Comparing the effects of serum GPER-1 and oxidant/antioxidant levels on retinopathy in patients with diabetes and healthy individuals: a pilot study.

PURPOSE: This study aimed to determine the effect of serum G receptor-mediated protein-1 levels on the development of retinopathy in patients with diabetes in comparison with healthy individuals. METHODS: The study enrolled patients with diabetic retinopathy (Group 1), patients without diabetic retinopathy (Group 2), and healthy individuals (Group 3). Levels of serum progesterone, serum G receptor-mediated protein-1, estradiol, oxidant/antioxidants, and thyroid-releasing hormones were analyzed and compared among the groups. Post-hoc analysis was performed to compare the subgroups in which significant differences were found. RESULTS: Groups 1, 2, and 3 each included 40 patients. A significant difference was found among all groups in terms of serum G receptor-mediated protein-1, oxidant/antioxidant, and estradiol levels (p<0.01), but no significant difference was found in terms of thyroid-releasing hormone or progesterone (p=0.496, p=0.220, respectively). In the post-hoc analysis of the groups with significant differences, another significant difference was found among all groups for serum G receptor-mediated protein-1 and oxidant/antioxidant levels (p<0.05). Serum G receptor-mediated protein-1 and oxidant levels were positively correlated, whereas serum G receptor-mediated protein-1 and antioxidant levels were negatively correlated (r=0.622/p<0.01, r=0.453/p<0.01, r=0.460/p<0.01, respectively). The multiple regression analysis showed that increased levels of serum G receptor-mediated protein-1 may help prevent diabetic retinopathy. CONCLUSIONS: Serum G receptor-mediated protein-1 levels, which were the highest in the diabetic retinopathy Group, increased as the oxidant/antioxidant balance changed in favor of oxidative stress. This appears to be a defense mechanism for preventing neuronal damage.

Retinopathy of prematurity incidence and treatment modalities in moderate and late preterm infants: a study from two tertiary centers.

OBJECTIVE: The aim of this study was to evaluate the incidence, severity, and treatment modalities of retinopathy of prematurity (ROP) in moderate and late preterm infants with a gestational age (GA) >31 + 6 weeks. METHODS: ROP screening results of preterm infants with GA >31 + 6 weeks to 36 + 6 weeks between March 2013 and January 2019 were evaluated retrospectively. Infants were divided into 2 groups according to GA as 32-33 + 6 weeks (moderate preterm) and 34-36 + 6 weeks (late preterm). In these groups, any ROP and severe ROP (requiring treatment) development rates and ROP types and treatment modalities were evaluated. RESULTS: A total of 4156 preterm infants, 1875 (45.1%) female and 2281 (54.9%) male, were included. Overall, 1466 (35.2%) of the infants were moderate preterm and 2690 (64.8%) were late preterm. The incidences of any ROP and severe ROP were 22% and 2.5%, respectively. The rate of severe ROP was 5.3% in moderate preterm infants and 0.9% in late preterm infants. Significant correlations were determined between duration of hospital stay, birth weight (BW), and GA with ROP development (r = +0.415, r = -0.258, r = -0.199, respectively; p < 0.001 for all). Of 102 patients (2.5%) requiring treatment, 64 (62.7%) had laser, 34 (33.3%) had intravitreal bevacizumab (IVB), 2 (1.9%) had sequential IVB and laser, and 2 (1.9%) had vitreoretinal surgery. CONCLUSION: ROP seems to still be an important health problem in moderate and late preterm infants in our country according to data from screening high-risk preterm infants with a GA >31 + 6 weeks. In this cohort, ROP development correlates with GA, BW, and duration of hospitalization significantly.

The results of intravitreal bevacizumab monotherapy for treating aggressive posterior retinopathy of prematurity and Type 1 retinopathy of prematurity.

OBJECTIVES: This study evaluated the efficacy of intravitreal bevacizumab (IVB) monotherapy for aggressive posterior retinopathy of prematurity (APROP) and Type 1 retinopathy of prematurity (ROP), along with recurrence rates and treatment outcomes for recurrences. METHODS: This retrospective cohort study reviewed the records of infants with ROP (Type 1 and APROP), who received IVB treatment between March 2013 and February 2018. RESULTS: A total of 257 eyes from 130 cases (unilateral eyes in three cases) were included. Cases were followed for 121.7 ± 45.7 weeks (range: 70-260 weeks). Recurrence requiring treatment was determined in 14.8% of all eyes at a mean of 9.6 ± 2.7 weeks (range: 6-15 weeks) after initial treatment and a mean of 42.3 ± 2.2 weeks (range: 38-48 weeks) postmenstrual age. Recurrence requiring treatment was observed in 20.8% of APROP and 5.8% of Type 1 ROP eyes at a statistically significant difference (p = 0.001). Persistent avascular areas were found in 54 eyes (25.8%) at the corrected age of 1 year, and prophylactic laser treatment was applied. This was statistically significantly higher in APROP (38.6%) than in Type 1 ROP (10.5%) (p < 0.001). An unfavourable structural outcome (progression to retinal detachment) occurred in one eye (0.4%), which developed insufficient regression and progression. CONCLUSIONS: IVB monotherapy is effective for APROP and Type 1 ROP with Zone 1 and posterior Zone 2 localisation. However, because of recurrences requiring treatment and persistent peripheral avascular areas, severe, late complications must be considered, and follow-up examinations must be made. Prophylactic laser treatment for persistent avascular areas seems effective for minimising long-term complications.

Evaluation of Macular Microcirculation in Healthy Children Using Optical Coherence Tomography Angiography.

OBJECTIVES: This study was designed to evaluate macular perfusion in a healthy pediatric population using optical coherence tomography angiography (OCTA). METHODS: Fifty-three eyes of 30 healthy children (20 boys and 10 girls) were included in this prospective, cross-sectional study. Age, gender, foveal thickness (FT), superficial foveal avascular zone area (FAZs), deep foveal avascular zone area (FAZd), superficial capillary plexus flow area (SCP), deep capillary plexus flow area (DCP), choriocapillaris flow area (CC), vascular density in the SCP (VDs), vascular density in the DCP (VDd), and subfoveal choroidal thickness (SFCT) were evaluated. RESULTS: The mean age was 12.0±4.0 years (range: 6-15 years). Gender did not have a statistically significant influence on the FAZs or FAZd. However, there was a positive correlation between the CC and age (r=0.31; p=0.025). The FAZs and FAZd were negatively correlated with the FT (p<0.001). The VDd was positively correlated with the FT (p=0.03) and was negatively correlated with the FAZd (p=0.019). CONCLUSION: The present study determined normative data of OCTA parameters in healthy children and provides useful insight into the relationship between age, macular microvascular networks, and the FAZ.

Red cell distribution width and its association with retinopathy of prematurity.

OBJECTIVE: The aim of this study was to evaluate whether there is a relationship between red cell distribution width (RDW) values and the development of retinopathy of prematurity (ROP) in premature infants. METHODS: This retrospective study was conducted on a total of 159 infants with gestational age (GA) < 35 weeks including 77 infants diagnosed as ROP (patients' group) and 82 infants without ROP (control group) between September 2015 and January 2018. RDW values of the preterm infants were obtained from their medical records (routine postpartum cord blood sample and follow-up venous blood samples taken at first week, second week and first month). The possible relationship between RDW values and clinical features of ROP development was evaluated. RESULTS: The mean GA of all infants was 29.2 ± 2.4 (24-35) weeks, and the mean birth weight was 1268 ± 419 (550-2500) g. The RDW values measured in the first and the second weeks were significantly higher in infants with ROP compared with those wihout ROP (p < .001 for both). There was no statistically significant difference between the groups in terms of cord blood and first month RDW values (p = .719, p = .108, respectively). The first and second week's RDW values of infants with ROP requiring treatment (severe ROP) were significantly higher than those of infants with ROP not requiring treatment (mild ROP) (p = .005, p = .031, respectively), but no statistically significant difference was observed between the groups in terms of cord blood and first month values (p = .114 and p = .371, respectively). CONCLUSION: RDW is an easily accessible and inexpensive marker that may reflect the clinical risk factors for ROP. Follow-up measures of RDW have the potential to help clinicians for the prediction of ROP development in the first 2 weeks postnatally.

Evaluation of the effect of fasting on intraocular pressure, anterior segment parameters and density of crystalline lens and cornea.

PURPOSE: To evaluate the effect of fasting on anterior chamber depth, anterior chamber volume and corneal and lens density by Scheimpflug technology and to measure intraocular pressure changes. METHODS: Totals of 50 healthy fasting individuals in Ramadan (study group) and 50 healthy non-fasting subjects (control group) were included. Central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), corneal density (CD) and lens density (LD) were evaluated with Scheimpflug technology. Intraocular pressure (IOP) was measured with applanation tonometry. Both eyes of each participant were examined and also compared. RESULTS: Comparison of groups: There was a statistically significant difference between CD, ACD, ACV and IOP (respectively, right/left eye: fasting: CD: 12.81 ± 0.76/12.73 ± 0.73; ACD: 2.92 ± 0.37 mm/2.93 ± 0.37 mm; ACV: 168.3 ± 41.82 mm3/183.34 ± 32.46 mm3; IOP: 13.80 ± 1.22 mmHg/14.88 ± 2.73 mmHg; non-fasting: CD: 13.28 ± 1.01/13.17 ± 0.77; ACD: 3.06 ± 0.31 mm/3.07 ± 0.31 mm; ACV: 167.46 ± 42.92 mm3/180.68 ± 31.45 mm3; IOP: 13.60 ± 1.65 mmHg/14.74 ± 2.93 mmHg) values on the right side (p < 0.01, p = 0.03, p = 0.04, p = 0.01, respectively). Although there was a statistically significant difference between the ACV, CD and IOP values on the left side (p < 0.01, p = 0.03, p = 0.01, respectively), no statistical significance was found for the ACV value on the left side (p = 0.08). CONCLUSION: The results demonstrated that, while fasting did not lead to any change in LD and CCT, it caused a small decrease in ACD and ACV, and a significant decrease in CD and IOP values. Scheimpflug technology seems to be a valuable tool for the evaluation of anterior segment changes in patients who are fasting.

Evaluation of the effect of smokeless tobacco (Maras powder) on choroidal and retinal blood flow: an optical coherence tomography angiography study.

ABSRTACT: PURPOSE: To investigate the acute and chronic effects of the use of smokeless tobacco (Maras powder) on macular and choroidal blood flow, via optical coherence tomography angiography (OCTA). METHODS: The study included 30 eyes of 30 patients using smokeless tobacco (ST) as the study group and 30 eyes of 30 healthy individuals as the control group. All subjects underwent a full ophthalmological examination, and baseline OCTA measurements were taken. Flow area in superficial capillary plexus (SCP), in deep capillary plexus (DCP), in choriocapillaris (mm2) and mean vascular density (VD) and foveal avascular zone in SCP and in DCP were assessed. Subfoveal choroidal thickness (SFCT) and central macular thickness were measured as well. RESULTS: The SFCT measurements were determined to be significantly low in the study group (p < 0.001). In the comparison of the study group measurements at 5 m, 30 m and 1 h after using ST compared to the baseline measurements, SCP and DCP flow area, VD, CC flow area and SFCT were determined to have significantly decreased, statistically (p < 0.001). CONCLUSION: OCTA could be important in showing that choroidal microvascular structures have been affected before occurence of the apparent clinical signs associated with acute and chronic ST use.

Quantitative assessment of the effect of fasting on macular microcirculation: an optical coherence tomography angiography study.

AIM: To analyse the effect of fasting on the retinal vascular plexus and choriocapillaris structures in healthy subjects via Optical Coherence Tomography Angiography (OCTA). METHODS: In this prospective study, OCTA scans of 98 eyes in 49 healthy subjects were compared in fasting and non-fasting period. All cases had a full ophthalmological examination, with OCTA parameters measured, including superficial flow area (SCP) (mm2), deep flow area (DCP) (mm2), choriocapillaris flow area (CC) (mm2), superficial and deep vascular density (SVD and DVD, respectively) (%), superficial foveal avascular zone area (FAZs) (mm2), deep foveal avascular zone area (FAZd) (mm2), subfoveal choroidal thickness (SFCT) (µm) and central macular thickness (CMT) (µm). RESULTS: The mean SCP, DCP and CC flow area values were induced to be significantly lower in a fasting than a non-fasting period (p<0.001, p<0.001, p=0.049, respectively). The mean VD in a fasting period was statistically significantly lower than in a non-fasting period at the SCP level (p=0.009). No statistically significant difference was found between the two periods in respect to DVD, FAZd and CMT (p=0.068, p=0.653 and p=0.531, respectively); however, FAZs were significantly lower in a non-fasting than fasting period (p=0.038). The SFCT was determined to be statistically significant and thicker during a fasting period (p<0.001). CONCLUSION: The current study documented several physiological changes in a fasting period, such as changes in SCP, DCP, CC flow, SVD and DVD, via OCTA.

Quantitative analysis of retinal microcirculation in optical coherence tomography angiography in cases with Behçet's disease without ocular involvement.

PURPOSE: To evaluate the retinal vascular plexus and choriocapillaris structures in patients with non-ocular Behçet's disease (BD) using optical coherence tomography angiography (OCTA). METHODS: The study included 42 eyes of non-ocular BD patients (study group) and 40 eyes of 20 healthy subjects (control group). Flow area (mm2), mean vascular density (VD) (%) and foveal avascular zone (FAZ) (mm2) were measured using OCTA (Optovue Inc., Fremont, CA, USA). Subfoveal choroidal thickness (CT) (µm) and central macular thickness (CMT) (µm) measurements were also performed. RESULTS: The mean superficial capillary plexus, deep capillary plexus and choriocapillaris flow area values were found to be significantly lower in the study group than in the control group (p < 0.001, p < 0.001, p = 0.008, respectively). In respect of mean VD, a statistically significant difference was determined between the study and control groups in both superficial and deep VD (p < 0.001). No statistically significant difference was found out between the groups in respect of superficial FAZ, deep FAZ and CMT (p = 0.165, p = 0.477, p = 0.457, respectively). The subfoveal CT was also measured to be significantly thicker in the study group than in the control group (p < 0.001). CONCLUSION: The results obtained with OCTA revealed that there could be both retinal and choroidal involvement in non-ocular BD patients before the emergence of evident clinical findings.

Density of crystalline lens and cornea in different trimesters of pregnancy.

PURPOSE: To evaluate topographic measurements of the anterior segment and densitometric measurements of the cornea and lens by Pentacam HR in different trimesters of pregnancy. METHODS: This prospective study included 150 healthy pregnant women in their first, second, or third trimester (Groups 1, 2 and 3, respectively) and 54 non-pregnant healthy women (Group 0). Topographic measurements, including central corneal thickness (CCT), corneal volume (CV), anterior chamber depth (ACD), corneal densitometry (CD) and lens densitometry (LD), were done with the Pentacam HR (Oculus, Wetzlar, Germany). The measurement results of the healthy pregnant women and non-pregnant healthy women were compared. RESULTS: CD values were found in Group 1 to be 13.19, in Group 2 to be 13.16, in Group 3 to be 13.17 and in Group 0 to be 13.22 (p = 0.811). The mean Group 1, Group 2, Group 3 and Group 0 LD-horizontal was 5.40 ± 0.5, 5.47 ± 0.38, 5.53 ± 0.44, 5.36 ± 0.43, respectively. The mean Group 1, Group 2, Group 3 and Group 0 LD-vertical was 5.6 ± 0.43, 5.66 ± 0.32, 5.71 ± 0.40 and 5.5 ± 0.44, respectively. Area LD values were higher in the advanced trimester period, and the only statistically significant difference was between Group 3 and Group 0 (p = 0.025). The difference between three-dimensional (3D) and peak LD values was not statistically significant between the groups (p = 0.89 and p = 0.91, respectively). DISCUSSION: The Pentacam HR seems to be an important option for the evaluation of LD, CD and topographic measurements of the anterior segment in pregnancy. In the present study, CD and LD, including LD-horizontal, LD-vertical, peak and 3D values, were not significantly different between pregnant women and non-pregnant women.

Syrian Civil-War-Related Intraocular Foreign Body Injuries: A Four-Year Retrospective Analysis.

PURPOSE: To analyze the data of patients who underwent vitreoretinal surgery due to intraocular foreign body (IOFB) injuries that occurred in the Syrian civil war. METHODS: Seventy-eight eyes of 78 patients who underwent vitreoretinal surgery due to IOFB injuries that occurred during the Syrian civil war were analyzed. RESULTS: Forty-four eyes (56.4%) had traumatic cataract, 44 (56.4%) had retinal tears, 42 (53.8%) had vitreous hemorrhage, 18 (23%) had retinal detachment, 12 (15.3%) had endophthalmitis, and eight eyes had hyphema (10.2%). IOFBs consisted of metal in 62 eyes (79.4%), stone in eight eyes (10.2%), organic material in four eyes (5.1%), and glass in four eyes (5.1%). Approximately 86% of the eyes had initial VAs of 4/200 or worse. However, VAs improved in 64 eyes (82%) after the surgeries. CONCLUSIONS: Despite delays in treatment and the severity of injuries, 82% (64/78) of the eyes had an improvement in VA after the surgeries.

The Process of Retinal Vascularization after Anti-VEGF Treatment in Retinopathy of Prematurity: A Comparison Study between Ranibizumab and Bevacizumab.

PURPOSE: To compare the effects on the process of retinal vascularization of intravitreal ranibizumab (IVR) and intravitreal bevacizumab (IVB) in the treatment of severe retinopathy of prematurity. METHODS: The present study is a bi-centered retrospective study. While 44 eyes of 22 patients in group 1 were applied 0.625 mg bevacizumab, 46 eyes of 23 patients in group 2 were applied 0.25 mg ranibizumab. Retinal vascularization was evaluated clinically. RESULTS: The mean time for completion of vascularization was found to be postmenstrual 55.93 ± 4.13 weeks in group 1 and 56.30 ± 4.30 weeks in group 2. There were significant differences in the recurrence prevalence between the two groups. The prevalence of recurrence was found to be significantly higher in the ranibizumab group than in the bevacizumab group (p = 0.023). CONCLUSIONS: The study showed that after IVR or IVB treatment, vascularization could be completed with delay; there were no differences in this delay time between the ranibizumab and bevacizumab groups. Besides, avascular areas may remain in the peripheral retina, and additional treatment may be necessary after IVB or IVR treatment. When the treatment was applied as monotherapy, more recurrence was observed in the ranibizumab group.

Clinical characteristics and surgical outcomes of pediatric rhegmatogenous retinal detachment.

The objective of this study was to analyze the characteristics and surgical results of pediatric rhegmatogenous retinal detachment (RRD). The medical records of 30 eyes of 29 patients younger than 18 years of age who underwent vitreoretinal surgery due to RRD were analyzed. The gender, age, laterality, duration of presenting symptom, etiology, ocular and systemic co-morbidities, type of breaks, lens status, presence of proliferative vitreoretinopathy (PVR) and its grade, initial and final best-corrected visual acuities (BCVAs), surgical management, number of operations, duration of follow-up, functional and anatomical success, and complications were noted. As the most common predisposing factors were trauma (trauma group) and myopia (myopia group), the data of these patients were further analyzed. The mean age was 12.6 ± 3.0 years. There were 23 male (79.3 %) and 6 female (20.6 %) subjects. The most common etiologic factors were high myopia (40 %) and trauma (36.6 %). Functional success rate was 70 % (n = 21) after the primary surgeries and was 80 % (n = 24) after the secondary surgeries. There were no significant differences between the trauma and myopia groups regarding the presence of total retinal detachment, macula-off status, and the rate of PVR worse than grade C. Although the preoperative mean BCVA and the initial and final retinal reattachment rates of the groups were statistically similar, trauma group had significantly higher postoperative mean BCVA compared to myopia group (p = 0.013). Myopia and trauma were the most common etiologic factors for RRD in children. The visual outcomes of trauma-associated RRD were better than those of myopia-associated RRD.

Choroidal thickness in healthy Turkish subjects.

AIM: To investigate choroidal thickness in healthy Turkish subjects. MATERIALS AND METHODS: Refraction, axial length (AXL) measurement, anterior chamber, and fundus examinations were performed. Eyes that had any retinal or choroidal pathology were excluded from the study. Enhanced-depth imaging optical coherence tomography was used to evaluate choroidal thickness. RESULTS: 139 eyes from 70 subjects were investigated. The mean age, AXL, spherical equivalent refractive error (SE), and subfoveal choroidal thickness (SCT) were 34.7 +/- 12.7 years, 23.31 +/- 0.91 mm, -0.15 +/- 1.64 diopters (D), and 326 +/- 60 microm, respectively. A negative correlation was found between SCT and AXL (P = 0.043). The mean age, SE, AXL, and SCT were 31.7 +/- 9.3 and 34.6 +/- 14.3 years, -0.27 +/- 1.45 and 0.02 +/- 1.89 D, 23.52 +/- 0.94 and 23.02 +/- 0.75 mm, and 324 +/- 69 and 329 +/- 40 mirom in male and female subjects, respectively (P = 0.14, P = 0.31, P = 0.001, and P = 0.58, respectively). Regression analysis showed that SCT decreased by 0.93 microm for each year of age. CONCLUSION: In healthy Turkish subjects, SCT decreased by 0.93 pm for each year of age and was thicker in men when the results were adjusted according to AXL measurements.

Comparison of intravitreal vancomycin and daptomycin application in experimental methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis in rabbits.

PURPOSE: To compare bactericidal activities of daptomycin and vancomycin in an experimental rabbit model of methicillin-resistant Staphylococcus aureus (MRSA) endophthalmitis. METHODS: The right eyes of 19 New Zealand rabbits weighing 2 to 2.5 kg were used. Each eye was inoculated with 1000 colony-forming units (cfu) of MRSA into the vitreous cavity. 24 h after the inoculation, the rabbits were randomly distributed into three groups: control group (n = 5) was given 0.1 ml of balanced saline solution, daptomycin group 2 (n = 7) was given 0.2 mg/0.1 ml daptomycin and vancomycin group 3 (n = 7) was given 1 mg/0.1 ml vancomycin intravitreally. Clinical examination scores were recorded and vitreous aspirates were obtained for microbiological analysis on days 2 and 3 after MRSA inoculation. Rabbits were sacrificed, and the eyes were enucleated for histopathological examination. RESULTS: There was no difference between the daptomycin group, vancomycin group and control in terms of the clinical grading of endophthalmitis 24 h after the inoculation. In all treatment groups, mean number of cfu and histopathological scores were significantly lower compared to the control group. There was no difference between the daptomycin and vancomycin group in terms of the histopathological and clinical examination scores. Culture negativity achieved on day 3 was 71.4% and 57.1% in the daptomycin treatment group and the vancomycin treatment group, respectively. CONCLUSIONS: Although both daptomycin and vancomycin are effective in treatment of experimental MRSA endophthalmitis, daptomycin has superior bactericidal activity 72 h after inoculation.

Cyclosporine a 0.05% eye drops for the treatment of subepithelial infiltrates after epidemic keratoconjunctivitis.

BACKGROUND: To evaluate the treatment with topical 0.05% cyclosporine A (CsA) in patients with subepithelial corneal infiltrates (SEI). METHODS: We reviewed 16 patients (22 eyes) before and after the treatment with 0.05% CsA eye drops. All patients had been treated previously with topical corticosteroids without any improvement and also they had to stop the medication secondary to intraocular pressure elevation. The objective data recorded included best-corrected visual acuity (BCVA), evaluation of corneal subepithelial infiltrate scores (CSIS), intraocular pressure (IOP) prior to treatment and the last follow-up visit. RESULTS: Six males (37.5%) and 10 females (62.5%), mean age of 35.2 ± 16.6 years, were included. The patients' average topical CsA use duration was 5.1 ± 3.5 months (1 - 13 months). The average follow up time of the patients was 9.2 ± 4.7 months (4 - 22 months). One patient, although he didn't have a 0 scale of SCIS, did not show up for follow up examinations after six months. The mean BCVA (logarithm of the minimum angle of resolution) before and after the treatment were 0.15 ± 0.15 and 0.07 ± 0.07 respectively, CSIS 1.68 ± 0.89 and 0.23 ± 0.53 respectively, IOP 18.50 ± 3.82 and 16.86 ± 2.76 mmHg respectively. There were statistically significant improvements in BCVA (p=0.002), reduction of CSIS (p=0.002) and reduction of IOP (p<0.001) prior to treatment and the last follow-up visit. 18 eyes (81.9%) showed clinical improvement and 4 (18.1%) had decreased SEI which did not fully disappear during the treatment period. The eyes which reached CSIS score 0 (18 eyes) were treated with CsA for 1 - 13 months; while the eyes which had clinical improvement but had not CSIS score 0 (4 eyes) were decided to discontinue of CsA treatment in last follow-up visit. There were recurrences in 2 eyes 3 months after the treatment. Patients reported reduction in the severity of symptoms after the treatment. Most of the patients reported no foreign body sensation, glare, or other side effects with topical CsA treatment. Overall, patients noted an improvement in vision and satisfaction with topical 0.05% CsA treatment. CONCLUSIONS: Topical 0.05% CsA is a safe and effective alternative treatment in patients with SEI who do not respond to other treatment modalities or have undesired side effects from topical steroids.

An unusual case of hydroa vacciniforme with ocular involvement.

Hydroa vacciniforme (HV) is a sporadic, rare and idiopathic chronic photodermatosis characterized by recurrent vesicles and crust formation on a sun-exposed skin, typically resulting in vacciniform or varioliform scarring. Herein, we report on a 18-year-old boy who presented with rare ocular involvement in HV.

Botulinum toxin injections for blepharospasm prior to ocular surgeries.

PURPOSE: The aim of this study was to show the efficiency of preoperative botulinum toxin A (Botox A) in patients with benign essential blepharospasm who were to undergo ocular surgery with local anesthesia. MATERIALS AND METHODS: Twenty-eight benign essential blepharospasm patients who were administered unilateral Botox A prior to ocular surgery between January 2004 and May 2011 were included in this study. Eleven cases had pterygiums, ten had cataracts, and four had glaucomas, while the remaining three had aphakia. All cases' severity of spasm (stage 0-4) and eyelid closing forces (stage 1-4) were evaluated according to the Jankovic scale prior to the injection, at 3 days, 14 days, 1 month, and 3 months after Botox A injection. RESULTS: Of the patients enrolled in the study, 16 were female and 12 were male, with an average age of 55.52 ± 1.53 years (52-65). Average onset of the Botox injection's effect was 2.8 ± 0.9 (2-5) days. Its effect lingered for about 11.5 ± 3.6 (8-22) weeks. The severity of spasm and eyelid closing forces of all the patients enrolled were compared prior to the injection at 3 and 14 days and the first and third months after the injection. There were statistically significant differences between prior to the injection and 3 days (P = 0.001), 14 days (P < 0.001) and 1 month after the injection (P < 0.001). There was no statistically significant difference between prior to the injection and 3 months after the injection (P = 0.513). Fourteen days following the injection, the surgeries were successfully performed. CONCLUSION: Botox A administered prior to ocular surgery will control both blepharospasm and lower the risks that can be encountered before and during surgery, thus increasing the comfort of the patient and the surgeon.

The role of resistin in Behçet's disease: a Turkish experiment.

The objective of this study was to assess the role of resistin, a proinflammatory cytokine potentially involved in Behçet's disease (BD), and to determine its relationship with tumor necrosis factor α (TNF-α), another important inflammatory cytokine known to be involved in BD. Forty-five persons diagnosed with BD were enrolled into this study, 25 of whom were being followed or had recently been diagnosed with clinically active BD, whereas the remaining 20 were previously diagnosed and had clinically inactive BD for the previous 3 months. Thirty persons were recruited as a healthy control group. Patients' C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), resistin, and TNF-α levels were determined with enzyme-linked immunosorbent assay (ELISA). Resistin and TNF-α levels were significantly higher in patients with BD (p < 0.05 and p < 0.05) than in the control group. The major interest of this study was to investigate the role of resistin in patients with BD. An elevated resistin level was associated with activation of BD. Elevated TNF-α and resistin levels could be determined simultaneously, and the presence of these two cytokines together suggests that resistin plays an important role in the pathogenesis and activation of BD.