Comparison of Two Scoring Systems in Pediatric Open Globe Injuries.

PURPOSE: The aim of this study is to determine the demographic characteristics of pediatric open globe injuries, evaluate the ocular trauma scores (OTS), and predict the visual outcomes. METHODS: All patients with pediatric open globe injuries who applied to Department of Ophthalmology, Faculty of Medicine, Mersin University between January 2018 and December 2019 were included in this study. Age, gender, type of injury, time of admission, time to surgery, OTS, and pediatric ocular trauma score (POTS) were calculated for each patient. The relation between these findings and final visual acuity (VA) after 12 months of follow-up was examined. RESULTS: Forty-two eyes of 41 patients were included in this study. The most common injuries observed were sharp objects such as knives (23.8%) and stones (23.8%). The wound locations were zone I in 36 patients (85.7%) and zone II in 6 patients (14.3%). The most common concomitant eye pathologies were iris prolapse in 37 (88.1%) and hyphema in 29 (69.1%). The mean original OTS was 77.21 and the mean POTS was 46.78. Association between OTS/POTS and final VA was very good (Kendall Tau-b = 0.665, P < 0.001, Kendall Tau-b = 0.505, P < 0.001, respectively). The level of agreement between the predicted VA for OTS and that for POTS was almost perfect (kappa = 0.8726). CONCLUSIONS: This study shows that the original OTS is still the gold standard in pediatric cases.

A Rare Ocular Complication of Autologous Fat Injection: Subconjunctival Fat Infiltration.

ABSTRACT: The aim of this brief clinical study to describe and discuss the subconjunctival fat infiltration encountered in a patient with autologous fat injection. A 50-year-old female patient, who had an autologous fat injection 2 days ago, applied to our clinic with the complaint of redness and burning in the left eye. On anterior segment examination, a raised 20 × 15 mm adipose tissue was observed in the temporal region under the conjunctiva. Infiltrated fat tissue was surgically removed from the subconjunctival area. Subconjunctival fat infiltration is an extremely rare complication after autologous fat injection.

Evaluation of Ocular Complications by Using Optical Coherence Tomography in Children With Sickle Cell Disease Eye Findings in Children With Sickle Cell Disease.

OBJECTIVE: The aim of this study was to compare optical coherence tomography (OCT) findings in pediatric patients with sickle cell disease (SCD) and healthy individuals and to investigate associations between these data and the patients' systemic findings. MATERIALS AND METHODS: The study included 108 eyes of 54 patients with SCD with no visual symptoms and a control group consisting of 110 eyes of 55 healthy subjects with no systemic or ocular pathology. After best-corrected visual acuity assessment, the study participants underwent a complete ophthalmologic examination including intraocular pressure. After examination and pupil dilation induced with 1% tropicamide, 9×9 mm macular sections were obtained with spectral-domain OCT. The macular sections were evaluated according to Early Treatment Diabetic Retinopathy Study (ETDRS) map and internal and external retinal thicknesses were measured using the software included in the OCT device. RESULTS: The patient group showed significantly more foveal flattening, temporal thinning, and vascular tortuosity than the control group (P<0.0001 for all). Foveal width was significantly greater in the patient group (1592.39±175.56 µm) compared with the control group (1391.01±175.56 µm) (P<0.0001), whereas foveal depth was significantly lower in the patient group (121.15±26.83 µm) than in the control group (146.1±12.25 µm) (P<0.0001). The mean total retinal thickness was 253.53±22.31 µm in the patient group and 261.03±18.48 µm in the control group (P=0.007). Similarly, central retinal thickness was significantly lower in the patient group (219.35±10.53 µm) compared with the control group (235.32±12.51 µm) (P<0.0001). DISCUSSION: Our study shows that pediatric patients with SCD may have subclinical retinal involvement and that temporal thinning, in particular, is an important OCT finding. This strongly suggests that OCT imaging would be a beneficial addition to routine ophthalmologic examination in the diagnosis and follow-up of this patient group.

Assessment of miR-182, miR-183, miR-184, and miR-221 Expressions in Primary Pterygium and Comparison With the Normal Conjunctiva.

OBJECTIVES: The aim of this study was to investigate the expression levels of miR-126-3p, miR-182-5p, miR-183-5p, miR-184, miR-221-3p, and miR-205-5p in primary pterygium tissue and compare these levels with those in healthy conjunctiva tissue. METHODS: Twenty-four patients who were diagnosed with grade 3 primary pterygium and scheduled for surgery between January 2014 and January 2016 and had no systemic disease or other ocular pathology were included in the study. The control group comprised nasal interpalpebral conjunctival tissue specimens from 24 age- and sex-matched patients with no history of systemic disease or ocular pathology other than cataract. Expression levels of miR-126-3p, miR-182-5p, miR-183-5p, miR-184, miR-221-3p, and miR-205-5p were determined and compared between the pterygium and conjunctiva specimens. RESULTS: Expression levels of miR-182-5p, miR-183-5p, and miR-184 were significantly higher in pterygium tissue compared with normal conjunctival specimens (P<0.0001, P=0.01, and P=0.01, respectively), whereas expression of miR-221-3p was significantly lower (P=0.02). Expression levels of miR-126-3p and miR-205-5p did not differ significantly between the 2 groups (P>0.05). CONCLUSIONS: Expression levels of miR-182-5p, miR-183-5p, and miR-184 are increased, whereas expression of miR-221-3p is decreased in primary pterygium tissue, and these miRNAs may play a role in the pathogenesis of pterygium.

Evaluation of microRNA responses in ARPE-19 cells against the oxidative stress.

PURPOSE: This study aimed to determine microRNA (miRNA) expression profile of human retinal pigment epithelium cell (ARPE-19) against the oxidative stress induced by hydrogen peroxide (H2O2). METHODS: ARPE-19 cells were incubated with different concentrations of H2O2 (200, 600 and 800 µM) for 18 h, and then cell viability, vascular endothelial growth factor levels and total oxidant status were evaluated. Expressions of 1152 miRNA were determined by quantitative real-time PCR in each group. RESULTS: Expressions of 90 miRNA were significantly changed in the ARPE-19 cells incubated with H2O2 compared to control group. However, miR-143-3p was only found to be expressed in groups incubated with H2O2. While 24 miRNA (hsa-miR-200c-3p, miR-192-5p, miR-194-5p, miR-141-3p, miR-658, miR-18 b-5p, miR-486-5p, miR-525-3p, miR-493-3p, miR-518d-3p, miR-29 b-1-5p, miR-675-3p, miR-1238-3p, miR-195-3p, miR-1539, miR-490-5p, miR-3200-5p, miR-1273d, miR-130a-5p, miR-30 b-5p, miR-1247-5p, miR-1910-5p, miR27a-5p and miR-200 b-3p) upregulated due to the increased dose of H2O2, nine miRNA (hsa-miR-96-5p, miR-33a-5p, miR-345-5p, miR-106 b-3p, miR-1285-3p, miR-23 b-5p, miR-27 b-5p, miR-103a-3p and miR-4289) were also found to be downregulated. CONCLUSION: This study suggests that oxidative stress may be an important factor on expression of miRNAs in ARPE-19 cells. These miRNAs may have a role in the pathogenesis of age-related macular degeneration related to oxidative stress. However, this relationship needs to be examined in new studies by evaluation of pathways and target genes.

Expression of prostaglandin E2 receptor subtypes in human pterygium and normal conjunctiva: immunohistochemical study.

PURPOSE: In the present study, we aimed to evaluate the expression of EP receptors in primary and recurrent human pterygium tissues. METHODS: Pterygium samples were collected from 65 patients with primary pterygium and 16 patients with recurrent pterygium. Normal conjunctival tissues were collected from nasal interpalpebral area from 17 patients without systemic and any other ocular pathology. Expression of EP receptors was evaluated by immunohistochemistry. The median value for each receptor staining score (RSS) was determined in normal conjunctival specimens. In this study, RSS of > median value was defined as positive staining or high expression and ≤ median value as negative staining or weak expression in specimens. Chi-square test was used for statistical analysis, and p value of less than 0.05 was considered significant. RESULTS: Stromal expression of EP1 was significantly higher in primary and recurrent pterygium specimens compared to normal conjunctival tissues (p = 0.007 and p = 0.002, respectively). Epithelial expressions of EP2 and EP3 were significantly lower in primary pterygium specimens compared to normal conjunctival tissues (p = 0.005 and p < 0.0001, respectively), and stromal expressions were insignificant. Stromal expression of EP4 was significantly higher in primary and recurrent pterygium specimens compared to normal conjunctival tissues (p = 0.002 and p = 0.012, respectively). CONCLUSIONS: Expression of EP receptors has been up- or downregulated in primary and recurrent pterygium tissues, and these receptors may play a role in formation and recurrence of pterygium.

Scleral fixated intraocular lens implantation with a modified Z-suture technique.

PURPOSE: To evaluate visual outcomes and complications in scleral fixated intraocular lens (IOL) implantation with the modified Z-suture technique. MATERIALS AND METHODS: Thirty-five eyes of 35 patients (20 male, 15 female) were included in the study. Patients underwent scleral fixated IOL implantation using the modified Z-suture technique and were followed in terms of visual acuity and complications. RESULTS: Mean postoperative follow-up time was 12.46 ± 7.46 months. Mean best corrected visual acuity was 1.35 ± 0.91 logMAR preoperatively and 0.48 ± 0.39 logMAR postoperatively, and difference was statistically significant (p < 0.001). No suture-related complications were observed during follow-up in any of the patients. Slight infero-temporal dislocation of the IOL was observed at postoperative 5 months in one patient (2.85%) who experienced blunt trauma. It caused no optical disturbance, and repeated surgery was not advised. Transient intravitreal hemorrhage was observed in two patients (5.7%) who underwent combined scleral fixation and pupilloplasty. DISCUSSION: The modified Z-suture technique is simple, fast, and was determined to be safe in terms of complications. However, long-term outcomes should be evaluated in larger patient groups.

Bilateral Subperiosteal Hematoma and Orbital Compression Syndrome in Sickle Cell Disease.

A 14-year-old boy with sickle cell disease presented with preseptal cellulitis findings as proptosis, eyelid edema, and hyperemia. His best corrected visual acuity in the right eye was 20/20 and 16/20 in the left eye. He had limited ductions in vertical and lateral gazes in both eyes. Bilateral venous tortuosity was observed in posterior segment examination. Orbital bone infarction and subperiosteal hematoma were seen in magnetic resonance imaging. He was diagnosed as having orbital compression syndrome secondary to vaso-occlusive crisis of sickle cell disease and was treated with intravenous ampicilin-sulbactam and methylprednisolone.

Evaluation of circulating miRNAs in wet age-related macular degeneration.

PURPOSE: In the present study, we aimed to investigate the changes in plasma miRNA in patients with wet age-related macular degeneration. METHODS: The expression profiles of 384 miRNAs in plasma from 33 patients (22 male, 11 female) who were diagnosed with wet age-related macular degeneration with fundus examination, fundus fluorescein angiography, and optical coherence tomography and 31 controls (17 male, 14 female) were evaluated using high-throughput quantitative real-time PCR. RESULTS: Our results demonstrated that the expression level of five miRNAs (miR-17-5p, miR-20a-5p, miR-24-3p, miR-106a-5p, and miR-223-3p) was significantly upregulated in patients with age-related macular degeneration when compared to the control group (p<0.05). The expression level of 11 miRNAs (miR-21-5p, miR-25-3p, miR-140-3p, miR-146b-5p, miR-192-5p, miR-335-5p, miR-342-3p, miR-374a-5p, miR-410, miR-574-3p, and miR-660-5p) was significantly downregulated in patients (p<0.05). In addition, ten miRNAs (miR-26b-5p, miR-27b-3p, miR-29a-3p, miR-139-3p, miR-212-3p, miR-324-3p, miR-324-5p, miR-532-3p, miR-744-5p, and miR-Let-7c) were expressed only in the patient group. CONCLUSIONS: Our results suggest that plasma miRNA levels may change in wet age-related macular degeneration. These molecules may have an important therapeutic target in patients who are unresponsive to antivascular endothelial growth factor therapy. However, further studies must be conducted for possible effects of miRNAs in vascular disorders of eye such as age-related macular degeneration.

Central retinal artery occlusion and irreversible blindness due to paranasal sinus infection in a pregnant woman.

Paranasal sinus infections can cause severe orbital complications leading to blindness. The mechanism for blindness with paranasal sinus infection can involve thrombophlebitis ischemia by valveless orbital veins, pressure ischemia resulting in central artery occlusion, or optic neuritis as a reaction to adherent infection. We present a case of orbital cellulitis leading to central retinal artery occlusion and blindness in a 30-week pregnant woman.

Intravitreal bevacizumab effects on VEGF levels in distant organs: an experimental study.

PURPOSE: The aim of this study was to determine the effects of single-dose intravitreal bevacizumab on the levels of vascular endothelial growth factor (VEGF) in serum and distant organs. METHODS: Adult New Zealand albino rabbits (n = 40) were divided into experimental and control groups. Experimental rabbits received a single 0.05 ml intravitreal injection of 1.25 mg bevacizumab (Avastin) into the right eye, and control rabbits (n = 8) received no injection. Following injection, group 1 rabbits (n = 8) were sacrificed on day 1, group 2 rabbits (n = 8) on day 7, group 3 rabbits (n = 8) on day 14, and group 4 rabbits (n = 8) on day 28; control rabbits were sacrificed on day 28. After sacrifice, samples of brain, heart, liver, kidney and blood were collected. Levels of VEGF in serum and tissue were measured using enzyme-linked immunosorbent assay. The presence of bevacizumab was evaluated by immunofluorescence staining in tissues. RESULTS: Positive bevacizumab immunoreactivity was observed in brain, heart and kidney. Serum VEGF levels significantly decreased in groups 3 and 4 compared with controls (p < 0.05). Liver VEGF levels significantly decreased in group 3 compared with controls (p < 0.05). CONCLUSIONS: Intravitreal bevacizumab not only may escape from the blood-retinal barrier and enter the general circulation, but also may be disseminated to distant organs. Our study demonstrates that a single dose of intravitreally injected bevacizumab decreases VEGF levels in serum and liver.

Retinal endoilluminator toxicity of xenon and light-emitting diode (LED) light source: rabbit model.

OBJECTIVE: This study evaluates retinal toxicity due to endoillumination with the light-emitting diode (LED) light source in comparison to endoillumination with xenon light source. MATERIAL AND METHODS: Twenty-five eyes of 14 New Zealand pigmented rabbits were used in the study. The LED light (Omesis Medical Systems, Turkey) group was composed of 7 right eyes, while the other 7 right eyes constituted the xenon group (420 nm filter, 357mW/cm(2)) (Bright Star; DORC, Zuidland, Netherlands). Eleven untreated left eyes composed the control group. Twenty gauge pars plana incision 1.5 mm behind the limbus was performed in the right eyes. Twenty gauge bullet type fiberoptic endoilluminator was inserted into the eye from the incision without any pars plana vitrectomy. Fiberoptic endoilluminator was placed in such a way that it was directed toward visual streak of the rabbit retina with a 5 mm distance to retinal surface. Endoillumination was then applied for 20 min with a maximum light intensity for LED and xenon light. In left control eyes, no surgical procedure and no endoillumination were performed. One week after the endoillumination procedure, both eyes of the rabbits were enucleated following electroretinography. Sections stained with hematoxylin and eosin to evaluate morphologic changes. Retina tissues were assessed by active caspase-3 staining. RESULTS: There was no difference in the shape of the waveforms recorded in the eyes endoilluminated with LED light and xenon light sources compared to control eyes both before and after endoillumination application (p > 0.05). Microscopic evaluation of the retinas with hematoxylin and eosin staining demonstrated that all study groups have normal histologic properties similar to control group. No apoptosis positive cells were found within all sections in all groups. CONCLUSIONS: When the LED light source is used with maximum power and limited duration for endoillumination in rabbit eyes it does not produce phototoxic effects that may be detectable by electrophysiology and histology similar to xenon light.

Peptide Nanofiber System for Sustained Delivery of Anti-VEGF Proteins to the Eye Vitreous.

Ranibizumab is a recombinant VEGF-A antibody used to treat the wet form of age-related macular degeneration. It is intravitreally administered to ocular compartments, and the treatment requires frequent injections, which may cause complications and patient discomfort. To reduce the number of injections, alternative treatment strategies based on relatively non-invasive ranibizumab delivery are desired for more effective and sustained release in the eye vitreous than the current clinical practice. Here, we present self-assembled hydrogels composed of peptide amphiphile molecules for the sustained release of ranibizumab, enabling local high-dose treatment. Peptide amphiphile molecules self-assemble into biodegradable supramolecular filaments in the presence of electrolytes without the need for a curing agent and enable ease of use due to their injectable nature-a feature provided by shear thinning properties. In this study, the release profile of ranibizumab was evaluated by using different peptide-based hydrogels at varying concentrations for improved treatment of the wet form of age-related macular degeneration. We observed that the slow release of ranibizumab from the hydrogel system follows extended- and sustainable release patterns without any dose dumping. Moreover, the released drug was biologically functional and effective in blocking the angiogenesis of human endothelial cells in a dose-dependent manner. In addition, an in vivo study shows that the drug released from the hydrogel nanofiber system can stay in the rabbit eye's posterior chamber for longer than a control group that received only a drug injection. The tunable physiochemical characteristics, injectable nature, and biodegradable and biocompatible features of the peptide-based hydrogel nanofiber show that this delivery system has promising potential for intravitreal anti-VEGF drug delivery in clinics to treat the wet form age-related macular degeneration.

Investigation of eNOS G894T Gene Polymorphism in Patients with Pseudoexfoliation Syndrome: A Preliminary Study.

Objectives: The aim of this study is to investigate the relationship between pseudoexfoliation syndrome (XFS) and pseudoexfoliative glaucoma (XFG) and endothelial nitric oxide synthase (eNOS) G894T polymorphism. Methods: Seventy-eight eyes of 78 patients who had undergone uncomplicated cataract surgeries for senile cataract were included in this study. Forty patients with XFS were included in the study group, and 38 patients without XFS constituted the control group. Patients with XFS were divided into two subgroups according to their XFG development, and subgroup analysis was performed. Venous blood samples were taken from all patients before surgery and 894 G>T (rs1799983) polymorphism on the eNOS gene was evaluated by RT-PCR. Results: While the mean age in the control group was 65.97±10.64 years (23 males and 15 females), the mean age in the study group was 73.05±6.79 years (30 males and 10 females), (p<0.001). Regression analysis of the risks caused by the genotype and alleles between the control and study groups revealed that the homozygous alleles were more common in the study group, and heterozygous or mutant alleles have reduced the development of XFS approximately 2-folds. However, this was not statistically significant (p=0.11). Similarly, when subgroup analysis was performed, it was found that there was no significant relationship between XFG in patients with XFS and gene polymorphism. Conclusion: In this study, it was observed that there was no relationship between the G894T polymorphism in the eNOS gene and the development of XFS/XFG.

Endoscopic endonasal dacryocystorhinostomy learning curve.

PURPOSE: To compare the learning curves of the specialists in two different fields without previous endoscopic endonasal dacryocystorhinostomy experience as well as to reveal the related complications with surgical success rates. METHODS: We retrospectively investigated 90 patients who received consecutive endoscopic endonasal dacryocystorhinostomy with mucosa preservation by an ophthalmologist (Group 1, n=45) and an otorhinolaryngologist (Group 2, n=45) between October 2017 and October 2019. Patients who were admitted with epiphora complaints and diagnosed with primary acquired nasolacrimal duct obstruction through lacrimal irrigation test and aged >18 years with at least 6 months of follow-up were included in the study. In all cases, additional pathologies such as septum deviation were evaluated by performing maxillofacial imaging. Patients' medical records were evaluated in terms of surgery duration, complications, and functional achievements. RESULTS: The mean surgical duration of the patients in Group-2 was 36.27 ± 11.61 min, while it was 43.62 ± 16.89 min in Group-1; the difference was statistically significant (p=0.018). Functional achievements in Group 1 was 84.4% (73.3% in the first set of 15 cases, 93.3% in the last set of 15 cases) in Group 2; this rate was 88.9% (80% in the first set of 15 cases, 93.3% in the last set of 15 cases), and the difference was not statistically significant (p=0.53). Septum intervention in addition to endoscopic surgery in both the groups (p=0.03, p=0.005, respectively) and intense bleeding during surgery (for both the groups, p<0.0001) significantly decreased the functional success. CONCLUSION: Endoscopic endonasal dacryocystorhinostomy, performed after the necessary training, can provide high success and low complication rates when even conducted by ophthalmologists who are unfamiliar with endoscopic surgery after an experience of 30 cases.

A case of late-onset Klebsiella oxytoca keratitis treated with topical imipenem after deep anterior lamellar keratoplasty.

The aim of this study was to discuss a case of late-onset Klebsiella oxytoca keratitis after deep anterior lamellar keratoplasty and its treatment. A 21-year-old female patient presented with redness and effluence in the left eye at 5 months after uncomplicated deep anterior lamellar keratoplasty surgery. In the examination, a single suture was loosened in the superior nasal region and there was an infiltration area and epithelial defect in the graft and recipient bed junction in the area of the loose suture. Topical fortified vancomycin and fortified ceftazidime treatment was started empirically hourly, but there was insufficient response. After K. Oxytoca growth in a swab and suture culture taken from the patient, fortified vancomycin was replaced with fortified imipenem. It was observed that the infiltration area rapidly regressed and the epithelial defect was closed after fortified imipenem treatment. Fortified imipenem may be considered as an alternative treatment, especially in cases in which there is no response to treatment and culture growth is detected.

Evaluation of Anti-Inflammatory and Antiapoptotic Effects of Bone Marrow and Adipose-Derived Mesenchymal Stem Cells in Acute Alkaline Corneal Burn.

Purpose: The aim of the present study is to comparatively evaluate the anti-inflammatory and antiapoptotic effects of bone marrow and adipose-derived mesenchymal stem cells (MSCs) applied subconjunctivally after alkaline corneal burn. Methods: Thirty-two rats were divided into 4 groups and included in the study (n = 8). While no intervention was made in the control group, a chemical burn was created by applying 4 µL of NaOH soaked in 6 mm filter paper to the right eye of each subject in the other groups under general anesthesia. While only subconjunctival 0.1 mL phosphate-buffered saline (PBS) was injected to in the group 1, 2 × 106 adipose or bone marrow-derived MSC in 0.1 mL PBS was applied subconjunctivally to the subjects in the remaining groups (Group 2 and 3, respectively). Tissue samples were collected for histological analysis on the third day after the burn. Tissue samples were evaluated light microscopically and immunohistochemically stained for interleukin-1 beta (IL-1ß), tumor necrosis factor alpha (TNF-α), caspase-3 (Cas-3), and CD68. Results: The IL-1ß and TNF-α staining scores and the number of CD68- and Cas-3-positive stained cells were significantly lower in the groups given bone marrow and adipose-derived MSC compared to the alkaline burn group (P < 0.0001, for all parameters). Epithelial IL-1ß and TNF-α staining scores were significantly lower in the bone marrow-derived MSC group compared to the adipose-derived MSC group (P < 0.0001, for all parameters). Conclusions: The presented study shows that both bone-marrow and adipose-derived MSCs support wound healing in the corneal tissue and strongly suppress the inflammation occured in the tissue.

Effects of Bone Marrow and Adipose-Derived Mesenchymal Stem Cells on microRNA Expressions in Acute Alkaline Corneal Burn.

Purpose: The aim of this study was to investigate the microRNA (miRNA) expressions of the corneal tissue after an alkaline burn and to compare the efficiency of adipose- and bone marrow-derived mesenchymal stem cells (MSCs) on expressions. Methods: Thirty-two rats were divided into 4 groups. No intervention was made in the control group. A chemical burn was created by applying 4 µL NaOH soaked in 6 mm filter paper to the right eye of each animal in the other groups. Whereas only subconjunctival 0.1 mL phosphate-buffered saline (PBS) was injected to in the group 1, 2 × 106 adipose- or bone marrow-derived MSC in 0.1 mL PBS was injected subconjunctivally to the animals in the remaining groups (groups 2 and 3, respectively). Tissue samples were collected for miRNA analysis on the third day after the burn. Results: When group 1 was compared with the control group, the expression of 3 of 93 miRNAs increased significantly, whereas the expression of 50 miRNAs decreased significantly. Significant changes in miRNA expressions were observed when group 1 was compared with groups 2 and 3. Although a significant change was observed in the expression of 6 miRNAs in the adipose-derived MSC group, it was found that the expression of 65 miRNAs significantly changed in the bone marrow-derived MSC group. Conclusion: This study shows that there are significant changes in some miRNA expressions after corneal alkaline burn and these changes can be reversed with the subconjunctival injection of MSCs.

Inducing ocular allergy with beta-lactoglobulin: a new experimental model.

PURPOSE: To develop a new experimental ocular allergy animal model induced by beta-lactoglobulin (BLG), a major cow's milk allergen, and to discuss the clinical, histopathological and immunohistochemical findings. METHODS: Forty Balb/c mice were randomized and separated into groups of 10. Groups were determined according to the different concentrations of BLG drops used. Study groups were immunized with 2.5, 5 or 10 mg/ml topical BLG (groups 2, 3 and 4, respectively) following intraperitoneal injection for the systemic immunization. The control group (group 1) was immunized with aluminium hydroxide (alum) alone within the same intervals. After ocular challenge, all the animals were evaluated clinically, histopathologically (mast cell and eosinophil infiltration) and immunhistochemically in terms of both T helper type 1- (IFNgamma, TNFalpha) and T helper type 2- (IL-3, IL-4, IL-5, IL-10) specific cytokines. RESULTS: Both clinical and immunohistochemical findings showed that an allergic conjunctivitis was induced in all study groups, with an optimized dosage of topical 5 mg/ml BLG. The conjunctivitis was associated with both Th1 and Th2 response, with a slight predominance of Th1 reaction. CONCLUSION: We describe a new murine model of acute allergic conjunctivitis induced by BLG. We believe that this new preliminary model has the immune parameters of the late phase of acute allergic conjunctivitis and it provides an alternative means for studying the pathogenesis and future treatments of ocular allergy. Our results should be enhanced with more detailed cellular and humoral parameters.

The Role of Optical Coherence Tomography Signal Strength in the Diagnosis and Follow-up of Patients with Posterior Capsular Opacification Treated with Nd:YAG Laser Capsulotomy

Objectives: To investigate the relationship between optical coherence tomography (OCT) signal strength (SS) and visual acuity in patients with posterior capsule opacification (PCO) and evaluate the effect of PCO on retinal thickness measurements. Materials and Methods: Forty-one eyes of 35 patients who were diagnosed with PCO were included in the study. Patients with any anterior or posterior segment pathology other than PCO were excluded. After ophthalmologic examination, pupil dilation was induced using 0.5% tropicamide and OCT images were acquired. The assessment was repeated 1 month after Nd:YAG laser capsulotomy and postoperative values were compared with baseline values. Results: The patients' mean best corrected visual acuity (BCVA) was 0.28±0.13 preoperatively and 0.78±0.09 postoperatively (p<0.0001). Strong positive correlations were observed between BCVA and SS both pre- and postoperatively (p<0.0001 and p=0.01, respectively). Central retinal thickness (CRT) and SS increased significantly postoperatively (p<0.0001 for both). OCT SS and CRT were strongly correlated preoperatively (p=0.001) but not postoperatively (p=0.46). Conclusion: OCT SS correlates with visual acuity in patients with PCO, and PCO can affect the accuracy of objective data obtained with OCT.