Ayşe Vural Özeç

Comparison of the effects of bevacizumab and ranibizumab injection on corneal angiogenesis in an alkali burn induced model.

AIM To investigate the effects of bevacizumab and ranibizumab on corneal neovascularization in an alkali burn-induced model of corneal angiogenesis. METHODS Fifteen Wistar albino rats were divided randomly into 3 groups after chemical cauterization of the cornea. The first group received a single dose of 0.1mL saline solution as a control group whereas second and third groups received a single dose of 2.5mg bevacizumab or 1mg ranibizumab by subconjunctival injection, respectively. After three weeks, the rat corneas were evaluated by biomicroscopy and corneal photographs were taken. The percentage of neovascularization area, length of the longest new vessel, corneal edema and corneal opacity scores were assessed. RESULTS The analysis of digital photographs showed that the percentage of neovascularization area to the total corneal area, the length of the longest new vessel, corneal edema and opacity scores were significantly lower in both study groups compared to the control group (P<0.05). Additionally, the percentage of corneal neovascularization area, the length of the longest new vessel and corneal opacity score were less with bevacizumab than ranibizumab. CONCLUSION Subconjunctival bevacizumab and ranibizumab treatments may be effective methods in reducing corneal neovascularization. Furthermore, bevacizumab is more effective than ranibizumab in the inhibition of corneal neovascularization.

Total oxidative stress, paraoxonase and arylesterase levels at patients with pseudoexfoliation syndrome and pseudoexfoliative glaucoma

AIM To investigate the oxidative stress status of the aqueous humor and serum of patients with pseudoexfoliation (PEX) syndrome and pseudoexfoliative glaucoma (PEG) and to measure paraoxonase (PON) and arylesterase (ARE) levels. METHODS A total of 78 patients were enrolled in the study, with 26 patients in each separate group. The patients were divided into three groups: the first group entailed PEX syndrome patients, while the second group consisted of patients with PEG and the third group involved patients with no additional systemic diseases, other than the diagnosis of cataract as control. Total oxidative stress (TOS), total antioxidant capacity (TAC), PON, and ARE levels in aqueous humor and serum were measured. RESULTS TAC, PON and arylesterase levels in aqueous humor and serum of the PEX syndrome and PEG patients were significantly decreased compared with control group (P<0.05). TOS values were higher in patients with PEX syndrome and PEG than controls (P<0.05). TAC, PON and ARE levels of aqueous humor did not differ significantly between the PEX syndrome and PEG groups. CONCLUSION These findings are potentially of significance and add to the growing body of evidence for oxidative stress in PEX syndrome and PEG. Decreased antioxidant defense and increased oxidative stress system may play an important role in the pathogenesis of PEX syndrome and PEG.

The Association between Diabetic Retinopathy and Levels of Ischemia-Modified Albumin, Total Thiol, Total Antioxidant Capacity, and Total Oxidative Stress in Serum and Aqueous Humor.

Purpose. To investigate the oxidant and antioxidant status of patients with type 2 diabetes mellitus and nonproliferative diabetic retinopathy (DRP). Methods. Forty-four patients who had cataract surgery were enrolled in the study. We included 22 patients with DRP in one group and 22 patients in the control group. Samples of aqueous humor and serum were taken from all patients. Serum and aqueous ischemia-modified albumin (IMA), total thiol, total antioxidant capacity (TAC), and total oxidative stress (TOS) levels were compared in two groups. Results. Median serum IMA levels were 44.80 absorbance units in the DRP group and 40.15 absorbance units in the control group (P = 0.031). Median serum total thiol levels in the DRP group were significantly less than those in the control group (3051.13 and 3910.12, resp., P = 0.004). Mean TOS levels in the serum were 2.93 ± 0.19 in the DRP group and 2.61 ± 0.26 in the control group (P = 0.039). The differences in mean total thiol, TAC, and TOS levels in the aqueous humor and mean TAC levels in the serum were not statistically significant. Conclusion. IMA, total thiol, and TOS levels in the serum might be useful markers in monitoring the risk of DRP development.

Effect of latanoprost/timolol and dorzolamide/tiomolol on intraocular pressure after phacoemulsification surgery

AIM To evalaute the effect of fixed-combination latanoprost 0.005%/timolol maleate 0.5% and dorzolamide hydrochloride 2%/timolol maleate 0.5% on postoperative intraocular pressure after phacoemulsification cataract surgery. METHODS This study is a prospective, randomized, double-masked and placebo-controlled. The study included 90 eyes of 90 patients which were scheduled to have phacoemulsification surgery. Patients were randomly assigned preoperatively to 1 of 3 groups (30 eyes of 30 patients). Two hour before surgery, the patients received one drop latanoprost/timolol (group 1), dorzolamide/timolol (group 2) and placebo (group 3, control group). The IOPs were measured at preoperative and postoperative 4, 8, and 24 hours. RESULTS The preoperative mean intraocular pressure was not statistically significant between both drug groups and control group. In group 1 and 2, the postoperative mean IOP [group1: (14.03±3.15)mmHg and group 2: (14.16±4.43)mmHg] at 24 hours were significantly lower than the control group [(16.93±3.70)mmHg, (P<0.05)]. In addition, the postoperative mean IOP of group 1 [(14.90±3.69)mmHg] at 8 hours was significantly lower than the control group [(17.70±3.89)mmHg, (P<0.05)], but there was no significant difference between group 2 [(16.16±5.23)mmHg] and control group at 8 hours (P>0.05). CONCLUSION When compared with placebo, the use of preoperative fixed combination of latanoprost/timolol and dorzolamide/timolol is an effective method for preventing intraocular pressure elevation in 24 hours after phacoemulsification surgery, but did not completely prevent IOP spikes.

Prevalence of refraction errors and color blindness in heavy vehicle drivers.

AIM To investigate the frequency of eye disorders in heavy vehicle drivers. METHODS A cross-sectional type study was conducted between November 2004 and September 2006 in 200 driver and 200 non-driver persons. A complete ophthalmologic examination was performed, including visual acuity, and dilated examination of the posterior segment. We used the auto refractometer for determining refractive errors. RESULTS According to eye examination results, the prevalence of the refractive error was 21.5% and 31.3% in study and control groups respectively (P<0.05). The most common type of refraction error in the study group was myopic astigmatism (8.3%) while in the control group simple myopia (12.8%). Prevalence of dyschromatopsia in the rivers, control group and total group was 2.2%, 2.8% and 2.6% respectively. CONCLUSION A considerably high number of drivers are in lack of optimal visual acuity. Refraction errors in drivers may impair the traffic security.

Association of neutrophil/lymphocyte ratio and retinal vein occlusion

Purpose To evaluate the association between neutrophil/lymphocyte ratio (NLR) and the development of retinal vein occlusion (RVO). Methods Forty patients were included in the study. Forty age- and sex-matched healthy volunteers were recruited as the control group. The RVO diagnosis was made clinically, based on the findings of fundus examination. The NLR and file records of the patients and the control group were compared. Results The mean age of patients was 64 ± 12 years. Neutrophil levels were higher in RVO patients compared to the control subjects (5.1 ± 1.9 vs 3.6 ± 1.0, p<0.001). Lymphocyte levels were lower in RVO patients compared with the control subjects (2.0 ± 0.7 vs 2.6 ± 0.9, p = 0.005). The NLR was significantly higher in RVO patients compared with the control subjects (3.0 ± 2.7 vs 1.5 ± 0.3, p<0.001). According to the receiver operator characteristics curve analysis, the optimal cutoff value of NLR to predict RVO was >1.89, with 72.5% sensitivity and 100% specificity. Conclusions The current study demonstrated that higher NLR was associated with the development of RVO. The NLR may be used as a predictive tool for identifying risk for RVO.

Apoptotic effects of topical antiglaucoma medications on conjunctival epithelium in glaucoma patients.

Purpose In this study, we aimed to investigate the apoptotic effects of topical antiglaucoma medications on the conjunctival epithelium. Methods A total of 65 patients were included in the study. Thirty patients were included in the first group who had received antiglaucomatous therapy before trabeculectomy. In the second group, 20 patients who had received no drugs before trabeculectomy were included, while the third group underwent only cataract surgery as control. During the surgery, 2 × 4 mm conjunctival samples were harvested from the upper bulbar conjunctiva. The mean apoptosis rate was calculated by determining apoptosis at conjunctival epithelium using the terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) method. Results The mean apoptosis rate was 0.537 ± 0.369 (0.026 ± 0.962) in group 1, 0.139 ± 0.162 (0.005 ± 0.676) in group 2, and 0.078 ± 0.035 (0.035 ± 0.142) in the control group (group 3). The mean apoptosis rate was significantly higher in the first group than the other 2 groups (p = 0.0001). Conclusions Apoptotic effects of topical antiglaucoma drugs on the conjunctival epithelial cells were found. However, our results revealed that the number of medications, duration of medication, and type of glaucoma had no effect on the apoptotic effect.

Evaluation of Choroidal Thickness in Patients with Pseudoexfoliation Syndrome and Pseudoexfoliation Glaucoma

Purpose. To compare the macular and peripapillary choroidal thickness in eyes with pseudoexfoliation (PEX) syndrome and PEX glaucoma with the normal eyes of healthy controls. Materials and Methods. In this prospective study, 30 eyes of 30 patients with PEX syndrome, 28 eyes of 28 patients with PEX glaucoma, and 30 eyes of 30 age-matched healthy subjects were enrolled. Choroidal thicknesses in the macular and peripapillary areas were measured by using spectral domain optical coherence tomography. Results. Gender, age, and axial length did not significantly differ between the groups (all, p > 0.05). The mean values of choroidal thickness in the macular and peripapillary areas (except the superior quadrant) in the patients with PEX syndrome and PEX glaucoma were lower compared with controls (all p < 0.05). The mean values of the macular and peripapillary choroidal thickness in the PEX glaucoma group were lower compared with PEX syndrome group; however this difference was not significant. Conclusions. The findings of this study revealed that macular and peripapillary choroidal thicknesses were decreased in PEX syndrome and PEX glaucoma cases. The role of choroid in the development of glaucomatous damage in patients with PEX syndrome remains unclear.

Evaluation of inner and outer retinal thickness in patients receiving intravitreal ranibizumab injections for diabetic macular edema.

Purpose To measure inner and outer retinal thickness with optical coherence tomography (OCT) in patients in whom intravitreal ranibizumab was administered due to diabetic macular edema (DME) and to investigate its relation to the visual prognosis. Methods In this retrospective case series, there were 60 consecutive eyes with DME in which intravitreal ranibizumab injection was performed for 3 times in 1-month intervals. All patients underwent full ophthalmic examination and spectral-domain OCT (SD-OCT). The total retinal thickness, the inner thickness, and the outer thickness in 4 parafoveal subfields were measured. The correlation between the retinal thickness and logMAR best-corrected visual acuity (BCVA) was investigated. Results No significant correlation was found between the total retinal thickness in the central and other subfields and either the baseline or final visit logMAR BCVA values (p>0.05). There was a significant positive correlation between the final visit logMAR BCVA values and pretreatment inner retinal thickness in the nasal and inferior subfields (r = 0.270, p = 0.037, and r = 0.410, p = 0.001, respectively). There was significant negative correlation between the final visit logMAR BCVA values and pretreatment outer retinal thickness in nasal and temporal parafoveal subfields (r = −0.297, p = 0.021, and r = −0.268, p = 0.038, respectively). Conclusions It could be beneficial to use inner and outer retinal thickness instead of total retinal thickness in determination of short-term prognosis in patients who had intravitreal ranibizumab injection for DME.

Evaluation and Comparison of Contrast Sensitivity in Patients with Zaraccom Ultraflex or F260 Intraocular Lens Inserted

Yaz›flma Adresi/Address for Correspondence: Dr. Ayfle Vural Özeç, Cumhuriyet Üniversiyesi T›p Fakültesi, Göz Hastal›klar› Anabilim Dal›, Sivas, Türkiye Gsm: +90 0 505 375 40 33 E-posta: vural.ayse@gmail.com Gelifl Tarihi/Received: 03.06.2010 Kabul Tarihi/Accepted: 14.03.2011 Özet Amaç: Katarakt nedeni ile ameliyat edilen ve Zaraccom Ultraflex (UF) veya Zaraccom F260 (F260) marka göz içi mercek tak›lan hastalarda fotopik ve mezopik ›fl›k flartlar›nda merceklerin kontrast duyarl›l›¤a etkisi karfl›laflt›r›larak UF merce¤in optik kalitesini de¤erlendirmek. Yöntem: Prospektif olarak yap›lan bu çal›flmaya, Cumhuriyet Üniversitesi Göz Hastal›klar› Anabilim Dal›’nda 2009-2010 y›llar›nda komplikasyonsuz Fakoemülsifikasyon ve arka kamara kapsül içine göz içi lensi (G‹L) implante edilen toplam 60 hastan›n 60 gözü (Grup 1: 30 hasta UF, Grup 2: 30 hasta F260) al›nd›. Postoperatif l. gün, 1. hafta ve 1. ayda rutin izlem muayeneleri yap›ld›. 3. ayda ise en iyi düzeltilmifl görme keskinli¤i de¤erleri kaydedildikten sonra tüm hastalara fotopik (kamaflmal›-kamaflmas›z) ve mezopik (kamaflmal›-kamaflmas›z) olmak üzere 1.5, 3, 6, 12 ve 18 devir/derecede kontrast duyarl›l›k testleri uyguland›. Bulgular: ‹ki grubun kontrast duyarl›l›k sonuçlar› karfl›laflt›r›ld›¤›nda bütün uzaysal frekanslarda (1,5; 3; 6; 12; 18 devir/derece) UF grubunun de¤erleri daha yüksek bulundu. Bu yükseklik; mezopik kamaflmas›z 1.5 (p=0,016) ve 18 (p=0,005) devir/derecede, mezopik kamaflmal› 6 (p=0,002) devir/derecede, fotopik kamaflmas›z 1,5 (p=0,01); 3 (p=0,04); 6 (p=0,001) ve 12 (p=0,001) devir/derecede, fotopik kamaflmal› 6 (p=0,01) ve 12 (p=0,02) devir/derecede istatistiksel olarak anlaml› idi (p<0,05). Tart›flma: Bu sonuçlar her iki merce¤inde iyi seviyelerde kontrast duyarl›l›¤› sa¤lad›¤›n› ve UF göz içi merce¤i ile görsel alg›laman›n daha iyi oldu¤unu göstermektedir. Elde edilen sonuçta, UF göz içi merce¤indeki yüksek Modülasyon Transfer Fonksiyonu (MTF) de¤erinin önemli bir etken oldu¤u düflünüldü. (Turk J Ophthalmol 2011; 41: 230-5) Anahtar Kelimeler: Katarakt, fakoemülsifikasyon, kontrast duyarl›l›k, mezopik, fotopik, kamaflma