Background: In patients with type 2 diabetes mellitus, the development of diabetic retinopathy (DR) correlates positively with elevated serum chemerin levels. This study was aimed at investigating the probable association between the serum chemerin level and the development of DR in patients with type 1 diabetes mellitus (T1DM). Methods: In this cross-sectional study, we included Egyptians and classified them into four groups: group 1, including healthy individuals; group 2, including patients with T1DM without DR; group 3, including patients with T1DM with non-proliferative DR (NPDR); and group 4, including patients with T1DM with proliferative DR (PDR). The assessment included best-corrected distance visual acuity assessment, slit-lamp biomicroscopy, funduscopy, fundus fluorescein angiography, and macular ocular coherence tomography. Fasting blood samples were obtained from all participants to measure serum chemerin, glycated hemoglobin (HbA1c), total cholesterol, triglyceride, and creatinine levels. Serum chemerin levels were compared among the groups, and their correlations with age, duration of diabetes, HbA1c, total cholesterol, triglyceride, and creatinine levels were analyzed. Results: We recruited 209 participants, including 46 healthy individuals in group 1, 52 patients (T1DM and no DR) in group 2, 61 patients (T1DM and NPDR) in group 3, and 50 patients (T1DM and PDR) in group 4, with comparable mean ages and sex ratios among groups. The diabetes duration, body mass index, HbA1c, total cholesterol, triglyceride, and serum chemerin levels differed significantly among the groups (all P < 0.001), whereas the creatinine level did not (P > 0.05). The serum chemerin level was significantly higher in group 4 than in groups 3 and 2, in group 3 than in group 2, and in groups 3 and 4 than in group 1 (all P < 0.001). However, it was comparable between groups 1 and 2 (P > 0.05). It correlated with the duration of T1DM and HbA1c, total cholesterol, triglyceride, and creatinine levels but not with age. Conclusions: Patients with T1DM with DR showed higher serum chemerin levels than those with T1DM without DR or healthy individuals. Serum chemerin levels were higher in those with PDR than in those with NPDR. Thus, serum chemerin levels are a potential biomarker of the development and severity of DR in patients with T1DM. Nevertheless, future diagnostic accuracy studies are required to confirm these potential applications.

AIM: The purpose of the study was to study the effect of implantation method and fluid load (aspiration time, aspiration volume) on corneal endothelium in uneventful phacoemulsification surgeries. METHODS: This study was a prospective and interventional study involved 77 eyes, 50−81 years, divided into three groups according to implantation method (on Saline, Healon, or Methylcellulose). Specular microscope analysis of corneal endothelial parameters: Cell density (CD), central corneal thickness (CCT), coefficient of variation (CV), and Hexagonality (HEX) were done before and 3 months after surgery. RESULTS: A total of 77 eyes with cataracts were studied, and there was a significant increase in CCT and CV with a decrease in CD and HEX in all three groups. On comparing the same parameters between the three groups, there were insignificant differences regarding CCT and HEX changes. Although there was a significant change in CD, the highest loss was in the Healon group (median −0.138), followed by the Saline group (median −0.118), and the lowest was in the Methyl group (median −0.075). There was a significant change in CV, showing the highest increase in the Healon group (median 0.16129) followed by the Saline group (median 0.13307) and the lowest in the Methyl group (median 0.1266). There was a non-significant change in all corneal parameters among cases in each group with different aspiration volumes and times. CONCLUSION: Endothelial cell loss was lowest with Methyl followed by saline, and highest with Healon implantation. Fluidics had an insignificant effect in the three groups. Saline implantation was comparable to Healon, with an insignificant difference in CD loss.

BACKGROUND: Branch retinal vein occlusion (BRVO) has an incidence of 0.5–1.2%. COVID-19 is associated with both venous and arterial thromboembolisms due to excessive inflammation, hypoxia, immobilization, and diffuse intravascular coagulation. AIM: The present study aims to describe our experience with BRVO in Egyptian COVID-19 patients. PATIENTS AND METHODS: The present retrospective study included 17 polymerase chain reaction (PCR)-proven COVID-19 patients with BRVO. Data obtained from the studied patients included detailed history taking. In addition, patients were diagnosed with BRVO based on a comprehensive ophthalmic evaluation, including logMAR Best-corrected visual acuity assessment, slit-lamp bio-microscopy, fundoscopy, fundus fluorescein angiography, and optical coherence tomography macular assessment. RESULTS: The present study included 17 PCR-proven COVID-19 patients with BRVO. They comprised 9 males (52.9%) and 8 females (47.1%) with an age of 52.8 ± 13.3 years. Fundus examination revealed BRVO as superior temporal in 9 patients (52.9%), inferior temporal in 5 patients (29.4%), superior nasal in 2 patients (11.8%), and inferior nasal in 1 patient (5.9%). The reported retinal thickness was 355.7 ± 41.7 μm. In addition, fundus fluorescein angiography identified ischemic changes in 2 patients (11.8%). CONCLUSION: BRVO is a rare severe complication of COVID-19 infection. In patients with proven or suspected infection with a diminution of vision, there should be high suspicion of BRVO and prompt full-scale ophthalmological examination to exclude the condition.

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