Aqueous humor pentraxin-3 levels in patients with diabetes mellitus.

PurposeTo evaluate aqueous humor (AH) pentraxin-3 (PTX3) levels in diabetic patients with and without diabetic retinopathy (DR).MethodsIn this prospective study, patients undergoing cataract surgery were enrolled. The study group was composed of 26 type-2 diabetic patients without DR (group 1), 32 diabetic patients with DR (group 2) and 29 age-matched subjects without any systemic disease (group 3). Fifteen proliferative DR (PDR) and 17 non-proliferative DR (NPDR) patients were enrolled in Group 2. HbA1c levels and duration of diabetes were noted. AH samples were obtained from anterior chamber at the beginning of cataract surgery and PTX3 levels were analyzed with Elisa kit.ResultsBaseline demographic characteristics were similar between groups. The mean duration of diabetes was 11.9±7.9 years in group 1 and 15.8±7.8 years in group 2 (P=0.11). The mean plasma HbA1c levels in group 1 was 9.1±2.6 and 8.2±2.4 in group 2 (P=0.36). PTX3 levels were 5.75±0.41 in group 1, 6.11±1.47 in group 2 and 4.93±0.84 ng/ml in group 3 (P=0.01). PTX3 levels in group 2 were higher than in group 1 and 3 (P=0.06 and P=0.01, respectively). There was no correlation between HbA1c and PTX3 levels (P=0.06 r=0.57, P=0.19 r=0.3, respectively). The mean PTX3 was 6.6±0.3 in PDR group and 5.6±0.5 ng/ml in NPDR group (P=0.04).ConclusionsPTX3 is an important marker especially for vascular endothelial damage. Since diabetic vascular changes are dependent on endothelial cell damage, high levels of AH PTX3 of DR patients may indicate the importance of PTX3 protein in the pathogenesis of DR.

Comparison of intraocular pressure lowering effect of once daily morning vs evening dosing of latanoprost/timolol maleate combination.

PURPOSE: To compare intraocular pressure (IOP) reduction profiles of latanoprost-timolol maleate fixed combination (LTFC) administered in the morning or evening in primary open angle glaucoma (POAG). METHODS: A prospective, randomized study including 60 eyes of 30 patients with POAG was carried out. Patients were randomized to treatment with LTFC at 8 PM (Group 1) or at 8 AM (Group 2). After therapy of 4 weeks, IOP was measured at 2 AM, 6 AM,10 AM, 2 PM, 6 PM, and 10 PM and compared with baseline values and latanoprost therapy alone. RESULTS: Mean diurnal baseline IOPs and IOPs after treatment with latanoprost and LTFC were 23.6+/-2.6, 16.7+/-2.3, and 15.5+/-2.2 mmHg in Group 1 and 23.1+/-2.6, 16.9+/-2.4, and 15.7+/-2.4 mmHg in Group 2. LTFC lowered IOP more than latanoprost at all time points in both groups (p<0.001) (except 6 AM in Group 2). The mean IOP range after LTFC therapy was lower than the baseline in Group 1 whereas it was not different in Group 2. IOP at 10 AM was significantly higher than the other time points at baseline measurements in both groups (p<0.01) but after treatment there was no difference (p>0.05). According to IOP reduction from baseline, there was a statistically significant difference between groups in favor of Group 1 at 6 AM, 10 AM, and mean diurnal measurement (p<0.01). CONCLUSIONS: Both morning and evening dosing of LTFC were effective in lowering diurnal IOP in patients with POAG. However, evening dosing of LTFC seemed to be more effective in controlling IOP especially in the morning and avoiding the fluctuations with lower range of IOP.

Clinical features, complications, and incidence of intraoperative floppy iris syndrome in patients taking tamsulosin.

PURPOSE: To evaluate the intraoperative findings, complication rates, effect of intracameral adrenaline, and incidence of intraoperative floppy iris syndrome (IFIS) in patients using tamsulosin. METHODS: In this prospective nonrandomized observational study, 858 eyes of 774 patients who had phacoemulsification between August 2005 and November 2006 were evaluated. Duration and preoperatively discontinuing time of tamsulosin intake were questioned. Preoperative pupil size, intraoperative iris behavior, progressive miosis, adrenalin usage, and complications were recorded. RESULTS: The incidence of IFIS was 1.6% and IFIS was seen in 14 of the 18 eyes of patients using tamsulosin (77.8%). One eye had floppy iris only, 2 eyes had floppy iris and intraoperative miosis, 3 eyes had floppy iris and iris prolapse, and 8 eyes had all three signs of IFIS. IFIS was seen in 7 of the 10 eyes where intracameral adrenaline was used, and in 7 of the 8 eyes without adrenaline (p=0.588). Intraoperative miosis was seen only in 3 of the 10 eyes with adrenaline and in 7 of the 8 eyes without adrenaline (p=0.025). Posterior capsule rupture occurred in 1 of the eyes with IFIS and in 5 eyes focal iris stromal atrophy caused by prolapse was seen. CONCLUSIONS: IFIS occurred in 1.6% of cases having phacoemulsification. Intracameral adrenaline usage did not change the IFIS occurrence rate, but it seemed to be effective in preventing intraoperative miosis. There are still many questions about IFIS, and there is need for future studies strengthening the understanding of IFIS.