The role of protein oxidation in the development of diabetic microvascular complications.

OBJECTIVE: The role of protein oxidation in the development of diabetic microvascular complications was investigated. METHODS: In total, 266 participants were split into five groups: Group 1; diabetes mellitus for at least 10 years without any complications, Group 2; diabetic nephropathy, Group 3; diabetic neuropathy, Group 4; diabetic retinopathy, and Group 5; control group. Thiol, disulfide, ferroxidase, and ischemia-modified albumin (IMA) levels were analyzed in the serum. RESULTS: Native thiol, total thiol, and native thiol/total thiol were lower in Group 4 than Groups 1, 3, and 5 (p<0.001). However, disulfide/native thiol and disulfide/total thiol were higher in Group 4 than all other groups (p<0.001). IMA was higher in Groups 3 and 4 than all other groups (p<0.001). Ferroxidase was lower in Groups 3 and 4 than Group 2 (p<0.001). CONCLUSION: Thiol-disulfide homeostasis impairment in favor of disulfide may have a function in the progress of diabetic retinopathy. Furthermore, the disruptions of IMA and ferroxidase levels involve in the development of diabetic retinopathy and neuropathy.

Protection against experimental cisplatin-induced optic nerve toxicity using resveratrol: A rat model study.

AIM: To investigate the effects of resveratrol on oxidative stress and inflammation parameters and histological alterations in cisplatin-induced optic nerve damage in a mouse model. MATERIAL AND METHOD: Thirty-six albino Wistar male rats were divided into three groups as control, 5 mg/kg cisplatin-administered (Cis) and 5 mg/kg cisplatin + 25 mg/kg resveratrol-administered (Cis + Res) animals. At the end of the experimental period, the rats were sacrificed with high-dose (50 mg/kg) thiopental sodium, and their optic nerves were dissected. Malondialdehyde (MDA), total glutathione (tGSH), total oxidant status (TOS), total antioxidant status (TAS), tumour necrosis factor alpha (TNF-α), nuclear factor kappa B (NF-KB) levels, and histopathological findings were assessed using the optic nerve tissues. RESULTS: In the Cis + Res group, the MDA, TOS, OSI, TNF-a and NFK-B levels were significantly lower and the tGSH and TAS levels were significantly higher compared with the Cis group (P = 0.001). In histological evaluations, there were dilated and congested blood vessels, destruction, oedema, degeneration, haemorrhage, and proliferating capillaries indicating the presence of inflammation and damage only in the Cis-administered group. However, in the Cis + Res group, the histological findings were very similar to the healthy controls. CONCLUSION: Resveratrol is a promising neuroprotective agent for cisplatin-induced optic nerve toxicity with its anti-oxidant and anti-inflammatory effects. Further investigations are needed to evaluate the possible therapeutic effects on other optic nerve toxicities.

Comparison of Six Methods of Central Corneal Thickness Measurement in Healthy Eyes.

OBJECTIVES: Several methods of measuring central corneal thickness (CCT) have been compared, however, the data are still limited and conflicting. The aim of this study was to determine the agreement of CCT measurements performed in healthy eyes using ultrasound pachymetry (USP), non-contact tono/pachymetry, specular microscopy, biometry, Scheimpflug-based corneal topography, and optical coherence tomography (OCT). METHODS: All of the participants underwent a complete ophthalmological examination. The CCT of all of the eyes included was measured using 6 different methods. The agreement between the methods was analyzed using the mean difference and Bland-Altman analysis based on a 95% limits of agreement. RESULTS: A total of 64 patients with a mean age of 40.96±14.52 years (range: 20-78 years) were included in the study. The mean CCT value was 552.10±35.65 µm, 550.40±35.55 µm, 554.67±35.49 µm, 545.39±34.21 µm, 546.25±35.49 µm, and 552.64±33.59 µm using USP, non-contact tono/pachymetry, non-contact specular microscopy, biometry, Scheimpflug-based corneal topography, and OCT, respectively. The bias values determined by Bland-Altman plots were -1.70, -2.56, 6.71, 5.85, and -0.53 for tono/pachymetry, specular microscopy, biometry, topography, and OCT, respectively. OCT demonstrated the lowest bias compared to USP. The overall intraclass correlation coefficient was 0.961 (range: 0.945-0.974) with a 95% confidence interval. CONCLUSION: All of the CCT measurements obtained using non-contact tono/pachymetry, non-contact specular microscopy, biometry, Scheimpflug-based corneal topography, and OCT were consistent with the USP measurements of healthy controls. Larger prospective studies to determine the interchangeability of different methods for CCT measurements in pathological conditions are warranted.

Evaluation of the Optic Disc and Macula in Healthy Children Using Optical Coherence Tomography Angiography

Objectives: To perform the measurements of the optic disc and macula in healthy children using optical coherence tomography angiography (OCTA) in order to determine the normative data values and compare these by age, gender, spherical equivalent (SE), and axial length (AL). Materials and Methods: A total of 146 eyes belonging to 146 healthy children (74 girls, 72 boys) aged 6 to 16 years were included in this prospective study. Refraction and biometry measurements were performed. Retinal nerve fiber layer thickness (RNFLT), central macular volume, and central macular thickness (CMT) were measured by optical coherence tomography (OCT) after dilatation. Using the OCTA device, foveal avascular zone (FAZ) area, vascular density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) of the macula, and the VD of the radial peripapillary capillary plexus (RPCP) of the optic disc were recorded. Results: The mean age of the study group was 11.27±3 years, the mean AL was 23.39±1.18 mm and the mean SE was -1.31±1.61 diopters. The mean FAZ area was 0.3±0.09 mm2, the mean SCP-VD was 43.88±3.4%, the mean DCP-VD was 39.6±3.55%, and the mean RPCP-VD was 52.47±3.42%. When the relationship between the OCTA measurements and the SE and AL values were analyzed, there was no statistical significance (p>0.05). When age and OCTA measurements were compared, only DCP-VD values were found to significantly decrease with increasing age (p=0.015). There was no significant difference in OCTA measurements based on gender (p>0.05). Similarly, no statistical age-based differences were observed in RNFLT, CMV and CMT values (p>0.05). Conclusion: With its short procedure time and no dye requirement, OCTA can be safely used in the evaluation of the optic disc and macular perfusion in children. Determination of normative values in children will be useful in detecting pathologic changes in tissue in patients with retinal diseases.

The findings of corneal specular microscopy in patients with type-2 diabetes mellitus.

BACKGROUND: We aimed to compare the morphological characteristics of corneal endothelial cells in type 2 diabetic patients and age-matched healthy subjects by specular microscopy. We also aimed to determine the association of corneal morphological features with the general characteristics and laboratory data of diabetic patients, including disease duration, haemoglobin A1c (HbA1c) levels and urine albumin creatinine ratio. METHODS: A total of 195 diabetic patients and 100 healthy controls were enrolled in the study. All participants underwent a complete ophthalmological examination. Corneal endothelial measurements were performed using a noncontact specular microscopy. Laboratory data including serum fasting glucose, haemoglobin A1c levels, creatinine levels, and the urinary albumin-to-creatinine ratio were recorded. Diabetic patients were further subdivided into 3 groups according to the presence and stage of diabetic retinopathy. Specular microscopy findings and central corneal thickness of all patients were compared. RESULTS: The ECD and hexagonal cell ratio were significantly lower, while the average cell size, CV%, and central corneal thickness were determined to be significantly higher in diabetic patients than in healthy controls (p = 0.001). With the presence and advancement of diabetic retinopathy, the ECD and hexagonal cell ratio decreased, while the average cell size, CV%, and central corneal thickness increased. When correlation analysis was performed between corneal morphological features and laboratory data of diabetic patients, ECD showed a significant negative correlation with diabetes duration (p = 0.028). HbA1c levels, urinary albumin-creatinine ratio (p = 0.041), average cell size and CV showed a positive correlation with these parameters. CONCLUSION: In conclusion, keratopathy is an important complication of type 2 diabetes. With an increase in the stage of diabetic retinopathy, alterations in corneal findings also increased. In that respect, we can suggest that keratopathy should be evaluated more cautiously in diabetic patients.

Alterations in optical coherence tomography angiography findings in patients with high myopia.

PURPOSE: The aim of this study was to determine the macular changes using optical coherence tomography (OCT) and OCT-angiography (OCT-A) in eyes with high myopia. Determining the alterations in vascular structures can provide a clearer understanding of the pathophysiological mechanisms of this disease and help define new treatment options and preventive measures. MATERIALS AND METHODS: Ninety-two patients with high myopia (axial length ≥ 26 mm) and 70 control cases without any known systemic or ocular diseases were enrolled in this prospective study. One eye of each patient was included in the statistical analyses. RESULTS: Retinal nerve fiber layer (RNFL) thickness and Early Treatment Diabetic Retinopathy Study (ETDRS) macula map values were lower in myopia compared with the controls. Both superior and inferior ganglion cell complex (GCC) thicknesses were significantly thinner in the high myopia compared with the controls (p < 0.001). Regarding the OCT-A findings, although superficial or deep foveal avascular zones (FAZ) did not significantly differ between the two groups, the density values of superficial and deep microvessels were significantly lower in the high myopia group compared with the control cases. CONCLUSIONS: In patients with high myopia, with an increase in the axial length and a decrease in RNFL and GCC thicknesses, the vascular densities of the superficial and deep retina were reduced in the macular region.

The Relation of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio with High Axial Myopia.

Purpose: To investigate the relation between high axial myopia and neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) values.Methods: Seventy-nine cases were enrolled, 50 myopic and 29 emmetropic. All participants were assigned into three groups: Group I (high myopia with no retinal involvement), Group II (high myopia with retinal involvement) and Group III (control). NLR and PLR values calculated from blood tests were compared among the groups.Results: Mean NLR levels were 2.23 ± 0.78 in Group I, 2.36 ± 1.06 in Group II, and 1.57 ± 0.33 in Group III. Mean PLR levels were 114.62 ± 23.21 in Group I, 145.16 ± 52.36 in Group II, and 91.42 ± 18.73 in Group III. NLR and PLR values in the high myopia groups were significantly higher than in the control group.Conclusion: NLR and PLR values in cases with high axial myopia were higher than in the emmetropic group. Higher inflammation in the degenerative myopic group in particular may be related to pathological chorioretinal changes.

Serum SCUBE-1 levels in patients with diabetic retinopathy.

PURPOSE: Signal peptide-CUB-Epidermal growth factor-like domain-containing protein 1 (SCUBE-1) is a protein expressed on the cell surface of endothelial cells and platelets. We aimed to determine the alterations in SCUBE-1 levels in patients at different stages of diabetic retinopathy (DR). MATERIALS AND METHODS: Participants were grouped into 4 regarding the presence and stage of diabetic retinopathy as follows: control group (n 32), patients without DR (n 39), patients with background DR (n 42) and patients with proliferative DR (n 55). Age, gender, duration of diabetes, fasting blood glucose levels, serum hemoglobin A1c (HbA1c), SCUBE-1 and malondialdehyde (MDA) levels of the patients were recorded. Central macular thickness and central macular volume were recorded and compared between groups. RESULTS: Totally 136 patients with diabetes mellitus and 32 control cases were included in the study. There is a significant increase in SCUBE-1 and MDA levels with an advance in DR. In correlation analysis, there was only a significant correlation present between serum SCUBE-1 and MDA levels (p 0.001) but not with other parameters. CONCLUSION: For the first time in literature, we determined a significant increase in SCUBE-1 levels in patients with DR. Moreover, with an advance in DR, SCUBE-1 levels were also increasing.

Effects of two different contact lenses on ocular physiological parameters and tear function tests / Efeitos de duas lentes de contacto diferentes nos parâmetros fisiológicos oculares e nos testes de função lacrimal

Abstract Objective: To investigate the effects of two types of contact lenses made of two different types of silicone hydrogel material on ocular physiological parameters and tear function tests. Methods: The contact lenses with the appropriate diopters were supplied to the volunteering patients. The patients were evaluated before wearing the contact lenses (visit0:V0), at the first month(visit1:V1) and at the thirth month(visit2:V2) following their wear. At all visits a detailed biomicroscopic examination was done, ocular physiological variables were collected, the tear function tests were performed and the tear meniscus area (TMA) was visualized and measured with anterior segment optical coherence tomography (AS-OCT). Results: The results of Schirmer 1 test were 12.07 ± 1.51 [9-16] mm for the right eyes (samfilcon A group) and 12.09 ± 1.5 [9-16] mm for the left eyes (senofilcon A group) at V0. (p=0.950) At V2, the mean Schirmer 1 test results were 11.92±1.34 [9-15] mm in the samfilcon A group and 12.2±1.41 [9-16] mm in the senofilcon A group (p=0.239). The mean TMA dimensions in the AS-OCT images were 338.42±47.1 [241-401] microns in the samfilcon A group and 338.42±47.1 [241-401]microns in the senofilcon A group at V0. (p>0.05). At V2, the mean TMA dimensions were 337.2±45.53 [241-402] microns in thesamfilcon A group and 340.31±48.22 [240-411] microns in the senofilcon A group (p=0.728). Conclusions: Our study has demonstrated that contact lenses containing samfilcon A and senofilcon A silicone hydrogel material do not cause meaningful ocular surface problems.

Resumo Objetivo: Investigar os efeitos de dois tipos de lentes de contacto feitas de dois tipos diferentes de material de hidrogel de silicone nos parâmetros fisiológicos oculares e testes de função lacrimal. Métodos: As lentes de contacto com as dioptrias apropriadas foram fornecidas aos pacientes voluntários. Os pacientes foram avaliados antes do uso das lentes de contacto (visita0: V0), no primeiro mês (visita1: V1) e no terceiro mês (visita2: V2), após o uso destas. Em todas as visitas, foi realizado um exame biomicroscópico detalhado, as variáveis fisiológicas oculares foram recolhidas, os testes de função lacrimal foram realizados e a área do menisco lacrimal (TMA) foi visualizada e medida com tomografia de coerência óptica do segmento anterior (AS-OCT). Resultados: Os resultados do teste de Schirmer 1 foram 12,07 ± 1,51 [9-16] mm para os olhos direitos (grupo samfilcon A) e 12,09 ± 1,5 [9-16] mm para os olhos esquerdos (grupo senofilcon A) em V0. (p = 0,950) Em V2, os resultados médios do teste de Schirmer 1 foram 11,92 ± 1,34 [9-15] mm no grupo samfilcon A e 12,2 ± 1,41 [9-16] mm no grupo senofilcon A (p = 0,239). As dimensões médias do TMA nas imagens AS-OCT foram 338,42 ± 47,1 [241-401] mícrons no grupo samfilcon A e 338,42 ± 47,1 [241-401] mícrons no grupo senofilcon A em V0. (p> 0,05).> Em V2, as dimensões médias do TMA foram 337,2 ± 45,53 [241-402] mícrons no grupo samfilcon A e 340,31 ± 48,22 [240-411] mícrons no grupo senofilcon A (p = 0,728). Conclusões: O nosso estudo demonstrou que as lentes de contacto que contêm material de hidrogel de silicone de samfilcon A e senofilcon A não causam problemas significativos na superfície ocular.

The effects of thiamine pyrophosphate on ethanol induced optic nerve damage.

BACKGROUND: We aimed to determine the protective effects of thiamine pyrophosphate on ethanol induced optic neuropathy in an experimental model. METHODS: The rats were assigned into 4 groups, with 6 rats in each group as follows: healthy controls (HC group), only ethanol administered group (EtOH group), ethanol + thiamine pyrophosphate (20 mg/kg) administered group (TEt-20 group), and only thiamine pyrophosphate (20 mg/kg) (TPG group) administered group. To the rats in TEt-20 and TPG groups, 20 mg/kg thiamine pyrophosphate was administered via intraperitoneal route. To the rats in HC and EtOH groups, the same volume (0.5 ml) of distilled water as solvent was applied in the same manner. To the rats in TEt-20 and EtOH groups, one hour after application of thiamine pyrophosphate or distilled water, 32% ethanol with a dose of 5 g/kg was administered via oral gavage. This procedure was repeated once a day for 6 weeks. From the blood samples and tissues obtained from the rats, Malondialdehyde (MDA), reduced glutathione (GSH), interleukin 1 beta (IL-1ß) and tumor necrosis factor alpha (TNF-α) levels were studied. Histopathological evaluations were performed to the optic nerve tissue. RESULTS: Serum and tissue IL-1ß, TNF-α and MDA levels were the highest in EtOH group which were significantly lower in thiamine pyrophosphate administered group (TEt-20 group) (p: 0.001). Serum and tissue reduced GSH levels were the lowest in EtOH group which were also significantly higher in TEt-20 group (p:0.001). In histopathological evaluations, in EtOH group there was obvious destruction and edema with hemorrhage and dilated blood vessels which were not present in any other groups. CONCLUSIONS: There was an apparent destruction in ethanol administered group in histopathological analyses with an augmented level of oxidative stress markers and all those alterations were prevented with concomitant thiamine pyrophosphate administration. These protective effects of thiamine pyrophosphate are extremely important in chronic ethanol consumption. Clinical studies are warranted to define the exact role of thiamine pyrophosphate in prevention of ethanol induced optic neuropathy.

Normative Data Assessment of Vessel Density and Foveal Avascular Zone Metrics Using AngioScan Software.

Purpose: To establish a normative database for macular and peripapillary vessel densities (VD) and foveal avascular zone (FAZ) metrics in healthy subjects with the new version of AngioScan software of RS-3000 Advance (Nidek Co, Ltd) optical coherence tomography angiography (OCT-A) device.Methods: The study design was prospective and cross-sectional. VDs of the SCP, deep capillary plexus (DCP), retinal peripapillary capillary plexus (RPCP) and FAZ area, perimeter and circularity index (CI) along with the structural OCT measurements were scanned by using the Nidek's RS-3000 Advance OCT-A device in healthy subjects. The new version of the AngioScan software was used for analytics. The relations between the OCT-A parameters with age, gender and OCT parameters were analyzed.Results: A total of 128 right eyes of 128 subjects (50% female) were included in this study. We divided subjects into 3 groups in accordance with age; 19-39 years to Group 1, 40-59 years to Group 2, >60 y. to Group 3. The mean SCP and DCP VDs were 41.25 ± 2.51% and 36.01 ± 5.07% respectively (P < .001). The DCP VD was significantly different between groups (P = .001). The mean FAZ area, perimeter and CI were 0.33 ± 0.12 mm2, 2.68 ± 0.6 mm and 0.47 ± 0.09 respectively. Only FAZ CI significantly differed between groups (P = .003). The FAZ area was significantly greater in female subjects than males (P = .025). The SCP and DCP VDs were inversely correlated with FAZ area and perimeter (P < .05).Conclusion: Our study provided for the first time the normative data of the recently updated AngioScan software of Nidek. Additional studies are needed to define pathological vascular changes in ocular and systemic diseases with this new software.

Thiol-Disulfide Homeostasis and Serum Ischemia Modified Albumin Levels in Patients with Primary Open-Angle Glaucoma.

Aim: Glaucoma is an optic neuropathy causing progressive impairment of visual functions. We aimed to assess the alterations in thiol-disulfide homeostasis and serum ischemia modified albumin (IMA) levels, which are the determinants of antioxidant status, in patients with primary open-angle glaucoma (POAG). Material and Method: A total of 140 eyes from 70 patients with POAG and 174 eyes of 87 healthy, control cases were included in the study. All study participants underwent a complete ophthalmic evaluation. Alterations in serum thiol-disulfide homeostasis and IMA levels were measured in all participants. Results: IMA levels were significantly higher in glaucoma group (p:0.001). Native thiol, Total thiol and Native/Total thiol ratio were significantly decreased while Disulfide, Disulfide/Native thiol, and Disulfide/Total thiol ratios were significantly higher in glaucoma group (p:0.001). There was no significant difference regarding central corneal thickness (CCT), iridocorneal angle, albumin, IMA and adjusted IMA levels in patients with different stages of glaucoma. In correlation analysis, there was a negative correlation between Native thiol, Total thiol and Native/Total thiol ratio and disease period, number of daily drops required and stage of the disease in glaucoma patients. There was also a positive correlation between Disulfide, Disulfide/Native thiol and Disulfide/Total thiol levels and the disease activity. Conclusion: In patients with POAG, thiol-disulfide homeostasis is disturbed in the favor of pro-oxidant molecules and IMA levels are increased, indicating the presence of augmented oxidative stress. In that aspect, systemic and local anti-oxidant treatments may be new targets in glaucoma treatment. Larger, prospective studies about the role of anti-oxidants in prevention and treatment of POAG are warranted.

Prevalence and Load of Demodex folliculorum and Demodex brevis (Acari: Demodicidae) in Patients With Chronic Blepharitis in the Province of Erzincan, Turkey.

Chronic blepharitis is an ocular disease frequently encountered by ophthalmologists. Demodex mites can play a role in the pathogenesis of blepharitis along with bacterial agents, especially in treatment-resistant cases or recurrent cases after treatment. This study was performed to determine the prevalence and load of Demodex folliculorum (Simon) and Demodex brevis Akbulutova in chronic blepharitis patients and to assess the relationship between the prevalence and load of Demodex species and ocular symptoms. The study included 365 patients diagnosed with chronic blepharitis in clinical examination, and 175 controls without any chronic or ocular disease. In the study, two eyelashes were sampled from the lower and upper lids of the right and left eyes (a total of eight samples) of the participants. Eyelash samples were examined under a light microscope, and Demodex species were identified and counted. Demodex were detected in 79.2% (95% CI: 75-83%) of patients and 31.4% (95% CI: 24-38%) of controls in this study. D. folliculorum alone (mean: 4.96; min: 1; max: 17; P < 0.001) was detected in 72.3% of patients, in 0.7% D. brevis alone (mean: 1.00, P > 0.05), and in 27% both D. folliculorum and D. brevis (mean: 21.65; min: 2; max: 79; P < 0.001). In Demodex positive controls, only D. folliculorum (mean: 2.38; min: 1; max: 6) was detected while there was no D. brevis. Nevertheless, mean ocular symptom scores were significantly higher in Demodex positive patients than in Demodex negative patients (P < 0.001). Itching, foreign body sensation, and redness were the most common complaints in Demodex positive patients. As a result, Demodex mites were high in numbers in patients with chronic blepharitis in Erzincan. There was a positive correlation between Demodex mites and chronic blepharitis and ocular symptoms. It may be helpful to consider these findings in clinical assessment of blepharitis patients.

The effects of lycopene on alloxan induced diabetic optic neuropathy.

AIM: To determine the effects of lycopene treatment in prevention of diabetes associated inflammatory response and oxidative stress in an experimental model. With this aim we investigated the levels of oxidative stress markers including Malondialdehyde (MDA), and total oxidative status (TOS)together with inflammatory markers including nuclear factor- kappa B (NFKB) and tumor necrosis factor α (TNF-α) and antioxidants including total glutathione (TGSH), total oxidative status (TOS) and total anti-oxidative status (TAS) levels on eye tissue. MATERIAL AND METHODS: Totally 18 albino Wistar male rats (250-280 grams) assigned into three groups, with six rats in each group as follows: healthy group (HG), control group (CG), and lycopene group (LG). The diabetes was induced with alloxan administration in rats of CG and LG. Lycopene (4 mg/kg) was administered to the rats in LG once a day for 3 months. At the end of this period, the animals were sacrificed and their eyes were enucleated for histopathological evaluations. From the tissues, MDA, GSH, TOS, TAS, TNF-α and NF-κB levels were analyzed. RESULTS: MDA, TOS, OSI, NFKB and TNF-α levels were significantly higher, while TGSH and TAS levels were significantly lower in CG compared with HG (p < 0.001). On the other hand in LG; MDA, TOS, OSI, NFKB and TNF-α levels were significantly lower, while TGSH and TAS levels were significantly higher compared with CG (p < 0.001). Regarding histopathological findings, although there was severe damage on optic nerve of rats in CG; there was only a slight damage in lycopene administered group. CONCLUSION: For the first time in literature we determined that, lycopene was significantly effective in prevention of augmented inflammation and oxidative stress on eye tissue associated with diabetes, as well as the tissue damage on optic nerve. However, studies investigating the long-term clinical effects of lycopene on diabetic individuals are warranted.

The effects of lutein on optic nerve injury induced by ethambutol and isoniazid: an experimental study.

AIM: Ethambutol and isoniazid are two major effective first line agents in tuberculosis treatment having some visual adverse effects. We aimed to determine the protective effects of lutein on oxidative optic neuropathy induced by ethambutol and isoniazid in an experimental model. MATERIAL AND METHOD: Totally 24 albino Wistar male rats were assigned into 4 groups, with 6 rats in each group as follows: healthy controls (HC group), 50 mg/kg ethambutol +50 mg/kg isoniazid administered group (EI), 0.5 mg/kg lutein +50 mg/kg ethambutol +50 mg/kg isoniazid administered group (LEI-05) and only Lutein (0.5 mg/kg) (LUT group) administered group. From the blood samples and tissues obtained from the rats, Malondialdehyde (MDA), total glutathione (GSH), interleukin 1 beta (IL-1ß) and tumor necrosis factor alpha (TNF-α) levels were studied. Histopathological evaluations were performed at the end of the study. RESULTS: Serum and tissue IL-1ß, TNF-α and MDA levels were the highest in EI group which were significantly lower in lutein administered group. On the other hand, serum and tissue total GSH levels were the lowest in EI group which were significantly higher in Lutein administered group. In histopathological evaluations, there were significant differences between EI group and all other three groups with edema and hemorrhage in connective tissue covering optic nerve, dilated and congested capillary, decrease in astrocytes and oligodendrocytes. CONCLUSION: Isoniazid and ethambutol induced toxic optic neuropathy although not common, may have some potential devastating effects on vision. Lutein is determined as an effective agent in prevention of isoniazid and ethambutol induced toxic optic neuropathy.

The Effects of Intravitreal Ranibizumab, Aflibercept or Dexamethasone Implant Injections on Intraocular Pressure Changes.

BACKGROUND The aim of this study was to compare the alterations in intraocular pressure (IOP) values during the early postoperative period after intravitreal ranibizumab, aflibercept, or dexamethasone implant injections. MATERIAL AND METHODS In this retrospective study, a total of 188 patients were grouped into 3 groups: the ranibizumab group, the aflibercept group, and the dexamethasone group. Ocular axial length (AXL) and anterior chamber depth (ACD) were measured in the pre-injection period. IOP was measured just before the injection at 1 minute,10 minutes, 1 hour, 1 day, and 1 month after injection. RESULTS There was a transient peak in the ranibizumab group and the aflibercept group at 1 minute that started to decrease at 10 minutes and IOP values returned to preoperative values at approximately 1 hour. Similar alterations were also determined for the dexamethasone group with a lesser increase noted. In the correlation analysis, only alterations in IOP levels at 1 minute were negatively correlated with preoperative AXL values. There was not any correlation between preoperative AXL or ACD values and IOP alterations at any other time points. CONCLUSIONS There was a sudden, transient increase in IOP values after intravitreal ranibizumab or aflibercept injections; which return to normal values in a short time without requirement of any medical treatments. This transient peak was determined to be negatively correlated with the preoperative AXL.

Evaluation of the Efficacy of Tea Tree Oil On the Density of Demodex Mites (Acari: Demodicidae) and Ocular Symptoms In Patients With Demodectic Blepharitis.

The objective of this study was to examine the efficacy of 7.5% tea tree oil (TTO) eyelash shampoo on the density of Demodex (Acari: Demodicidae) and ocular symptoms in patients with demodectic blepharitis. A total of 135 patients diagnosed with demodectic blepharitis, following clinical inspection and parasitological examinations, were included in the study. Patients were treated with eyelash shampoo, with or without TTO. Full Demodex reduction was attained in 36% of the patients who used eyelash shampoo with TTO, and the average Demodex count was reduced from 6.33/eyelash to zero ( P < 0.001). In contrast, the average Demodex count in patients who did not achieve full reduction (64%) was reduced from 12.46/eyelash to 4.15/eyelash ( P < 0.001). Full reduction was observed in 11.7% of patients who used TTO-free eyelash shampoo, and average Demodex count reduced from 2.00/eyelash to zero ( P = 0.017). The average Demodex count was reduced from 11.98/eyelash to 7.91/eyelash in patients (88.3%) who did not achieve full reduction ( P = 0.024). Additionally, ocular symptom scores (which are generated based on subjective experiences of itching, burning, the feeling of a foreign body in the eye, eye redness, and cylindrical dandruff) were reduced significantly ( P < 0.001) in patients who used the eyelash shampoo with TTO. The symptom scores remained almost the same in patients who used TTO-free eyelash shampoo ( P > 0.05). In conclusion, it was determined that eyelash shampoo with TTO is 3 times more effective at achieving full Demodex reduction, significantly reducing the Demodex count, and relieving ocular symptoms in patients where full reduction cannot be attained, without adverse side effects.

Effects of Pycnogenol on cisplatin-induced optic nerve injury: an experimental study.

AIM: To determine the effects of Pycnogenol on cisplatin-induced optic nerve damage. MATERIAL AND METHOD: Totally 18 albino Wistar male rats were assigned into three groups, with six rats in each group as follows: healthy controls (HC group), only cisplatin (2.5 mg/kg) administered group (CIS group) and Pycnogenol (40 mg/kg) + cisplatin (2.5 mg/kg) administered group (PYC group). We analyzed the levels of malondialdehyde (MDA) as a marker of lipid peroxidation and oxidative stress, total glutathione (tGSH) as a marker of antioxidant status, nuclear factor-kappa B (NF-κB) and tumor necrosis factor alpha (TNF-α) as inflammatory markers, total oxidative status (TOS) and total antioxidant status (TAS) on eye tissue together with histopathological evaluation of optic nerve in an experimental model. RESULTS: In CIS group MDA, TOS, TNF-α and NF-κB levels were statistically significantly higher (p < 0.001) than HC group while tGSH and TAS levels were significantly lower (p < 0.001). On the other hand, in PYC group MDA, TOS, TNF-α and NF-κB levels were statistically significantly lower (p < 0.001) than CIS group while tGSH and TAS levels were significantly higher (p < 0.001). CONCLUSION: Pycnogenol pretreatment was highly effective in preventing augmentation of cisplatin-induced oxidative stress and inflammation in eye tissue.

Protective effects of Rutin against methanol induced acute toxic optic neuropathy: an experimental study.

AIM: To determine the effects of Rutin on methanol induced optic neuropathy and compare the results with the effects of ethanol. METHODS: Totally 30 rats were divided into 5 groups, with 6 rats in each group as follows: healthy controls (C), methotrexate (MTX), methotrexate+methanol (MTM), methotrexate+methanol+ethanol (MTME) and methotrexate+ methanol+Rutin (MTMR). In all rabbits except those of the control group, MTX, diluted in sterile serum physiologic, 0.3 mg/kg per oral was applied for 7d by the aid of a tube. After this procedure to the rats of MTM, MTME and MTMR groups, 20% methanol with a dose of 3 g/kg per oral was given by the aid of a tube. In MTME group, 4h after the application of methanol, 20% ethanol was applied by the same way with a dose of 0.5 g/kg. On the other hand, in MTMR group 4h after the application of methanol, Rutin, which was dissolved in distilled water, was applied by the same way with a dose of 50 mg/kg. RESULTS: There were statistically significant differences in tissue 8-hydroxy-2 deoxyguanine (8-OHdG), interleukin-1ß (IL-1ß), tumor necrosis factor-alpha (TNF-α), malondialdehyde (MDA), myeloperoxidase (MPO). glutathione peroxidase (tGSH) and superoxide dismutase (SOD) levels between groups (P<0.001). In MTMR group tissue 8-OHdG, IL-1ß, MDA, and MPO levels were similar with the healthy controls but significantly different than the other groups. In histopathological evaluations, in MTX group there was moderate focal destruction, hemorrhage and decrease in number of astrocytes and oligodendrocytes; in MTM group there was severe destruction and edema with decrease in number of astrocytes and oligodendrocytes; in MTME group there was mild hemorrhage, mild edema, mildly dilated blood vessels with congestion while in MTMR group, optic nerve tissue was resembling the healthy controls. CONCLUSION: Rutin may prevent methanol-induced optic neuropathy via anti-inflammatory effects and decreasing the oxidative stress. New treatment options are warranted in this disease to avoid loss of vision in patients.

The effects of lutein on cisplatin-induced retinal injury: an experimental study.

AIM: Lutein is one of the most common carotenoids defined in human plasma as having potent anti-oxidant effects. We aimed to determine the biochemical and histopathological effects of lutein on cisplatin-induced oxidative retinal injury in rats. MATERIALS AND METHODS: Twenty-four rats were equally divided into four groups as healthy controls (HC group), only cisplatin (5 mg/kg) administered group (CIS group), Lutein (0.5 mg/kg) + cisplatin (5 mg/kg) administered group (LC group), and only Lutein (0.5 mg/kg) (LUT group) administered group. From the blood samples obtained, serum malondialdehyde (MDA), total glutathione (tGSH), interleukin 1 beta (IL-1ß), and tumor necrosis factor alpha (TNF-α) levels were investigated. In histopathological analyses, the total retinal thickness, retinal pigment epithelium (RPE), photoreceptor layer (PL), outer nuclear layer (ONL), outer plexiform layer (OPL), inner nuclear layer (INL), inner plexiform layer (IPL), and ganglion cell layer (GCL) were evaluated. RESULTS: MDA, IL-1ß, and TNF-a levels were statistically significantly higher (p < 0.001) in CIS group compared with other three groups while tGSH levels were statistically significantly lower (p < 0.001). In subgroup analyses, there was no any statistically significant difference regarding all four parameters analyzed between HC, LC, and LUT groups. In histopathological analyses, cisplatin-induced retinal damage included atrophy and disorganization on outer segment, degeneration and detachment of RPE and PL from choroid, degeneration and edema of INL and IPL, total degeneration of GCL; while cisplatin-induced retinal damage was determined to be significantly prevented with 0.5 mg lutein treatment on histopathological evaluations. CONCLUSIONS: Lutein co-administration was highly effective in prevention of cisplatin-induced retinal damage due to the anti-oxidant and anti-inflammatory effects of lutein.