Development of the extraocular muscles during the fetal period.

PURPOSE: The aim of this study was to investigate the morphometric development of the extraocular muscles in the fetal period and to create a modified Tillaux spiral. METHODS: We dissected 157 fetal eyes (82 right eyes, 75 left eyes) obtained from 79 fetuses (46 boys, 33 girls) between 13 and 40 weeks of gestation. The tendon widths of the extraocular muscles and the distances of the tendon attachment sites to the limbus were measured. Tillaux's modified spiral was created. RESULTS: In addition to the rectus muscles, we added tendon widths and tendon-limbus distances of the upper (SO) and lower (IO) obliques to the modified Tillaux spiral. When tendon widths were compared between genders, no statistically significant difference was observed. When tendon widths were compared between the sides, it was determined that SO was more in the left eye, whereas other extraocular muscles were more in the right eye. There was no statistically significant difference between genders when the distances of tendon attachment sites to the limbus were compared. There was no statistically significant difference in SO and IO values between the sides. There was a statistically significant difference in the rectus muscles and this difference was found to be higher in the right eye. CONCLUSION: We think that the findings obtained will contribute to disciplines such as fetopathology, obstetrics, ophthalmology and plastic surgery and to future studies on this subject.

Low-dose ranibizumab administration in retinopathy of prematurity.

PURPOSE: To evaluate the efficiency of low-dose intravitreal ranibizumab therapy in the treatment of aggressive retinopathy of prematurity (A-ROP). METHODS: A total of 124 eyes of 62 patients who underwent intravitreal ranibizumab after an A-ROP diagnosis between January 2015 and January 2021 were evaluated retrospectively. After receiving family-approved informed consent, low-dose intravitreal ranibizumab was administered, and regular follow-ups were performed. RESULTS: Patients included in the study had a mean birth week of 26.6 (23-33 weeks), a mean birth weight of 905 (450-1970) grams, and an average injection postnatal time of 9.1 (4-19) weeks. The mean follow-up period was 63 (24-250) weeks. In all eyes, ROP regressed in the first week after injection, and no asymmetrical response was observed in the eyes of any baby. A total of 58 eyes recovered with a single dose of intravitreal injection therapy, and peripheral retinal vascularization was completed. A second injection was required in 38 eyes. Rescue treatment was applied in addition to intravitreal ranibizumab treatment in 22 eyes of 11 babies. None of the patients had any ocular or systemic side effects. CONCLUSION: Low-dose intravitreal ranibizumab injection with close follow-up and appropriate timing is an effective treatment modality in A-ROP. Even among patients undergoing rescue laser treatment, the treatment can be completed with a wide visual field.

Evaluation of corneal parameters in patients with Parkinson's disease.

The aim of this study was to evaluate blink rate (BR), tear tests and corneal parameters by Scheimpflug imaging and also to clarify the associations between the severity of disease and corneal parameters in patients with Parkinson's disease (PD). Forty patients with PD and 40 healthy subjects were included in this study. All participants underwent a detailed neurological and ophthalmological evaluation. The severity of disease was measured according to Hoehn-Yahr (H-Y) scale. BR was determined for participants. Corneal parameters were measured using Pentacam. Additionally, Schirmer test, tear break-up time (TBUT), corneal fluorescein staining, and Ocular Surface Disease Index (OSDI) scores were assessed. Corneal parameters were significantly different between the patients with PD and healthy controls. The mean central corneal thickness (538.95 ± 30.9 µm versus 557.60 ± 26.6 µm, p = 0.005) was significantly reduced in patients with PD compared to healthy controls. The BR and the values of TBUT and Schirmer test scores were significantly lower in patients with PD than in controls. Also, corneal fluorescein staining and OSDI scores were higher in patients with PD than in controls. The BR was significantly negative correlated with the severity of the disease. Factors related to the corneal thickness were BR, TBUT and Schirmer test (p < 0.05 for all). Corneal thickness may decrease in patients with PD which may be affected by reduced BR and tear dysfunction.

The effect of cigarette smoking on retinal nerve fiber layer thickness in patients with migraine.

CONTEXT: Migraine is a frequent and disabling chronic neurological condition with complex pathophysiology. Both cigarette smoking and migraine may cause damage to the optic nerve. OBJECTIVE: The primary objective of this study was to investigate the effect of cigarette smoking on retinal nerve fiber layer (RNFL) thickness in patients with migraine. MATERIALS AND METHODS: Eighty-four consecutive patients diagnosed with migraine (34 smokers and 50 nonsmokers) and 66 age- and gender-matched healthy non-smoker controls were enrolled for this observational cross-sectional study. RNFL thickness was measured using spectral-domain optical coherence tomography (OCT) and then RNFL thickness in patients with migraine who smoke was compared to nonsmoking patients with migraine and healthy subjects. RESULTS: The average, superior, nasal and inferior RNFL thicknesses were significantly thinner in patients with migraine compared to the control group (p < 0.001, p = 0.02, p < 0.001 and p = 0.04, respectively). The average and inferior RNFL thicknesses were significantly reduced in smoker patients with migraine compared to the nonsmokers (p = 0.011, p = 0.045, respectively). Nonsmoker patients with migraine had significantly thinner average and nasal RNFL thicknesses than the control group (p = 0.001, p = 0.001, respectively). CONCLUSION: Cigarette smoking may cause significant RNFL thinning in patients with migraine. OCT may be a feasible technique for determination of smoking-induced ocular damage in patients with migraine.

Lens and cornea lesions of rats fed corn syrup and the protective effects of alpha lipoic acid.

OBJECTIVE: To examine the pathological findings that occurred in the lens and cornea and biochemical findings in the lens of rats fed with corn syrup and the protective effects of alpha lipoic acid (ALA). MATERIALS AND METHODS: Twenty-four rats were randomly divided into three groups. Group I served as the control group. Group II was used as the study group; the rats were treated with 30% corn sugar solution for 10 weeks. Group III was the treatment group. Corn syrup was given by the oral route to the rats during the study, and ALA (100 mg/kg) was added to the treatment 4 weeks after the study began. At the end of the experiment, central corneal thickness (CCT) was measured in all rats with an ultrasonic pachymeter. Then the right eyes of the rats were enucleated for histopathological examination of the cornea and lens. The left lenses were homogenized for biochemical analyses. RESULTS: The lenses of the rats treated with corn syrup revealed severe damage; many lens fibers appeared swollen and ruptured with large vacuoles near the lens epithelium. In addition, malondialdehyde (MDA) levels, a parameter of oxidative stress, increased but not significantly in Group II; however. ALA treatment decreased MDA levels significantly. Antioxidant enzyme and catalase (CAT) activities were significantly decreased in Group II, and ALA treatment increased these activities; however, the increase was not significant. Changes were observed in the cornea such as epithelial alterations, subepithelial vacuolizations, collagen fibers loss in the stromal layer, interruptions in the subepithelial basement membrane and central corneal thickening. CONCLUSIONS: Corn syrup can cause severe damage in rat lenses and corneas. However, ALA ameliorates the effect of corn syrup-related lesions on the cornea and lens.

Elevated hydrostatic pressures induce apoptosis and oxidative stress through mitochondrial membrane depolarization in PC12 neuronal cells: A cell culture model of glaucoma.

BACKGROUND: Despite the importance of oxidative stress and apoptosis through mitochondrial depolarization in neurodegenerative diseases, their roles in etiology of glaucoma are poorly understood. We aimed to investigate whether oxidative stress and apoptosis formation are altered in rat pheochromocytoma-derived cell line-12 (PC12) neuronal cell cultures exposed to elevated different hydrostatic pressures as a cell culture model of glaucoma. MATERIALS: Cultured PC12 cells were subjected to 0, 15 and 70 mmHg hydrostatic pressure for 1 and 24 h. Then, the following values were analyzed: (a) cell viability; (b) lipid peroxidation and intracellular reactive oxygen species production; (c) mitochondrial membrane depolarization; (d) cell apoptosis; (e) caspase-3 and caspase-9 activities; (f) reduced glutathione (GSH) and glutathione peroxidase (GSH-Px). RESULTS: The hydrostatic pressures (15 and 70 mmHg) increased oxidative cell damage through a decrease of GSH and GSH-Px values, and increasing mitochondrial membrane potential. Additionally, 70 mmHg hydrostatic pressure for 24 h indicated highest apoptotic effects, as demonstrated by plate reader analyses of apoptosis, caspase-3 and -9 values. CONCLUSION: The present data indicated oxidative stress, apoptosis and mitochondrial changes in PC12 cell line during different hydrostatic pressure as a cell culture model of glaucoma. This findings support the view that mitochondrial oxidative injury contributes early to glaucomatous optic neuropathy.

Combined use of intravitreal bevacizumab and oral steroid treatment in three diabetic papillopathy patients: a diagnostic and treatment challenge.

Diabetic papillopathy (DP), a form of optic disc edema, is characterized by decreased visual acuity and mild to severe visual field defects. While there is no consensus about treatment, some publications report that intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection may be beneficial. To our knowledge, however, no research reports on the effects of combining anti-VEGF injection and oral steroids in DP treatment. In this case report we present three DP cases that showed rapid improvement following therapy with intravitreal bevacizumab and oral steroids. Optic disc edemas were significantly decreased, and visual acuities were markedly increased in the first week of treatment. This report suggests that combined use of these therapies may be safely used in patients diagnosed with DP.

An Organism-Level Quantitative Flux Model of Energy Metabolism in Mice.

Mammalian tissues feed on nutrients in the blood circulation. At the organism-level, mammalian energy metabolism comprises of oxidation, storage, interconverting, and releasing of circulating nutrients. Though much is known about the individual processes and nutrients, a holistic and quantitative model describing these processes for all major circulating nutrients is lacking. Here, by integrating isotope tracer infusion, mass spectrometry, and isotope gas analyzer measurement, we developed a framework to systematically quantify fluxes through these metabolic processes for 10 major circulating energy nutrients in mice, resulting in an organism-level quantitative flux model of energy metabolism. This model revealed in wildtype mice that circulating nutrients have more dominant metabolic cycling fluxes than their oxidation fluxes, with distinct partition between cycling and oxidation flux for individual circulating nutrients. Applications of this framework in obese mouse models showed on a per animal basis extensive elevation of metabolic cycling fluxes in ob/ob mice, but not in diet-induced obese mice. Thus, our framework describes quantitatively the functioning of energy metabolism at the organism-level, valuable for revealing new features of energy metabolism in physiological and disease conditions. Highlights: A flux model of energy metabolism integrating 13 C labeling of metabolites and CO 2 Circulating nutrients have characteristic partition between oxidation and storageCirculating nutrients' total cycling flux outweighs their total oxidation fluxCycling fluxes are extensively elevated in ob/ob but not in diet-induced obese mice.

Clinical, demographic characteristics, and treatment protocols of optic neuropathies: Three-year follow-up experiences from a tertiary hospital in Turkey.

Background: This study was conducted to review the demographic and clinical characteristics, treatment protocols, and visual outcomes of patients with optic neuropathy. Methods: This historical cohort study analyzed the clinical features of 91 patients with optic neuropathy followed up for three years at a university hospital in Turkey. Results: Non-arteritic anterior ischemic optic neuropathy (NA-AION) was the most common group among the optic neuropathy subgroups (47.2%), and optic neuritis (ON) was the second most common group (38.5%). The mean age of symptom onset for NA-AION was 64.97 ± 12.15 years, significantly higher than the mean age of onset for ON (40.28 ± 15.52 years). Most of the patients with NA-AION had at least one systemic disease causing microangiopathy [51.1% had diabetes mellitus (DM), 33.3% had hypertension (HTN)]. Among the patients with ON, 51.4% were idiopathic, and 25.7% were multiple sclerosis (MS)-related ON cases. Patients with ischemic optic neuropathy (ION), ON, and traumatic optic neuropathy received pulse intravenous (IV) corticosteroids, and eleven patients with NA-AION received acetylsalicylic acid (ASA) therapy in addition to corticosteroids. There was a statistically significant increase in visual acuity in NA-AION and ON groups (P = 0.019). It was observed that the cases of ON peaked in the winter months in Turkey. Conclusion: In the differential diagnosis between NA-AION and idiopathic ON, the presence of one or more vascular systemic diseases and mean age may be the main factors. IV steroid treatment given to patients with NA-AION in the acute phase may significantly improve visual acuity.

Prognostic factors influencing final visual acuity in open globe injuries.

BACKGROUND: To investigate the factors that influence final visual acuity (VA) in open globe injuries. METHODS: The records of patients with open globe injuries who were followed for longer than 6 months between 1998 and 2009 in two different centers were retrospectively reviewed. The data collected included patients' demographics as well as their initial VA, wound location, mechanism and type of injury, clinical findings, and final best-corrected VA. Statistical analysis was conducted using univariate analysis and multiple logistic regression analysis. RESULTS: Of 313 patients, 73.2% were men, and the mean age was 32.01 years ± 21.04 years. Penetrating injury was the most common type of injury. Of 313 injuries, 212 were caused by sharp/projectile objects, and injuries most commonly occurred in the workplace. In a univariate analysis, the factors contributing to a final VA worse than 20/200 included being older than 50 years, injury in zone 2 or 3, blunt injury, rupture-type injury, poor initial VA, and the presence of endophthalmitis, retinal detachment, relative afferent papillary defect, hyphema, vitreous prolapse, and uveal prolapse. In a multiple logistic regression analysis in which all factors that may influence final VA were analyzed together, poor initial VA, retinal detachment, and vitreous prolapse were found to be statistically significant. CONCLUSION: In this retrospective study, the most important factors influencing final VA were initial VA, retinal detachment, and vitreous prolapse, all of which are important with regard to informing the patient of the prognosis and determining the approach the physician will take.

Characteristics of open globe injuries in geriatric patients.

BACKGROUND: We aimed to evaluate the etiological and demographic characteristics of open globe injuries in geriatric patients, to determine the factors affecting the prognosis and to discuss the differences between geriatric and young populations in light of the current literature. METHODS: The medical files of 30 patients aged 65 years and older who were treated and followed up for open globe injuries between 1998 and 2009 were evaluated retrospectively. RESULTS: The mean age was 73.1 years. Sixty percent of the patients were male, with a predominance of left eye involvement. The most common type of trauma was rupture due to a blunt object. The presenting visual acuity was no light perception in 13 patients, light perception/hand movement in 15 patients and 1/200-19/200 in 2 patients. In a univariate analysis assessing the effects of demographic and clinical characteristics on final vision, the wound location, type of trauma and Ocular Trauma Score were found to be statistically significant variations. CONCLUSION: The prognosis of open globe injuries is very poor in geriatric patients. Age-related structural changes and previous history of surgeries contribute to easy development of a rupture. During the treatment process, limited recovery capacity, ocular pathology in patients and low functional capacity in this age group exert negative effects on the prognosis.

Effects of increased physical activity and/or weight loss diet on serum myokine and adipokine levels in overweight adults with impaired glucose metabolism.

AIM: The purpose of this study was to investigate the changes in serum irisin, fibroblast growth factor-21 (FGF21), visfatin, follistatin like protein-1 (FSTL1), and meteorin-like protein (Metrnl) levels in response to increased physical activity and/or diet interventions in overweight subjects with impaired glucose metabolism (IGM). METHODS: A total of 60 subjects (BMI > 25.0 kg/m2) with IGM were recruited in this single-centered interventional study. Twelve subjects dropped out during the study and the study was completed with 48 patients. Patients were divided into two groups as diet only (DI, n = 24) and diet and physical activity intervention (DPA, n = 24). Patients in DI group received a diet program while DPA group received a diet combined with a physical activity intervention for 12 weeks. Additional 24 healthy subjects were recruited to compare the baseline levels of proteins. Serum protein levels, anthropometric measurements, and biochemical parameters were assessed. RESULTS: Irisin, FGF21, visfatin, and FSTL1 levels significantly decreased in both groups after 12-week intervention (p < 0.001). However, there were no differences in protein levels between DI and DPA groups (p > 0.05). Likewise, the total change in weight was similar in both DI (-4.35 kg) and DPA (-4.85 kg) groups (p > 0.05). A 5% reduction in initial body weight with DPA therapy resulted in a stronger correlation between the changes in irisin, visfatin, and FSTL1 levels and fasting glucose and HbA1c levels. CONCLUSIONS: These results demonstrate that serum irisin, FGF21, visfatin, and FSTL1 levels decreased in response to weight loss interventions. Weight loss induced by DI or DPA therapies had similar lowering effects on these proteins in subjects with IGM, and these myokines might be related to glucose metabolism biomarkers.

A 4-week diet with exercise intervention had a better effect on blood glucose levels compared to diet only intervention in obese individuals with insulin resistance.

BACKGROUND: The majority of prediabetic people are overweight and weight loss is still the most effective treatment strategy. The aim of this study was to evaluate the effects of short-term exercise and/or diet on weight loss and clinical parameters in subjects with insulin resistance (IR). METHODS: A total of 60 subjects (BMI≥25.0 kg/m2) were included in the study. Subjects divided into two groups as follows: diet only (DI, N.=27) and diet and exercise (DEI, N.=27). DI group received an energy restricted diet program, while DEI group received a diet combined with an exercise program for four weeks. Anthropometric measurements and biochemical parameters were assessed at baseline and at the end. RESULTS: Total body weight (BW) loss was 2.3 kg (2.5%) in DI group and 3.0 kg (3.2%) in DEI group at the end of four weeks. Fasting blood glucose (FBG) levels decreased significantly in DEI group (P=0.021). However, the reductions in FBG levels were mild and not statistically significant in DI group (P>0.05). Total cholesterol and LDL-c levels reduced in both groups, while triglyceride levels significantly decreased only in DI group (P<0.05). CONCLUSIONS: Short-term lifestyle interventions have beneficial effects on weight loss and clinical parameters associated with glucose control and lipid profile in subjects with IR. Even small changes in BW (loss of <5% of initial BW) have a positive impact on clinical parameters.

Retinal nerve fiber layer thickness in chronic renal failure without diabetes mellitus.

PURPOSE: To evaluate the retinal nerve fiber layer (RNFL) thickness in patients with chronic renal failure (CRF) without diabetes mellitus by using optical coherence tomography (OCT). METHODS: Sixty-six eyes of 33 patients with CRF were evaluated. Eighteen patients have been treated with hemodialysis (group 1) and 15 patients have been treated with peritoneal dialysis (group 2). The RNFL thicknesses were assessed before and after the hemodialysis in group 1. None of these patients had diabetes mellitus. Forty eyes of 20 age-matched normal control subjects were assessed in group 3. An RNFL thickness protocol was used to acquire circular scans of 3.4 mm in diameter around the optic nerve. For each eye, RNFL thicknesses were evaluated in 4 quadrants. All of the measurements were automatically calculated by the existing OCT software. All normal subjects and CRF patients underwent comprehensive ophthalmologic examination. The mean and quadrantal RNFL thickness values in patients with CRF were compared with the control group. RESULTS: The mean RNFL thickness values in patients with CRF were statistically significantly lower than the control group. Differences between the RNFL thickness values in group 1 and group 2 and the predialysis and postdialysis measurements were not statistically significant. CONCLUSIONS: The RNFL thickness in CRF without DM, which was measured by OCT-3, was found to be significantly decreased. The presence of CRF can be a source of false positive results and lead to overestimation of glaucomatous optic neuropathy.

Effects of astaxanthin on antioxidant parameters in ARPE-19 cells on oxidative stress model.

AIM: To observe the protective effect of astaxanthin (AST) against hydroquinone (HQ) mediated cell death in the apoptotic cascade and evaluate intracellular Ca2+ release, caspase-3, and -9 activation, reactive oxygen species (ROS) production in ARPE-19 cells. METHODS: We cultured ARPE-19 cells in special mediums and performed MTT tests to determine protective effect of AST, before exposing the cells to HQ in an incubator. We analyzed intracellular Ca2+ release experiments, mitochondrial membrane depolarization, glutathione (GSH), glutathione peroxidase (GSH-Px) and ROS experiments, and apoptosis assay. RESULTS: ROS production ranges depend on the amount of cell death. We computed the correlation between ROS ranges and cell death by 20,70-dichlorofluorescein fluorescence, and Ca2+ levels by Fura-2-AM. HQ-induced cell death found out to rise ranges of caspase-3 and -9, and mitochondrial depolarization. These three steps were delayed by AST management. CONCLUSION: ARPE-19 cells are avoided from HQ-induced ROS production and caspase-3 and -9 activation by AST. AST may limit the range of caspase synthesis, Ca2+ release and excess production of ROS with antiapoptotic effect. This study proposes a new therapeutic approach for the treatment of age-related macular degeneration.

Topical cyclosporine A in the prevention of pterygium recurrence.

AIMS: To investigate the efficacy and safety of postoperative topical cyclosporine A 0.05% (tCsA) (Restasis, Allergan Pharmaceutical) eye drops in preventing the recurrence of pterygium. METHODS: 31 patients with bilateral pterygium were examined between January 2006 and February 2007. During a 1-year follow-up, the right eyes of the patients assigned as the treatment group were treated by tCsA and the left eyes were considered as the control group. RESULTS: The pterygium recurred in 4 (12.9%) of 31 right eyes in the treatment group and in 14 (45.2%) of 31 left eyes in the control group (p = 0.005). The mean follow-up +/- SD was 9.39 +/- 4.14 months (range, 1 to 12 months). The control group had a 7.37 times higher risk of recurrence in pterygium compared with the treatment group (OR = 0.1357, p = 0.0051). A statistically significant difference in recurrence-free probabilities was found for the treatment and control groups (log-rank test; p = 0.006). A multivariate Cox regression model showed that age (p = 0.0093) and tCsA (p = 0.0103) were independent statistically significant impacts on recurrence-free time for pterygium. CONCLUSION: This study suggests that primary excision of pterygium with postoperative instillation of 0.05% cyclosporine is both safe and efficient.

Assessment of Corneal Parameters in Patients with Constitutional Thinness Using Scheimpflug Imaging.

PURPOSE: To assess corneal parameters in constitutional thinness (CT) subjects and to compare them with those of healthy individuals. METHODS: Twenty-four CT subjects (BMI < 18.5 kg/m2) and 24 healthy subjects (BMI: 18.5-25 kg/m2) were enrolled in this observational cross-sectional study. All participants were screened for age, gender, and medical history, then underwent a detailed ophthalmological examination. Corneal parameters were evaluated by Scheimpflug imaging. Height and weight of all subjects were measured and body mass index (BMI) was calculated. RESULTS: The mean corneal thicknesses at the apex point, the center of pupil, the thinnest point, and the mean corneal volume were significantly lower in CT patients than those of controls. The mean intraocular pressure (IOP) was significantly lower in CTs than in controls. There was a significant correlation between BMI and IOP, and BMI was significantly correlated with all pachymetric measurements and corneal volume. CONCLUSION: Corneal thicknesses were significantly thinner in CT subjects compared to those in control subjects. The impact of constitutional thinness on corneal parameters should be further investigated.

Prevalence of Pseudoexfoliation Syndrome in Turkish Patients with Senile Cataract.

PURPOSE: To investigate the prevalence of pseudoexfoliation syndrome (PEX) among Turkish patients with senile cataract. MATERIALS AND METHODS: Records of 352 eyes of 352 patients who underwent cataract surgery were analyzed in this retrospective study. The presence of PEX, type of cataract, intraocular pressure (IOP), glaucoma, age-related macular degeneration, and systemic diseases (coronary artery disease, hypertension, diabetes mellitus) were recorded. RESULTS: The overall prevalence of PEX syndrome was detected to be 11%. The mean age of PEX patients was significantly higher than without PEX (74.4 ± 7.2 years and 69.3 ± 11.4 years, respectively, p = 0.004). The most common cataract type in the PEX patients was mixed-type cataract determined in 51.2% of patients. IOP was significantly higher in eyes with PEX than in eyes without it (16.1 ± 4.5 mmHg and 14.7 ± 3.8 mmHg, respectively; p = 0.03). Moreover, the prevalence of age-related macular degeneration was found to be significantly higher, and prevalence of glaucoma slightly higher in PEX patients than without PEX. CONCLUSION: Pseudoexfoliation syndrome is a common condition in Turkish people. PEX is associated with mixed type of cataract, age-related macular degeneration, and elevated IOP. Therefore, PEX patients should be checked for concomitant diseases.

Assessment of Corneal Parameters with Scheimpflug Imaging in Patients with Ankylosing Spondylitis.

PURPOSE: To evaluate corneal parameters of patients with ankylosing spondylitis (AS) by Scheimpflug imaging and also to clarify the associations between disease severity and clinical status of AS and corneal parameters. METHODS: Fifty-seven patients with AS and 57 healthy subjects were included in this cross-sectional study. All participants underwent a detailed ophthalmological evaluation. Corneal parameters were measured by Pentacam. In addition, Schirmer test, tear break-up time (TBUT), corneal fluorescein staining, and Ocular Surface Disease Index (OSDI) scores were evaluated. Duration of disease and scores of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Quality of Life scale (ASQoL) of the patients were recorded. The laboratory evaluation consisted of human leukocyte antigen (HLA)-B27, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). RESULTS: Corneal parameters were significantly different between patients with AS and healthy controls. The mean central corneal thickness (538 ± 26 µm versus 569 ± 27 µm, p < 0.001) and the mean corneal volume (59.8 ± 3.33 mm3 versus 62.3 ± 3.40 mm3, p < 0.001) were reduced significantly in AS patients compared to those in healthy controls. The values of TBUT and Schirmer test scores were significantly lower in AS patients than in controls. Also, corneal fluorescein staining and OSDI scores were higher in AS patients than in controls. Factors related to the corneal parameters were dry eye tests (TBUT, Schirmer test, corneal fluorescein staining), OSDI score, and CRP (p < 0.05 for all). CONCLUSION: The AS patients have thinner corneas compared to control subjects, which may be affected by tear disfunction and inflammatory processes.

Neutrophil to Lymphocyte Ratio in Patients with Nonarteritic Anterior Ischemic Optic Neuropathy.

PURPOSE: To evaluate the neutrophil to lymphocyte ratio (NLR) in patients with nonarteritic anterior ischemic optic neuropathy (NAION). METHODS: We investigated 112 subjects comprising 56 patients with NAION and 56 healthy controls at Süleyman Demirel University. Complete blood count, demographic, and clinic data from NAION patients were evaluated in this study. The NLR was calculated in all individuals and compared between the patient and control groups. Cut-off values were also determined. Then, the relationship between NLR and visual outcomes was investigated. RESULTS: The cut-off value for NLR was 1.64. NLR values were significantly higher in NAION patients than in healthy subjects (p < 0.001) and were directly correlated with erythrocyte sedimentation rate levels (r = 0.263, p = 0.006). Also, the NLR value was associated with visual outcomes. Receiver operator characteristic curve analysis revealed a 0.63 area under the curve (confidence interval, 53.7% to 74.1%), 85% sensitivity and 41% specificity at the cut-off NLR value. CONCLUSIONS: The NLR may be a biomarker with good sensitivity that is quick, cost effective and easily detected in serum. It can be used in clinical practice to predict a NAION patient's prognosis in terms of visual outcomes.