Evaluation of the Corneal Layers in Meibomian-Gland-Dysfunction-Related Dry Eye by In Vivo Slit-Scanning Confocal Microscopy.

In the current study it was aimed to evaluate the findings of cornea in Dry Eye related Meibomian Gland Dysfunction through in vivo confocal microscopy. 30 patients of Dry Eye related Meibomian Gland Dysfunction (DEMGD) and 30 healty individuals were included. 46 eyes of 30 DEMGD patients (group 1) and 46 eyes of 30 healthy individuals (group 2) were formed as control group and images were captured from the centre of the cornea. 26 of the patients (%86,6) in Group 1 were male, and four of them (%13,4) were female and 25 of healthy individuals (% 83,3) were male and 5 of them(%16,7) were female. The ages of the patients in Group 1 were between 23-67 (51,58±13,4 on average). The ages of the healthy individuals in Group 2 were between 23-67 (51,45±10,4 on average). Tear film break-up time and Schirmer 1 values were significantly lower in the MGDDE group than the control group (p<0.001). There were statistically significant intergroup differences in basal epithelial cell density and area and stromal nerve thickness (p<0.05). Surface epithelium changes, anterior stromal hyperreflectivity and subepithelial nerve morphology changes were not observed in the control group. As a result, some of the effects on cornea tissue caused by Dry Eye related Meibomian Gland Dysfunction were able to be visualized with confocal microscopy at micro level.

Comparison of the efficacy of topical N-acetyl-cysteine and a topical steroid-antibiotic combination therapy in the treatment of meibomian gland dysfunction.

PURPOSE: This study aimed to compare the efficacy of topical N-acetyl-cysteine (NAC) with a topical steroid-antibiotic combination, betamethasone-sulfacetamide sodium therapy in patients with meibomian gland dysfunction (MGD). METHODS: Twenty patients with MGD were prospectively randomized and assigned into 2 groups. The patients were instructed to use either NAC 5% or a topical steroid-antibiotic combination, betamethasone 0.1%-sulfacetamide sodium 10%, topically 4 times a day for a month. All patients were instructed to apply lid hygiene once daily. RESULTS: One month of topical therapy provided statistically significant improvements in fluorescein break-up time and Schirmer scores as compared with the initial study visit in both groups (P≤0.001). Significant improvements for the symptoms of ocular burning, itching, and intermittent filmy or blurred vision were noted in both groups at 1 month as compared with 1 day (P<0.05). Considering these rates, there was no significant difference between the groups (P>0.05). None of the patients developed an allergic reaction to the medications, and intraocular pressure measurements were within the normal limits in both groups. CONCLUSION: When used in conjunction with eyelid hygiene, topical administration of NAC appears to be as effective as a topical steroid-antibiotic combination, betamethasone-sulfacetamide sodium therapy in patients with MGD.

Central corneal thickness in patients with meibomian gland dysfunction.

PURPOSE: The aim was to evaluate central corneal thickness in patients with meibomian gland dysfunction. METHODS: The study group was made up of 40 eyes of 20 patients with meibomian gland dysfunction (mean age, 40.55 ± 10.7 years). Forty eyes of 20 healthy individuals (mean age, 39.25 ± 11.1 years) without any ophthalmic or systemic pathology were used as a control group. The central corneal thickness was measured with ultrasonic pachymetry. RESULTS: The mean central corneal thickness was 541.45 ± 24.68 µm in the study group and 544.30 ± 22.16 µm in the control group. There was no statistically significant difference in the mean central corneal thickness measurements in the meibomian gland dysfunction group in comparison with the control group (p > 0.05). CONCLUSION: Central corneal thickness measurements do not differ in patients with meibomian gland dysfunction compared with healthy control subjects.

Efficacy of topical N-acetylcysteine in the treatment of meibomian gland dysfunction.

PURPOSE: To evaluate the efficacy of topical N-acetyl-cysteine (NAC) therapy in patients with meibomian gland dysfunction (MGD). METHODS: Twenty patients with MGD were prospectively randomized and assigned into 2 groups. The patients were instructed to use either NAC 5% or preservative-free artificial tear topically 4 times a day for a month. All patients were instructed to apply lid hygiene once daily. Preservative-free artificial tears treated group served as control. Paired sample Student's t-tests were used to detect differences between the baseline and 1 month after treatment initiation in mean ocular symptoms, fluorescein break-up time (FBUT) values, and Schirmer scores in each group. Difference in mean ocular symptoms, Schirmer's test scores, and FBUT values between the baseline and 1 month after treatment initiation were compared between the groups using Mann-Whitney U test. RESULTS: One month of topical NAC therapy provided statistically significant improvements in FBUT and Schirmer scores as compared with the initial study visit. The average Schirmer increase rate was significantly better in the NAC group than in the control group. Significant improvements for the symptoms of ocular burning, foreign body sensation, and intermittent filmy or blurred vision were noted in both groups; and only NAC-treated group showed improvement for the symptom of itching, at 1 month as compared with 1 day. NAC provided significantly better improvement in itching symptom when compared with controls. CONCLUSIONS: Topical administration of NAC is thought to be effective and well tolerated in patients with MGD.

Decreased serum paraoxonase 1 activity and increased serum homocysteine and malondialdehyde levels in age-related macular degeneration.

Age-related macular degeneration (AMD) is one of the most common causes of vision loss. AMD has been classified into two forms: atrophic and exudative forms. The exudative form is associated with choroidal neovascularization of the subretinal macular region, resulting in a sudden loss of central vision. However, the exact cause of AMD remains unknown. Several risk factors have been postulated, including smoking, atherosclerosis, and low levels of antioxidant enzymes. Malondialdehyde (MDA), a lipid peroxidation product, is used as a marker of oxidative stress. Paraoxonase 1 (PON1) metabolizes lipid peroxides and prevents oxidation of low-density lipoprotein. Increased levels of homocysteine may cause vascular endothelial injury by releasing free radicals. The purpose of this study is to investigate the relationships between serum PON1 activity and the serum levels of homocysteine and MDA in AMD. Forty patients with exudative-type AMD (63.3 +/- 5 years) and 40 controls (61+/- 4 years) were assessed in a cross-sectional study. The serum PON1 activity was significantly lower in the patients with AMD than that in the controls (p < 0.001). In contrast, the serum levels of MDA and homocysteine were significantly higher in the patients than those in the controls (p < 0.001, for both). In AMD patients, significant negative correlation was found between PON1 activity and MDA level (r = -0.493, p < 0.05) and between PON1 activity and homocysteine level (r = -0.557, p < 0.05). Increased serum homocysteine and MDA levels may be responsible for the decreased PON1 activity in patients with AMD.

The effect of L-carnitine treatment on levels of malondialdehyde and glutathione in patients with age related macular degeneration.

OBJECTIVE: The aim of this study was to determine the antioxidant properties of the L-carnitine (LC) in the treatment of patients with age-related macular degeneration (AMD). MATERIALS AND METHODS: This study involved 60 patients diagnosed with early AMD. The patients were divided into two groups. Group I was the study group that received LC supplementation for 3 months. Group II was the control group and did not consent to LC supplementation over the 3 months. At the end of the 3-month period, markers of lipid peroxidation, malondialdehyde (MDA) and reduced glutathione (GSH) were measured in the two groups. RESULTS: In the study group, the MDA level was significantly reduced, while the GSH level was significantly increased at the end of the 3-month period (P<0.001). CONCLUSION: Our results suggest that LC may protect against oxidative damage by decreasing the MDA level, a marker of lipid peroxidation, and increasing GSH.