Melatonin concentrations in serum of primary glaucoma patients.

AIM: To determine whether glaucoma patients exhibit an abnormal melatonin concentration in serum and the effects of psychiatric disorders caused by glaucoma in melatonin secretion. METHODS: A sample of 80 primary angle-closure glaucoma (PACG) patients, 120 primary open angle glaucoma (POAG) patients, and 120 normal controls were enrolled in this study. All the participants were asked to complete the following questionnaires: Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS), and self-rating depression scale (SDS). Variance analysis was used to compare the subscores between the groups. After that, we chose 58 patients with primary glaucoma and 20 non-glaucoma control patients to collect their serum samples at 7-10 a.m. Serum melatonin levels were measured using enzyme linked immunosorbent assay (ELISA). RESULTS: Of all participants, the scores of PSQI, SAS, and SDS in PACG and POAG group were 9.38±0.40, 46.08±8.99, 51.11±10.72 and 7.43±0.35, 45.42±9.87, 49.04±12.24 respectively, significantly higher than those in control group (4.16±0.28, 35.49±9.18, 40.31±13.08). The serum melatonin levels in PACG (37.29±2.99 pg/mL) and POAG (35.97±3.64 pg/mL) were significantly higher than the controls (29.96±3.94 pg/mL) (P<0.001). But no difference was found between the PACG and POAG (P=0.216). Glaucoma patients with sleep disorders, anxiety and depression were more likely resulting in the increase of melatonin levels. CONCLUSION: There is a significant increase in serum melatonin levels in glaucoma patients compared to the controls especially in glaucoma patients with psychiatric disorders such as sleep disorders, anxiety and depression.

Etiology, diagnosis, management and outcomes of epiphora referrals to an oculoplastic practice.

AIM: To investigate the etiology, diagnosis, management and outcome of epiphora referrals to an oculoplastic practice. METHODS: Retrospective chart review of patients referred for epiphora to an oculoplastic clinic between 2005 and 2009. Patient demographics, past history, ophthalmic examination, treatment and outcome were analyzed. RESULTS: There were 237 subjects with a primary complaint of epiphora. They included 130 (55%) females and 107 (45%) males with an average age of 55.9±25.9y. The most common cause of epiphora was lacrimal obstruction (46%); followed by multifactorial epiphora (22%), reflex tearing (22%) and eyelid malposition (11%). Differences in prevalence of etiology were noted in terms of age and gender distribution. Of the 182 (77%) patients who returned for follow up, 41 (23%) reported a complete resolution and 102 (56%) reported a significant improvement in their symptoms. CONCLUSION: Epiphora is a common condition with many causes. A thorough history and examination are required to provide the appropriate treatment tailored to the underlying cause.

High Levels of 17ß-Estradiol Are Associated with Increased Matrix Metalloproteinase-2 and Metalloproteinase-9 Activity in Tears of Postmenopausal Women with Dry Eye.

Purpose. To determine the serum levels of sex steroids and tear matrix metalloproteinases (MMP) 2 and 9 concentrations in postmenopausal women with dry eye. Methods. Forty-four postmenopausal women with dry eye and 22 asymptomatic controls were enrolled. Blood was drawn and analyzed for serum levels of sex steroids and lipids. Then, the following tests were performed: tear collection, Ocular Surface Disease Index (OSDI) questionnaire, fluorescein tear film break-up time (TBUT), corneal fluorescein staining, Schirmer test, and conjunctival impression cytology. The conjunctival mRNA expression and tear concentrations of MMP-2 and MMP-9 were measured. Results. Serum 17ß-estradiol levels were significantly higher in the dry eye subjects than in the controls (P = 0.03), whereas there were no significant differences in levels of testosterone, dehydroepiandrosterone sulfate (DHEA-S), and progesterone. Tear MMP-2 and MMP-9 concentrations (P < 0.001), as well as the MMP-9 mRNA expression in conjunctival samples (P = 0.02), were significantly higher in dry eye subjects than in controls. Serum 17ß-estradiol levels were positively correlated with tear MMP-2 and MMP-9 concentrations and negatively correlated with Schirmer test values. Conclusions. High levels of 17ß-estradiol are associated with increased matrix metalloproteinase-2 and metalloproteinase-9 activity in tears of postmenopausal women with dry eye.

Effect of Moisture Chamber Spectacles on Tear Functions in Dry Eye Disease.

PURPOSE: To evaluate the effect of moisture chamber spectacles (MCS) on tear functions in dry eye subjects. METHODS: In this short-term study, 30 subjects with dry eye were recruited and randomly divided into two groups. Fifteen subjects (MCS group) were instructed to wear the appropriately sized MCS for a total of 90 min. Another 15 subjects (control group) received a drop of sterile nonpreserved 0.9% sodium chloride solution immediately after baseline measurement. Ocular comfort, tear meniscus height (TMH), noninvasive tear film break-up time (NIBUT), tear film lipid layer, and conjunctival hyperemia were evaluated in both groups at 15-min intervals for a period of 90 min (baseline and 15, 30, 45, 60, 75, and 90 min). RESULTS: There were significant improvements in ocular comfort, TMH, NIBUT, and lipid layer in the MCS group compared with those in the control group (p < 0.05). After wearing MCS, values of ocular comfort, TMH, NIBUT, and lipid layer continuously increased across time and reached the maximum at 60 min and then slowly decreased but still remained higher (p < 0.05) than baseline values. No significant differences were observed in conjunctival hyperemia in either group or between groups across time (p > 0.05). CONCLUSIONS: Wearing MCS provided improvement in ocular comfort and tear film stability. Moisture chamber spectacles seem to be a safe and promising alternative treatment for dry eye, especially for patients who work in adverse environmental conditions.

Biodegradable PTLGA Terpolymers versus Collagen Implants Used as an Adjuvant in Trabeculectomy in Rabbit Eye.

Purpose. To evaluate the effectiveness and safety of three biodegradable terpolymers prepared from L-lactide, trimethylene carbonate, and glycolide (PTLGA) as an aid for trabeculectomy compared with the Ologen (OLO). Methods. Trabeculectomy was carried out on rabbits with implantation made from OLO or three PTLGA terpolymers. Intraocular pressure (IOP) was recorded 1, 2, 3, and 6 months postoperatively and bleb evaluations were performed using ultrasound biomicroscopy (UBM) 3 months after surgery, optical coherence tomography (OCT) every month, and transmission electron microscopy (TEM) six months after surgery followed by histological examination 1, 2, 3, and 6 months postoperatively. Result. IOP was significantly reduced in all groups after surgery. There were no significant differences in the IOL between groups at any time after implantation. There was no significant difference between the groups examined by OCT, UBM, and TEM. Exposure of the implant was observed in one eye from the OLO group and one eye in the P1. Subconjunctiva hyperblastosis was observed in one eye from group P3 and two eyes from the OLO group. Conclusions. Subconjunctival implantation of filtering devices made from PTLGA may present a safe and effective additional surgical tool for the treatment of filtering surgery. Fewer complications were observed in the group with P2 implants compared to other groups.

Characterization of particle size distribution of mainstream cigarette smoke generated by smoking machine with an electrical low pressure impactor.

Cigarette smoking is a particle-related exposure. Studying the characteristics of the particle size distribution of cigarette smoke can aid in providing knowledge of smoke aerosol attributes. We used an electrical low pressure impactor (ELPI) to measure the particle size distribution of mainstream cigarette smoke generated by a smoking machine and provided a continuum of particle sizes of cigarette smoke from a whole cigarette. The results showed that the aerodynamic diameters (D, geometric mean of a channel) of particles ranged from 0.021 to 1.956 µm, and the number concentrations were on the order of 10(5)-10(9) cm(-3) for different sizes of particles. The particle number of the size category below 0.1 µm approximated that of the category 0.1-2.0 µm, and the particles in the size category of 0.1-2.0 µm contributed extremely heavily to total particulate mass. In addition, the results with small samples indicated that the tar yields normalized per milligram of nicotine showed an approximately linear increase with increasing concentration of total particles.

Structural identification of isomallotusinin and other phenolics in Phyllanthus emblica L. fruit hull.

The air-dried fruit hull of Phyllanthus emblica L. was extracted with 95% ethanol, and then the extract was partitioned by diethyl ether and ethyl acetate (EA). The EA fraction was then subjected to separation and purification using silica gel and Sephadex LH-20 column chromatography repeatedly to obtain five hydrolysable tannins. They were identified as mucic acid 1,4-lactone 3-o-gallate (C1), isocorilagin (C2), chebulanin (C3), chebulagic acid (C4) and isomallotusinin (C5) using mass spectrometry and nuclear magnetic resonance (NMR) spectrometry. Isomallotusinin and chebulanin were identified from emblica dried fruit hull for the first time, and isomallotusinin was the first time identified from Phyllanthus. Furthermore, the antioxidant abilities of these hydrolysable tannins were investigated using DPPH and ABTS+ radical scavenging systems. All hydrolysable tannins showed strong DPPH and ABTS+ radical scavenging activities. Isomallotusinin and chebulagic acid exhibited the highest antioxidant activity compared to other purified compounds tested.