Effect of topical motesanib in experimental corneal neovascularization model.

PURPOSE: This study aimed to compare the efficacy of topical bevacizumab and motesanib in an experimental corneal neovascularization model, and find the most effective motesanib dose. MATERIALS AND METHODS: In experiments, 42 Wistar Albino rats were randomly divided into six groups (n = 7). Corneal cauterization was applied to all groups except the group 1. Group 1 did not receive any treatment. Topical dimethylsulfoxide was applied to sham group three times a day(tid). Topical bevacizumab drops (5 mg/ml) were applied to Group 3 tid. Topical motesanib drops with a dose of 2.5, 5, and 7.5 mg/ml were respectively applied in Groups 4, 5, and 6 tid. On the 8th day, corneal photographs of all rats were taken under general anesthesia, and the percentage of corneal neovascular area was calculated. VEGF-A mRNA, VEGFR-2 mRNA, miRNA-21, miRNA-27a, miRNA-31, miRNA-126, miRNA-184, and miRNA-204 were evaluated by the qRT-PCR method in corneas taken after decapitation. RESULTS: The percentage of corneal neovascularization areas and VEGF-A mRNA expression levels were decreased in all treatment groups compared to group 2 (p < 0.05). VEGFR-2 mRNA levels were found to be statistically significantly decreased in groups 4 and 6 compared to group 2 (p < 0.05). Statistically significant changes were detected in the expression levels of only miRNA-126 among all miRNAs. CONCLUSION: Motesanib with a dose of 7.5 mg/ml statistically significantly suppressed the VEGFR-2 mRNA level compared with other treatment doses and may be more effective than bevacizumab. Further, miRNA-126 can be used as a proangiogenic marker.

A rare cause of acquired esotropia: Leprosy.

Leprosy is an infective chronic granulomatous disease involving the skin and peripheral nerves caused by Mycobacterium leprae. Complications such as lagophthalmos, corneal opacity and uveitis are common, but cranial nerve involvement is rarely seen. The fifth and seventh cranial nerves are most commonly involved. We report a case of acquired esotropia due to sixth nerve palsy following a rare cranial nerve involvement by leprosy.

Investigation of effect of nintedanib in experimental uveitis model.

PURPOSE: This study aims to investigate the protective efficacy of nintedanib in experimental uveitis induced by endotoxins. MATERIALS AND METHODS: In this study, 24 Wistar albino rats were randomly divided into three groups: Group I was the healthy control with no uveitis that did not receive any treatment, Group II (sham) group did not receive treatment, and Group III (nintedanib) received oral nintedanib for 10 days. On the 10th day, endotoxin-induced uveitis (EIU) was induced by lipopolysaccharide (LPS) injection in Groups II and III. The clinical activity score was evaluated in all groups at the 24th hour, when uveitis formation was thought to be the most intense after LPS injection. All rats were then killed via anaesthesia. Tumour necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) levels were measured in their right eyes using the enzyme-linked immunosorbent assay (ELISA) method. Further, histopathological examinations were performed on their left eyes. RESULTS: For Groups I, II, and III, the IL-6 levels were 30.88 ± 1.79, 36.77 ± 1.21, and 30.93 ± 3.96 mg/pr, respectively, and TNF-α levels were 50.20 ± 3.24, 59.87 ± 2.98, and 50.23 ± 4.83 mg/pr, respectively. IL-6, TNF-α levels and clinical activity score were higher in the sham group compared to the other groups, and it decreased significantly in the treatment group (p < 0.05). Intense inflammatory cell infiltration of the ciliary body, edema and hyperaemia were evident in the sham group compared to the healthy control group (p < 0.05). These pathological findings were significantly decreased in the treatment group compared to the sham group (p < 0.05). CONCLUSION: Nintedanib may be preferable as a new agent for treating non-infectious uveitis. However, further studies are needed to evaluate its long-term effects, effects on other antiinflammatory pathways, side-effects, and ideal dose optimization.

Protective effect of filgotinib in rat endotoxin-induced uveitis model.

PURPOSE: To investigate the protective effect of filgotinib in endotoxin-induced uveitis model in rats. MATERIALS AND METHOD: This study used 24 Wistar Albino rats. Group I (control group) included the healthy controls; in Group II (sham group), only 300 µg/kg intraperitoneal (ip) lipopolysaccharide (LPS) was administered; and in Group III (treatment group), 3 mg/kg/day filgotinib was administered orally for 10 days followed by 300 µg/kg ip LPS. In all groups, clinical activity scores were evaluated after 24 h. Moreover, histopathological and immunological examinations were performed. RESULTS: In Groups I, II, and III, the mean clinical activity and histopathological examination scores were 0.00, 3.25 ± 0.70, and 1.89 ± 0.60 and 0.00, 2.88 ± 1.12, and 1.44 ± 0.52, respectively. The clinical activity and histopathological examination scores were significantly increased in the sham group compared to the control group (p < 0.05); these findings were significantly reduced in the treatment group (p < 0.05). The mean TNF-α and IL-6 ELISA levels in all groups were 50.20 ± 3.24, 59.87 ± 2.98, and 54.34 ± 4.62 and 30.88 ± 1.79, 36.77 ± 1.21, and 33.66 ± 1.86, respectively. The TNF-α and IL-6 ELISA levels were significantly decreased in the treatment group compared to the sham group (p < 0.05); there was no significant difference between the treatment group and the control group (p = 0.105, p = 0.067, respectively) CONCLUSION: Filgotinib may be an alternative treatment option in preventing the development of noninfectious uveitis.

Effect of Decorin and Bevacizumab on oxygen-induced retinopathy in rat models: A comparative study.

Purpose: The aims of this study were to evaluate the effects of decorin (DCN) in rat oxygen-induced retinopathy (OIR) model and to compare the results with those of bevacizumab. Methods: Twenty-eight newborn Sprague-Dawley rats were randomly divided into four groups. Group I (control): normoxia plus intraperitoneal (ip) normal saline (NS), Group II (sham): OIR plus ip NS, Group III (DCN): OIR plus ip 0.1 mg/kg DCN, and Group IV (bevacizumab): OIR plus ip 2.5 mg/kg bevacizumab. The OIR model was induced by cycling the oxygen concentration between 50% and 10% every 24 h for 14 days following their birth. In all groups, injections were administered on postnatal day (PD) 15. All animals were sacrificed and their right eyes were enucleated on PD 18. The nuclei of neovascular endothelial cells on the vitreal side of the inner limiting membrane were counted, and vascular endothelial growth factor (VEGF) and tumor necrosis factor-alpha (TNF)-α immunoreactivity were detected in histopathological and immunohistochemical examinations. One-way analysis of variance and post hoc Tukey tests were used for statistical analyses of the data. Results: In Groups II, III, and IV, the mean neovascular cell nuclei counts were 13.14 ± 1.34, 6.57 ± 1.51, and 6.71 ± 1.49, respectively. The mean neovascular cell nuclei count was significantly reduced in treatment groups compared with sham group (P < 0.001). In immunohistochemical staining, the immunoreactivity of VEGF was 0.07 ± 0.02, 0.97 ± 0.21, 0.37 ± 0.12, and 0.23 ± 0.17, respectively. Likewise, immunoreactivity of TNF-α was 0.02 ± 0.02, 1.11 ± 0.36, 0.37 ± 0.13, and 0.62 ± 0.21, respectively. VEGF and TNF-α immunoreactivity increased markedly in the sham group compared with those in the control group (P < 0.001). VEGF and TNF-α immunoreactivity of treatment groups decreased significantly compared to sham group (P < 0.001). Conclusion: The beneficial effects obtained by DCN administration in OIR model were comparable to the effects of bevacizumab.

Evaluation of aqueous humor and serum cortistatin levels in diabetic patients with and without diabetic retinopathy.

PURPOSE: To evaluate the aqueous humor and serum cortistatin levels in diabetic patients with and without diabetic retinopathy and its relationship with various metabolic markers that have been reported to be associated with diabetes mellitus. METHODS: The current study included 20 diabetes mellitus patients with diabetic retinopathy, 20 diabetes mellitus patients without diabetic retinopathy, and 20 healthy control subjects with the same sex and age characteristics. Aqueous humor and serum cortistatin, fasting blood glucose, hemoglobinA1c, 25-hydroxyvitamin D levels, blood lipid profiles, and body mass index were measured in all subjects. RESULTS: In diabetic patients with and without diabetic retinopathy and in healthy control subjects, the mean aqueous humor cortistatin levels were 25.55 ± 2.03, 27.71 ± 2.01, and 32.76 ± 3.43 ng/mL, respectively. Likewise, the mean serum cortistatin levels were 6.16 ± 1.08, 6.57 ± 1.00, and 7.56 ± 1.51 ng/mL, respectively. Aqueous humor cortistatin levels were decreased in diabetic patients with and without diabetic retinopathy when compared to healthy controls (p < 0.001). Although aqueous humor cortistatin levels tended to be reduced in diabetic patients with diabetic retinopathy, the difference was not statistically significant between diabetic patients with and without diabetic retinopathy (p = 0.147). Serum cortistatin levels were not statistically significant between diabetic patients with and without diabetic retinopathy and healthy control subjects (p = 0.166). Body mass index, fasting blood glucose, and hemoglobinA1c levels were significantly different between the groups (p < 0.05 for all parameters tested). CONCLUSION: Aqueous humor cortistatin levels were decreased in diabetic patients with and without diabetic retinopathy. The results suggest that a local decrease in the amount of cortistatin may play a role in the pathogenesis of diabetic retinopathy.

Anti-inflammatory effect of cortistatin in rat endotoxin-induced uveitis model.

PURPOSE: To evaluate the anti-inflammatory effect of cortistatin (CST) in endotoxin-induced uveitis (EIU) model and to compare the results with corticosteroid treatment. METHODS: A total of 35 healthy Wistar albino rats were randomly divided into five groups. EIU was induced by a single subcutaneous injection of lipopolysaccharide (LPS). Group I received intraperitoneal (ip) normal saline (NS), Group II received ip 150 µg LPS plus NS, Group III received ip 150 µg LPS plus 250 µg/kg CST, Group IV received ip 150 µg LPS plus 1mg/kg dexamethasone, and Group V received ip 250 µg/kg CST only. The aqueous humor was collected 24 h after injection and the infiltrating cells were determined. Moreover, histopathological and immunohistochemical examinations were also performed. RESULTS: The clinical score and infiltrated cell count were reduced in Groups III and IV compared with Group II (P < 0.001). The pathological findings of Groups III and IV were significantly reduced compared with Group II (P < 0.001). These findings were similar between Groups III and IV (P = 1.000). Tumor necrosis factor-alpha (TNF-α) and interleukin 1 beta (IL-1ß) immunoreactivity in the ciliary body of Group III and Group IV were significantly reduced compared with Group II (P < 0.001). TNF-α and IL-1ß immunoreactivity in the ciliary body of Group III and Group IV were similar compared with Group I and Group V (range of P values was 0.539-0.958). CONCLUSION: CST administration as a therapeutic agent might ameliorate the severity of intraocular inflammation in uveitis patients. In conclusion, effect of CST and dexamethasone in EIU model was comparable.

Thiol/disulfide homeostasis in patients with ocular-active and ocular-inactive Behçet disease.

PURPOSE: To evaluate thiol/disulfide homeostasis in ocular-active (OA) and ocular-inactive (OI) Behçet disease (BD) patients and compare the data with healthy subjects. METHODS: Twenty OABD patients, 20 OIBD patients and 20 healthy control subjects were included into the study. The BD ocular attack score 24 (BOS24) scoring system was used to assess the activity of disease in ocular BD patients. Systemic activity was also evaluated using BD current activity form (BDCAF). The native thiol (NT), total thiol (TT) and disulfide levels and NT/TT, disulfide/NT and disulfide/TT ratios were measured via using an innovative and automated method. RESULTS: BOS24 and BDCAF scores were 13.25 ± 2.32 and 4.18 ± 2.06 in OABD patients and 0.31 ± 0.47 and 2.14 ± 1.98 in OIBD patients, respectively. The NT, TT levels and NT/TT ratio were significantly reduced; in contrast, the disulfide levels, disulfide/NT and disulfide/TT ratios were significantly increased in OABD and OIBD patients compared to the healthy control subjects (p < 0.05). Moreover, while the levels of NT and TT were significantly reduced, the disulfide levels as well as disulfide/NT and disulfide/TT ratios were significantly elevated between OABD and OIBD patients (p < 0.05). However, the ratio of NT/TT did not significantly differ between OABD and OIBD patients (p = 0.449). The multiple regression model including BOS24 and BDCAF score statistically significantly predicted NT level, TT level and disulfide level (p < 0.001 for all). CONCLUSION: Thiol oxidation in BD patients resulted in a change of the thiol/disulfide balance. Therefore, thiol/disulfide homeostasis in BD patients can be used an innovative oxidative stress marker.

Comparison of the effect of topical bevacizumab and sorafenib in experimental corneal neovascularization.

PURPOSE: The purpose of this study was to compare the neovascularization inhibiting the effect of topical bevacizumab and sorafenib and to determine the effective dose of sorafenib. MATERIAL AND METHODS: Forty-two healthy Wistar albino rats were randomly divided into six groups. The right corneas of all rats except group 1 were cauterised with silver nitrate. Group 2 received DMSO, group 3 received topical bevacizumab (5 mg/dL, 3 times a day) and group 4, 5 and 6 received topical sorafenib (2.5 mg/dl, 5 mg/dL, 7.5 mg/dL, 2 times a day respectively), between days 1 and 7. Corneal photographs were taken on day 8 and the corneal neovascular area percentage was calculated. Following decapitation, the corneas were removed to determine the levels of VEGF ELISA and corneal immune staining. The Mann-Whitney U-test was used for statistical analysis. RESULTS: The neovascular corneal area percentage was statistically significantly lower in the treatment groups than group 2 (p < 0.05). The intensity of VEGF immune staining was also lower in groups 3, 5 and 6 from the group 2. Group 3, 5 and 6 were no significant differences compared to group 1. The VEGF ELISA levels were statistically significantly lower in group 3, 5 and 6 compared to group 2 (p < 0.05). There was no statistically difference between VEGF ELISA levels of group 2 and 4 (p > 0.05). CONCLUSIONS: Sorafenib was as effective as bevacizumab in the regression of corneal neovascularization. The effect of sorafenib seems to be dose-dependent. The low doses and twice a day administration are important advantages of sorafenib.

Clinical and Demographic Features of Pediatric-Onset Behçet's Disease and Evaluation of Optical Coherence Tomography Findings.

PURPOSE: To evaluate the clinical characteristics, including spectral domain optical coherence tomography (SD-OCT) findings, of pediatric-onset Behçet's disease (PBD) patients. METHODS: Medical records of 23 PBD (15 males and 8 females) and 24 (15 males and 9 females) healthy subjects were evaluated retrospectively. The main outcomes were compared between PBD patients, with and without ocular involvement, and healthy subjects. RESULTS: The mean age at onset was 12.00 ± 2.10 years. Mean follow-up period was 25.17 ± 15.36 months (range 6-48). Retinal vasculitis was the most common ocular finding (7 patients). Most of the complications of systemic treatment were associated with long term corticosteroid therapy. There was no significant difference between the mean retinal thickness of the PBD patients and healthy controls (p > 0.05). The mean choroidal thickness was significantly increased in all measured segments of PBD patients with ocular involvement (p < 0.01). CONCLUSION: Choroidal thickness of PBD patients with ocular involvement was significantly thicker compared to the PBD patients without ocular involvement and to healthy control subjects.

Serum Cortistatin Levels in Patients with Ocular Active and Ocular Inactive Behçet Disease.

PURPOSE: To evaluate serum cortistatin (CST) levels in patients with ocular active and ocular inactive Behçet disease (BD) and its relationship with disease activity. METHODS: 24 BD patients with ocular active, 24 BD patients with ocular inactive patients and 24 healthy control subjects were included in the study. RESULTS: In ocular active and ocular inactive BD patients and healthy control subjects, the mean serum CST levels were 4.38 ± 1.63ng/ml, 5.46 ± 1.81ng/ml and 7.56 ± 1.73ng/ml, respectively. ESR, serum CRP, CST levels and NLR were significantly different between the groups (p < 0.001 for all). The CST levels were similar between ocular active and inactive BD patient groups (p = 0.197). ESR, CRP and NLR were significantly higher in ocular active BD patients compared to ocular inactive BD patients and healthy control subjects (p < 0.05 for all). CONCLUSION: Serum CST level was significantly lower in BD patients. CST may be a neuropeptide that plays a role in the pathogenesis of BD.

A case of Ross syndrome presented with Horner and chronic cough.

Ross syndrome is a rare sweating disorder associated with Adie's tonic pupil, decreased or diminished tendon reflex and unknown etiology. Although autonomic disturbances affecting sudomotor and vasomotor functions are seen commonly, they are rarely symptomatic. While Ross syndrome is typically characterized with dilated tonic pupil, it may be rarely manifested with miotic pupils (little old Adie's pupil), which can make diagnosis difficult. In this article, we aim to specify the atypical clinical manifestations of syndrome by means of Ross syndrome manifested by autonomic symptoms, Horner syndrome, chronic cough together with bilateral little old Adie's pupil.

Effects of a water-loading test on intraocular pressure and corneal hysteresis in young healthy subjects.

PURPOSE: To evaluate the influence of a water-loading test on corneal compensated intraocular pressure (IOPcc) and corneal hysteresis (CH) in young healthy subjects. MATERIALS AND METHODS: Forty healthy adult subjects (20 female and 20 male), with a mean age of 27.55±2.57 years (range, 24 to 35 y), participated in this prospective study. IOPcc and CH were measured for 1 eye from each participant with an Ocular Response Analyser. These measurements were taken before and 10, 20, and 30 minutes after water loading. RESULTS: Thirty-seven right and 3 left eyes of the 40 subjects fulfilled the study's inclusion criteria. A statistically significant increase in IOPcc was observed between 0 and 10 minutes (P=0.002) and a significant decrease between 10 and 30 minutes (P<0.001). We did not observe any statistically significant changes in CH. The Pearson correlation revealed that there was a weak negative correlation between IOPcc and CH measurements taken at the baseline, 10 minutes, and 30 minutes [r values were -0.275 (P=0.086), -0.369 (P=0.019), and -0.246 (P=0.125), respectively]. CONCLUSIONS: This study revealed changes in IOPcc and CH after a water-loading test, but only the change in the IOPcc measurement was statistically significant. The association of changes in IOP and CH identified in this study suggests that IOP changes might alter corneal biomechanical properties.

Effect of hemodialysis duration on conjunctival bacterial flora and susceptibility of conjunctival bacterial isolates to fluoroquinolones.

PURPOSE: To determine the differences between conjunctival bacterial flora of hemodialysis patients and healthy subjects, the effect of duration of hemodialysis on conjunctival bacterial flora, and in vitro antibiotic susceptibility patterns of conjunctival bacterial flora to fluoroquinolones. METHODS: Sixty healthy subjects (32 male, 28 female) and 60 hemodialysis patients (33 male, 27 female) who had renal failure due to reasons other than diabetic nephropathy and with no previous history of intraocular surgery participated in this study. Statistical analysis of the difference between the culture positivity of hemodialysis patients and a control group was determined using the chi-square test. Pearson's correlation test was used to quantify the correlations among culture positivity and duration of hemodialysis. RESULTS: Conjunctival culture positivity of the hemodialysis patients and the control group was 58.3 and 45.0%, respectively, and there was no statistically significant difference between these groups (p = 0.144). Pearson's correlation test revealed that there was a weak but statistically significant positive correlation between culture positivity and duration of hemodialysis (r value was 0.378 [p = 0.003]). Staphylococcus aureus (28.3%) and Staphylococcus epidermidis (20.0%) were the most frequently isolated organisms in the hemodialysis patients, Staphylococcus epidermidis (26.7%) and Staphylococcus aureus (6.7%) were the most frequently isolated organisms in the control group. Resistance of most frequently isolated organisms (Staphylococcus aureus and Staphylococcus epidermidis) from control group and hemodialysis patients to ofloxacin, levofloxacin, moxifloxacin, and gatifloxacin were 20, 15, 5, and 5%, and 34.5, 20.7, 6.9, and 6.9%, respectively. CONCLUSIONS: As distinct from the control group, S. aureus colonization was isolated more from the hemodialysis patients. Culture positivity of the hemodialysis patients was positively correlated with the duration of hemodialysis. Antibiotic susceptibility of isolates from conjunctival bacterial flora of hemodialysis patients were less than healthy control group.

Effect of prophylactic intraocular pressure-lowering medication on pain during cataract surgery.

PURPOSE: This study evaluated the effects of acetazolamide, latanoprost, travoprost, bimatoprost, brimonidine, brinzolamide, and timolol on pain during phacoemulsification cataract surgery. METHODS: This prospective randomized comparative study included 323 eyes of 323 patients with no history of intraocular surgery or chronic eye disease who underwent uncomplicated phacoemulsification cataract surgery and foldable intraocular lens implantation under topical anesthesia. Patients were divided into 8 groups according to the preoperative prophylactic intraocular pressure (IOP)-lowering medication. The intraoperative pain was assessed postoperatively using a visual analog pain scale. The Kruskal-Wallis test investigated the differences in the visual analog pain-scale scores of the groups, and the Mann-Whitney U test investigated the pairwise comparison of the groups. RESULTS: The median visual analog pain-scale score of the group that did not receive any IOP-lowering medication was 2.0±1.89. The brimonidine group exhibited the lowest visual analog pain-scale scores, and the prostanoids, especially the bimatoprost group, demonstrated the highest visual analog pain-scale scores (median±standard deviation were 0.0±1.50 and 2.0±1.91, respectively). The median visual analog pain-scale scores of the acetazolamide, latanoprost, travoprost, brinzolamide, and timolol groups were 0.0±1.62, 2.0±1.67, 2.0±1.73, 0.0±1.66, and 1.0±1.54, respectively. A pairwise comparison using the Mann-Whitney U test with Bonferroni correction revealed significant differences between the groups of acetozolamide and travoprost (p=0.001), acetozolamide and bimatoprost (p<0.001), travoprost and brimonidine (p<0.001), bimatoprost and brimonidine (p<0.001), and bimatoprost and timolol (p=0.001). CONCLUSIONS: Prophylactic application of the IOP-lowering medication may alter the pain sensation during phacoemulsification cataract surgery.

Association of dehydroepiandrosterone sulfate, serum lipids, C-reactive protein and body mass index with age-related macular degeneration.

The present study was designed to evaluate the associations between exudative age-related macular degeneration (AMD) and the serum concentrations of C-reactive protein (CRP), dehydroepiandrosterone sulfate (DHEAS), and lipids as well as the relationship between exudative AMD and body mass index (BMI). This cross-sectional study included of 141 healthy control subjects (70 males and 71 females with a mean age of 71.01 ± 3.84 years) and 142 exudative AMD patients (70 males and 72 females with a mean age of 70.92 ± 3.60 years). BMI and the serum concentrations of CRP, DHEAS, and lipids were measured in both groups. The data were statistically analysed using the Mann-Whitney U test, Chi squared test, independent sample t test, Cramer's V, point biserial correlation and logistic regression analysis. BMI values and serum concentrations of CRP, total cholesterol, and low-density lipoprotein (LDL) cholesterol were significantly higher in exudative AMD patients compared with normal controls (p values were 0.001, <0.001, 0.005 and <0.001, respectively). The serum concentrations of DHEAS were not significantly different between the controls and the exudative AMD patients for the subgroups of either gender (p values in males and females were 0.785 and 0.159, respectively). A logistic regression analysis revealed that the BMI and serum concentration of CRP moderately contributed to the predictive ability of the model (odds ratios were 1.205 and 1.179, respectively). Elevated total cholesterol concentrations and LDL cholesterol concentrations, BMI values and serum concentrations of CRP were associated with exudative AMD. However, no association between the serum DHEAS concentration and exudative AMD was established.

[Our results of endoscopic dacryocystorhinostomy and bicanalicular silicone tube intubation surgery]. / Endoskopik dakriyosistorinostomi ve bikanaliküler silikon tüp entübasyonu cerrahisi sonuçlarimiz.

OBJECTIVES: In this study, we evaluated the results of endoscopic dacryocystorhinostomy and bicanalicular silicone tube intubation (EDCR + BSTI) surgery in the patients with epiphora due to nasolacrimal duct obstruction. PATIENTS AND METHODS: A total of 120 eyes in 112 patients (40 males, 72 females; mean age 42; range 6 to 74 years) who underwent EDCR + BSTI surgery under general anesthesia between August 2006 and December 2010 were analyzed retrospectively. RESULTS: Of the patients, 104 underwent unilateral surgery, while eight underwent bilateral surgery. One hundred nine of 120 surgeries were primary, whereas 11 were revision surgery. Follow-up was performed on a regular basis in the first week, at one, three, six, and 12 months following surgery. Successful results were obtained in 113 of 120 operation, however seven patients required revision surgery. Repeated EDCR + BSTI surgery gave successful results in all cases, as assessed during the follow-up visits. CONCLUSION: EDCR + BSTI surgery is a primary treatment of choice for the patients with epiphora due to nasolacrimal duct obstruction with a high success rate.

The effect of infliximab, cyclosporine A and recombinant IL-10 on vitreous cytokine levels in experimental autoimmune uveitis.

BACKGROUND: To identify the effect of infliximab, cyclosporine A and recombinant IL-10 in experimental autoimmune uveitis. MATERIALS AND METHODS: Sixty male rats were assigned to five groups of 12 each. All the groups (except the control group) were administered 30 microg retinal-S antigen intraperitoneally. On the 14th day, after confirmation of uveitis with histopathological study, daily cyclosporine A injection was given in cyclosporine A treatment group and physiological serum in the uveitis-induced placebo treatment and control groups. In the infliximab treatment group, infliximab was administered on the 14th, 15th, 17th, 19th and 21st days. In the recombinant IL-10 treatment group, three doses of recombinant IL-10 were given four hours and a half hours before and eight hours after retinal-S antigen administration. On the 21st day of the study, all rats were sacrificed and vitreous cytokine levels (IL-1, IL-6, IL-8 and TNF-alpha) were studied with ELISA. RESULTS: In the treatment groups, cytokine levels (IL-1, IL-6 and TNF-alpha) were significantly lower than the uveitis-induced placebo treatment group. Compared with the control group, there was no significant difference with respect to TNF-alpha and IL-8 in the infliximab treatment group; IL-8 in the cyclosporine A treatment group; IL-6 and IL-8 in the recombinant IL-10 treatment group. The drugs used did not significantly differ in respect to their effects on vitreous IL-6, IL-8 and TNF-alpha levels. CONCLUSION: Cyclosporine A, infliximab and recombinant IL-10 reduce the vitreous cytokines levels. Among these drugs, recombinant IL-10, which is still in its experimental phase, might be considered as a new therapeutic agent.