Association of exudative age-related macular degeneration with matrix metalloproteinases-2 (-1306 C/T) rs243865 gene polymorphism.

Purpose: Age-related macular degeneration (AMD) is a disease of the macula that significantly affects eyesight and leads to irreversible central vision loss. Recent studies have demonstrated that angiogenesis is the most important mechanism of AMD development. It is associated with extracellular remodeling involving different proteolytic systems, among them matrix metalloproteinases (MMPs), which play an essential role in the etiopathogenesis of AMD. The main objective of the present study was to determine the relationship between exudative AMD and MMP-2 (-1306 C/T) rs243865 polymorphism. Methods: The study enrolled 267 patients with exudative AMD and 318 controls. DNA was extracted from peripheral venous blood leukocytes by commercial kits. Genotyping of MMP-2 (-1306 C/T) rs243865 was carried out using real-time polymerase chain reaction method. Results: The analysis of MMP-2 (-1306 C/T) polymorphism did not reveal any differences in the distribution of CC, CT, and TT genotypes between the exudative AMD and control groups: 58.8%, 31.5% and 9.7% vs. 59.75%, 33.96% and 6.29%, respectively, P = 0.287). When the study population was subdivided into age groups, MMP-2 (-1306 C/T) rs243865 CT genotype showed 5.7-fold increased the risk of exudative AMD development compared to CC and TT genotypes together in younger (<65 years) males group (P = 0.05). Conclusion: MMP-2 (-1306 C/T) polymorphism is associated with exudative AMD development in younger males.

CYP4F2 (rs2108622) Gene Polymorphism Association with Age-Related Macular Degeneration.

Background. Age-related macular degeneration is the leading cause of blindness in elderly individuals where aetiology and pathophysiology of age-related macular degeneration are not absolutely clear. Purpose. To determine the frequency of the genotype of rs2108622 in patients with early and exudative age-related macular degeneration. Methods. The study enrolled 190 patients with early age-related macular degeneration, 181 patients with exudative age-related macular degeneration (eAMD), and a random sample of 210 subjects from the general population (control group). The genotyping of rs2108622 was carried out using the real-time polymerase chain reaction method. Results. The analysis of rs2108622 gene polymorphism did not reveal any differences in the distribution of C/C, C/T, and T/T genotypes between the early AMD group, the eAMD group, and the control group. The CYP4F2 (1347C>T) T/T genotype was more frequent in males with eAMD compared to females (10.2% versus 0.8%; p = 0.0052); also T/T genotype was less frequently present in eAMD females compared to healthy control females (0.8% versus 6.2%; p = 0.027). Conclusion. Rs2108622 gene polymorphism had no predominant effect on the development of early AMD and eAMD. The T/T genotype was more frequent in males with eAMD compared to females and less frequently present in eAMD females compared to healthy females.

Photodynamic therapy and central serous chorioretinopathy.

Central serous chorioretinopathy is a common acquired maculopathy. Multiple studies showed that photodynamic therapy is useful treatment for acute and chronic central serous chorioretinopathy. The exact mechanism of photodynamic therapy in treating central serous chorioretinopathy is not clear, but it is thought to be caused by short-term choriocapillaris hypoperfusion and long-term choroidal vascular remodeling, leading to a reduction in choroidal congestion, vascular hyperpermeability and extravascular leakage. Furthermore, photodynamic therapy seems to be an effective means of improving or stabilizing visual acuity in patients with central serous chorioretinopathy.

[Association of metabolic syndrome with abnormalities of bulbar conjunctival vessels]. / Metabolinio sindromo ir jo komponentu sasajos su akies obuolio jungines kraujagysliu pokyciais.

AIM: To examine and evaluate the relationships of the metabolic syndrome and abnormalities of bulbar conjunctival vessels among middle-aged Kaunas population. MATERIAL AND METHODS: Analysis was performed on 383 asymptomatic persons aged 38-39 years (170 men and 212 women). Metabolic syndrome was defined using criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). For determination of abnormalities in bulbar conjunctiva vessels and microcirculation, each participant underwent noncontact slit lamp examination. The changes of vessel walls and bloodstream, extravasal alterations were evaluated, and conjunctival index was calculated. RESULTS: Metabolic syndrome was present in 10.7% of individuals. Persons with metabolic syndrome had a 2.35-point higher conjunctival index compared to the controls (P=0.003). After evaluation of various components of metabolic syndrome to conjunctival index, it was determined that the greatest change in the means of conjunctival index was due to hyperglycemia (P=0.02) and central obesity (P=0.05). Metabolic syndrome was related to venular dilatation (OR=3.78; 95% CI, 1.86-7.72), arteriolar narrowing (OR=1.98; 95% CI, 0.97-4.09), decreased arteriolar-venular ratio (OR=2.35; 95% CI, 1.13-4.98), and increased venular tortuosity (OR=2.24; 95% CI, 1.06-4.82). Multiple logistic analysis revealed that venular dilatation (OR=3.38; 95% CI, 1.43-7.99) and arteriolar narrowing (OR=2.22; 95% CI, 0.98-5.01) were significant factors in the prognosis of metabolic syndrome. CONCLUSIONS: Metabolic syndrome was significantly related to abnormalities of bulbar conjunctival vessels such as venular dilatation, arteriolar narrowing, decreased arteriolar-venular ratio, and increased venular tortuosity. Both conjunctival index and individual conjunctival microvascular changes may be prognostic factors for metabolic syndrome, but long-term studies on associations between metabolic syndrome and changes of bulbar conjunctival vessels are needed.

[The European Registry of Cataract Surgery Outcomes: Clinic of Ophthalmology, Kaunas University of Medicine]. / Europos kataraktos chirurginio gydymo rezultatu registras: Kauno Medicinos Universiteto akiu ligu klinika.

PURPOSES: Evaluate the outcome of cataract surgery in Clinic of Ophthalmology, Kaunas University of Medicine (COKUM) and to compare it with the outcome of the European Cataract Outcome Study Group (ECOSG) data. METHODS: The study was started on the 1st of October, 2000 and ended on the 30th April, 2001 on the basis of the protocol of the European Cataract Outcome Study Group. Every patient at each participating unit having surgery during the first study month was evaluated. The study was closed 6 months after surgery. RESULTS: The study enroled 3944 patients, out of them 361 was from COKUM. The mean induced astigmatism was 0.86+/-0.21 D in COKUM and 0.63+/-0.23 D in ECOSG. The visual acuity of the operated eye was 0.3 or lower in 28.1 percent of patients, 0.4-0.7 in 31.7 percent and 0.8 or higher in 40.2 percent of COKUM patients in the whole study group percentages were 11.8, 27.6 and 60.6, respectively. 44.3 percent of COKUM patients; underwent phacoemulsiphication, while among ECOSG this procedure was the most common (91.8 percent). The number of complications during surgery was 5.5 percent of all cases in COKUM while in European countries it was 3.7 percent. CONCLUSION: Cataract surgery data collected from 39 units in 18 European countries allowed participants to compare their performance with that of colleagues in an anonymous manner. This study is also an indicator of cataract surgery development in COKUM and in Lithuania.