Cytokine, C-Reactive Protein, and Heat Shock Protein mRNA Expression Levels in Patients with Active Behçet's Uveitis.

BACKGROUND To investigate the gene expression levels of interleukin 10 (IL10), IL18, interferon gamma (IFNG), IFN-gamma receptor (IFNGR), C-reactive protein (CRP), and heat shock protein 70 (HSP70) in patients with active Behçet's uveitis. MATERIAL AND METHODS Forty patients with Behçet's disease diagnosed according to the International Study Group criteria and 30 healthy individuals were included in the study. IL10, IL18, IFNG, IFNGR, CRP, and HSP70 gene expression levels were compared. RESULTS Expression levels of IL18, IFNG, IFNGR, and CRP were significantly higher in patients with active Behçet's uveitis than in control subjects (P<0.01 for all), whereas no significant differences were found in IL10 and HSP70 gene expression levels (P>0.01 for both). CONCLUSIONS IL18, IFNG, IFNGR, and CRP gene expression is significantly increased in active Behçet's uveitis. There was no significant difference between active Behçet's uveitis patients and controls in terms of IL10 and HSP70 gene expression levels. We conclude that drugs prescribed to Behçet's patients with active uveitis downregulate gene expression.

Central corneal thickness in patients with atopic keratoconjunctivitis.

BACKGROUND: The aim of this study was to evaluate central corneal thickness in patients with atopic keratoconjunctivitis. MATERIAL AND METHODS: The study was conducted in the Atatürk University School of Medicine between April 2011 and June 2013. The study group included 60 eyes of 30 patients with atopic keratoconjunctivitis. Sixty eyes of 30 healthy individuals without any ophthalmic or systemic pathology were used as a control group. The central corneal thickness was measured with ultrasonic pachymetry. RESULTS: In each group, all subjects included in the study had a best corrected visual acuity (BCVA) of 20/25 or better. In the study group past medical histories revealed eczema in 19 patients, asthma in 16, and atopic dermatitis in 15. During clinical examination cicatricial conjunctivitis was noted in 5 patients, giant papillae in 4, symblepharon in 2, and entropion in 2. The mean central corneal thickness was 523.45±18.03 µm in the study group (mean age: 37.05±5.7 years) and 540.30±38.91 µm in the control group (mean age: 36.55±7.1 years), and the difference was statistically significant (p<0.001). CONCLUSIONS: Evaluation of corneal thickness is important in situations such as corneal refractive surgery and contact lens use, and is an essential parameter in a wide range of ocular disorders, including glaucoma and keratoconus. Therefore, ophthalmologists should be aware of the low central corneal thickness in patients with atopic keratoconjunctivitis.

Toxic effects of chronic mercury exposure on the retinal nerve fiber layer and macular and choroidal thickness in industrial mercury battery workers.

BACKGROUND: The aim of this study was to evaluate the toxic effects of mercury on retinal nerve fiber layer thickness (RNFLT), macular thickness (MT), and choroidal thickness (CT) by using spectral-domain optical coherence tomography (SD-OCT) in battery industry workers who had been chronically exposed to mercury. MATERIAL/METHODS: Battery factory workers (n=31) and healthy non-factory employee controls (n=15) participated in the study. Participants were divided into 3 groups: Group 1 (n=15) was factory workers who had worked for more than 5 years in a mercury battery factory; Group 2 (n=16) was factory worker who had worked for less than 5 years in a mercury battery factory; and Group 3 (n=15) was healthy non-employees. Systemic symptoms were recorded. Ophthalmic examination included best-corrected visual acuity test, color vision test, full ophthalmologic examination, and SD-OCT of the RNLF, macula, and choroid. To determine mercury exposure, venous blood samples were collected and mercury levels were assessed. RESULTS: In our study group the most common systemic symptoms were insomnia (67.7%) and fatigue (67.7%). There were no significant differences between Group 1 and Group 2, but there were significant differences between Group 3 and both Group 1 and Group 2 in best-corrected visual acuity values (1=2<3), color vision scores, blood mercury levels, and duration (mean ±SD, range) of mercury exposure(1>2>3). OCT values of RNFLTs, MTs, and CTs of all 3 groups were statistically different from each another (1<2<3). CONCLUSIONS: SD-OCT can be useful for evaluating the toxic effects of chronic exposure to mercury.

Nd: YAG laser posterior capsulotomy rates in myopic eyes after implantation of capsular tension ring.

BACKGROUND: The aim f this study was to evaluate the effect of capsular tension ring implantation during cataract surgery on the incidence of neodymium: YAG (Nd: YAG) laser posterior capsulotomy in myopic (axial length [AL] ≥25.00 mm) eyes. MATERIAL/METHODS In this retrospective study, the records of the cases of 117 myopic patients who underwent cataract surgery between January 2004 and January 2011 were reviewed. A total of 153 eyes with an axial length of 25 mm or higher were included in the study with consideration of exclusion criteria mentioned below. Eyes were grouped by presence or lack of capsular tension ring (CTR+ and CTR-, respectively). RESULTS: The study included 153 eyes from 107 myopic patients. Hydrophilic acrylic IOL and capsular tension ring (CTR) were implanted in 78 eyes (CTR+ group), and 75 eyes received only the hydrophilic acrylic IOL (CTR- group). Six eyes (7.6%) in CTR+ and 16 eyes (21.3%) in CTR- required Nd: YAG laser capsulotomy within 7 years. The difference between the 2 groups was statistically significant (p=0.021). CONCLUSIONS: Because CTRs significantly decrease subsequent need for Nd: YAG laser posterior capsulotomy in myopic patients, are very inexpensive, and provide other benefits, our data suggest that the use of CTRs in myopic eyes undergoing cataract surgery with an hydrophilic acrylic IOL implantation is advantageous and should be standard practice.

Paintball-related ocular trauma: Paintball or Painball?

BACKGROUND: The aim of this study is to describe the type and severity of paintball-related ocular trauma and to determine the necessary precautions to minimize the risk of ocular injury regardless of whether adequate eye protection was used. MATERIAL AND METHODS: A retrospective chart review identified patients treated for paintball-related ocular trauma at the Ataturk University Medical Hospital from June 2010 through March 2013. A descriptive analysis of data was performed. RESULTS: Ten patients with paintball-related ocular trauma were identified. At the time of their first examination, 7 of these patients had visual acuity (VA) of 20/200 or worse. One patient had a final VA of no light perception and 4 patients had a final VA of 20/200 or worse. Hyphema was noted in 7 patients, traumatic cataract in 2, iridodialysis in 2, retinal detachment in 3, and secondary glaucoma in 1. Six patients required surgery. Although all victims have used eye protection during the game, all patients were injured after they thought the game was over and had taken off their helmets or eye-protective devices. CONCLUSIONS: Paintball-related accidents result in serious ocular trauma and most of the patients require surgery. These injuries result in severe loss of VA in some patients. Uninterrupted use of proper eye protection whenever a player is in the game field, even after they believe the game has ended, may reduce the incidence of severe ocular trauma in paintball players.

Retinal nerve fibre layer, ganglion cell layer and choroid thinning in migraine with aura.

BACKGROUND: The aim of this study was to investigate the thickness of the retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL), and choroid thickness (CT) in patients who have migraines, with and without aura, using spectral optical coherence tomography (OCT). METHODS: Forty-five patients who had migraines without aura (Group 1), 45 patients who had migraines with aura (Group 2), and 30 healthy participants (control group) were included in the study. Spectral OCT was used to measure the RNFL, GCL and CT values for all patients. RESULTS: The mean age of Group 1, Group 2, and the control group was 34.6 ± 4.3, 32.8 ± 4.9, and 31.8 ± 4.6 years, respectively. The mean attack frequency was 3.6/month in Group 1 and 3.7/month in Group 2. The mean age among the groups (p = 0.27) and number of attacks in migraine patients (p = 0.73) were not significantly different. There was significant thinning in the RNFL and GCL in Group 2 (p < 0.05, p < 0.001 respectively), while there were no significant differences in RNFL and GCL measurements between Group 1 and the control group (p > 0.05). All groups were significantly different from one another with respect to CT, with the most thinning observed in Group 2 (p < 0.001). When all migraine patients (without grouping) were compared with the control group, there were significant differences on all parameters: RNFL thickness, GCC thickness and CT (p < 0.05). CONCLUSIONS: RNFL and GCL were significantly thinner in the migraine patients with aura as compared with both the migraine patients without aura and the control subjects. In migraine, both with aura and without aura, patients' choroid thinning should be considered when evaluating ophthalmological findings.

Orbital malign trichilemmal tumor with cerebral involvement.

Proliferating trichilemmal tumor is a rare encountered neoplasm. This neoplasm is usually benign, but it may be locally aggressive. To the best of our knowledge, magnetic resonance (MR) imaging features of cerebral involvement of this unusual neoplasm have not been described. We report the MR imaging findings of a case of malign proliferating trichilemmal tumor, with cerebral involvement.

Choroidal Thickening in Patients with Sleep Apnea Syndrome.

Sleep apnoea syndrome (SAS) is characterised by repetitive episodes of cessation of breathing during sleep, resulting in hypoxaemia and hypercapnia. Ophthalmological consequences such as glaucoma, non-arteritic anterior ischaemic neuropathy and papilloedema are relevant to hypoxaemia. The choroid is a vascular structure that performs several regulatory functions for the retina. Defects in this structure contribute to degenerative, inflammatory, and neovascular changes in the retina. The authors examined the choroidal thickness (CT) in sleep apnoea patients using optical coherence tomograpy (OCT). The sleep apnoea patients were divided into subgroups according to their apnoea-hypopnoea index (AHI) scores, and statistical analysis was performed using the AHI and minimal arterial oxygen saturation (min. Spo2) values. There was a medium-high negative correlation between CT and AHI (Spearman rho: r = -0.744, p = 0.000), and a positive correlation between CT and min. Spo2 values (Pearson correlation: r = 0.308, p = 0.000).

Peripapillary Retinal Nerve Fibre Layer Thinning Secondary to Nutritional Folic Acid Deficiency.

Folic acid has a fundamental role in central nervous system (CNS) function at all ages, especially the methionine synthase-mediated conversion of homocysteine to methionine, which is essential for nucleotide synthesis and genomic and non-genomic methylation. Folic acid and vitamin B12 may have roles in the prevention of disorders of CNS development, mood disorders, and dementias, including Alzheimer disease and vascular dementia in elderly people. The authors examined the peripapillary retinal nerve fibre layer thickness (RNFLT) in patients with nutritional folic acid deficiency using optical coherence tomography (OCT). Patients were divided into two groups according to blood folic acid levels: blood folic acid <7 nmol/L as Group 1 and >7 nmol/L as Group 2. Peripapillary RNFL measurements were performed. There were significant positive correlations between serum folate levels and RNFLT in all quadrants (p < 0.05), except for the temportal quadrant (p = 0.41).

The long-term follow-up results of external dacryocystorhinostomy skin incision scar with "W incision".

OBJECTIVE: To determine the effect of "W incision" instead of classical vertical incision at external DCR on scar formation. MATERIALS AND METHODS: Patients with acquired nasolacrimal duct obstruction (NLDO) who were treated with external DCR with classical vertical incision, and patients who were treated with external DCR with "W incision" were included in the study. The first 39 eyes were operated with a vertical incision, and the remaining 37 eyes were operated with a "W incision". All the skin incision scars of the patients were assessed and scored by at least the 6th month. The assessment was made by both the patients themselves, and by an ophthalmologist other than the surgeon himself, each scored the incision scar separately (single-masked study). Scores for both groups were compared, and statistical analyses were performed. RESULTS: Self-assessment scores for the incision scar were Grade 2.28 ± 0.94 in the Vertical incision group, and Grade 1.68 ± 0.57 in the "W incision" group (p < 0.01). The "W incision" scar formation was significantly less noticable than the Vertical incision scar formation. Similarly, the assessment scores of the ophthalmologist other than the surgeon himself were significantly lower for the "W incision" group than for the Vertical incision group. The mean scar assessment scores were Grade 2.13 ± 0.95 in the Vertical incision group, and Grade 1.57 ± 0.68 in the "W incision" group (p < 0.01). CONCLUSION: Skin scar tissue was found to be significantly reduced with a "W incision" in external DCR operations.

A case with multisystemic involved of Tuberculosis.

Cases of tuberculosis with multisystemic involvement are rarely reported and these are often children and patients with AIDS whose and immune system is suppressed. Tuberculosis can mimic and present with various disorders. A 18-year-old Georgian male patient was admitted to the hospital with double vision, swelling and wound on the 3rd digit of the right hand. We defined the multisystemic tuberculous disease including orbital bone with soft tissue tuberculosis, tuberculosis spondylitis, tuberculosis dactylitis, scrofuloderma and pulmonary tuberculosis in these patient.

Association of MICA Alleles and Human Leukocyte Antigen B in Turkish Patients Diagnosed With Behçet's Disease.

OBJECTIVES: This study aims to investigate whether or not MHC class I polypeptide-related sequence A (MICA) polymorphisms are associated with the susceptibility to Behçet's disease (BD) in a Turkish population. PATIENTS AND METHODS: The study included 38 Turkish BD patients (20 males, 18 females; mean age 34±10.9 years) and 51 ethnically matched healthy controls (30 males, 21 females; mean age 36±12.8 years). MICA and human leukocyte antigen B (HLA-B) alleles were determined in all subjects by using the Luminex technology. LABType sequence-specific oligonucleotide MICA test (One Lambda) and sequence-specific oligonucleotide B locus tests (Gene-Probe) were used for the typing studies. RESULTS: A total of 16 MICA alleles were found in BD patients as well as in control subjects. The gene frequency of MICA*006 was significantly higher in the BD patients compared to controls (14.5% vs. 0.9%; odds ratio [OR]: 17.092 95% confidence interval [CI] [2.155~135.554]; p<0.05). When haplotypes were evaluated, an association was found between the haplotypes HLA-B*51-MICA*006 (11.8% and 0.9%; OR: 13.567 95% CI [1.679~109.577]; p<0.001) and HLA-B*51-MICA*009 (27.6% and 13.7%; OR: 2.4 95% CI [1.127~5.109]; p<0.05). Frequencies of HLA-B*49-MICA*004 (0% and 6.8%) and HLA-B*52- MICA*009 (0% and 10.7%) were significantly higher in controls compared to BD patients (p<0.05). CONCLUSION: Our study shows that the MICA*006 (MICA-A6) and the MICA*009 alleles are associated with BD susceptibility in HLA-B*51 positive Turkish population, particularly in HLA-B*51 patients with MICA*006, which might be considered as a diagnostic biomarker for BD in the future.

Effect of intravenous preoperative versus postoperative paracetamol on postoperative nausea and vomiting in patients undergoing strabismus surgery: A prospective randomized study.

OBJECTIVES: This prospective randomized study aimed to compare the efficacy of preoperative versus postoperative paracetamol on postoperative nausea and vomiting (PONV) in children undergoing strabismus surgery. METHODS: Ninety-six patients were randomly divided into three equal groups (n=32). In the preoperative paracetamol group, patients received intravenous (IV) infusion of paracetamol [15 mg kg-1 (1.5 ml kg-1)] 1 h before surgery over 20 min and that of saline (1.5 ml kg-1) in the recovery room. In the postoperative paracetamol group, patients received IV infusion of saline (1.5 ml kg-1) 1 h before surgery over 20 min and that of paracetamol [15 mg kg-1 (1.5 ml kg-1)] in therecovery room. In the control group, patients received the IV infusion of saline (1.5 ml kg-1) pre- and postoperatively. Postoperative pain condition was evaluated using the Faces Pain Scale. In the recovery room, an observer recorded the pain score, complaints of nausea and vomiting, the need for rescue analgesics, and the need for antiemetic drug during 24 h postoperatively. RESULTS: The incidence of nausea and vomiting during the first 0-6 h postoperatively was significantly lower in the preoperative paracetamol group than in the control and postoperative paracetamol groups (p<0.001). The number of patients requiring antiemetic administration during the first 0-6 and 6-12 h postoperatively was found to be higher in the control group than in the other groups (p<0.001, for all). CONCLUSION: The preoperative administration of paracetamol reduces PONV incidence in children undergoing strabismus surgery.

Uncovering the Forgotten Effect of Superior Cervical Ganglia on Pupil Diameter in Subarachnoid Hemorrhage: An Experimental Study.

AIM: To investigate the relationship between neuron density of the superior cervical sympathetic ganglia and pupil diameter in subarachnoid hemorrhage. MATERIAL AND METHODS: This study was conducted on 22 rabbits; 5 for the baseline control group, 5 for the SHAM group and 12 for the study group. Pupil diameters were measured via sunlight and ocular tomography on day 1 as the control values. Pupil diameters were re-measured after injecting 0.5 cc saline to the SHAM group, and autologous arterial blood into the cisterna magna of the study group. After 3 weeks, the brain, superior cervical sympathetic ganglia and ciliary ganglia were extracted with peripheral tissues bilaterally and examined histopathologically. Pupil diameters were compared with neuron densities of the sympathetic ganglia and ciliary ganglia which were examined using stereological methods. RESULTS: Baseline values were; normal pupil diameter 7.180±620 ?m and mean neuron density of the superior cervical sympathetic ganglia 6.321±510/mm3, degenerated neuron density of ciliary ganglia was 5±2/mm3 after histopathological examination in the control group. These values were measured as 6.850±578 ?m, 5.950±340/mm3 and 123±39/mm3 in the SHAM group and 9.910±840 ?m, 7.950±764/mm3 and 650±98/mm3 in the study group. A linear relationship was determined between neuron density of the superior cervical sympathetic ganglia and pupil diameters (p < 0.005). Degenerated ciliary ganglia neuron density had an inverse effect on pupil diameters in all groups (p < 0.0001). CONCLUSION: Highly degenerated neuron density of the ciliary ganglion is not responsible for pupil dilatation owing to parasympathetic pupilloconstrictor palsy, but high neuron density of the pupillodilatatory superior cervical sympathetic ganglia should be considered an important factor for pupil dilatation.

A Comparative Study of the Effects of Intravitreal Anidulafungin, Voriconazole, and Amphotericin B in an Experimental Candida Endophthalmitis Model.

PURPOSE: To compare the safety and efficacy of intravitreal anidulafungin injection with voriconazole and amphotericin B (Amp B) in an experimental Candida endophthalmitis (CE) model. METHODS: Intravitreal 1 × 105 CFU/0.1 ml Candida albicans was injected into the right eyes of 24 New Zealand rabbits, which were divided into 4 groups. Voriconazole 50 µg/0.1 ml, Amp B 10 µg/0.1 ml, and Anidulafungin 50 µg/0.1 ml were injected by intravitreal injection 72 h after inoculation. The control group was injected with 0.1 ml 0.9% NaCl. Clinical scoring was performed by assessing the cornea, conjunctiva, iris, and vitreous on days 3 and 7 of therapy. At the end of the study, the right eyes of all rabbits were enucleated and histopathological evaluation was performed. Therapy groups were compared according to the clinical, histopathological, and microbiological analysis scores. RESULTS: Total clinical scores were significantly different between treatment groups and the control group (p < 0.05). On day 7 of the therapy, clinical scores of the anidulafungin group were found to be significantly lower when compared with the other therapy groups, while a significant improvement was observed in the eyes of rabbits in the anidulafungin group (p < 0.05). Also, microbiological scores of the anidulafungin group were lower than those of the control group (p < 0.05). Histopathological scores of the anidulafungin treatment group were significantly better than the voriconazole and control groups. Inflammation was evidently suppressed and marked retinal toxicity was not observed with anidulafungin. CONCLUSIONS: This is the first study comparing the efficacy of anidulafungin with other antifungal agents. In this CE model, an intravitreal single dose of anidulafungin was shown to be noninferior to voriconazole and Amp B. As an alternative to Amp B or voriconazole, intravitreal anidulafungin is suggested as an effective antifungal agent for the treatment of CE.

Phacoemulsification and Core Vitrectomy in Fuchs' Heterochromic Uveitis.

OBJECTIVE: To evaluate the efficacy of phacoemulsification combined with posterior capsulorhexis, core vitrectomy and ciliary sulcus intraocular lens (IOL) implantation in patients with Fuchs' heterochromic uveitis (FHU). MATERIALS AND METHODS: A total of 18 eyes of 18 patients with FHU underwent cataract surgery were included in the study. 18 eyes with FHU underwent posterior capsulorhexis, core vitrectomy and poly (methyl methacrylate) (PMMA) IOL implantation in the ciliary sulcus. Subjects were chosen for this procedure based on an intraoperative vitreous haziness assessment, performed by indirect ophthalmoscopy. Patients with +2 or more vitreous haziness qualified for this procedure. RESULTS: Of the 83 eyes with FHU that underwent cataract surgery, 18 eyes (21.6%) of 18 patients were employed in the study. There were 11 (61.1%) men and 7 (38.9%) women in the study; ages ranged from 23 to 47, with a mean of 32.06 years. Follow-up ranged from 8 months to 49 months. There were no intraoperative complications except for peripheral iris bleeding in 7 eyes. There was no severe intraocular inflammation in any patient postoperatively. All patients had 0.05 or better logMAR visual acuity after corneal suture removal. Glaucoma developed in 2 patients. For the short term period, the main vision threatening problem was suture-induced astigmatism. CONCLUSION: Cataract surgery combined with posterior capsulorhexis, core vitrectomy and IOL implantation in the ciliary sulcus is safe and leads to good visual outcome due to the removal of the hazy vitreous in patients with FHU.

Intravitreal Infliximab Injection to Treat Experimental Endophthalmitis.

OBJECTIVE: The purpose of this study was to compare the use of an intravitreal injection of infliximab and of dexamethasone combined with vancomycin to treat experimental endophthalmitis induced by Staphylococcus epidermidis. MATERIALS AND METHODS: The study was conducted between March 25 and April 13, 2012. Twenty-five six-month-old healthy rabbits were used, each weighing 2.5-3 kg. The rabbits were randomized into five groups with five animals per group. Endophthalmitis was induced by 0.1 mL (103 colony-forming units) S. epidermidis in all groups. In group 1, injection was not implemented after the occurrence of endophthalmitis. In groups 2, 3, and 4, the following intravitreal injections were given 24 h after the occurrence of endophthalmitis: group 2, 0.1 mg/0.1 mL vancomycin; group 3, 1 mg/0.1 mL vancomycin and 1 mg/0.1 mL dexamethasone; and group 4, 1 mg/0.1 mL vancomycin and 2 mg/0.1 mL infliximab. Group 5 was the control/uninfected group. The rabbits were clinically assessed each day for seven days. On day 9, a histopathologic evaluation was performed after enucleation. RESULTS: After a clinical evaluation, no statistically significant difference was found between the vancomycin+infliximab and vancomycin+dexamethasone groups (p>0.05). The difference was significant when both groups were compared with the vancomycin group (p<0.001). After the histopathologic evaluation, no statistically significant difference was found among the three groups (p>0.05). CONCLUSION: An intravitreal injection of infliximab and of dexamethasone combined with vancomycin have similar clinical and histopathologic effects. To supplement the antibiotic treatment of endophthalmitis, infliximab in a safe dose range can be used as an alternative to dexamethasone to suppress inflammation and prevent ocular damage.

Measurement of Choroidal Thickness Following Caffeine Intake in Healthy Subjects.

PURPOSE: The aim of this study is to investigate the effect of 200 mg caffeine on subfoveal choroidal thickness (CT) in the macular area as measured by enhanced depth imaging optical coherence tomography (EDI-OCT) in healthy subjects. MATERIALS AND METHODS: Fifty healthy individuals (study group) and 50 healthy individuals (control group) were enrolled in study. In the study group, participants received a 200 mg caffeine capsule and the control group consisted of subjects who received plasebo capsule. The subfoveal CT was measured by EDI-OCT before the caffeine intake and at 30 min, 1 h, 2 h, 3 h, 4 h and 6 h following caffeine intake. RESULTS: SFCT after caffeine intake was significantly decreased at 30 min, 1 h, 2 h, 3 h and 4 h compared to the baseline measurement, while the difference between baseline and 6 h was not statistically significant in the study group. There were no significant differences between the baseline and the other measurement times in the control group (p > 0.05). CONCLUSION: The thinning of CT begins about 30 min after the oral ingestion of 200 mg of caffeine and lasts for about four hours.

Neopterin Release and Tryptophan Degradation in Patients with Uveitis.

PURPOSE: Uveitis is an intraocular inflammation affecting the highly vascularized uveal tissue. Early recognition and appropriate therapeutic intervention of uveitis are important since the condition may be associated with systemic disease and untreated uveitis may lead to blindness. Neopterin, an unconjugated pteridine, is an important biomarker of cell-mediated immunity and has a potential function in the process of inflammation. In addition to neopterin release, cellular immune activation also induces indoleamine 2,3-dioxygenase (IDO). In this study, the aim was to investigate possible immune changes in uveitis by determination of neopterin concentrations and tryptophan (Trp) degradation. MATERIALS AND METHODS: The participants who attended to the ophthalmology clinic with uveitis were divided into two groups: active (n = 63) and remission (n = 41). Additionally 30 healthy subjects were recruited as a control group. RESULTS: In total, in 104 uveitis patients, urinary and serum neopterin, kynurenine (Kyn), and Kyn/Trp were found to be statistically higher than the 30 controls (all, p < 0.05). It was observed that all of the measured parameters did not differ between active and remission uveitis groups (all, p > 0.05), except for the Kyn/Trp ratio (p < 0.05). Urinary and serum neopterin levels were positively correlated with Kyn/Trp in the uveitis patients (both p < 0.05). CONCLUSIONS: From these results, it can be concluded that uveitis can cause alterations in neopterin levels and the Kyn pathway. It seems that the measured parameters can be useful markers of cellular immune response in uveitis, although they might not be used to differentiate active or remission uveitis.

An experimental study of the neurophysical mechanisms of photophobia induced by subarachnoid hemorrhage.

BACKGROUND: Photophobia is defined as a painful psychosomatic discomfort triggered by intense light flow through the pupils to the brain, but the exact mechanism through which photophobia is induced by subarachnoid hemorrhage (SAH) is not well understood. In this study, we aimed to investigate whether there was any relationship between the mydriasis induced by the degeneration of the ciliary ganglion (CG) and photophobia in instances of SAH. MATERIALS AND METHODS: Five of a total of 25 rabbits were used as the intact control group; five were used in the sham-operated control group; and the remaining 15 were used as the SAH group, which was created by injecting autologous blood into their cisterna magna. All animals were examined daily for 20days to evaluate their level of photophobia, after which their brains, CGs and superior cervical ganglia (SCGs) were extracted bilaterally. The densities of normal and degenerated neurons in these ganglia were examined by stereological methods. RESULTS: In SAH animals with a high photophobia score, the mean pupil diameter and density of degenerated neurons density in the CG were greater than in cases with a low photophobia score (p<0.05). Further analysis revealed that the increase in the density of degenerated neurons in the CG following SAH resulted in the paralysis of the parasympathetic pathway of the pupillary muscles and mydriasis, which facilitates the excessive transfer of light to the brain and photophobia. CONCLUSION: Our findings indicate that SAH results in a high density of degenerated neurons in the CG, which induces mydriasis and is an important factor in the onset of photophobia. This phenomenon is likely due to more light energy being transferred through mydriatic pupils to the brain, resulting in vasospasm of the supplying arteries.