SUMMARY Forty-six eyes with chronic open-angle glaucoma (COAG) and 24 eyes which had previously undergone trabeculectomy for COAG were studied and the postural reponse of the intraocular pressure compared with that of 70 normal eyes. In all three groups the greatest rise in intraocular pressure (1OP) occurred when the subject changed from the sitting to the lying position. In the control group this was never more than 2 mmHg in any subject. The rise was greater than 2 mmHg in 93% of the patients suffering from COAG who were treated medically and in 100% of the eyes of those on which trabeculectomy had been performed. The well recognised abnormal postural response of intraocular pressure in COAG appears both to be retained and to be unaffected in those eyes which have undergone trabeculectomy.An abnormal postural response of the intraocular pressure (1OP) is well known in patients with chronic open-angle glaucoma (COAG)'3 and associated disorders such as retinal vein occlusion4 and ocular hypertension.6 An abnormal postural response of IOP in eyes which had suffered a traumatic hyphaema has also been described.7Trabeculectomy is a well established method of surgical treatment of COAG.8 We studied the postural intraocular pressure response in patients with COAG to determine whether or not an abnormal response was retained after this operation. Materials and methodsThirty-five patients attending for outpatient treatment of chronic open-angle glaucoma at Southampton Eye Hospital were examined. Twenty of these patients had received medical therapy only for control of their glaucoma. They had a mean age of 69-8 years (range 52 to 85 years), there being 11 males and nine females. The other 15 patients (seven males and eight females) had undergone a trabeculectomy operation within six years of the current examination, though no account was taken of the time elapsing between surgery and the examination. Nine of these 15 patients had undergone bilateral trabeculectomy and had a mean age of 70-6 years (range 52 to 81 years). The other six patients had undergone * Work undertaken during fourth year medical student elective.

Objectives Lycopene intake is associated with reduced risk of prostate cancer, especially lethal disease. Tangerine tomatoes contain highly bioavailable lycopene isomers, compared to red tomatoes, but impact of isomers on cancer preventive bioactivity are unknown.  Our goals are: (1) to determine if feeding tomato containing diets with differing lycopene isomers inhibit transgenic adenocarcinoma of the mouse prostate (TRAMP) carcinogenesis, and (2) to determine key early metabolic and transcriptional pathways through which tomatoes act to prevent carcinogenesis. Methods We examine prostate carcinogenesis in the TRAMP model, comparing two tomatoes with distinct lycopene isomer profiles: all-trans-lycopene-rich red tomatoes and cis-lycopene-isomer-rich tangerine tomatoes. Weanling TRAMP and wild type (WT) mice were fed AIN-93 G control, 10% tangerine tomato + AIN-93 G (w/w), or 10% red tomato + AIN-93 G (w/w) diet until 10 or 18 wks. At 10 wks., prostate RNA-seq and plasma metabolomics were performed on TRAMP and WT samples. At 18 wks., plasma carotenoid analysis and histopathology was performed on TRAMP mice. Results At 18 wks., plasma lycopene concentrations were 2.84-fold greater in tangerine tomato-fed mice than red tomato-fed mice (p < 0.0001), yet both red and tangerine tomato diets similarly prevent carcinoma incidence compared to the control diet by 43% and 36% respectively (p < 0.001, both vs. control). Our investigation of early carcinogenesis (10 wks.) shows that both tomato diets similarly impact the plasma metabolome, and we define prostate transcriptomic profiles mediated by TRAMP genotype, such as inflammation- and immune-regulated pathways, that are inhibited by dietary tomato. We identify an inflammatory gene panel (Olr1, Il1a, Cscl9, and Ccl22) which is inhibited by tomato diets. In a human prostate cancer database, higher expression of this gene panel is associated with a more aggressive phenotype. Conclusions Together, our results implicate red and tangerine tomatoes as potentially beneficial for the inhibition of early prostate carcinogenesis through the modulation of transcriptional programs centered on inflammation and the immune response. Our findings support efforts to test novel tomato products for the inhibition of human prostate carcinogenesis. Funding Sources AICR, NIH P30, USDA NNF.

SUMMARY Twenty patients with previous unilateral traumatic hyphaema and 25 age-matched controls were studied. There was a progressive rise in intraocular pressure when the patient changed from the standing to the sitting position and then to the lying position in both groups. No control eye showed a rise greater than 2 mmHg when the subject changed from sitting to lying. However, 14 (70%) of the injured eyes and 12 (60%) of the fellow eyes showed an exaggerated response. We suggest that the presence of an abnormal postural response may indicate a predisposition to post-traumatic glaucoma. Our findings are compatible with a linked control of postural intraocular pressure response between the two eyes.

Summary:A 22 year old man presented with a severe ischaemic diabetic retinopathy and, in spite of photocoagulation therapy, was blind in one eye 16 months after diagnosis. Four similar cases of aggressive diabetic retinopathy are reviewed. There is increasing evidence that a small group of young men with insulin dependent diabetes (IDD) may develop severe diabetic retinopathy at, or soon after, diagnosis.

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