Serum dehydroepiandrosterone sulphate level in age-related macular degeneration.

PURPOSE: To evaluate plasma dehydroepiandrosterone sulphate (DHEAS) levels in patients diagnosed with age-related macular degeneration (AMD) and controls. DESIGN: Case-controlled, prospective, comparative noninterventional study. METHODS: This study involved 32 men and 35 women with exudative AMD, 37 men and 38 women with nonexudative AMD, and 32 men and 32 women of an age-matched control group. The Wisconsin Age-Related Maculopathy Grading System was used to asses the severity of AMD lesions. DHEAS levels were measured and compared according to a gender based subdivision. Analysis of variance was used to assess the association between DHEAS and AMD. Linear regression model was used to examine the relation among DHEAS level and AMD severity scale. RESULTS: Mean +/- SD of DHEAS levels in exudative AMD, nonexudative AMD, and controls in men was 2.67 +/- 0.68 micromol/l, 2.89 +/- 0.95 micromol/l, and 4.43 +/- 1.44 micromol/l, respectively (P = .001), and in women was 1.64 +/- 0.72 micromol/l, 1.85 +/- 0.73 micromol/l, and 2.78 +/- 0.91 micromol/l, respectively (P = .001). Post hoc Tukey analyses revealed a significant reduction in serum DHEAS level in both AMD groups, compared with controls for men and women (P = .001), while no difference was found between AMD groups in both men and women (P = .668 and 0.49, respectively). Regression analyses revealed an inverse correlation among serum DHEAS level and AMD severity scale both in men and women (P = .006 and .007, respectively). CONCLUSIONS: This study suggests an inverse correlation between serum DHEAS level and AMD severity scale with a considerably reduced DHEAS level in AMD.

Comparative trial of different anti-bacterial combinations with propolis and ciprofloxacin on Pseudomonas keratitis in rabbits.

The aim of the current study was to evaluate the effects of five different treatment combinations to find out whether propolis could be an alternative or an adjunctive treatment, in experimental Pseudomonas aeruginosa keratitis. Intrastromal P. aeruginosa strains were given to both eyes of 20 young New Zealand white rabbits. The rabbits were randomly divided equally into five treatment groups; ciprofloxacin and dexamethasone drops (C+D), ciprofloxacin drop (C), ciprofloxacin and propolis drops (C+P), propolis drop (P), 3% ethanol drop (control), respectively. Directly before the first treatment and 108 h after inoculation, the eyes were examined by slit lamp to assess the corneal opacity and rabbits were sacrificed for bacterial count. The mean corneal opacity scores and the mean bacterial counts log cfu/ml were significantly different in the treatment groups (P=0.001; ANOVA). According to post hoc tests for both the mean bacterial counts and corneal opacity scores, C+D, C, C+P groups were found to be statistically the same (P>0.05), and although the P group had significantly better scores than the control group it did not reach the scores of the rest of the treatment groups (P<0.01). We conclude that propolis may be a useful adjunctive agent but should not be regarded as a replacement for traditional antibiotic therapy for P. aeruginosa keratitis in rabbits.

Primary peripheral primitive neuroectodermal tumour of the orbit.

CASE REPORT: We present the clinical, radiologic, and histopathologic features of an orbital mass in a 10-year-old boy. Immunohistochemistry confirmed the diagnosis of primary peripheral primitive neuroectodermal tumour. COMMENTS: This recently recognized rare tumour of the orbit should be considered in the differential diagnosis of hypercellular small round cell tumour of the orbit.

Tear film tests in Parkinson's disease patients.

OBJECTIVE: Parkinson's disease (PD) has both motor and nonmotor features. Parkinson's disease patients are prone to dry eye due to both autonomic dysfunction and motor symptoms affecting blinking. This study was conducted to investigate the changes in tear functions in PD patients. DESIGN: Nonrandomized, prospective, clinical study. PARTICIPANTS: Fifty-six eyes of 56 consecutive patients with PD were studied. Thirty-six eyes of age-matched non-PD patients without pathology affecting tear tests were examined as control subjects. INTERVENTION: Modified Hoehn-Yahr (H-Y) scale, blink rate (BR), and tear tests were examined. MAIN OUTCOME MEASURES: Modified H-Y scale, BR, dry eye assessment questionnaire, meibomian gland evaluation, tear meniscus height, tear breakup time, fluorescein stain, rose bengal stain, Schirmer's test, and phenol red thread test. RESULTS: Overall tear function abnormalities were significantly more common in PD patients (P = 0.001, Mann-Whitney U test). Each test was found to be significantly disturbed in PD patients relative to controls (P<0.05, Mann-Whitney U test). Each PD patient had at least 1 abnormal test. Overall tear function abnormalities as assessed by the total abnormal test count correlated with the H-Y score (P<0.001, Spearman rho correlation). Parkinson's disease patients' mean BR (12.7+/-7.42 per minute) was significantly less than the controls' (21.8+/-7.37) (P<0.01, Student's t test). The abnormality in each tear test, except those for meibomian gland function and tear meniscus height, was significantly related to the H-Y scores (P<0.05, chi2 linear-by-linear association). CONCLUSION: The results of this study indicate that PD is associated with disturbances in tear function. With the exception of meibomian gland disease and tear meniscus height, the tests were found to have a linear association with the H-Y scale, which may be attributed to associated dysfunctions of PD.

Circadian intraocular pressure control with dorzolamide versus timolol maleate add-on treatments in primary open-angle glaucoma patients using latanoprost.

PURPOSE: To compare the 24-hour efficacy of dorzolamide and timolol maleate administered twice daily to primary open-angle glaucoma patients whose intraocular pressure (IOP) could not be adequately controlled with latanoprost monotherapy. METHODS: In this double-blind prospective crossover clinical comparison trial, 36 primary open-angle glaucoma patients with uncontrolled IOP despite treatment with latanoprost applied once daily were administered timolol and dorzolamide twice daily. The treatment sequence was randomized. All patients underwent measurements for four 24-hour tonometric curves: at baseline and after each 4-week period of treatment. The IOP measurements were taken at 06:00, 09:00, 12:00, 15:00, 18:00, 21:00, 24:00 and 03:00 h. The between-group differences were tested for significance by means of parametric analysis of variance at each time point and circadian curve. The peak values within circadian curve were defined. The mean of the exact amount and percentage of additional IOP reductions from baseline were evaluated and success rates (a minimum of 10% reduction) were determined for both drug regimens. RESULTS: The mean peak/circadian curve IOPs were 23.4 +/- 2.2/21.8 +/- 2.2 mm Hg at dorzolamide baseline, 23.3 +/- 2.2/21.7 +/- 2.1 mm Hg at timolol baseline, and reduced to 20.2 +/- 1.7/18.7 +/- 1.7 mm Hg and 20.7 +/- 2.4/19.4 +/- 1.6 mm Hg, respectively. When added to latanoprost, both dorzolamide and timolol lowered IOP at circadian curve significantly (p < 0.05). Dorzolamide reduced baseline IOP values at each time point. Timolol also significantly reduced baseline IOP values at all time points except at 03:00. The mean of the exact amount and percentage of reduction in IOP at circadian curve and 5 out of 8 time points were significantly greater with dorzolamide add-on treatment (p < 0.05). The successful reduction rates were 86% for the dorzolamide group and 61% for the timolol group (p = 0.016; chi(2) test). CONCLUSION: Both of the combinations are effective in lowering IOP, the exact amount and percentage of reduction is greater with the latanoprost + dorzolamide regimen, especially at night-time.

Androgen status of the nonautoimmune dry eye subtypes.

PURPOSE: To evaluate androgen levels of patients diagnosed with nonautoimmune dry eye, either with meibomian gland dysfunction (MGD) or without MGD (non-MGD), and normal control subjects. This is a prospective, comparative, case-control study. METHODS: Sixty-four (32 men and 32 women) subjects were enrolled for each of the three diagnostic groups. All dry eye patients were symptom positive. Nonfasting testosterone (T), sex hormone-binding globulin, serum albumin, dehydroepiandrosterone (DHEA), and DHEA sulphate levels of all study participants were determined using either automated immunoenzymatic assay, or standard radioimmunoassay. Analysis of variance was used to compare androgen levels among the three diagnostic groups in a gender-based design, followed by post-hoc multiple comparisons with the Tukey honestly significant difference test. RESULTS: Mean T levels in men and women of the three diagnostic groups were not significantly different (p = 0.808, p = 0.156, respectively; ANOVA). Statistical analyses of the three diagnostic groups revealed a significant difference for men and women in bioavailable T levels (p = 0.002, p = 0.014, respectively; ANOVA), DHEA levels (p = 0.009, p = 0.004, respectively; ANOVA), and DHEA sulphate levels (p = 0.001, p = 0.001, respectively; ANOVA), whereas there was no statistically significant difference between non-MGD dry eye patients and controls for any of the measured androgen levels according to the post-hoc tests. CONCLUSION: This study demonstrates that the androgen pool of nonautoimmune dry eye patients with MGD is significantly depleted compared with that of non-MGD and control cases.