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.

WHAT IS THE INCIDENCE OF RETINOPATHY OF PREMATURITY (ROP) IN 'BIG' BABIES?: RESULTS OF A RETROSPECTIVE MULTICENTER STUDY.

AIM: This study aims to determine the incidence of ROP and to investigate its prognosis among premature babies with a BW of ≥2000 g. MATERIAL AND METHOD: We retrospectively analyzed the data of 1004 babies with BW≥2000 g admitted to the ROP Diagnosis and Treatment Centers of X University Hospital and X Hospital between 2018 and 2019. Examination findings were recorded according to the Classification of Retinopathy of Prematurity guideline. We recorded the following information: GA, BW, type of delivery, oxygen therapy, age at the time of diagnosis (weeks), the location of ROP, the severity of ROP, vascular characteristics of ROP, treatment status, PMA, treatment modality, and retinal vascular development. RESULTS: The 2008 eyes of 1004 subjects were included in the study. Mean GA (SD) of subjects was 34.3 (1.3) weeks (range: 31-36) and mean BW (SD) was 2377.3 (244.2) g (range: 2000-3400). The 283 eyes of 144 patients (14.1%, 95% CI: [11.7-17.3%]) had been diagnosed with ROP. We evaluated the location of ROP and found that it was in Zone II in 279 of the 283 eyes and in Zone I in 4 eyes. We found that 213 of the 283 eyes had stage 1 ROP, 53 eyes had stage 2 ROP, and 17 eyes had stage 3 ROP. According to the international ROP classification, 17 eyes of 9 patients had Type 1 ROP, and 266 eyes of 135 patients had Type 2 ROP in the study. Seventeen eyes (0.85%, 95%CI: [0.62-1.36%]) required treatment. CONCLUSION: We conclude that the incidence of ROP in babies with BW≥2000 g is higher in Turkey compared to developed countries. It is important to include these babies in the screening program as they can develop advanced ROP requiring treatment.

Ocular Findings Associated with Hypoparathyroidism.

Purpose: To determine the corneal and retinal changes associated with serum calcium, phosphorus and parathyroid hormone (PTH) levels in patients with hypoparathyroidism.Methods: Patients who were under follow-up for hypoparathyroidism in the endocrinology department were included in the study. All participants underwent a complete ophthalmological examination. Moreover, central corneal thickness (CCT), anterior chamber depth (ACD), retinal nerve fiber layer (RNFL) thickness, ganglion cell layer (GCL) thickness were recorded. Serum biochemical parameters were recorded.Results: In a total of 75 patients (35 in the hypoparathyroidism group and 40 in the healthy control group) were included in this study. Central corneal thickness (519.95 ± 33.21 vs. 539.10 ± 32.96, p: 0.001) and RNFL (105.10 ± 11.89 vs. 113.56 ± 9.54, p: 0.005) were significantly thinner and ACD was significantly deeper in the hypoparathyroidism group.Conclusion: We determined thinner CCT and RNFL values in patients with hypoparathyroidism related to serum calcium levels together with a significant deepness in ACD.

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.

Altered Macular Vasculature in Migraine Patients without Aura: Is It Associated with Ocular Vasculature and White Matter Hyperintensities?

AIM: We aimed to determine the alterations in macular and optic nerve vasculature in patients with migraine without aura using optical coherence tomography-angiography (OCTA). We also aimed to determine whether there were clinical differences and alterations in ocular structures in migraine cases with white matter hyperintensities (WMH) using magnetic resonance imaging (MRI). Materials and Methods. The study group comprised patients with migraine without aura and age- and sex-matched healthy controls. Detailed histories of the patients with migraine were recorded including the disease duration, number of attacks in the last month, and attack durations. Visual evoked potentials (VEP) were recorded in all migraine patients. The migraine disability assessment (MIDAS) questionnaire was administered to all patients. The patients were divided into two groups as migraine with WMHs and migraine without WMHs. All subjects underwent a complete neurological and ophthalmological examination. Only the right eyes of the patients were included in the study. Retinal imaging was performed using OCT and OCTA. RESULTS: A total of 66 migraine patients (29 with WMH and 37 without WMH) and 43 healthy controls were included in this study. Among the migraine patients, disease duration, attack frequency in the last month, attack durations, and the visual analogue scale (VAS), MIDAS, and VEP scores were all similar between those with and without WMHs. There was no significant difference between the groups regarding the ganglion cell complex, foveal, and retinal nerve fiber layer thicknesses. The superficial or deep vascular perfusion densities of the optic disc were also similar between the groups. The foveal avascular zone (FAZ) was significantly larger (P=0.034), and both superficial and deep macular vascular densities were significantly lower in the migraine groups compared with the healthy controls (P=0.001). There was no significant difference concerning the FAZ size or vascular densities between the migraine groups with and without WMHs. In the correlation analysis performed between the migraine patients, the FAZ size was correlated with age and VAS and MIDAS scores while both superficial and deep macular vascular densities were negatively correlated with age and VAS and MIDAS scores. CONCLUSION: We suggest that for not only migraine with aura but also migraine without aura, neurovascular structures play an important role in pathogenesis, and novel studies are warranted to elucidate the alterations in these and determine the significance of WMHs in these patient groups.

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.

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.

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 rutin on cisplatin induced oxidative retinal and optic nerve injury: an experimental study.

AIM: To determine the role of rutin in prevention of cisplatin induced retinal and optic nerve injury in an experimental study. MATERIALS AND METHODS: Totally 18 albino Wistar male rats were assigned into three groups, as follows: healthy controls (HC group), only cisplatin administered group for 14 days (CIS group), and rutin + cisplatin administered group for 14 days (RC group). Blood samples were obtained from animals just before the scarification. Serum malondialdehyde (MDA), myeloperoxidase (MPO), total glutathione (tGSH), superoxide dismutase (SOD), interleukin 1 beta (IL-1ß) and tumour necrosis factor alpha (TNF-α) levels were investigated. The eyes were enucleated for histopathological evaluations of retina and optic nerve. RESULTS: MDA, MPO, IL-1ß and TNF-α levels were statistically significantly higher (p < 0.001) in CIS group compared with other two groups while tGSH and SOD levels were statistically significantly lower (p < 0.001). Regarding these parameters, in CIS group MDA, MPO, IL1ß and TNF-α levels were statistically significantly increased with cisplatin administration and giving rutin concomitantly with cisplatin prevented this increase. On the other hand, tGSH and SOD levels were statistically significantly decreased with cisplatin administration and giving rutin concomitantly with cisplatin prevented this decrease. In qualitative analyses of histopathological findings of retina and optic nerve; the results of RC group were similar with the results of healthy controls; but there was statistically significant differences between CIS group and other two groups (p < 0.001). CONCLUSIONS: Concomitant rutin administration may prevent the detrimental effects of cisplatin on lipid peroxidation, oxidative stress and inflammation markers and may also avert the histopathological damage on retina and optic nerve. Further studies are warranted to determine the effects of cisplatin and rutin on eye.