Assessment of COL1A1 and MMP9 expression in patients with dermatochalasis.

PURPOSE: Dermatochalasis is a clinical condition characterized by loss of elasticity of eyelid skin and soft tissue, which typically affects the elderly population. The aim of this study is to investigate the mRNA expression levels of collagen type 1 alpha 1 (COL1A1) and matrix metalloproteinase-9 (MMP9) genes in dermatochalasis tissue. METHODS: The study group consisted of 15 patients who underwent upper eyelid blepharoplasty and were above 40 years old. The patients in our control group were divided into two subgroups according to their ages. Fourteen patients who were under 40 years old and had anterior blepharoptosis surgery for blepharoptosis were designed as the young control group. Sixteen patients who were older than 40 years old and had anterior blepharoptosis surgery for blepharoptosis were designed as the old control group. The patients in the dermatochalasis group were also evaluated according to their smoking status. Surgical tissue specimens were analyzed for COL1A1 and MMP9 mRNA gene expression levels by using real-time polymerase chain reaction. RESULTS: COL1A1 and MMP9 mRNA gene expression levels were not statistically different between the groups (p = 0.247; p = 0.052, respectively). When compared in means of the smoking habit, smokers in the dermatochalasis group exhibited higher COL1A1 mRNA expression levels when compared to nonsmokers (p = 0.008). MMP9 gene expression levels of smokers exhibited almost statistically higher levels but at the limit when compared to nonsmokers (p = 0.05). CONCLUSIONS: This study represents a preliminary study to detect the tissue changes at a molecular level in dermatochalasis, which is known to be related to connective tissue pathology. Collagen and MMPs are essential components of the extracellular matrix, and smoking might affect their gene expression. Further prospective studies on these regulatory genes and encoded protein levels with a larger group of patients may provide particular contribution to explaining the pathophysiology of dermatochalasis.

Evaluation estrogen, progesteron and androgen receptor expressions in corneal epithelium in keratoconus.

PURPOSE: To evaluate the role of sex steroid hormone receptors in corneal epithelium in etiopathogenesis of keratoconus (KC). METHODS: Thirty patients with KC who were planned for corneal collagen-crosslinking and 20 patients who were planned for excimer laser for refractive errors included in this study. Corneal epitheliums were curated mechanically during surgeries. Right eyes were evaluated immunohistochemically and left eyes were evaluated by quantitative polymerase chain reaction (qPCR) to investigate estrogenα, estrogenß, progesterone and androgen receptors. RESULTS: Immunohistochemically, staining for progesterone and androgen receptors did not significantly differ between KC and control groups (p > 0.05). None of the cases had staining for estrogenα and estrogenß receptors. qPCR showed that mRNA expressions of estrogenα and androgen receptors were significantly higher in the KC group (p < 0.001). CONCLUSION: A significantly higher rate of estrogenα and androgen receptor expressions in corneal epithelium from patients with KC through qPCR supports a possible relation between KC and sex steroid hormones.

Effects of hemodialysis on corneal and anterior chamber morphometry and intraocular pressure in patients with end-stage renal disease.

PURPOSE: To evaluate the effects of hemodialysis (HD) on corneal and anterior chamber morphometry, as well as intraocular pressure (IOP) in patients with end-stage renal disease. METHODS: Fifty right eyes were examined 30 minutes before and after HD. IOP was measured with a Goldmann applanation tonometer, and Ehlers' formula was used to calculate the corrected IOP values. The central corneal thickness (CCT), corneal volume (CV), keratometric values, anterior chamber depth (ACD), aqueous depth (AQD), anterior chamber volume (ACV), and anterior chamber angle (ACA) in the nasal and temporal quadrants were measured with a Sirius anterior segment analysis system. Blood urea nitrogen levels, body mass, and systolic and diastolic arterial pressure were also measured before and after HD. RESULTS: The mean age was 60.80 ± 13.38 (range: 35-80) years. The mean uncorrected and corrected IOP values decreased from 18.06 ± 3.91 and 18.31 ± 4.83 mmHg to 16.94 ± 3.87 and 16.95 ± 4.74 mmHg after HD, respectively (p=0.011 and p=0.003, respectively). The mean CCT decreased from 536.38 ± 24.73 to 533.18 ± 27.25 µm (p=0.002), and the mean CV decreased from 57.52 ± 3.15 to 55.68 ± 3.55 mm³ (p<0.001) after HD. There were no significant changes in ACD, AQD, ACV, ACA, or the keratometric values (p>0.05 for all values). There were no significant correlations between the ocular and systemic parameters (p>0.05 for all correlations). CONCLUSIONS: Uncorrected IOP, corrected IOP, CCT, and CV values decreased after HD, whereas the anterior chamber morphometry values remained similar between the measurements performed before and after HD.

Effects of hemodialysis on corneal and anterior chamber morphometry and intraocular pressure in patients with end-stage renal disease / Efeitos da hemodiálise na morfometria da córnea e da câmara anterior, e na pressão intraocular em pacientes no estágio final da doença renal

ABSTRACT Purpose: To evaluate the effects of hemodialysis (HD) on corneal and anterior chamber morphometry, as well as intraocular pressure (IOP) in patients with end-stage renal disease. Methods: Fifty right eyes were examined 30 minutes before and after HD. IOP was measured with a Goldmann applanation tonometer, and Ehlers' formula was used to calculate the corrected IOP values. The central corneal thickness (CCT), corneal volume (CV), keratometric values, anterior chamber depth (ACD), aqueous depth (AQD), anterior chamber volume (ACV), and anterior chamber angle (ACA) in the nasal and temporal quadrants were measured with a Sirius anterior segment analysis system. Blood urea nitrogen levels, body mass, and systolic and diastolic arterial pressure were also measured before and after HD. Results: The mean age was 60.80 ± 13.38 (range: 35-80) years. The mean uncorrected and corrected IOP values decreased from 18.06 ± 3.91 and 18.31 ± 4.83 mmHg to 16.94 ± 3.87 and 16.95 ± 4.74 mmHg after HD, respectively (p=0.011 and p=0.003, respectively). The mean CCT decreased from 536.38 ± 24.73 to 533.18 ± 27.25 µm (p=0.002), and the mean CV decreased from 57.52 ± 3.15 to 55.68 ± 3.55 mm³ (p<0.001) after HD. There were no significant changes in ACD, AQD, ACV, ACA, or the keratometric values (p>0.05 for all values). There were no significant correlations between the ocular and systemic parameters (p>0.05 for all correlations). Conclusions: Uncorrected IOP, corrected IOP, CCT, and CV values decreased after HD, whereas the anterior chamber morphometry values remained similar between the measurements performed before and after HD.

RESUMO Objetivo: Avaliar os efeitos da hemodiálise (HD) na morfometria da córnea e da câmara anterior e da pressão intraocular (PIO) em pacientes com doença renal terminal. Métodos: Cinquenta olhos direitos foram examinados 30 minutos antes e após hemodiálise. A pressão intraocular foi medida com um tonômetro de aplanação de Goldmann, e a fórmula de Ehlers foi utilizada para calcular os valores de pressão in traocular corrigidos. Mediram-se a espessura corneana central (CCT), o volume corneano (CV), os valores ceratométricos, a profundidade da câmara anterior (ACD), a profundidade aquosa (AQD), o volume da câmara anterior (ACV) e o ângulo da câmara anterior (ACA) nos quadrantes nasais e temporais com um sistema de análise de segmento Sirius anterior. Os níveis de nitrogênio ureico no sangue (BUN), peso corporal e pressão arterial sistólica e diastólica também foram medidos antes e após a HD. Resultados: A média de idade foi de 60,80 ± 13,38 (35-80) anos. Os valores médios não corrigidos e corrigidos da pressão intraocular diminuíram de 18,06 ± 3,91 e 18,31 ± 4,83 mmHg para 16,94 ± 3,87 e 16,95 ± 4,74 mmHg após hemodiálise (p=0,011 e p=0,003, respectivamente). A espessura corneana central média diminuiu de 536,38 ± 24,73 para 533,18 ± 27,25 µm (p=0,002), e o volume corneano médio diminuiu de 57,52 ± 3,15 para 55,68 ± 3,55 mm³ (p<0,001) após hemodiálise. Não houve alteração significativa nos valores de profundidade da câmara anterior, profundidade aquosa, volume da câmara anterior, ângulo da câmara anterior e ceratométricos (p>0,05 para todos os valores). Não houve correlação significativa entre os parâmetros oculares e sistêmicos (p>0,05 para todas as correlações). Conclusão: A pressão intraocular não corrigida, a pressão intraocular corrigida, a espessura corneana central e os valores de volume corneano diminuíram após hemodiálise, enquanto os valores de morfometria da câmara anterior foram semelhantes entre as medidas realizadas antes e após a hemodiálise.

Biomechanical evaluation of cornea in patients with ankylosing spondylitis.

PURPOSE: The aim of this study was to evaluate the corneal biomechanical parameters in patients with ankylosing spondylitis (AS) and to compare them with the healthy subjects. METHODS: Sixty patients with AS (study group) and 60 healthy subjects (control group) were enrolled in this prospective study. The study group was further classified as active (n:30) and inactive (n:30). After detailed ophthalmological examination including intraocular pressure (IOP) measurement with Goldmann applanation tonometer (IOPGAT), corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated IOP (IOPcc), and Goldmann-correlated IOP (IOPg) were measured with the Reichert Ocular Response Analyzer (ORA). Central corneal thickness (CCT) was measured with the Spectral-Domain Optical Coherence Tomography (SD-OCT). RESULTS: The study group's mean CH, CCT, IOPg, and IOPGAT values were lower than the control group (p < 0.05 for all variables). The mean CH, CRF, CCT, IOPg, and IOPGAT values were higher in active patients when compared to the inactive ones (p < 0.001, p < 0.001, p = 0.013, p = 0.021, and p = 0.002, respectively). CONCLUSIONS: AS patients have lower CCT, CH, IOPg, and IOPGAT when compared with healthy subjects. In the active stage of AS, patients present with higher levels of corneal biomechanical parameters with thicker corneas. IOPcc is a more accurate measurement than IOPGAT or IOPg in AS patients.

Tear-Film Osmolarity Changes Following Dacryocystorhinostomy in Primary Acquired Nasolacrimal Duct Obstruction.

PURPOSE: To evaluate tear osmolarity (TO) in patients with epiphora caused by primary-acquired nasolacrimal-duct obstruction (PANDO), before and after an external dacryocystorhinostomy (DCR) and to compare with healthy control subjects. MATERIALS AND METHODS: Twenty eyes of 20 patients (15 women, 5 men) who suffered from epiphora for at least one year due to PANDO, and 20 eyes of 20 healthy subjects (13 women, 7 men), were included in this study. External DCR was applied to all patients with PANDO, and TO measurements were repeated during the first month follow-up visit after surgery. RESULTS: The mean period for complaints of epiphora was 1.7 ± 0.6 years (1-3). Patients had a mean TO of 282.6 ± 10 mOsm/l (range: 269-302) prior to DCR, and this increased to 297.7 ± 7.7 mOsm/l (range: 284-310) one month after DCR (p = 0.0001). Preoperative TO values were significantly lower when compared with the healthy control subjects' (301.7 ± 10.6 mOsm/l (range: 280-316) (p = 0.0001). No significant differences were detected between postoperative and control group TO values (p = 0.18). CONCLUSIONS: Epiphora due to PANDO causes lower TO values. One month after DCR, TO came to similar TO levels when compared to healthy subjects.