Sensitivity of cognitive tests in four cognitive domains in discriminating MDD patients from healthy controls: a meta-analysis.

BACKGROUND: We performed a meta-analysis in order to determine which neuropsychological domains and tasks would be most sensitive for discriminating between patients with major depressive disorder (MDD) and healthy controls. METHODS: Relevant articles were identified through a literature search of the PubMed and Cochrane Library databases for the period between January 1997 and May 2011. A meta-analysis was conducted using the standardized means of individual cognitive tests in each domain. The heterogeneity was assessed, and subgroup analyses according to age and medication status were performed to explore the sources of heterogeneity. RESULTS: A total of 22 trials involving 955 MDD patients and 7,664 healthy participants were selected for our meta-analysis. MDD patients showed significantly impaired results compared with healthy participants on the Digit Span and Continuous Performance Test in the attention domain; the Trail Making Test A (TMT-A) and the Digit Symbol Test in the processing speed domain; the Stroop Test, the Wisconsin Card Sorting Test, and Verbal Fluency in the executive function domain; and immediate verbal memory in the memory domain. The Finger Tapping Task, TMT-B, delayed verbal memory, and immediate and delayed visual memory failed to separate MDD patients from healthy controls. The results of subgroup analysis showed that performance of Verbal Fluency was significantly impaired in younger depressed patients (<60 years), and immediate visual memory was significantly reduced in depressed patients using antidepressants. CONCLUSIONS: Our findings have inevitable limitations arising from methodological issues inherent in the meta-analysis and we could not explain high heterogeneity between studies. Despite such limitations, current study has the strength of being the first meta-analysis which tried to specify cognitive function of depressed patients compared with healthy participants. And our findings may provide clinicians with further evidences that some cognitive tests in specific cognitive domains have sensitivity to discriminate MDD patients from healthy controls.

Hyperreflective external limiting membranes after successful macular hole surgery.

PURPOSE: To evaluate changes in external limiting membranes (ELMs) in the foveae of patients with surgically closed macular holes. METHODS: In this retrospective observational case series, spectral-domain optical coherence tomography scan images were obtained from eyes of patients with macular holes closed after vitrectomy. The integrity of the ELMs was evaluated at the fovea. In eyes with a restored ELM, the reflectivity of the ELM was estimated. RESULTS: At a mean of 19 months (range, 3.0-59.7 months) after surgery, the integrity of the ELM was restored in 21 (77.8%) of 27 eyes with closed macular holes. The ELM was not restored in six eyes with glial sealing, in which glial tissues were present in the entire retinal layer. All 21 eyes with restored ELMs had an area of hyperreflectivity within the ELM observed at the thinnest part of the fovea; this was associated with an underlying photoreceptor defect. CONCLUSION: Abnormally hyperreflective ELMs were frequently observed at the thinnest point of the fovea after macular hole surgery. These hyperreflective ELMs may be newly formed after surgery.

Fixation and photoreceptor integrity in optical coherence tomography.

PURPOSE: To investigate eccentric fixation (EF) in full-thickness macular hole (FTMH) and epiretinal membrane (ERM) and its relationship to photoreceptor integrity. METHODS: The amount of EF during spectral domain optical coherence tomography scanning was determined as the distance between the scan center and the foveal center. We investigated the difference in reflectivity of the photoreceptor inner segment/outer segment (IS/OS) junction at the scan center and the foveal center. RESULTS: The amount of EF was significantly greater in preoperative FTMH (median, 209 µm; interquartile range [IQR], 146 µm, 367 µm), postoperative FTMH (median, 138 µm; IQR, 95 µm, 461 µm), preoperative ERM (median, 210 µm; IQR, 151 µm, 308 µm), and after removal of ERM (median, 129 µm; IQR, 72 µm, 175 µm) than normal eyes (median, 67 µm; IQR, 47 µm, 101 µm). Abnormal EF was more frequently observed in eyes with greater inner segment/outer segment reflectivity at the scan center than at the foveal center. CONCLUSIONS: Fixation during the spectral domain optical coherence tomography scanning was frequently eccentric in FTMH and ERM and might be dependent on photoreceptor integrity.

The change of macular thickness measured by optical coherence tomography in relation to glycemic control in diabetic patients.

BACKGROUND: To demonstrate the change in macular thickness using optical coherence tomography in diabetic patients and to assess its relationship with glycosylated hemoglobin (HbA1c) levels. METHODS: Diabetic patients who underwent at least two macular thickness measurements with OCT within a 12-month period were included. HbA1c values within 1 month of each OCT study, and clinical data such as age, insulin treatment, systemic hypertension, and the severity of diabetic retinopathy were collected. The change in three macula parameters including center point thickness (CPT), central subfoveal macular thickness (CSMT), and total macular volume (TMV) between two measurements was calculated. Patients were divided into two groups based on the half-width of the 95% confidence interval for percent change, the increase group (group 1) and the decrease group (group 2). The associations of CPT change, CSMT change, and TMV change with baseline HbA1c levels, HbA1c change, and other clinical factors were investigated using correlation analysis and group comparison. RESULTS: A total of 23 eyes of 23 patients were studied. In correlation analysis; the increase in CPT, CSMT, and TMV was correlated with baseline HbA1c (CPT, Spearman's rho = 0.462, p = 0.027; CSMT, Spearman's rho = 0.479, p = 0.021; TMV, Spearman's rho = 0.589, p = 0.003), and the change of HbA1c (CPT, Spearman's rho = -0.585, p = 0.003; CSMT, Spearman's rho = -0.583, p = 0.004; TMV, Spearman's rho = -0.725, p < 0.001). In group comparison for CPT, group 1 have a higher baseline HbA1c (11.2% vs 8.7% of THb, p = 0.044) and a greater HbA1c reduction (-3.3% vs -1.2% of THb, p = 0.044) than group 2. For CSMT, group 1 tended to have a greater HbA1c reduction (-2.9% vs -1.2% of THb, p = 0.074) than group 2. For TMV, group 1 had a higher baseline HbA1c (11.6% vs 8.4% of THb, p = 0.001) and a greater HbA1c reduction (-3.5% vs -0.5% of THb, p < 0.001) than group 2. CONCLUSIONS: The change in macular thickness and volume developed in relation to HbA1c levels during a less than 12-month period. A high baseline HbA1c and a large reduction of HbA1c were risk factors for the increase in macular thickness. Prospective study with a large number of patients is needed to clarify the change of macular thickness in relation to glycemic control.

Prevention of UV-induced skin damages by 11,14,17-eicosatrienoic acid in hairless mice in vivo.

Polyunsaturated fatty acids (PUFAs) are known to play important roles in various physiological and pathological processes. Recent studies have shown that some omega-3 (omega-3) PUFAs, such as eicosapentaenoic acid (EPA) and dodecahexaenoic acid (DHA), have protective effects on acute and chronic UV-induced changes. However, the effects of other omega-3 PUFAs including 11,14,17-eicosatrienoic acid (20:3) (ETA) on UV-induced skin damages are poorly understood. In this study, we investigated the cutaneous photoprotective effects of ETA in hairless mice in vivo. Female HR-1 hairless mice were topically treated with vehicle (ethanol:polyethylene glycol=30:70) only, 0.1% ETA, or 1% ETA once a day for 3 successive days after one time UV irradiation (200 mJ/cm(2)) on dorsal skins. Skin biopsy was carried out on the fourth day (72 hr after UV irradiation). We found that topical treatment with ETA attenuated UV-induced epidermal and dermal thickness and infiltration of inflammatory cells, and impairment of skin barrier function. In addition, ETA suppressed the expression of IL-1beta, COX-2, and MMP-13 induced by UV irradiation. Our results show that the topical application of ETA protects against UV-induced skin damage in hairless mice and suggest that ETA can be a potential agent for preventing and/or treating UV-induced inflammation and photoaging.

Risk factors for retinal hemorrhage after photodynamic therapy in age-related macular degeneration.

BACKGROUND: Subretinal or intraretinal hemorrhage may occur after photodynamic therapy (PDT). However, risk factors for post-PDT hemorrhage have not yet been investigated. METHODS: We reviewed the medical records of patients who had undergone PDT for subfoveal choroidal neovascularization secondary to age-related macular degeneration. Primary outcomes were the occurrences of hemorrhages at 2 and 12 weeks after PDT. To identify the risk factors of hemorrhages after treatment, ocular and systemic factors were investigated. The secondary outcome was visual acuity. RESULTS: Ninety-two eyes from 92 patients were analyzed. New hemorrhages developed in 9 (9.8%) within 2 weeks and in 8 (8.3%) between 2 and 12 weeks after PDT. Hypertension [odds ratio (OR) 356.9, 95% confidence interval (CI) 3.7-34,487.1], minimally classic lesion (OR 53.4, 95% CI 2-1,429) and advanced age (OR 1.2, 95% CI 1-1.5) were related to hemorrhagic events within 2 weeks after PDT. A tendency toward recurrent hemorrhage was noted after repeat treatments (p < 0.05). Forty-four percent of the patients with a hemorrhagic event within 2 weeks after PDT experienced decreased vision. CONCLUSION: Hypertension, minimally classic lesion, advanced age and a previous hemorrhagic event were associated with the development of hemorrhage within 2 weeks after PDT.

Risk factors of iris posterior synechia formation after phacovitrectomy with three-piece acrylic IOL or single-piece acrylic IOL.

AIMS: To identify the risk factors of posterior iris synechia formation after phacovitrectomy with posterior chamber single-piece acrylic intraocular lens (IOL; Acrysof SA60AT) or 3-piece acrylic IOL (Acrysof MA60BM) implantation. METHODS: We selected 153 eyes of 153 patients treated by phacovitrectomy between March 2000 and August 2006 and retrospectively reviewed the relationship between iris posterior synechiae and various factors, such as IOL type, tamponade, preoperative iris posterior synechiae, major indications for surgery, axial length and preoperative anterior chamber (AC) depth. RESULTS: IOL type (p = 0.0447), C(3)F(8) gas tamponades (p = 0.0074), preoperative iris posterior synechiae (p = 0.0001) and postoperative AC fibrin deposition (p = 0.0303) were significantly associated with postoperative iris posterior synechiae by multiple logistic regression analysis. The odds ratio (OR) for single-piece IOL versus 3-piece IOL was 2.658 (95% confidence interval, CI: 1.010-6.993), the OR for C(3)F(8) gas versus balanced salt solution was 4.051 (95% CI: 1.455-11.281), for the presence of preoperative iris posterior synechiae 12.868 (95% CI: 3.511-47.165), and the OR for postoperative AC fibrin deposition was 6.012 (95% CI: 1.186-30.468). CONCLUSION: Preoperative iris posterior synechiae, C(3)F(8) gas tamponade, postoperative AC fibrin deposition and the single-piece IOL could increase the rates of iris posterior synechiae after phacovitrectomy.

Retinal pigment epithelial tear after half fluence PDT for serous pigment epithelial detachment in central serous chorioretinopathy.

Retinal pigment epithelial tears may occur after photodynamic therapy (PDT) in various diseases. The authors report a case of a retinal pigment epithelial tear after half light intensity (300 mW/cm2) PDT in a large serous pigment epithelial detachment associated with chronic atypical central serous chorioretinopathy. A 52-year-old woman with a large serous pigment epithelial detachment associated with chronic atypical central serous chorioretinopathy in the left eye received her first PDT treatment using verteporfin with a spot size of 6,640 microm, a duration of 83 seconds, and half (300 mW/cm2) of the standard 600 mW/cm2 light intensity, where the delivered PDT light dose was only 25 J/cm2. Two weeks later, visual acuity improved to 20/30. However, a large crescent-shaped retinal pigment epithelial tear was found during fundus examination. Even 50% reduced light fluence PDT can produce a retinal pigment epithelial tear in pigment epithelial detachment associated with chronic atypical central serous chorioretinopathy.

Isolation and molecular characterization of a cryptic plasmid from Bifidobacterium longum.

An isolate from the fecal samples of children was identified as Bifidobacterium longum. A plasmid isolated from it pBIFA24 was 4,892 bp with three open reading frames, ORFI, ORFII, and ORFIII. ORFI encoded a replication protein involved in a rolling-circle replication mechanism, and three sets of tandem repeat sequences featuring iteron structure were identified. Secondary structure prediction analysis of ORFII suggested it was a transmembrane protein. ORFIII showed high amino acid sequence identity with some mobilization proteins and contained an oriT sequence.

Long-term visual outcome of arteriovenous adventitial sheathotomy on branch retinal vein occlusion induced macular edema.

PURPOSE: To evaluate long-term visual outcome of arteriovenous adventitial sheathotomy in BRVO-induced macular edema. METHODS: The visual outcomes of 8 patients following vitrectomy with arteriovenous adventitial sheathotomy for BVO-induced macular edema (surgery group) were retrospectively evaluated. The three-year post-operative visual acuity of the surgery group was compared with that of the conservatively managed controls. RESULTS: All patients were followed for a minimum of 36 months. Mean BCVA (logMAR) in the surgery group changed from 1.10+/-0.34 to 1.19+/-0.70 and to 0.80+/-0.36 at 12 and 36 months, respectively (p=0.959 at 12 months, p=0.018 at 36 months). In the control group, visual acuity improved from 1.15+/-0.43 to 0.43+/-0.44 and to 0.43+/-0.39 at 12 and 36 months, respectively (p=0.015 at 12 months, at p=0.003 at 36 months). A strong trend toward better visual acuity at 12 months and final examination was observed for controls. (surgery vs. control group, p=0.052 at 12 months, p=0.066 at 36 months). CONCLUSIONS: Considering the favorable natural course of BVO and the unproven effect of reperfusion on macular edema, surgical efficacy of arteriovenous adventitial sheathotomy requires further evaluation.

Pre-Hepatectomy Assessment of Bile Transporter Expression by Gadoxetic Acid-Enhanced MRI in a Rat Model of Liver Cirrhosis.

BACKGROUND: Gadoxetic acid is a liver-specific intravenous T1 magnetic resonance (MR) contrast agent that is excreted via the hepatobiliary system. We hypothesize that hepatocyte expressions of bile transporters (OATP1 and MRP2) correlate with dynamic profile of Gadoxetic acid enhanced (GE)-MR imaging (MRI). METHODS: Two groups of rats, control (n = 6) and cirrhosis (n = 12), received gadoxetic acid enhanced MRI followed by 70% hepatectomy. The change in MR signal intensity from the baseline before the contrast injection (ΔSI) was analyzed every minute for 30 min. Dynamic signal intensity retention ratio (DSR) was defined as the mean ΔSI of the third 10-minmin period divided by the first 10-minmin period. Real-time PCR was utilized to quantify mRNA expressions. RESULTS: Compared to the control, cirrhosis group demonstrated lower mRNA levels of OATP1 (0.038 ± 0.020 vs. 0.232 ± 0.0979; p = 0.004), MRP2 (0.201 ± 0.084 vs. 0.7567 ± 0.254; p = 0.002), and OATP1/MRP2 mRNA ratio (0.193 ± 0.065 vs. 0.342 ± 0.206; p = 0.032). DSR was higher in the cirrhosis group (0.678 ± 0.554 vs -0.125 ± 0.839; p = 0.033). In the cirrhosis group, there was an inverse correlation between the ratios of OATP1/MRP2 mRNA and DSR (R = -0.709, p = 0.01). CONCLUSION: Bile transporters OATP1/MRP2 mRNA expression ratio in rat liver tissue decreased with DMN-induced liver injury. The expressions of bile transporters correlated with GE-MRI DSR. The GE-MRI DSR has potential utility in qualifying OATP1/MRP2 mRNA expression.

Intravitreal versus posterior subtenon injection of triamcinolone acetonide for diabetic macular edema.

PURPOSE: To compare the short-term effects of intravitreal versus posterior subtenon injection of triamcinolone acetonide for diabetic macular edema. METHODS: This is a prospective and interventional study. Sixty eyes of 60 patients who had diffuse diabetic macular edema were assigned to receive a single intravitreal injection (4 mg) or a single posterior subtenon injection (40 mg) of triamcinolone acetonide. The central retinal thickness was measured using optical coherent tomography before injection and at 1 and 3 months after injection. Visual acuity and intraocular pressure (IOP) were also measured. RESULTS: Both intravitreal and posterior subtenon injections of triamcinolone acetonide resulted in significant improvements in visual acuity at 1 month and 3 months after injection. Both groups resulted in a significant decrease in central macular thickness (CMT) at 1 month and 3 months post-injection. IOP in the intravitreal injection group was significantly higher than in the posterior subtenon injection group at 3 months after injection. CONCLUSIONS: The posterior subtenon injection of triamcinolone acetonide had a comparable effect to the intravitreal triamcinolone injection and showed a lower risk of elevated IOP. Posterior subtenon injection of triamcinolone acetonide may be a good alternative for the treatment of diffuse diabetic macular edema.

Antioxidant activity is required for the protective effects of cyclophilin A against oxidative stress.

Cyclophilin (Cyp) belongs to a group of proteins that have peptidyl-prolyl cis-trans isomerase (PPIase) activity. CypA is the major cellular target for the immunosuppressive drug cyclosporin A and mediates its actions. Previous studies have demonstrated that CypA has diverse cellular functions and have suggested that CypA may function as an antioxidant. The present study investigated the antioxidant activity of CypA and its association with PPIase activity. The purified CypA/wild-type (WT) and CypA/P16S mutant proteins were active in PPIase assays. A total antioxidant capacity assay revealed that the purified CypA/WT protein had significantly higher antioxidant activity, whereas the CypA/P16S mutant was defective in its antioxidant activity. To confirm the importance of CypA antioxidant activity, CypA/P16S was overexpressed in Chang human liver cells and the rate of cell death was measured following treatment with cisplatin or H2O2. Overexpression of CypA/WT protected the cells against cisplatin or H2O2-induced oxidative damage, however, the CypA/P16S mutant had no effect. These findings suggested that CypA exhibits a protective antioxidant effect.

Retinal topography of myopic eyes: a spectral-domain optical coherence tomography study.

PURPOSE: The purpose of this study was to investigate topographic characteristics of the retina in myopic eyes. METHODS: We reviewed spectral-domain optical coherence tomography (SD-OCT) images of patients with myopia retrospectively. Retinal topography (RT) was defined as the topography of the retinal pigment epithelium layers. Retinal topographies were classified into several types, and the distribution and characteristics of each type were assessed in eyes with varying degrees of axial length (AL). RESULTS: A total of 167 subjects with myopia were included in this study. Seventy eyes (41.9%) were classified as regular (R) type, 48 (28.7%) were wave (W) type, 32 (19.2%) were band (B) type, and 17 (10.2%) were pond (P) type. The distribution of these types varied significantly among eyes with different degrees of AL (P < 0.001); R-type was predominant in eyes with 24 mm less than or equal to AL less than 26 mm, and P-type in eyes with AL greater than or equal to 28 mm. The retina sloped away from the cornea more frequently on the nasal side than it did on the temporal side or in between the nasal and the temporal sides, with the exception of the P-type RT. Topography of the central zone was frequently slanted, except in B-type eyes. The difference between the refractive and corneal astigmatism of eyes with P-type RT was greater than that of B-type eyes (P = 0.002). CONCLUSIONS: Retinal topography varies according to the degree of AL. This variation in RT may originate from the differences between healthy eyes and highly myopic eyes, and may be related to the optical characteristics of the eye.

Three-dimensional configuration of subretinal fluid in central serous chorioretinopathy.

PURPOSE: The purpose of this study was to characterize the 3-dimensional (3D) configuration of subretinal fluid (SRF) in idiopathic central serous chorioretinopathy (CSC) using spectral-domain optical coherence tomography (SDOCT). METHODS: The OCT images of patients with CSC were reviewed retrospectively. The 3D configurations of SRF were assessed using a modified segmentation algorithm of SDOCT. The differences of the configurations between acute and chronic CSC were compared. For the patients with acute CSC, we investigated a possible relationship between early change in 3D configuration and disease prognosis. RESULTS: We included 69 eyes of 68 patients in this study. The mean volume, the greatest basal diameter (GBD), and the area of SRF were not different between acute and chronic CSC. The mean peak height (PH) of SRF and the ratio of PH to GBD in acute CSC (298.13 ± 92.67 µm, 9.44 ± 2.57%) were significantly greater than those in chronic CSC (192.97 ± 71.05 µm, 5.97 ± 1.90%; P < 0.001, P < 0.001, respectively). In patients with acute CSC, the early changing pattern of 3D configurations was significantly different according to the SRF prognosis (P = 0.003). In situ decrease of SRF was observed in 94.7% of the spontaneously resolving group. However, downward elongation of SRF was observed more frequently in the persistent group (58.3%) than in the spontaneously resolving group (6.3%). CONCLUSIONS: The 3D configurations of SRF were different between acute and chronic CSC. In patients with acute onset, the early change of 3D configuration was different and varied according to the SRF prognosis.

Correlation of fundus autofluorescence gray values with vision and microperimetry in resolved central serous chorioretinopathy.

PURPOSE: To evaluate the prognostic value of grayscale parameters in fundus autofluorescence (FAF) for visual function in resolved central serous chorioretinopathy (CSC). METHODS: Seventy-six eyes of 67 patients with CSC that had been resolved for more than 4 months were analyzed retrospectively. Both the short-wavelength (SW)-FAF and near infrared (NIR)-FAF gray value parameters, including the mean, standard deviation, and coefficient of variation (CV), were calculated at 350-µm- and 1200-µm-diameter circles centered on the fovea. The FAF gray value parameters correlated with -logMAR best corrected visual acuity (BCVA) and mean microperimetry (MP) at the 2° and 4° diameters from the foveal center. RESULTS: The mean -logMAR BCVA was 0.15 ± 0.23. The mean MP was 12.87 ± 3.79 dB at 2° and 13.54 ± 3.37 dB at 4°. The -logMAR BCVA correlated most strongly with the mean SW-FAF gray value at the 350-µm circle centered around the fovea (SW-M350; ρ = 0.353; P = 0.002), and the SD of the SW-FAF gray value at the 350-µm circle centered around the fovea (SW-SD350) correlated most strongly with the MP at 2° (ρ = -0.416, P < 0.0001) and 4° (ρ = -0.435, P < 0.0001). The NIR-FAF gray value parameters did not correlate with the macular function tests. CONCLUSIONS: In subjects with resolved CSC, FAF gray values correlated with visual function. BCVA correlated most strongly with SW-M350. MP at 2° and at 4° correlated most strongly with SW-SD350.

Changes in aqueous concentrations of various cytokines after intravitreal triamcinolone versus bevacizumab for diabetic macular edema.

PURPOSE: To investigate the changes in aqueous inflammatory and angiogenic cytokine levels after intravitreal injection of triamcinolone or bevacizumab for reducing foveal thickness in diabetic macular edema (DME). DESIGN: Prospective, interventional case series. METHODS: Twenty-two eyes of 11 patients with bilateral DME and 6 eyes of 6 patients undergoing cataract surgery participated in this study. In each DME patient, 1 eye received an intravitreal injection of 4 mg triamcinolone acetonide and the other eye received 1.25 mg bevacizumab. Aqueous humor samples were obtained before and 4 weeks after the intravitreal injection in the DME group and before the surgery in the control group. Aqueous concentrations of interleukin (IL)-6, IL-8, interferon-induced protein (IP)-10, monocyte chemotactic protein (MCP)-1, platelet-derived growth factor (PDGF)-AA, and vascular endothelial growth factor (VEGF) were measured by multiplex bead assay. RESULTS: Before the administration of the drugs, aqueous levels of IL-8, IP-10, MCP-1, and VEGF were significantly higher in the DME group than in the control group. After intravitreal injection, foveal thickness was more decreased in the triamcinolone acetonide (IVTA) group compared with the bevacizumab (IVBe) group. IL-6, IP-10, MCP-1, PDGF-AA, and VEGF were significantly decreased in the IVTA group, but only VEGF in the IVBe group. Aqueous levels of VEGF were more decreased in the IVBe group than in the IVTA group. CONCLUSIONS: These findings suggest that the pathogenesis of DME is not only related to VEGF dependency, but also to other mechanisms suppressed by corticosteroids. We suppose that these cytokines would have an important role in both the pathogenesis of DME and the underlying mechanism of intravitreal injections.

Inflammatory and angiogenic factors in the aqueous humor and the relationship to diabetic retinopathy.

PURPOSE: To determine the relationship between the aqueous concentrations of inflammatory and angiogenic factors and the severity of diabetic retinopathy and diabetic macular edema. METHODS: Aqueous samples were obtained from 50 eyes of diabetic patients and 28 eyes of nondiabetic subjects. The aqueous levels of inflammatory factors, including IL-1ß, TNF-α, MCP-1, IP-10, IL-8, IL-6, and VEGF were measured with multiplex bead array assays. The aqueous levels of cytokines were investigated according to the severity of diabetic retinopathy and diabetic macular edema measured by optical coherence tomography. RESULTS: The aqueous levels of MCP-1, IP-10, IL-8, and VEGF were higher in eyes of diabetic patients than in eyes of nondiabetic subjects. The aqueous levels of MCP-1 and IP-10 were elevated in eyes with severe NPDR and PDR compared to eyes with less severe DR and eyes of nondiabetic subjects. There was a trend toward elevated IL-8 levels in eyes with severe NPDR compared to eyes of nondiabetic subjects. The aqueous levels of VEGF were markedly elevated in eyes with PDR that had not received PRP compared to eyes with severe NPDR. Eyes with PDR that had received PRP treatment showed higher MCP-1 and IP-10 levels than eyes with PDR that had not received PRP treatment. The aqueous levels of IL-6 were positively correlated with TMV and CSMT in eyes with DR. CONCLUSIONS: Elevation of MCP-1, IP-10, and IL-8 levels in eyes with severe NPDR suggests that inflammatory change precedes the development of neovascularization in PDR. The positive correlation between the aqueous levels of IL-6 and macular thickness indicates that IL-6 may play a central role in the development of diabetic macular edema.

UV decreases the synthesis of free fatty acids and triglycerides in the epidermis of human skin in vivo, contributing to development of skin photoaging.

BACKGROUND: Although fatty acids are known to be important in various skin functions, their roles on photoaging in human skin are poorly understood. OBJECTIVE: We investigated the alteration of lipid metabolism in the epidermis by photoaging and acute UV irradiation in human skin. METHODS: UV irradiated young volunteers (21-33 years, n=6) and elderly volunteers (70-75 years, n=7) skin samples were obtained by punch biopsy. Then the epidermis was separated from dermis and lipid metabolism was investigated. RESULTS: We observed that the amounts of free fatty acids (FFA) and triglycerides (TG) in the epidermis of photoaged or acutely UV irradiated human skin were significantly decreased. The expressions of genes related to lipid synthesis, including acetyl-CoA carboxylase (ACC), fatty acid synthase (FAS), stearoyl-CoA desaturase (SCD), sterol regulatory element binding proteins (SREBPs), and peroxisome proliferator-activated receptors (PPARgamma) were also markedly decreased. To elucidate the significance of these changes of epidermal lipids in human skin, we investigated the effects of TG or various inhibitors for the enzymes involved in TG synthesis on the expression of matrix metalloproteinase-1 (MMP-1) in cultured human epidermal keratinocytes. We demonstrated that triolein (TG) reduced basal and UV-induced MMP-1 mRNA expression. In addition, each inhibitor for various lipid synthesis enzymes, such as TOFA (ACC inhibitor), cerulenin (FAS inhibitor) and trans-10, cis-12-CLA (SCD inhibitor), increased the MMP-1 expression significantly in a dose-dependent manner. We also demonstrated that triolein could inhibit cerulenin-induced MMP-1 expression. Furthermore, topical application of triolein (10%) significantly prevented UV-induced MMP-13, COX-2, and IL-1beta expression in hairless mice. CONCLUSION: Our results suggest that TG and FFA may play important roles in photoaging of human skin.

Diurnal variation of the incidence of symptomatic branch retinal vein occlusion.

AIM: To investigate the diurnal variation that is related to the incidence of branch retinal vein occlusion (BRVO). METHODS: This is a cross-sectional study. 72 consecutive patients who were newly diagnosed with BRVO were precisely questioned about the time of their symptom onset. The clinical history, systemic illnesses, ocular findings, and body mass index were obtained for each patient. RESULTS: Analysis of the diurnal variation of symptom onset showed a distribution with the peak in the period from 6 a.m. to noon compared with all the other time periods (p < 0.001). Multivariate analysis showed that involvement of the superior retina was the only factor that influenced the onset time of BRVO. CONCLUSION: Patients with symptomatic BRVO frequently noted their visual deterioration in the morning, which is the same as the other types of ocular and systemic vascular disease. Our results may be helpful for understanding the pathophysiology of BRVO. Our findings require conformation and further studies on this subject are certainly warranted.