Carnitine analysis in pterygium / Análise de carnitina no pterígio

ABSTRACT Purpose: The aim of the present study was to measure the free carnitine and acylcarnitine levels in pterygium tissue and normal conjunctival tissue at the metabolomics level using tandem mass spectrometry. Methods: In this prospective, clinical randomized study, pterygium tissues and normal conjunctival tissues taken during pterygium excision with autograft were compared regarding their free carnitine and acylcarnitine profiles. After tissue homogenization, carnitine levels were measured using tandem mass spectrometry. The data were statistically analyzed with the Wilcoxon signed-rank test. Results: Pterygium and normal conjunctival tissue samples from a single eye of 29 patients (16 females, 13 males; mean age, 54.75 ± 11.25 years [range, 21-78 years]) were evaluated. While the free carnitine (C0) level was significantly high in the pterygium tissue (p<0.001), acylcarnitine levels were significantly high in some esterized derivatives (C2, C5, C5:1, C5DC, C16:1, C18, methylglutarylcarnitine) (p<0.05). No statistically significant difference was determined for the other esterized derivatives (p>0.05). Conclusion: That the carnitine levels in pterygium tissue were higher suggests that acceleration of cell metabolism developed secondary to chronic inflammation and the premalignant characteristics of pterygium tissue. High carnitine levels may also effectively suppress the apoptosis process. The data reported in our study indicate that further, more extensive studies of the carnitine profile could help clarify the pathogenesis of pterygium.

RESUMO Objetivo: O objetivo deste estudo foi medir os níveis de carnitina livre e acil-carnitina a nível metabolómico com espectrometria de massa em tandem no tecido do pterígio e no tecido conjuntivo normal. Método: Neste estudo prospetivo, clínico e aleatório, os tecidos de pterígio e os tecidos normais de conjuntiva, retirados durante a cirurgia de pterígio com autoenxerto, foram comparados em relação ao perfil de carnitina livre e de acil-carnitina. Após a homogeneização dos tecidos, os níveis de carnitina foram medidos por espectrometria de massa em tandem. A análise estatística dos dados foi realizada com o teste dos postos sinalizados de Wilcoxon. Resultados: A avaliação foi feita através de amostras de tecido pterígio e de conjuntiva normal de um único olho de 29 pacientes (16 mulheres, 13 homens). A média de idade dos pacientes foi de 54,75 ± 11,25 anos (faixa dos 21 aos 78 anos). Enquanto o nível de carnitina livre (C0) foi significativamente elevado no tecido pterígio (p<0,001), os níveis de acil-carnitina foram significativamente elevados em alguns derivados esterificados (C2, C5, C5: 1, C5DC, C16:1, C18, metilglutaril carnitina) (p<0,05). Não foi determinada uma diferença estatisticamen te significante noutros derivados esterificados (p>0,05). Conclusão: Os níveis mais elevados de carnitina no tecido do pterígio sugerem que a aceleração do metabolismo celular se tenha tornado secundária com o efeito da inflamação crónica e o caráter pré-maligno do tecido do pterígio. Os níveis elevados de carnitina também podem ser eficazes na supressão do processo de apoptose. Os dados obtidos no estudo indicam que estudos mais extensivos do perfil da carnitina contribuiriam para o esclarecimento da patogénese do pterígio.

Carnitine analysis in pterygium.

PURPOSE: The aim of the present study was to measure the free carnitine and acylcarnitine levels in pterygium tissue and normal conjunctival tissue at the metabolomics level using tandem mass spectrometry. METHODS: In this prospective, clinical randomized study, pterygium tissues and normal conjunctival tissues taken during pterygium excision with autograft were compared regarding their free carnitine and acylcarnitine profiles. After tissue homogenization, carnitine levels were measured using tandem mass spectrometry. The data were statistically analyzed with the Wilcoxon signed-rank test. RESULTS: Pterygium and normal conjunctival tissue samples from a single eye of 29 patients (16 females, 13 males; mean age, 54.75 ± 11.25 years [range, 21-78 years]) were evaluated. While the free carnitine (C0) level was significantly high in the pterygium tissue (p<0.001), acylcarnitine levels were significantly high in some esterized derivatives (C2, C5, C5:1, C5DC, C16:1, C18, methylglutarylcarnitine) (p<0.05). No statistically significant difference was determined for the other esterized derivatives (p>0.05). CONCLUSION: That the carnitine levels in pterygium tissue were higher suggests that acceleration of cell metabolism developed secondary to chronic inflammation and the premalignant characteristics of pterygium tissue. High carnitine levels may also effectively suppress the apoptosis process. The data reported in our study indicate that further, more extensive studies of the carnitine profile could help clarify the pathogenesis of pterygium.

Investigating the effect of intracameral cefuroxime on oxidative stress and apoptosis in the rat cornea.

PURPOSE: We examined the effect of intracameral administration of cefuroxime on oxidative stress and endothelial apoptosis in rat corneal tissue. METHODS: In total, 30 rats were divided into 3 groups of 10 rats each (intracameral administration of cefuroxime 0.1 mg/0.01 mL (cefuroxime group); intracameral administration of balanced salt solution 0.01 mL (control group); or absence of intracameral injection (sham group). Corneal endothelial apoptosis was assessed by immunohistochemical analysis using caspase-3 and caspase-8. Total oxidant status, total antioxidant status, oxidative stress index, and paraoxonase and arylesterase levels were examined in corneal endothelial tissue and serum. RESULTS: Paraoxonase levels in the serum were significantly different between the sham and cefuroxime groups (p=0.027). A significant difference was also observed in total oxidant status levels between the cefuroxime and balanced salt solution groups (p=0.023). In addition, there were significant differences in total antioxidant status levels in corneal tissue between the cefuroxime and sham groups (p<0.001) and between the cefuroxime and balanced salt solution groups (p<0.001). Furthermore, significant differences were also observed in oxidative stress index levels between the cefuroxime and balanced salt solution groups (p=0.001) and between the cefuroxime and sham groups (p=0.026). According to the immunohistochemical staining results, a significant association with caspase-3 activity existed between the cefuroxime and balanced salt solution groups (p=0.007), while no significant difference was found with caspase-8 activity (p=0.541). Caspase-3 activity exhibited a significant relationship between the sham and balanced salt solution groups (p=0.018), but no relationship was found with caspase-8 activity (p=0.623). CONCLUSION: Immunohistochemical examination revealed that intracameral cefuroxime increased apoptosis when compared to the sham and balanced salt solution groups. Moreover, intracameral cefuroxime increased oxidative stress in the cornea and simultaneously induced apoptosis.

Metabolomics analysis in pterygium tissue.

PURPOSE: The aim of the study was to measure amino acid levels with the metabolomics analysis in pterygium tissue and normal conjunctiva tissue. MATERIALS AND METHODS: In this prospective, randomized, clinical study, a comparison of the amino acid profile of pterygium tissue and normal conjunctiva tissue taken during autograft pterygium surgery was made. After homogenization of the tissues, amino acid levels were measured with chromatography-mass spectrometry (LC-MS/MS) in the biochemistry laboratory. Statistical analysis was made using the Wilcoxon signed-rank test. RESULTS: Evaluation of pterygium and normal conjunctiva tissues of 29 patients, comprising 16 females and 13 males with a mean age of 54.75 ± 11.25 years (range 21-78 years) was made. While a dramatic increase was observed in all the amino acid levels in the pterygium tissue compared to the normal conjunctiva (p > 0.05), only the increases in arginine, methionine, glycine and tyrosine amino acids were determined to be statistically significant (p < 0.01), (p = 0.028), (p = 0.038), (p = 0.046). CONCLUSION: Pterygium is known to be degenerative inflammatory fibrovascular tissue. When the aetiology is examined in depth, several metabolic processes are seen to have an effect. Further studies of the amino acid profile with more extensive patient series could confirm the data obtained in the current study and contribute to the clarification of the pathogenesis of pterygium.

A Comparison of Central Corneal Thicknesses Measured with Two Different Methods in Cases of Primary Open-Angle Glaucoma.

Accurate and repeatable measurement of the central cornea thickness (CCT) is important in terms of follow-up of glaucoma patients. The aim of this study was to compare CCT measurements made with an ultrasonic pachymeter (USP) and with the Spectralis Anterior Segment Module optical coherence tomography (OCT) device. The study included 52 eyes of 26 primary open-angle glaucoma patients. CCT measurements were taken with the USP device and then with the OCT by imaging cornea slices. The mean CCT was measured as 555.71 ± 47.76 µm with USP and 569.46 ± 49.5 µm with OCT. Despite the differences between the measurements of the two methods, a very strong degree of consistency was seen between the CCT measurement with USP and OCT (ICC = 0.93, p < 0.001).

The Evaluation of Reading Performance with Minnesota Low Vision Reading Charts in Patients with Age-related Macular Degeneration.

PURPOSE: To evaluate the reading performance using the Minnesota low vision reading (MNREAD) charts, of patients with age-related macular degeneration (AMD) who use low vision aid (LVA) devices. MATERIALS AND METHODS: This prospective study enrolled 27 patients with AMD. Distance visual acuity (VA) was evaluated with a distance chart designed for patients with low vision. Near vision and reading performance were evaluated with the Turkish version of the MNREAD charts. Unaided vision and vision with LVA devices and high spherical add near glasses was measured. P <0.05 was considered statistically significant. RESULTS: The mean unaided near VA was 1.05 ± 0.27 log of the minimum angle of resolution (LogMAR). The mean VA with the LVA devices was 0.71 ± 0.41 LogMAR. Reading acuity ranged between 1.15 and 0.21 LogMAR, critical print size was between - 1.2 and 0.2 LogMAR. Maximum reading speeds were between 0 and 103 words/min. The cases are divided into groups in terms of reading speed according to age, gender, diagnosis, and education. Reading speed was negatively correlated to increasing age. CONCLUSION: MNREAD reading charts can be used to evaluate reading performance in patients with AMD with low vision. The outcomes of the present study indicate that optical correction is adequate for near VA requirements in this patient population. However, optical correction was inadequate for improving reading performance. Appropriate rehabilitation programs can be used to increase reading speed.

Fonsecaea pedrosoi as a rare cause of acute conjunctival ulceration.

Conjunctival ulceration accompanied with secretion and pain was observed in a 30-year-old male, 3 days after a perforating corneal trauma. Cultures of conjunctival ulcer samples grew Fonsecaea pedrosoi, a major causative agent of chromoblastomycosis that is typically transmitted during trauma. The conjunctival ulcer was successfully treated with amphotericin B, itraconazole, and fluconazole. This case report summarizes the diagnosis and treatment of a conjunctival ulcer due to F. pedrosoi, which is a rare complication of contaminated ocular trauma. To the best of our knowledge, this is the first reported case of F. pedrosoi causing acute conjunctival ulceration in the literature.

Fonsecaea pedrosoi as a rare cause of acute conjunctival ulceration / Fonsecaea pedrosoi como agente raramente associado à úlcera conjuntival aguda

ABSTRACT Conjunctival ulceration accompanied with secretion and pain was observed in a 30-year-old male, 3 days after a perforating corneal trauma. Cultures of conjunctival ulcer samples grew Fonsecaea pedrosoi, a major causative agent of chromoblastomycosis that is typically transmitted during trauma. The conjunctival ulcer was successfully treated with amphotericin B, itraconazole, and fluconazole. This case report summarizes the diagnosis and treatment of a conjunctival ulcer due to F. pedrosoi, which is a rare complication of contaminated ocular trauma. To the best of our knowledge, this is the first reported case of F. pedrosoi causing acute conjunctival ulceration in the literature.

RESUMO O quadro clínico de uma úlcera conjuntival acompanhada de secreção e dor foi observado em homem de 30 anos de idade, 3 dias após um trauma perfurante da córnea. As culturas de uma amostra retirada da úlcera conjuntival foi positiva para Fonsecaea pedrosoi, uma cromoblastomicose, geralmente transmitido após traumatismos. O caso foi tratado com sucesso com a anfotericina B, itraconazol e fluconazol. Este relato de caso reporta o diagnóstico e tratamento de uma úlcera conjuntival causada por F. pedrosoi, que raramente é visto nos olhos expostos a traumatismos contaminados. Até onde sabemos, este é o primeiro caso relatado na literatura de F. pedrosoi causando úlcera conjuntival aguda.

Spontaneous Regression of Over-elevation in Adduction Following Esotropia Surgery.

PURPOSE: To evaluate the course of over-elevation in adduction in patients who had esotropia following correction of horizontal deviation. METHODS: The review of the medical files identified 28 patients who had esotropia with over-elevation in adduction. Data collected from the patients' full ophthalmological examinations included visual acuity, ocular alignment, duction, versions and sensory tests for binocularity and stereopsis, cycloplegic retinoscopy, and fundus evaluation. Oblique muscle function was graded on a scale of -4 to +4. The primary outcome measure was the amount of improvement in over-elevation in adduction following esotropia surgery. RESULTS: Of the 28 patients (mean age: 53.5 ± 53.7 months), 13 were males and 15 were females. Of these, 22 (78.6%) had infantile esotropia and 6 (21.4%) had partial accommodative esotropia. The mean follow-up was 16.3 ± 7.9 months. All patients underwent bilateral medial rectus recession for correction of esotropia. The mean preoperative inferior oblique overaction was +2.1 ± 0.7 and the final postoperative value was +0.8 ± 0.9 (P < .001). There was a statistically significant decrease in postoperative over-elevation in adduction at all postoperative visits compared to the preoperative value (P < .001 at 3- and 6-month and final visits). Over-elevation in adduction regressed in 42 eyes (80.8%). Of these, 18 eyes (34.6%) completely resolved without any additional surgery to the inferior oblique muscle. CONCLUSIONS: Spontaneous regression in over-elevation in adduction was observed after esotropia surgery without additional inferior oblique weakening surgery. This may affect presurgical evaluation of and surgical planning for patients.

Anti-inflammatory effect of lycopene on endotoxin-induced uveitis in rats.

PURPOSE:: We evaluated the efficacy of lycopene, a dietary carotenoid and potent antioxidant, against ocular inflammation and oxidative stress in an experimental uveitis model. METHODS:: Endotoxin-induced uveitis (EIU) was induced in Sprague-Dawley rats by a single subcutaneous injection of 200 µg lipopolysaccharide (LPS). Induction of EIU was preceded by daily intraperitoneal injection of 10 mg/kg lycopene for three consecutive days (Lycopene + LPS group) or equivolume vehicle (Vehicle + LPS group). A positive control group received 1 mg/kg dexamethasone pretreatment (DEX + LPS), and a negative control group received daily vehicle injection but no LPS (Vehicle Control). Twenty-four hours after LPS or final vehicle administration, eyes were enucleated, and aqueous humor was collected for measurement of the number of infiltrating cells, total protein concentration, and levels of nitric oxide (NO), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and oxidative stress markers. Inflammatory response severity was compared among groups clinically and histopathologically. RESULTS:: Infiltrating cell number, total protein concentration, and NO, TNF-α, and IL-6 levels were significantly elevated in the aqueous humor of Vehicle + LPS group rats compared to Vehicle Controls. Compared to the Vehicle + LPS group, lycopene pretreatment significantly reduced aqueous humor concentrations of oxidative stress markers, NO (0.29 ± 0.1 µM vs. 0.19 ± 0.1 µM, p=0.003), TNF-α (71.0 ± 22.3 ng/ml vs. 50.1 ± 2.1 ng/ml, p=0.043), and IL-6 (121.6 ± 3.0 pg/ml vs. 111.1 ± 5.6 pg/ml, p=0.008). Inflammatory score was also reduced (2.0 ± 0.0 vs. 0.4 ± 0.5, p=0.001). Lycopene reduced the infiltrating cell count and protein concentration, but differences did not reach significance. Most lycopene effects were equivalent to dexamethasone. CONCLUSIONS:: Lycopene may aid in the clinical management of uveitis by suppressing inflammation and oxidative stress.

Changes of intraocular pressure in different trimesters of pregnancy among Syrian refugees in Turkey: A cross-sectional study.

OBJECTIVE: To evaluate the physiologic changes in intraocular pressure associated with pregnancy in healthy Syrian refugee women in Turkey. MATERIALS AND METHODS: In this cross-sectional study, intraocular pressures were measured using a Goldmann tonometer in 235 patients in the first, second, and third trimester of pregnancy and puerperium among Syrian refugees in Turkey. RESULTS: Mean intraocular pressures values of the right eye were 15.5±2.5 mmHg, 14.4±1.4 mmHg, 13.9±1.6 and 14.7±1.9 mmHg in the three trimesters and puerperium, respectively. Mean intraocular pressures values of the left eye were 15.3±1.6 mmHg, 14.3±1.4 mmHg, 13.9±1.6 and 15.3±2.2 mmHg in the three trimesters and puerperium, respectively. The mean intraocular pressures values measured from both eyes were significantly higher in first trimester and puerperal period than in the third trimester (p<0.001). CONCLUSION: Changes in the intraocular pressure in pregnancy are common and temporary. This study shows the baseline changes in the intraocular pressure during pregnancy in healthy women. Therefore, we cannot extrapolate the results to the whole eye. A decrease in intraocular pressures was shown in healthy pregnant women.

Tear Film and Serum Prolidase Activity and Oxidative Stress in Patients With Keratoconus.

PURPOSE: To determine and compare the serum and tear film prolidase activity (PA) between patients with keratoconus and healthy subjects. Also, we aimed to evaluate the serum oxidative stress level and the correlation with serum PA in patients with keratoconus. METHODS: This prospective, comparative clinical study included 31 patients with keratoconus and 33 age-matched and sex-matched control subjects. All participants underwent a detailed ophthalmologic examination. Serum and tear samples were obtained from all participants. Tears and serum PA and serum oxidative stress markers were measured. RESULTS: No significant differences in demographic characteristics were detected between groups (P > 0.05). The serum PA was significantly lower in the keratoconus group than in the control group (895.6 ± 198.7 vs. 1145.9 ± 285.4 U/L, P < 0.001). A tear film comparison showed that PA was lower in the keratoconus group than in the control group; however, this difference was not significant (3075.4 ± 672.2 vs. 3225.8 ± 903.2 U·L⁻¹·g⁻¹ protein, P = 0.45). Oxidative stress markers, such as total oxidant status and oxidative stress index, were found to be significantly higher in the keratoconus group (P < 0.001). CONCLUSIONS: The serum PA was found to be lower in patients with keratoconus than in the controls. Additionally, serum oxidative stress markers were found to be higher than those of the controls. Thus, prolidase and systemic oxidative stress may have a role in the pathogenesis of keratoconus.