Ayça Yilmaz

Serum oxidant/antioxidant balance in exfoliation syndrome

Background: To evaluate the relationship between the serum oxidant–antioxidant balance and the presence of exfoliation syndrome (XFS) in a prospective study.

May glutathione S-transferase M1 positive genotype afford protection against primary open-angle glaucoma?

PurposeTo find out whether the polymorphism at GSTM1, GSTT1 and GSTP1 loci is associated with increased susceptibility to glaucoma.MethodsWe genotyped 153 primary open angle patients and 159 healthy controls. Genomic DNA from peripheral blood was examined using polymerase chain reaction and defined for the genetic polymorphisms of glutathione S-transferase.ResultsThe frequency of the GSTM1 null genotype individuals among the glaucoma patients was significanlty higher than in controls (54.9 vs 40.9%) with odds ratio of 1.64 (95% CI: 1.10–2.59). The frequency of the GSTT1 and GSTP1 in both groups were not statistically different.ConclusionThe present study suggests that the GSTM1 null genotype may be a genetic risk factor for development of primary open angle glaucoma. Further associations studies in other polymorphic genes for xenobiotic–metabolizing enzymes are needed to elucidate the environmental-genetic interaction in the underlying cause of primary open angle glaucoma.

N-Acetyltransferase 2 Phenotype May Be Associated with Susceptibility to Age-Related Cataract

Free radicals and oxidative damage play roles in aging and age-related ocular diseases such as cataracts, so defensive mechanisms become important factors for protection. Because N-acetylation is involved in a wide variety of detoxification processes, this study was conducted to examine the relationship between the acetylator phenotypes and genotypes in a group of patients with age-related cataract. Sixty-one cases of age-related cataract and 104 controls were included in this study. Blood was collected in EDTA-containing tubes, and genomic DNA was extracted from the white blood cells by high pure PCR template preparation kit. Genotyping of NAT2 polymorphisms were detected by using a LightCycler-NAT2 mutation detection kit in real-time PCR. There was a significant difference in the distribution of the NAT2*6A acetylator phenotype between cases and the controls. The odds ratio of cataract for the NAT2*6A slow phenotype was 3.8 (95% CI = 1.08 to 13.11, p = 0.032) compared with the fast type. Our results suggest that slow acetylators are at higher risk of developing age-related cataracts than fast acetylators. As NAT2 is an important xenobiotic-metabolizing enzyme and theoretically xenobiotics such as ultraviolet B radiation, smoking, and alcohol use may induce cataract formation, NAT2 gene polymorphisms may be associated with genetic susceptibility of cataract.

Selenium and Pseudoexfoliation Syndrome

PURPOSE To investigate the levels of selenium (Se), an essential trace element, in aqueous humor, conjunctival specimens, and serum of patients with pseudoexfoliation (PEX) syndrome and control subjects; and to determine the role of Se in the development and pathogenesis of PEX syndrome. DESIGN A prospective case-control study. METHODS Twenty-seven cataract patients with PEX syndrome and 20 age-matched cataract patients without PEX syndrome were enrolled in this institutional study. Patients with ophthalmic conditions other than PEX and conditions that may influence Se levels were excluded. During cataract surgeries, aqueous humor, conjunctival specimens, and serum were collected in both groups. Selenium levels of all samples were measured by using atomic absorption spectrophotometer. RESULTS The mean Se levels in aqueous humor of patients with PEX syndrome (50.96 ± 23.79 μg/L) were significantly lower than the control group (77.85 ± 19.21 μg/L) (P < .001). The mean Se levels in conjunctival specimens of patients with PEX syndrome (4.04 ± 1.44 μg/mg) were significantly lower than the control group (7.19 ± 2.00 μg/mg) (P < .001), as well. The mean Se levels in serum of patients with PEX syndrome (115.25 ± 25.20 μg/L) were lower than the control group (124.25 ± 14.40 μg/L), but this was not statistically significant (P = .325). CONCLUSION Reduced levels of Se in aqueous humor, conjunctival specimens, and serum of patients with PEX may support the role of impairment in antioxidant defense system in the pathogenesis of PEX syndrome.

Is GST Gene Polymorphism a Risk Factor in Developing Exfoliation Syndrome

Purpose: To evaluate the distribution of GSTM1, GSTP1, and GSTT1 gene polymorphisms in exfoliation syndrome (XFS) and the possible associations between the presence of exfoliation syndrome and glutathione S-transferase (GST) gene polymorphisms. Methods: Using a real-time polymerase chain reaction, GSTM1, GSTP1, and GSTT1 gene polymorphisms were detected in 60 patients with exfoliation syndrome, among which 71.7% had exfoliative glaucoma (43 patients), 16.7% had XFS with elevated intraocular pressure (IOP) (10 patients), and 11.7% had XFS only (7 cases), and in 65 otherwise healthy control group of similar age. Results: Although the exfoliation syndrome group presented a higher prevalence of the GSTM1 null and GSTP1 Ile/Val genotypes than the control group, this increase was not statistically significant. GSTT1 null and GSTP1 Val/Val polymorphisms were also not different among groups. The risk of exfoliation syndrome was not increased as the number of putative high-risk genotypes increase (p = 0.73). Conclusions: GSTM1, GSTP1, and GSTT1 gene polymorphisms were not different among exfoliation syndrome patients, with or without glaucoma, and the controls therefore GSTM1, GSTP1, and GSTT1 gene polymorphisms did not seem to be associated with the risk of development of exfoliation syndrome.

Effects of Caffeic Acid Phenethyl Ester on Endotoxin-Induced Uveitis in Rats

Purpose: Caffeic acid phenethyl ester (CAPE) has antimicrobial, anti-inflammatory, antioxidant, immunomodulatory, and carcinostatic properties. In this study, the efficacy of CAPE in endotoxin-induced uveitis (EIU) in rats is investigated. Methods: EIU was induced by a footpad injection of lipopolysaccharide (LPS). In the treatment group, 10 μ mol/kg CAPE was injected intraperitoneally immediately after LPS injection. At 24 hr after LPS injection, the number of infiltrating cells, protein concentration, and levels of myeloperoxidase (MPO) in aqueous humor; malondialdehyde (MDA), MPO, and total antioxidant levels in serum were determined. Eyes were enucleated for histopathologic evaluation, and, counting inflammatory cells in iris-ciliary body (ICB), the efficacy of treatment was determined. Results: CAPE significantly suppressed LPS-induced increase in the number of inflammatory cells (p = 0.0001), protein concentration (p = 0.0001), and MPO levels (p = 0.0001) in aqueous humor as well as MDA (p = 0.001) and MPO (p = 0.0001) levels in serum. Histopathologic evaluation of ICB showed significant reduction in the inflammatory cell counts in the treatment group (p = 0.0001). Conclusions: CAPE was found efficient in suppressing inflammation and ocular tissue damage induced by LPS in rats.

Traumatic subconjunctival crystalline lens dislocation

Purpose: To evaluate the clinical features and visual outcomes in patients with traumatic subconjunctival crystalline lens dislocation. Setting: Izmir Atatürk Education and Research Hospital, Department of Ophthalmology, Izmir, Turkey. Methods: The clinical records of 5 patients with subconjunctival crystalline lens dislocation secondary to blunt trauma were reviewed. Results: The median age of 3 women and 2 men was 63 years (range 62 to 73 years). The lenses were dislocated to the superior (n = 1), temporal (n = 1), superotemporal (n = 1), and superonasal (n = 2) quadrants. All patients had various degrees of hyphema and vitreous hemorrhage. One patient had traumatic optic neuropathy. Visual acuity improved in all patients after lens removal and scleral rupture repair. Conclusion: With timely intervention, the visual outcome was reasonably good in patients with subconjunctival dislocation of the crystalline lens.

Cranial optic nerve involvements in patients with severe COPD

Objective:  The relationship between neuropathy and increased morbidity in patients with COPD is clear, but few studies have assessed cranial neuropathies, especially optic nerve involvement, in COPD patients. We evaluated peripheral involvement of the optic nerve and determined factors influencing this condition in patients with severe COPD.

Evaluation of left ventricular functions in patients with pseudoexfoliation syndrome using tissue Doppler echocardiography and its association with plasma BNP levels

OBJECTIVE Pseudoexfoliation syndrome (PES) is a systemic disorder that involves various visceral organs. In this observational cross-sectional study we aimed to investigate the left ventricular functions in patients with PES by using tissue Doppler imaging and correlations between B-type natriuretic peptide (BNP) levels and cardiac functions. METHODS The study enrolled 22 patients with PES (9 male, 41%), aged 57.0 ± 8.8 years, and 23 control subjects (9 male, 39%), aged 52.8 ± 4.9 years. Patients with any cardiovascular disease were excluded. Fasting blood samples were taken and tissue Doppler imaging was performed at the mitral annulus with echocardiographic examination. The independent t and Mann-Whitney U tests were used. RESULTS The Em velocities at the basal septum and lateral annulus were significantly lower in patients with PES showing decreased diastolic functions (7.6 ± 2.0 versus 9.1 ± 1.6 cm/s, p=0.01 and 9.3 ± 3.5 versus 11.5 ± 3.1 cm/s, p=0.04 respectively). While global left ventricular systolic function assessed by ejection fraction was not significantly different between patients with PES and controls, the septum S-wave velocities of PES patients were lower (7.6 ± 1.3 versus 8.5 ± 1.2 cm/s, p=0.03). Total plasma BNP levels were significantly higher in PES patients (129.04 ± 99.38 pg/mL versus 59.64 ± 53.69 pg/mL; p=0.005) and there was a negative correlation between plasma BNP concentration and mitral annulus average Em velocities (r=-0.554, p=0.009). E/Em ratio was also significantly higher in PES patients (7.85 ± 2.01 versus 6.64 ± 1.48, p=0.03). CONCLUSION In this study we showed decreased left ventricular diastolic functions correlated with plasma BNP levels in PES patients. Although further studies needed, evaluation and follow-up of PES patients in terms of left ventricular functions will be useful.

Serum Levels and H/L Gene Polymorphism of Mannose-Binding Lectin in Primary Open Angle Glaucoma

Purpose: To analyze the serum levels and H/L gene polymorphisms of mannose-binding lectin-2 (MBL-2) in primary open angle glaucoma (POAG) cases and control subjects to investigate whether MBL-2 has a possible role in the development and pathogenesis of POAG. Materials and Methods: In 45 POAG cases and age and sex-matched 45 healthy controls, Elisa Kit was used to determine serum levels of MBL-2. The genomic DNA of patient and control groups was extracted from whole blood using High Pure PCR template preparation kit. Genotyping of MBL-2 polymorphisms were detected by using a MBL-2 mutation detection kit in real-time PCR. Chi-square or Fisher’s Exact Tests were used to evaluate the distribution of MBL-2 H/L genotypes among patients and control subjects. Associations between the H/L genotype and POAG risk were analyzed by using binary logistic regression. The serum MBL-2 levels of both groups were compared with Independent Sample t-test. Results: Mean MBL-2 serum levels in the patient group (21.30 ± 4.97 µg/mL) was significantly higher than the control group (17.48 ± 3.66 µg/mL), (p < 0.001). The distribution of alleles in the patient group was 28.9% for LL, 44.4% for HL, 26.7% for HH and in controls was 33.3% for LL, 37.8% for HL, 28.3% for HH. According to genotype ratios, the two groups were not different from each other. Conclusions: Our findings may suggest an association between high serum MBL-2 levels and POAG, but H/L gene polymorphism of MBL-2 seems not to be associated with POAG.