Analysis of an extended chromosome locus 2p14-21 for replication of the 2p16.3 association with glaucoma susceptibility.

PURPOSE: Susceptibility to primary open-angle glaucoma (POAG) has recently associated with three intergenic single-nucleotide polymorphisms (SNPs) on human chromosome 2p16.3, just outside of the POAG-linkage locus GLC1H (2p15-16.2), in an Afro-Caribbean population. Especially, association of one SNP (rs12994401) was very strong (odds ratio 35) and later replicated in Afro-Americans but not in Ghanaians or Japanese. An extended region was examined in this study to look for SNPs of cross-population association. METHODS: The three reported SNPs and all 63 SNPs considerably correlating with rs12994401 (r(2)≥0.3) in the African-descendent Yoruba were examined for POAG susceptibility association in a Korean population of 1,159 unrelated participants including 226 cases with glaucoma. As these 66 SNPs were spread from 2p14 to 2p21, all SNPs in this extended region were imputed for susceptibility association tests. RESULTS: No susceptibility association was detected with rs12994401 in comparisons between 933 controls and 188 POAG (or 175 high-tension glaucoma) cases (statistical power of 100%), as well as with all 19 other typed SNPs, using logistic regression with adjustment for age and gender. The other 46 SNPs were deemed non-polymorphic in Koreans. Among 21,201 SNPs located in 2p14-21, only 4,260 were imputed to be non-monomorphic, but none of them passed a significance level of multiple testing. No association was observed when the samples were stratified by age or gender. CONCLUSIONS: No typed or imputed SNPs within 2p14-21 showed association with susceptibility to POAG, suggesting that the population inconsistency in 2p16.3 association was unlikely due to linkage disequilibrium differences.

Changes in macular thickness after panretinal photocoagulation in patients with severe diabetic retinopathy and no macular edema.

PURPOSE: The purpose of this study was to investigate changes in macular thickness after panretinal photocoagulation (PRP) in patients with severe diabetic retinopathy (DR) without macular edema and to compare the visual acuity outcomes. METHODS: This prospective cohort study included 30 patients with severe nonproliferative DR or non-high-risk proliferative DR whose visual acuity was > or =0.8 before PRP. Sixty eyes of 30 patients with severe nonproliferative DR or non-high-risk proliferative DR received biweekly PRP treatment in 4 sessions. Macular thickness and visual acuity were measured before and at 1, 3, 6, and 12 months after PRP. RESULTS: The visual acuities were 0.02 +/- 0.11 before PRP and 0.04 +/- 0.11, 0.04 +/- 0.07, 0.02 +/- 0.07, and 0.04 +/- 0.08 at 1, 3, 6, and 12 months after PRP, respectively (P > 0.05 for each). Central macular thickness was increased at 1 (223.3 +/- 40.6 microm), 3 (216.8 +/- 23.5 microm), 6 (219.4 +/- 33.1 microm), and 12 months (220.4 +/- 17.3 microm) after PRP compared with that before PRP (199.0 +/- 20.9 microm; P < 0.05 for each). CONCLUSION: Biweekly PRP (1,200-1,600 spots) had no effect on visual acuity in patients with severe DR without macular edema, which was determined by clinical and optical coherence tomography examination, although mild macular thickening frequently persists.

Isolated abducens nerve palsy in a patient with scrub typhus.

Abducens nerve palsies associated with infectious diseases are infrequent. Scrub typhus is an acute, febrile, infectious illness caused by Orientia tsutsugamushi (formerly Rickettsia tsutsugamushi), an obligate-intracellular gram-negative bacterium. The organism has been reported to be capable of entering the nervous system, causing meningitis and focal neurologic abnormalities. We report a case of isolated abducens nerve palsy associated with a scrub typhus infection.

Changes in corneal endothelial cells after Ahmed glaucoma valve implantation: 2-year follow-up.

PURPOSE: To evaluate changes in corneal endothelial cells after Ahmed glaucoma valve (AGV) implantation for the treatment of refractory glaucoma. DESIGN: Observational case series. METHODS: We prospectively evaluated the change in density and shape of the corneal endothelium in 41 patients (41 eyes) who had undergone AGV implantation for the treatment of refractory glaucoma. Corneal specular microscopy was performed on the superior, supratemporal, supranasal, and central areas with a noncontact specular microscope before surgery and 1, 6, 12, 18, and 24 months after surgery. The changes at each time point were compared with those at baseline and with those of the control group, which consisted of 20 contralateral glaucomatous eyes receiving antiglaucoma medications. RESULTS: The mean follow-up was 19.1 months. The average percentage decrease in corneal endothelial cell count was 5.8% at 1 month, 11.5% at 6 months, 15.3% at 12 months, 16.6% at 18 months, and 18.6% at 24 months after surgery. The changes were statistically significant compared with those at baseline and those of the control eye at all time points during the study period (P < .05). The supratemporal area, the closest site to the tube, showed the greatest decrease in endothelial cell density, by 22.6%, whereas the central cornea showed the smallest decrease, by 15.4%, at 24 months after surgery. CONCLUSIONS: There was statistically significant corneal endothelial cell loss in the operated eye after AGV implant surgery. The corneal endothelial cell loss increased with time: 15.3% at 12 months and 18.6% at 24 months after surgery, on average, in all measured areas.