Aims. To assess the association of blood oxygen-transport capacity variables with the prevalence of diabetic retinopathy (DR), retinal ischemia, and macular oedema in patients with type 2 diabetes mellitus (T2DM). Methods. Cross-sectional, case-control study (N = 312) with T2DM: 153 individuals with DR and 159 individuals with no DR. Participants were classified according to the severity of DR and the presence of retinal ischemia or macular oedema. Hematological variables were collected by standardized methods. Three logistic models were adjusted to ascertain the association between hematologic variables with the severity of DR and the presence of retinal ischemia or macular oedema. Results. Individuals with severe DR showed significantly lower hemoglobin, hematocrit, and erythrocyte levels compared with those with mild disease and in individuals with retinal ischemia and macular oedema compared with those without these disorders. Hemoglobin was the only factor that showed a significant inverse association with the severity of DR [beta-coefficient = −0.52, P value = 0.003] and retinal ischemia [beta-coefficient = −0.49, P value = 0.001]. Lower erythrocyte level showed a marginally significant association with macular oedema [beta-coefficient = −0.86, P value = 0.055]. Conclusions. In patients with DR, low blood oxygen-transport capacity was associated with more severe DR and the presence of retinal ischemia. Low hemoglobin levels may have a key role in the development and progression of DR.

A 30-year-old male suffered an orbital trauma due to a traffic accident. At the Emergency Unit, the patient presented with avulsion of the upper left eyelid in the medial canthus, wounds in the lower eyelid and the inferior canaliculus, conjunctival laceration, proptosis and palpebral hematomas. The patient reported persistent diplopia. During the examination, exotropia and total absence of adduction were observed. Computerized tomography (CT) revealed a discontinuity at the left medial rectus. No orbital fractures were identifiable. The medial rectus was still attached to its anatomic insertion at the globe. The discontinuity was suggestive of laceration or rupture of this muscle at approximately 10-12 mm from its insertion. Surgical exploration revealed total rupture of the medial rectus at approximately 12 mm from its insertion. The posterior edge of the damaged muscle was found and sutured to its anterior edge with 6-0 polyglactin. The following day, the eyes were completely straight and the patient did not mention any signs of diplopia. Botulinum toxin injection into the ipsilateral lateral rectus was not necessary. After six months of follow-up, the patient still reported no diplopia. When muscular laceration is suspected after an orbital trauma, early CT is recommended. The only procedures that assure a significant recovery of the normal function of the eye are early muscle repair and avoidance, if possible, of transposition surgery.

Recurrence of duodenal Whipple disease may be associated with an OI picture that is immmunologically mediated.

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