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Steroid/antiinfective combinations have a number of advantages over the separate ingredients, but the possibility of complications has been a subject of concern. Based on data obtained from the files of eight pharmaceutical companies and the health registry records of the United Kingdom, Australia and New Zealand for the period 1964-1973, it is concluded that the statistical incidence of adverse reactions was no greater with the steroid/antiinfective combinations than with their separate ingredients. In addition, there was no increase in incidence of the reactions during the same period with combinations. These conclusions were borne out by adverse reaction data reported in the literature and in certain unpublished prospective clinical studies. It was not feasible to obtain data from ophthalmologists who may have observed adverse reactions, but not reported them. A critical evaluation by Dr. Philip Ellis follows the review.

The implanted cylinder model was used to measure LDH activity and lactate and pyruvate concentrations in the extracellular fluid of wounds and wound tissue. Total LDH activity corresponded directly to lactic acid concentration and inversely to oxygen availability. LDH isoenzymes in wound fluid were in an anaerobic pattern soon after injury and evolved toward the aerotic pattern as oxygen supply more nearly matched metabolic capacity. Lactate levels in the wound space are elevated soon after wounding and remain elevated far above those in blood. These data again indicate that wound metabolism is characterized by a relatively poor oxygen supply. Current data from several sources indicate that lactate found in the hypoxic area of the wound may stimulate collagen synthesis in fibroblasts lying in the high lactate environment. We postulate that elevated concentration of lactate in wounds is a major signal for collagen synthesis and repair.

A biomicroscopic method for evaluation of ocular and adnexal toxicity in the white rabbit has been developed. When compared to the Draize method, the biomicroscopic method demonstrates a greater spectrum of clinical signs allowing for better dose-response characteristics. This method was found to be both reproducible and easy to execute. The biomicroscopic method, by defining discrete anatomical entities, allows for a high degree of predictability as to severity of ocular and adnexal toxicity as well as the occurrence of permanent ocular injury.

Two independent, double-masked, controlled studies were made to evaluate the efficacy of calcium dobesilate for the treatment of nonproliferative diabetic retinopathy. Forty-two patients underwent a six-month crossover evaluation while receiving calcium dobesilate (750 mg per day) and placebo in random order. Thirty-six patients received calcium dobesilate (1,000 mg per day) or placebo for one year. Evaluation by clinical examination, fluorescein angiography, angiography, and fundus photography failed to demonstrate any beneficial effect of calcium dobesilate.