Evaluation of Aqueous Endocan and Endostatin Levels in Patients With Pseudoexfoliation Syndrome.

PURPOSE: The purpose of the present study was to evaluate the aqueous humor endocan and endostatin levels in patients with pseudoexfoliation (PEX) syndrome and to compare the results with healthy individuals. MATERIALS AND METHODS: Twenty nine cataract patients with PEX syndrome (PEX group) and 32 cataract patients without PEX syndrome (control group) were enrolled in the study. Endocan and endostatin were measured in the aqueous humor of the PEX and control groups by enzyme-linked immunosorbent assay. RESULTS: There was no difference between the PEX and control groups in terms of age (P=0.721) and sex (P=0.902). The aqueous levels of endocan in patients with PEX (26.39±5.80 pg/mL) was significantly higher than in the control group (11.42±2.44 pg/mL) (P=0.039). The aqueous levels of endostatin was 12.00±1.35 ng/mL in the PEX group and 14.22±3.31 ng/mL in the control group, however, the difference was not statistically significant (P=0.41). CONCLUSIONS: The findings of the present study could suggest that the increased levels of aqueous endocan may be related to pathogenesis of PEX. However, levels of aqueous endostatin did not show any significant difference in PEX.

N-acetylcysteine supplementation reduces oxidative stress for cytosine arabinoside in rat model.

Cytosine arabinoside (ARA-C) is a pyrimidine analog that may cause keratoconjunctivitis when used in high doses. The underlying mechanism may be the increased amounts of reactive oxygen radicals that may damage the DNA synthesis of corneal and conjunctival epithelial cells. Topical corticosteroids are one of the prophylactic treatments for keratoconjunctivitis induced by ARA-C. Forty Wistar-type albino rats were included in this study the rats were divided into four groups. The first group (Group 1) received only ARA-C, the second group (Group 2) received ARA-C and N-acetylcysteine (NAC), the third group (Group 3) received only NAC and the fourth group (Group 4) was the control group. The total oxidant status (TOS), the total antioxidant capacity and the oxidative stress index (OSI) measurements of the cornea and the conjunctiva were evaluated in these four groups. The mean TOS and OSI value was the highest in Group 1 and the lowest in Group 3. The differences in TOS and OSI values were statistically significant between Group 1 and Group 2. There are decreases in TOS and OSI values in rats which received ARA-C with NAC administration. NAC may have a protective effect on ARA-C-induced keratoconjunctivitis.

Oxidative stress of crystalline lens in rat menopausal model.

PURPOSE: To evaluate lenticular oxidative stress in rat menopausal models. METHODS: Forty Wistar female albino rats were included in this study. A total of thirty rats underwent oophorectomy to generate a menopausal model. Ten rats that did not undergo oophorectomy formed the control group (Group 1). From the rats that underwent oophorectomy, 10 formed the menopause control group (Group 2), 10 were administered a daily injection of methylprednisolone until the end of the study (Group 3), and the remaining 10 rats were administered intraperitoneal streptozocin to induce diabetes mellitus (Group 4). Total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI) measurements of the crystalline lenses were analyzed. RESULTS: The mean OSI was the lowest in group 1 and highest in group 4. Nevertheless, the difference between the groups was not statistically significant in terms of OSI (p >0.05). The mean TOS values were similar between the groups (p >0.05), whereas the mean TAC of group 1 was significantly higher than that of the other groups (p <0.001). CONCLUSIONS: Our results indicate that menopause may not promote cataract formation.

Retinal nerve fiber layer thickness and retinal vessel calibers in children with thalassemia minor.

OBJECTIVES: Evaluation of the peripapillary retinal nerve fiber layer thickness, subfoveal choroidal thickness, and retinal vessel caliber measurements in children with thalassemia minor. METHODS: In this cross-sectional and comparative study, 30 thalassemia minor patients and 36 controls were included. Heidelberg spectral domain optical coherence tomography was used for peripapillary retinal nerve fiber layer thickness, subfoveal choroidal thickness, and retinal vessel caliber measurements. RESULTS: There was no statistically significant difference in retinal nerve fiber layer thickness and subfoveal choroidal thickness between the two groups (p > 0.05). There was no correlation between retinal nerve fiber layer thickness and hemoglobin values. Both the arterioral and venular calibers were higher in thalassemia minor group (p < 0.05). CONCLUSION: There is increased retinal arterioral and venular calibers in children with thalassemia minor compared with controls.

Retinal Vessel Caliber, Choroidal Thickness and Ocular Pulse Amplitude Measurements in Essential Thrombocythemia.

PURPOSE: The choroid and retina receive most of the blood that enter to the eye, and this uptake may be affected by essential thrombocythemia (ET) in which thrombosis and hemorrhage is common. This study compares choroidal thickness, retinal vascular caliber, and ocular pulse amplitude (OPA) measurements between patients with ET and healthy adults. MATERIALS AND METHODS: Thirty-seven patients with ET and 37 age-sex-matched healthy adults were recruited in this cross-sectional and comparative study. Spectral-domain optical coherence tomography was used to measure the subfoveal choroidal thickness (SFCT) and retinal vascular caliber measurements. The Pascal dynamic contour tonometer was used for OPA and intraocular pressure (IOP) measurements. The independent samples t-test was used for comparison of measurements between the groups. Pearson's correlation coefficient analysis was used to detect correlations between the variables. A P < 0.05 was statistically significant. RESULTS: SFCT, OPA, and IOP measurements were not statistically significant differences between the study group and the control group (P > 0.05, all comparisons). Blood platelet counts were not associated with choroidal thickness, OPA, and IOP (P > 0.05). Retinal arteriolar and venular calibers were statistically, significantly thicker in healthy controls when compared to the study group (P < 0.05). CONCLUSIONS: Our results indicate that choroidal thickness and pulsatile blood flow are not significantly affected in ET and under high blood platelet counts. Retinal arteriolar and venular calibers are thinner in ET when compared to age-sex matched healthy controls.

Relationship Between Subfoveal Choroidal Thickness, Ocular Pulse Amplitude, and Intraocular Pressure in Healthy Subjects.

PURPOSE: To investigate the correlation between subfoveal choroidal thickness (SFCT), ocular pulse amplitude (OPA), and intraocular pressure (IOP) in healthy individuals. METHODS: In total, 106 eyes of 106 healthy adult participants were included in this cross-sectional study. Spectral-domain optical coherence tomography was used to measure the SFCT. OPA and IOP were measured with the Pascal dynamic contour tonometer. The Pearson correlation test was performed to examine the relationship between SFCT, OPA, and IOP. RESULTS: When age, sex, and body mass index (BMI) were controlled separately, a weak correlation occurred between SFCT and OPA (age controlled, r=0.20; sex controlled, r=0.19; BMI controlled, r=0.13). SFCT and OPA were fairly correlated in older age (r=0.33, P=0.02) and low BMI (r=0.33, P=0.02). SFCT and IOP were not correlated statistically significantly (r=0.05, P=0.59). CONCLUSION: There is a weak correlation between SFCT and OPA in healthy individuals when age is controlled. The association becomes stronger in participants with low BMI. There is no relation between SFCT and IOP.

Density of the crystalline lens in obese and nonobese children.

PURPOSE: To compare crystalline lens density in obese and nonobese children. METHODS: A total of 40 obese (25 females) and 46 age-sex matched controls (26 females) were included in this prospective study. Children with ocular diseases (except for mild refractive errors), ocular trauma, or surgery and any systemic disorders, including diabetes, were excluded. Lens densitometry (LD), central corneal thickness (CCT), anterior chamber depth (ACD) and corneal volume (CV) were measured by Pentacam HR. RESULTS: Mean participant age was 12.0 ± 1.9 (range, 7.2-18 years) in the obese group and 11.7 ± 2.0 (range, 7.5-16.1 years) in the control group. The BMI was 29.9 ± 4.5 in the obese group and 18.7 ± 2.5 in the control group (P ≤ 0.05). The vertical, horizontal, and areal lens density measurements were higher in obese group than in controls (P ≤ 0.05). There was a positive correlation between BMI and vertical, horizontal, and areal lens density measurements. The difference in CCT, ACD, and CV was not statistically significant between groups (P ≥ 0.05). CONCLUSIONS: There is increased lens density in the obese children compared with controls. Pentacam HR may provide objective data about lens density in children.

Optical densitometric measurements of the cornea and lens in children with allergic rhinoconjunctivitis.

BACKGROUND: Our aim was to investigate the impact of allergic rhinoconjunctivitis on corneal and lenticular optical densitometry, pachymetry and anterior chamber depth in children. METHODS: Fifty-four patients who had allergic rhinoconjunctivitis (study group) and 54 age-matched healthy children (control group) were recruited in this cross-sectional and comparative study. Corneal and lenticular optical densitometry, pachymetry, corneal volume and anterior chamber depth measurements were taken with the Scheimpflug imaging system. RESULTS: The lens density and anterior chamber depth were similar between the groups (p > 0.05), while corneal density and thickness were significantly higher in the study group (p < 0.05). Although the corneal volume was higher in children with allergic rhinoconjunctivitis, the difference was not statistically significant (p = 0.07). CONCLUSIONS: The cornea is affected in allergic rhinoconjunctivitis in respect to optical density and thickness, while the anterior chamber and lens are not influenced.

An evaluation of ocular elasticity using real-time ultrasound elastography in primary open-angle glaucoma.

OBJECTIVE: The aim of this study was to compare sonoelastographic findings in the retina-choroid-sclera (RCS) complex and vitreous in glaucomatous and healthy eyes. METHODS: For this cross-sectional comparative study, 20 patients with primary open-angle glaucoma and 20 healthy volunteers were recruited. Ultrasound elastography measurements were taken with a sonographic scanner of the RCS complex, anterior vitreous (AV), posterior vitreous (PV), retrobulbar fat tissue (RFT), optic disc (OD) and optic nerve (ON) in each eye. RESULTS: The elasticity index of the RCS complex, RFT, OD, ON, AV and PV was similar in both groups (p > 0.05), although the AV/PV strain ratio in the group of patients with glaucoma was significantly higher (p = 0.04). CONCLUSION: Glaucoma increases the AV/PV strain ratio. In providing reproducible and consistent values, the real-time elastography (RTE) technique may be helpful in elucidating the mechanisms of glaucoma in some aspects. ADVANCES IN KNOWLEDGE: This study can help to evaluate the elasticity of the RCS complex and vitreous in glaucomatous eyes with RTE.

Ocular pulse amplitude and retina nerve fiber layer thickness in migraine patients without aura.

BACKGROUND: To evaluate the ocular pulse amplitude (OPA), the posterior pole asymmetry analysis (PPAA), the peripapillary retinal nerve fiber layer (RNFL) thickness, the ganglion cell layer (GCL) thickness, macular thickness and visual field testing in migraine patients without aura. METHODS: In this prospective, cross-sectional and comparative study 38 migraine patients and 44 age and sex matched controls were included. OPA was measured by dynamic contour tonometry (DCT), PPAA, RNFL, GCL and macular thickness were measured by Heidelberg Spectral Domain Optical Coherence Tomography (SD-OCT) and standard perimetry was performed using the Humphrey automated field analyzer. RESULTS: The difference in OPA was not statistically significant between the two groups (p ≥ 0.05). In the PPAA there was no significant difference between two hemispheres in each eye (p ≥ 0.05). The RNFL thickness was significantly reduced in the temporal and nasal superior sectors in the migraine group (p ≤ 0.05). The GCL and macular thickness measurements were thinner in migraine patients but the difference between groups was not statistically significant (p ≥ 0.05). There was no correlation between RNFL, GCL, macular thickness measurements and OPA values. There was no significant difference in the mean deviation (MD) and pattern standard deviation (PSD) between the two groups (p ≥ 0.05). CONCLUSIONS: Migraine patients without aura have normal OPA values, no significant asymmetry of the posterior pole and decreased peripapillary RNFL thickness in the temporal and nasal superior sectors compared with controls. These findings suggest that there is sectorial RNFL thinning in migraine patients without aura and pulsative choroidal blood flow may not be affected during the chronic course of disease.

Genetic Polymorphism of Manganese Superoxide Dismutase in Behçet's Disease.

OBJECTIVES: This study aims to investigate the genetic association between single nucleotide mutation in mitochondrial manganese superoxide dismutase and a Behçet's disease (BD) population by using molecular techniques. PATIENTS AND METHODS: Ninety-three BD patients (45 males, 48 females; mean age 33.15±8.99 years; range 17 to 65 years) and 125 controls (58 males, 67 females; mean age 28.33±7.31 years; range 18 to 62 years) were genotyped by polymerase chain reaction-restriction fragment length polymorphism method. The genotypic distributions in BD patients and controls were consistent with the Hardy-Weinberg equilibrium. RESULTS: Significant differences were observed between BD patients and controls in terms of genotypic distribution. Frequencies of alanine (Ala)/Ala, Ala/valine (Val), and Val/Val were 14.0% (n=13), 45.2% (n=42), and 40.9% (n=38) in BD patients and 21.6% (n=27), 53.6% (n=67), and 24.8% (n=31) in controls, respectively (p=0.033). CONCLUSION: The Val/Val genotype of the manganese superoxide dismutase gene is associated with the physiopathology of BD in a group of Turkish patients.

Corneal melanosis successfully treated using topical mitomycin-C and alcohol corneal epitheliectomy: a 3-year follow-up case report.

We report a case of primary acquired corneal melanosis without atypia associated with corneal haze in a patient with a history of limbal malignant melanoma and the effect of mitomycin-C. A 75-year-old woman with a history of limbal malignant melanoma presented with loss of vision in right eye. Corneal examination showed a patchy melanotic pigmentation with a central haze. Topical mitomycin-C improved visual acuity and corneal haze. However, the pigmented lesions persisted, and they were removed with alcohol corneal epitheliectomy. Histopathological examination demonstrated primary acquired melanosis without atypia. The lesions were successfully removed, and there were no recurrences during the follow-up period of 36 months. The association of conjunctival and corneal melanosis without atypia is a rare condition. In addition, co-existence of central corneal haze and melanosis may decrease visual acuity. Topical mitomycin-C and alcohol corneal epitheliectomy can be useful treatments in this condition.

Posterior pole asymmetry analysis and retinal thickness measurements in young relatives of glaucoma patients.

The presence of a family history of glaucoma is a known risk factor for primary open-angle glaucoma (POAG) in middle-aged and older individuals. In this study, our aim was to demonstrate possible early glaucomatous alterations in young first- and second-degree relatives of POAG patients by spectral-domain optical coherence tomography. A total of 104 participants (52 relatives of POAG patients and 52 healthy individuals) were recruited in this cross-sectional study. All the participants were between 17 years and 45 years of age. All eyes underwent testing with spectral-domain optical coherence tomography. Peripapillary retinal nerve fiber layer thickness, hemifield macular thickness, macular ganglion cell complex thickness, posterior pole asymmetry analysis, and retinal arteriolar caliber measurements were taken for comparison between the study and control groups. The mean peripapillary retinal nerve fiber layer thickness was 104.9 ± 8.8 µm in the study group and 105.6 ± 7.4 µm in the control group (p = 0.68). Although whole macular thickness measurements were higher in the control group when compared with the study group (p = 0.008), the macular ganglion cell complex thickness was similar in both groups (p = 0.87). The posterior pole asymmetry analysis revealed no statistically significant difference between the groups in the aspect of consecutive black squares (p = 0.79). The mean retinal arteriolar caliber was 85.9 ± 4.8 µm in the study group and 86.0 ± 5.0 µm in the control group (p = 0.90). In conclusion, young relatives of POAG patients do not show characteristic glaucomatous damage when compared with the controls.

Subfoveal Choroidal Thickness Is Associated with Blood Hematocrit Level.

PURPOSE: To compare subfoveal choroidal thickness (SFCT), retinal vessel caliber, and ocular pulse amplitude between treated polycythemia vera (PV) patients and healthy adults. METHODS: Forty patients with PV and 40 age- and sex-matched healthy controls were recruited for this cross-sectional study. Spectral-domain optical coherence tomography was used for SFCT and retinal vessel caliber measurements. The Pascal dynamic contour tonometer was used for ocular pulse amplitude measurements. The correlations of blood hematocrit levels with the studied ocular parameters were analyzed. RESULTS: There were no statistically significant differences between the PV patients and controls in SFCT, retinal vessel caliber, and ocular pulse amplitude (p > 0.05). SFCT was associated with hematocrit level in both PV patients and healthy adults (p < 0.05). CONCLUSIONS: Although SFCT, retinal vessel caliber, and ocular pulse amplitude parameters are similar in treated PV patients and healthy controls, SFCT is associated with hematocrit level.

Comparison of Anterior Segment Measurements With a Dual Scheimpflug Placido Corneal Topographer and a New Partial Coherence Interferometer in Keratoconic Eyes.

PURPOSE: To evaluate the repeatability and agreement of the anterior segment measurements obtained using the Galilei dual Scheimpflug analyzer (Galilei DSA; Ziemer) and Nidek AL Scan (Nidek CO, Aichi, Japan) biometry in keratoconic and normal eyes. METHODS: Three consecutive measurements were performed by the same examiner using both devices in 62 healthy and 88 keratoconic eyes. Central corneal thickness (CCT), anterior chamber depth, keratometry readings (K) [in flattest meridian (Kf), in steepest meridian (Ks), and mean (Km)], and white-to-white distance were evaluated. Repeatability was assessed by calculating the within-subject SD and coefficient of variation. The agreement between both devices was assessed using the Bland-Altman method. RESULTS: Both devices achieved excellent repeatability for all parameters in each group. The 95% limits of agreement (LoA) between both devices were also very narrow and acceptable for all parameters in normal corneas. However, the 95% LoA for agreement was large for CCT and measurements related to K (Kf, Ks, and Km) using both 2.4 and 3.3 mm in keratoconic eyes. In addition, compared with the Galilei DSA, K values of the Nidek AL Scan using a diameter of 3.3 mm showed slightly closer 95% LoA than those obtained using a diameter of 2.4 mm. CONCLUSIONS: In normal eyes, the Galilei DSA and Nidek AL Scan can be used interchangeably for anterior segment measurements. In keratoconic eyes, both devices yielded interchangeable anterior chamber depth and white-to-white distance measurements, whereas CCT and keratometry measurements showed clinically significant differences.

Evaluation of ocular elasticity in high myopia.

PURPOSE: Our aim was to evaluate the ultrasound (US) elastography of ocular and periocular structures in high myopia. METHODS: There were 20 eyes of 20 high myopic patients in the study group, whereas there were 20 eyes of 20 age- and sex-matched healthy participants in the control group. The eyes in the study group had myopia greater than -5.0 diopters and had axial length (AL) greater than 25.0 mm. The US elastography measurements were performed with the LOGIQ E9 Ultrasound Elastography. The elastography values of anterior vitreous, posterior vitreous (PV), retina-choroid-sclera complex (RCS), and retrobulbar fat tissue (RF) were measured in each eye. RESULTS: Anterior vitreous US elastography values were similar in both groups (p = 0.17), whereas PV is more elastic in high myopic eyes (p = 0.01). There was a moderate negative correlation between AL and RCS/RF elastography ratio (r = -0.35, p = 0.03) and a positive correlation between refractive error and RCS/RF elastography ratio (r = 0.36, p = 0.02). CONCLUSIONS: High myopia is associated with more elastic PV. Elasticity of posterior RCS increases as the AL increases.

Choroidal thickness and retinal vascular caliber correlations with internal carotid artery Doppler variables.

PURPOSE: Decreased retinal arteriolar caliber and increased retinal venular caliber have been associated with increased cardiovascular mortality. This study aimed to evaluate correlations of choroidal thickness and retinal vascular caliber measurements with internal carotid artery (ICA) Doppler ultrasound variables. METHODS: In this cross-sectional and observational study, 43 eyes and ICAs of 43 healthy volunteers were examined. Spectral domain optical coherence tomography was used to measure subfoveal choroidal thickness (SFCT) and retinal vascular caliber. The ICA Doppler ultrasonographic parameters were diameter, flow volume, peak-systolic velocity, end-diastolic velocity, resistance index (RI), and pulsatility index (PI). RESULTS: Negative correlations emerged between ICA RI and SFCT (p = 0.017, r = -0.36) as well as between ICA PI and retinal arteriolar caliber (p = 0.015, r = -0.37). A negative linear correlation appeared between ICA diameter and SFCT (p = 0.005, r = -0.42), although ICA diameter and flow volume showed no association with retinal vessel caliber (p > 0.05). CONCLUSIONS: Choroidal thickness is negatively correlated with ICA diameter and ICA RI, while retinal arteriolar caliber is inversely related with ICA PI in normal volunteers.