Evaluation of vascular and perfusional changes in the retina and choroid of children with multisystem inflammatory syndrome.

BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is hyperinflammation following coronavirus disease 2019 (COVID-19), which affects many organs. The retina and choroid are affected by COVID-19 through microangiopathy and thrombosis but the literature on MISC-C is limited. METHODS: Thirty children (60 eyes) with MIS-C (the study group, or SG) and 32 age-and gender-matched healthy children (64 eyes) (the control group, or CG) were included in the prospective case-control study. Complete ophthalmological examinations, measurements of the vessel densities of the retinal layers, and flow area of the outer retina and choriocapillaris in both groups were conducted with optical coherence tomography angiography (OCT-A). RESULTS: The mean age of the SG was 11.9 ± 3.9 and that of the CG was 12.5 ± 4.6 years (p = 0.197). In this study we found that the vessel density of the deep layer of the inner retina was decreased significantly and was reduced in the outer retina of flow area in the SG in comparison with the CG (p < 0.05, for all). However, there was no significant difference between the groups regarding other measurements. CONCLUSIONS: In MIS-C patients, vessel densities in the deep layer of the inner retina and in the flow area of the outer retina decreased significantly. This OCTA-A finding suggests that MIS-C is related to endothelial thrombotic condition problems in small branches of the retinal artery. The results of this study support the idea that there is a need for screening of MIS-C patients for the presence of these microangiopathic and perfusional complications.

Intraocular pressure effect of anti-vascular endothelial growth factor injection for aggressive posterior retinopathy of prematurity.

PURPOSE: To compare the effect of 0.0125 mL and 0.025 mL doses of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection on intraocular pressure (IOP) in eyes with aggressive posterior retinopathy of prematurity (ROP). METHODS: In this retrospective cohort study, charts of 52 eyes of 26 consecutive infants were reviewed. The patients received 0.0125 mL (Group 1) or 0.025 mL (Group 2) anti-VEGF agents' intravitreally. The IOP was measured before injection, on the first day, during the first week, and in the first month. After each injection, optic nerve head perfusion was evaluated by a binocular indirect ophthalmoscope. IOP values, complications, use of antiglaucomatous drops, and the effects of anti-VEGF drugs were recorded. RESULTS: The mean baseline IOP before injection was 16.0 ± 3.7 mmHg for Group 1 and 15.5 ± 4.5 mmHg for Group 2 (p = 0.365). The mean value of IOP on the first day was statistically increased in Group 2 (29.2 ± 6.1 mmHg) compared with Group 1 (24.1 ± 6.8 mmHg) (p = 0.013). Moreover, antiglaucomatous drops were needed in 12 eyes for Group 2 compared with seven eyes for Group 1. Anterior chamber paracentesis was not performed after any of the injections. CONCLUSION: This study found that IOP increases after intravitreal injections of anti-VEGF agents for the treatment of ROP. The injection of 0.025 mL anti-VEGF agents increases IOP more than the 0.0125 mL injection in the treatment of infants with aggressive posterior ROP.

Effect of topiramate on choroidal thickness and anterior chamber parameters in the treatment of patients with migraine.

OBJECTIVE: To investigate the effects of topiramate on choroidal thickness and anterior chamber parameters using optical coherence tomography in the treatment of patients with migraine. METHODS: A total of 22 eyes of 22 adults (12 females, 10 males) diagnosed with migraine and scheduled to topiramate treatment for pain control were recruited in this prospective study. Choroidal thickness (CT), anterior chamber depth (ACD), anterior chamber angle (ACA), spherical refractive equivalent (SphEq) and intraocular pressure (IOP) measurements were recorded at baseline (prior the topiramate therapy), first and second month visits for the statistical analysis. One-way ANOVA with repeated measures test was used for the statistical evaluation. RESULTS: Mean age of the patients was 40.2 ± 6.5 years. Mean CT at central fovea was 324 ± 47 µm initially, 341 ± 45 µm in the first month and 344 ± 46 µm in the second month, thus first and second month measures were significantly higher than base values (p < 0.001). There was also a slight increase in IOP values among baseline (15.5 ± 2.4 mmHg) and follow-up visits (17.5 ± 2.6 mmHg, 19.0 ± 3.3 mmHg, respectively, ` p = 0.001). Baseline ACD (3.66 ± 0.22 mm) measures significantly decreased at the first month (3.63 ± 0.22 mm) and second month (3.62 ± 0.22 mm, p = 0.009). Also, a significant reduction was detected in the first (36.2 ± 4.9°) and second month (35.9 ± 5.1°) ACA measures comparing with baseline (39.1 ± 5.1°, p = 0.05). A significant myopic shift was determined in the first and second month SphEq values (-0.08 ± 0.6, -0.10 ± 0.6, respectively, p = 0.05). CONCLUSIONS: The study revealed increased CT and altered anterior chamber parameters and IOP due to topiramate therapy. Therefore, the patients using topiramate should be carefully monitored by an ophthalmologist considering the possible side effects.

The effects of smoking on dry eye parameters in healthy women.

AIM: To investigate the effects of chronic smoking on dry eye parameters. METHODS: Ocular surface disease index (OSDI) and tear function tests such as Schirmer's test, tear break-up-time (TBUT) test and impression cytology of 63 female chronic smokers and 40 age-matched female non-smokers were analyzed statistically. RESULTS: The mean OSDI scores, Schirmer test results and TBUT levels were 35.85 ± 24.01 point, 14.25 ± 5.94 mm and 5.17 ± 2.85 s in chronic smokers and 15.20 ± 12.93 point, 15.48 ± 7.01 mm and 10.03 ± 3.44 s in non-smokers, respectively. Differences in OSDI scores, TBUT levels and impression cytology grades among the chronic smokers and non-smokers were statistically significant. CONCLUSION: Smoking behavior seems to affect the dry eye parameters negatively.

Dry eye findings worsen with anticholinergic therapy in patients with urge incontinence.

INTRODUCTION AND HYPOTHESIS: To evaluate the effects of oral anticholinergic (OAC) drugs on tear secretion in women with overactive bladder over a 3-month follow-up period. METHODS: In this prospective study, 108 women with a diagnosis of overactive bladder were evaluated. All patients were examined ophthalmologically at baseline (day 0), and after 1 month (day 30) and 3 months (day 90) of OAC treatment. Tear film break-up time (BUT) and Schirmer 1 test results were recorded. The subjective complaints of the patients including dry mouth, and burning, dryness and foreign body sensation in the eyes, were also recorded. The chi-squared test or the paired sample t test as appropriate, was used for statistical analysis. RESULTS: The mean age of the patients was 51.8 ± 9.2 years (30 - 69 years). The most frequent subjective complaints were dry mouth and dry eyes and both complaints were significant on both day 30 and day 90. Both tear film BUT and Schirmer 1 test results were significantly lower on day 30 and day 90. Dry eye measurement values worsened with prolongation of OAC treatment (p = 0.037 and p = 0.012 for BUT, and p = 0.046 and p = 0.035 for Schirmer 1 test, on day 30 and day 90, respectively). CONCLUSIONS: OAC treatment in women with overactive bladder significantly and progressively affects tear secretion.

CHOROIDAL THICKNESS IN INFANTS WITH RETINOPATHY OF PREMATURITY.

PURPOSE: To evaluate choroidal thickness in premature infants and its relationship with stage of retinopathy of prematurity (ROP) using spectral domain optical coherence tomography (SD-OCT). METHODS: Spectral domain optical coherence tomography imaging for measuring subfoveal choroidal thickness was performed for 80 premature infants. Subfoveal choroidal thickness was defined as the distance from the hyperreflective line of the outermost retinal pigment epithelium (RPE) to the innermost hyperreflective line of the choroidoscleral junction. Each measurement was performed at the central fovea (CF) and 0.75 mm to 1.5 mm nasal (N1 and N2) and temporal (T1 and T2) to the fovea. Subfoveal choroidal thickness and grading of cystoid macular edema (CME) were analyzed statistically. RESULTS: Choroidal thickness of CF was found to be significantly greater than nasal (N1 and N2) and temporal (T1 and T2) choroidal thickness (P < 0.05). There was no significant relationship between stage of ROP and nasal (N1 and N2) choroidal thickness (P = 0.057, P = 0.282, respectively). However, CF and temporal (T1 and T2) choroidal thickness was found to be significantly lower at a higher stage of ROP (P = 0.005, P = 0.01 and P = 0.001). No significant relationship was found between subfoveal choroidal thickness and the grades of cystoid macular edema (P > 0.05). The choroidal thickness of CF was found to be correlated with birth weight (r = 0.267, P = 0.017) but not birth week (r = 0.140, P = 0.217). Maximum stage of ROP was found to be negatively correlated with choroidal thickness, at N1, T1, and T2 (r < -0.250, P < 0.02). CONCLUSION: The subfoveal choroid in premature infants can be effectively evaluated using a portable SD-OCT device. Choroidal thickness gets thinner with the severity of ROP and the decrease is more prominent at the central and temporal location. Cystoid macular edema is not correlated with choroidal thickness in premature infants.

Effects of commonly used intravitreal anti-vascular endothelial growth factor drugs on mesenchymal stem cells derived from the limbus and ciliary body.

BACKGROUND: To investigate the effects of commonly used intravitreal anti-vascular endothelial growth factor (anti-VEGF) antibodies on proliferation index and viability of mesenchymal stem cells derived from ciliary body and limbus (CB-MSC and LMSC). METHODS: CB-MSCs and LMSCs were isolated from newborn rats' eyes, and they were expanded in medium by the explant method. Intravitreally used anti-VEGF drugs, aflibercept, bevacizumab and ranibizumab were tested into the 16-well plates, respectively, at four different concentrations. After keeping them for 48 h, the proliferation indexes and viabilities of CB-MSCs and LMSCs were compared separately by Real-Time Cell Analyzer and Methylthiazoltetrazoli (MTT) test. RESULTS: Anti-VEGFs used at 5-times and 10-times of the standard clinical dosage caused statistically significant negative effects on proliferation indexes of CB-MSCs and LMSCs at the 24th hour compared to control group. Only the anti-VEGF group that had 10-times dosage of those used clinically had a statistically significant negative effect on the viabilties of CB-MSCs and LMSCs. CONCLUSION: Administrations of high doses or repeated standard doses of intravitreal anti-VEGF agents may affect the proliferation indexes and viabilities of CB-MSCs and LMSCs adversely. These novel findings deserve further in vivo investigations.

The short-term and long-term adverse ocular effects of fesoterodine fumarate.

AIM: To evaluate the short-term and long-term effects of fesoterodine fumarate treatment which is used for overactive bladder (OAB) on pupil diameter (PD), intraocular pressure (IOP) and accommodation amplitude (AA). METHOD: Ophthalmic examination was performed before and after receiving medication (on the 30th and 90th day) on 120 eyes of 120 women whom were planned to begin anticholinergic treatment (fesoterodine fumarate, 4 mg/day, peroral) for OAB, prospectively. The changes in PD, IOP and AA were analyzed statistically. RESULTS: The mean age of 120 women was 52.06 ± 9.39 years (30-70 years). The mean PD, IOP and AA values were 4.12 ± 0.61 mm (3.00-5.70 mm), 15.58 ± 1.74 mmHg (11-20 mmHg) 2.28 ± 1.26 Diopter (D) (0.50-5.50 D) at baseline; 4.68 ± 0.65 mm (3.20-5.80 mm), 16.11 ± 1.72 mmHg (11-20 mmHg), 1.68 ± 1.04 D (0.25-4.50 D) at 30th day; and 4.28 ± 0.58 mm (3.10-5.70 mm), 16.09 ± 1.96 mmHg (11-19 mmHg), 2.18 ± 1.19 D (0.50-5.00 D) at 90th day, respectively. Although increases in PD values and decreases in AA values were statistically significant (p < 0.001 for each), the changes in IOP values were not as such (p = 0.642). Visual complaint was not observed in any patient. DISCUSSION: The newest anticholinergic medication in women with OAB increased the PD and decreased the AA statistically significantly. Clinically, it seems to be well-tolerated by the patient.

Povidone iodine in the treatment of adenoviral conjunctivitis in infants.

CONTEXT: Adenoviral conjunctivitis. OBJECTIVE: To examine the effects of conjunctival irrigation with povidone iodine in infants with adenoviral conjunctivitis. MATERIAL AND METHODS: An outbreak of adenovirus conjunctivitis occurred between September and December 2012 at the neonatal intensive care unit of our hospital. Forty-three infants with adenoviral conjunctivitis were examined in this study. Thirty-five eyes of 35 infants who had detailed ophthalmological examination and clinical scoring were included. The conjunctiva of 15 infants (Group 1) were irrigated with povidone iodine 2.5% solution and then treated with preservative-free artificial tears and preservative-free antibiotic drops. Twenty infants (Group 2) were treated only with the same drops with the same posology, without conjunctival irrigation with povidone iodine. Patients were examined two times a week until the complete recovery. Lid edema, conjunctival chemosis, fragility of conjunctival vasculature, pseudomembrane formation, and corneal involvement were scored clinically. RESULTS: Twenty patients (57%) were female and 15 patients (43%) were male and mean age was 3.1 months (ranged from 1 to 4 months). No relation was found between gender and clinical scores. Statistically significant lower clinical scores were obtained from Group 1. The median recovery time was earlier in Group 1 (7 d) than Group 2 (12 d) (p = 0.001). CONCLUSION: Conjunctival irrigation with 2.5% povidone iodine is effective in the treatment of adenoviral conjunctivitis in infants.

Morphologic changes and visual outcomes in resolved central serous chorioretinopathy treated with ranibizumab.

CONTEXT: Central serous chorioretinopathy (CSC). OBJECTIVE: To evaluate the effect of intravitreal ranibizumab injection and the correlation between foveal morphologic changes and visual outcomes in patients with resolved CSC. MATERIALS AND METHODS: We measured outer nuclear layer (ONL) thickness, outer layer (OL) thickness and evaluated the integrity of the photoreceptor inner-outer segment (IS/OS) junction, the status of the external limiting membrane (ELM) at the central fovea using spectral-domain optical coherence tomography (OCT) in 35 eyes of 35 patients with resolved CSC. The eyes were divided into two groups: The initial medical treatment administered to Group1 (n = 17) then received intravitreal ranibizumab injections, Group 2 (n = 18) received medical treatment. Group 3 was composed of normal eyes (n = 20, as a control). We also investigated a correlation between the ONL thickness and best corrected visual acuity (BCVA). RESULTS: The mean age was 45.7 ± 7.2 (ranged from 27 to 55 years). The mean follow-up period was 14.2 months (minimum 6, maximum 24 months). The mean ONL and OL thickness in Group 1 were significantly thinner than Group 3 (p < 0.005). The ONL thickness was correlated with the BCVA (r = 0.681, p = 0.001). Thirty-tree patients had improvement in BCVA after treatment. Discontinuity of the IS/OS junction was found in 15 eyes (88.2%) in Group 1, in 5 eyes (27.7%) in Group 2 and in no eyes in Group 3. DISCUSSION: We demonstrated that prolonged serous detachment results in photoreceptor cell loss (apoptosis) and thinning of the ONL. Thinning of the ONL correlates with poorer vision, which has been found by other investigators. Furthermore, vascular endothelial growth factor (VEGF) may be neuroprotective to the photoreceptors which might explain the additional thinning in the patients treated with ranibizumab. This raises the possibility that treatment with VEGF inhibitors may be unfavourable to patients with CSC, even though it speeds recovery and vision does improve. CONCLUSION: Intravitreal ranibizumab injection leads to thinning of the ONL and the OL in patients with resolved CSC. The ONL thickness reduction and discontinuity of the IS/OS junction results in poor visual prognosis in resolved CSC eyes.

A five year retrospective surveillance; monitoring and evaluation for the regional tuberculosis control programme in Mersin, Turkey, 2004-2008.

AIM: The aim of this study is to identify and evaluate problems in regional tuberculosis control studies, using an international tuberculosis indicator. METHODS: In this retrospective cohort study, the records of a total of 1,776 patients diagnosed with tuberculosis, followed up and treated from 2004-2008 in Mersin were evaluated. Indicators recommended by the World Health Organization were used as assessment criteria. Descriptive statistics were used to summarize data. The Mantel-Haenszel test was used for calculation of the risk between urban/rural, and between male/ female which were in different age groups. RESULTS: During the five year period, new case notification rates were reduced and tuberculosis risk shifted to advanced age groups in our region. Tuberculosis development risk increased two-fold among males (p < 0.001). One-fifth of the tuberculosis cases had been diagnosed without sputum smears. Sputum microscopy was not done at the end of the initial phase in one-fifth of patients. During the five-year follow-up period, tuberculosis treatment success rate increased from 83% to 91% and cure rate increased from 49% to 67%. The death rate, treatment failure rate, default rate, and transmission rate decreased, and the directly observed treatment implementation increased. CONCLUSION: Improvements were seen in diagnosis and treatment indicators beginning from 2006; the year when the directly supervised treatment application started. However, use of sputum smear microscopy is inadequate for the diagnosis and treatment of tuberculosis. Tuberculosis control studies should be monitored and evaluated using a tuberculosis indicator.

Analysis of optical coherence tomography angiographic findings of prematurely born children and its relationship with macular edema of prematurity.

PURPOSE: To compare foveal avascular zone (FAZ) area, foveal vascular density (VD), and foveal thickness in pre- and full-term children and to evaluate their relationship with cystoid macular edema (CME) in the prematurity period using spectral domain optical coherence tomography angiography (SD-OCTA). METHODS: OCTA imaging was performed at 4-6 years of age in 90 eyes of 45 prematurely born children and 50 eyes of 25 term children. Subjects were divided into three groups: prematurely born with CME (group 1); prematurely born without CME (group 2); healthy, term children (group 3). Imaging results in the three groups were compared. RESULTS: FAZ area was significantly larger in group 3 than in groups 1 and 2 (P < 0.001 [ANOVA]). FAZ area was found to be correlated with birth weight (r = 0.511; P < 0.001) and gestational age (r = 0.532; P < 0.001). No significant relationship was found between history of CME and FAZ area. CONCLUSIONS: In our study cohort, FAZ area was smaller in prematurely born children and was correlated with older gestational age and higher birth weight. CME in the neonatal period did not seem to affect retinal microvascular development in premature infants.

Should parents be present during screening examinations for retinopathy of prematurity?

Purpose: To investigate whether parents should be present during screening examinations for retinopathy of prematurity (ROP) by investigating the anxiety levels of parents using two different approaches. Methods: This cross-sectional and two-center study was carried out with the parents at the time of the first ROP screening examination of their premature infants. At one center, the parents accompanied the infants during the ROP examination (Group 1), and in the other center, they did not (Group 2). Anxiety levels were assessed with the State-Trait Anxiety Inventory (STAI), which consists of the State Anxiety (STAI-S) and Trait Anxiety (STAI-T) subscales and a visual analog scale (VAS). Results: A total of 147 parents of 127 infants were included in the study. STAI-T and -S levels were 40.5 ± 8 and 37.9 ± 7.5, respectively, in Group 1 and 39.6 ± 8.1 and 39.4 ± 9.1 in Group 2 before the examination. There were no statistically significant differences in terms of these values between the two groups (P > 0.05). The state anxiety levels increased by an average of 1.7 ± 8 in Group 1 and reached 39.6 ± 10.1 after the examination. In Group 2, these levels decreased by an average of - 2.7 ± 7.5 points to a score of 36.4 ± 10.3. This difference was found to be statistically significant (P = 0.001). A similar pattern was observed in the evaluation of the VAS data. Conclusion: As a preliminary opinion, it may be more appropriate for parents to not participate in screening examinations, but single-center controlled studies are required to confirm the results.

Can IL-33 and Endocan be New Markers for Retinopathy of Prematurity?

BACKGROUND: Retinopathy of Prematurity (ROP) is a pathophysiologic condition of the retina due to abnormal proliferation of retinal vessels. OBJECTIVE: The study aimed too ascertain the importance of vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1), interleukin-33 (IL-33) and endocan in the diagnosis and follow-up of ROP. METHODS: This prospective cohort study was conducted in the neonatal intensive care unit (NICU) of Health Science University, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey, between February 2017 and August 2018. Preterm infants (gestational age (GA) of ≤32 weeks and birth weight of ≤1500 gr), diagnosed ROP were included in the study. VEGF, IGF-1, IL-33 and endocan levels were evaluated in the cord blood and in the serum before and after treatment of infants in the ROP and control groups. RESULTS: A final number of 146 infants were included in the study. During the study period, 73 infants were identified as the ROP group, and 73 infants were allocated as the control group. In the ROP group, the cord blood VEGF value was higher than the control group (p <0.05). However, IGF-1 levels in the cord blood were lower in the ROP group than control (P<0.05). IL-33 and endocan values in the cord blood were similar in both control and ROP groups (p>0.05). Although serum levels of IL-33, VEGF and endocan were higher before laser treatment, these biomarkers decreased significantly after laser treatment (p <0.05). CONCLUSION: We determined that serum IL-33 and endocan levels might be suggested as sensitive novel markers for the prediction of severe ROP.

Binocular Indirect Ophthalmoscopy Complements Non-contact Wide-field Imaging with Optos to Treat a Baby Outside ETROP Guidelines.

We report a male premature baby who was born at 24 weeks gestation weighing 600 grams. There was bilateral stage 2, zone 2 retinopathy of prematurity (ROP) without plus disease at 38 weeks postmenstrual age. Ultra-wide-field Optomap images obtained 1 week later showed no change in ROP stage. At 40 weeks postmenstrual age, stage 3, zone 2 ROP was detected using binocular indirect ophthalmoscopy and documented using Optos. Minor tortuosity and dilation of vessels was interpreted as pre-plus disease. One week later, at 41 weeks postmenstrual age, Optomap images identified progressive extraretinal fibroproliferation in the nasal quadrant. As a result, the baby was treated with fundus laser photocoagulation.

The Effect of Laser Photocoagulation on Intraocular Pressure in Premature Infants With Retinopathy of Prematurity.

PURPOSE: To evaluate the effects of diode laser treatment on intraocular pressure (IOP) of premature infants with retinopathy of prematurity (ROP). PATIENTS AND METHODS: The premature infants who underwent retinal laser photocoagulation therapy for ROP, and gestational age-matched, birth weight-matched, and sex-matched premature infants with ROP which recovered spontaneously without any treatment were enrolled into the study. Anterior segment examination and longitudinal IOP and central corneal thickness measurements were performed 5 times as follows: 1 day before the laser treatment (T0), and 24 hours (T1), 1 week (T2), 1 month (T3), and 3 months (T4) after the laser treatment. Premature infants who experienced any complication related to the laser treatment were excluded from the study. RESULTS: Laser treated 67 premature infants and 70 premature infants in control group met inclusion criteria. Significant linear decreases in IOP and central corneal thickness values were measured throughout the study period for both groups (both, P<0.001). These changes were similar in 2 groups. There was a statistically insignificantly (P=0.999) and transient increase in the mean IOP value in the laser-treated group 24 hours after laser treatment. None of the patients in the laser-treated group experienced a shallow anterior chamber or a remarkable IOP elevation. CONCLUSIONS: Diode laser treatment for ROP was safe, and did not raise the IOP of premature infants.

Prostaglandin E2 Levels of Aqueous and Vitreous Humor in Ketorolac 0.4% and Nepafenac 0.1% Administered Healthy Rabbits.

PURPOSE: To compare the lowering effects of ketorolac 0.4% and nepafenac 0.1% on aqueous and vitreous humor prostaglandin E2 (PGE2) levels in rabbits. METHODS: Ketorolac and nepafenac ophthalmic solutions were administered to the right eyes of 24 healthy rabbits after randomized division into two groups. The left eyes of these rabbits were considered as controls for the two groups. On the 4th day of the experiment, the samples were taken from the aqueous and vitreous humors of the rabbits bilaterally, and PGE2 levels were measured by an enzyme immune assay kit. RESULTS: Ketorolac and nepafenac achieved a statistically significant decrease (p<0.001, for each) in PGE2 levels in the aqueous (11.75 ± 6.15 and 14.75 ± 7.60 pg/mL, respectively) and the vitreous humor (6.58 ± 4.62 and 9.83 ± 4.55 pg/mL, respectively). CONCLUSIONS: Both ketorolac and nepafenac inhibited PGE2 levels in both the aqueous and vitreous humors of rabbits. Although PGE2-lowering effects were similar in the aqueous humor, nepafenac seemed to be more potent than ketorolac in the vitreous humor.

Short- and long-term effects of zinc treatment on lacrimal gland histopathology and tear functions tests in radioiodine-administered rats.

PURPOSE:: To investigate the short-term (1 week) and long-term (8 weeks) protective effects of zinc administration on radioiodine (RAI)-induced lacrimal gland damage of rats. METHODS:: A total of 40 rats were divided into two groups: an RAI group (n=20), which was administrated a single dose of 3 mCi of 131I and 1 mL physiologic saline for 7 days by gastric gavage, and a zinc group (n=20), which received a single dose of 3 mCi of 131I and 1 mL of physiologic saline containing zinc sulfate at a concentration of 10 mg/kg concentration for 7 days by gastric gavage. All rats underwent tear function tests before and 1 week after RAI administration. About 1 week after irradiation, half of the animals in each group were sacrificed and the extraorbital lacrimal glands were removed for histopathological examination. The remaining animals of the groups underwent the same procedures at 8 weeks after irradiation. RESULTS:: In the RAI and zinc groups, the mean tear production was 3.75 ± 1.55 and 3.65 ± 1.53 mm at baseline, 2.10 ± 1.07 and 3.30 ± 1.34 mm at week 1 (p=0.004), and 3.22 ± 1.48 and 3.50 ± 1.78 mm at week 8, respectively; further, the mean corneal fluorescein staining scores were 4.65 ± 2.16 and 4.80 ± 2.21 points at baseline, 7.85 ± 1.90 and 5.45 ± 2.06 points at week 1 (p=0.001), and 5.44 ± 2.13 and 4.90 ± 2.08 at week 8, respectively. The histopathological changes in rat lacrimal glands at weeks 1 and 8 were consistent with the tear function test results. CONCLUSIONS:: Zinc treatment seems to be protective against RAI-induced lacrimal gland damage of rats, particularly in the acute period.

Growth of biometric components and development of refractive errors in premature infants with or without retinopathy of prematurity.

BACKGROUND/AIM: To investigate the biometric components and refractive errors in premature infants with or without retinopathy of prematurity (ROP). MATERIALS AND METHODS: Anterior chamber depth, lens thickness, vitreous length, and axial length were measured with an ultrasound biometer. Cycloplegic refraction was performed by streak skiascopy. Infants with or without ROP were grouped according to postmenstrual age at the time of ocular examination: Group 1, ≤33 weeks; Group 2, 34-37 weeks; Group 3, 38-41 weeks; Group 4, 42-45 weeks; Group 5, ≥46 weeks. RESULTS: The mean postnatal age of 894 infants (451 females and 443 males) was 8.7 ± 4.5 weeks, gestational age was 30.9 ± 2.8 weeks, and birth weight was 1506 ± 484 g. In Group 2, the mean vitreous length and axial length of infants with ROP were significantly lower than those of infants without ROP (P = 0.011, P = 0.001). The mean anterior chamber depth, lens thickness, spherical equivalent, and astigmatism in all groups did not differ significantly among the infants with or without ROP (P > 0.05). CONCLUSION: The anterior chamber depth, lens thickness, vitreous length, and axial length showed a linear growth throughout the follow-up period. The maximum elongation was observed in vitreous length and axial length.

Maternal Diabetes as an Independent Risk Factor for Retinopathy of Prematurity in Infants With Birth Weight of 1500 g or More.

PURPOSE: To evaluate the relationship between maternal diabetes and the development of retinopathy of prematurity (ROP) in infants with a birth weight of 1500 g or more. DESIGN: Retrospective case-control study. METHODS: Data of 78 premature infants from diabetic mothers were compared with data of 258 controls. We examined the relationship between maternal diabetes and the development of ROP and type 1 ROP, adjusting for multiple risk factors. Multivariable logistic regression analysis was used to identify the risk factors of outcome variables. Prior to multivariable logistic regression analysis, the association of each independent variable with the outcome variables, a univariate estimate was performed. The crude and adjusted odds ratio (OR) values and their 95% confidence intervals (CI) were given. Main outcome measures were the development of ROP and the development of type 1 ROP. RESULTS: The study was conducted on 336 preterm infants; 78 were from diabetic mothers and 258 were from nondiabetic mothers. The rate of ROP (78.2% in case group and 14.7% in control group) and the rate of type 1 ROP (20.5% in case group and 4.7% for controls) were found significantly higher in the case group (P = .001 for both). Maternal diabetes was shown to be an independent risk factor for both ROP and type 1 ROP (OR with 95% CI: 25.040 [12.728-49.264]; 6.311 [2.647-15.048], respectively, and P < .001 for both). CONCLUSION: Our data suggest that the presence of maternal diabetes is significantly associated with the development of ROP and type 1 ROP in premature infants with a birth weight of 1500 g or more.