At the 6-month check-up the boy still show neurological signs of latent right hemiparesis. Disturbances, mostly cognitive, were noted on his psychological tests. A survey of the literature reveals no report of this nature in the paediatric age group. The necessity of continuous monitoring of new environmental risks as they occur, and the requirement for the prevention of recreational brain injuries in children, is stressed.

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