Cengaver Tamer

Circadian Intraocular Pressure Control with Dorzolamide versus Timolol Maleate Add-On Treatments in Primary Open-Angle Glaucoma Patients Using Latanoprost

Purpose: To compare the 24-hour efficacy of dorzolamide and timolol maleate administered twice daily to primary open-angle glaucoma patients whose intraocular pressure (IOP) could not be adequately controlled with latanoprost monotherapy. Methods: In this double-blind prospective crossover clinical comparison trial, 36 primary open-angle glaucoma patients with uncontrolled IOP despite treatment with latanoprost applied once daily were administered timolol and dorzolamide twice daily. The treatment sequence was randomized. All patients underwent measurements for four 24-hour tonometric curves: at baseline and after each 4-week period of treatment. The IOP measurements were taken at 06:00, 09:00, 12:00, 15:00, 18:00, 21:00, 24:00 and 03:00 h. The between-group differences were tested for significance by means of parametric analysis of variance at each time point and circadian curve. The peak values within circadian curve were defined. The mean of the exact amount and percentage of additional IOP reductions from baseline were evaluated and success rates (a minimum of 10% reduction) were determined for both drug regimens. Results: The mean peak/circadian curve IOPs were 23.4 ± 2.2/21.8 ± 2.2 mm Hg at dorzolamide baseline, 23.3 ± 2.2/21.7 ± 2.1 mm Hg at timolol baseline, and reduced to 20.2 ± 1.7/18.7 ± 1.7 mm Hg and 20.7 ± 2.4/19.4 ± 1.6 mm Hg, respectively. When added to latanoprost, both dorzolamide and timolol lowered IOP at circadian curve significantly (p < 0.05). Dorzolamide reduced baseline IOP values at each time point. Timolol also significantly reduced baseline IOP values at all time points except at 03:00. The mean of the exact amount and percentage of reduction in IOP at circadian curve and 5 out of 8 time points were significantly greater with dorzolamide add-on treatment (p < 0.05). The successful reduction rates were 86% for the dorzolamide group and 61% for the timolol group (p = 0.016; χ2 test). Conclusion: Both of the combinations are effective in lowering IOP, the exact amount and percentage of reduction is greater with the latanoprost + dorzolamide regimen, especially at night-time.

Effect of Propolis in the Treatment of Experimental Staphylococcus aureus Keratitis in Rabbits

Purpose: The aim of this study was to investigate the antimicrobial and anti-inflammatory properties of an ethanolic extract of propolis, a natural resin produced by honeybees, and to determine synergistic activity between ciprofloxacin and propolis in the treatment of experimental Staphylococcus aureus keratitis. Methods: Sixteen young New Zealand white rabbits were given intrastromal injections of S. aureus strains. Twenty-four hours later, the rabbits were randomly divided into 4 groups: group 1 was treated with topical 0.3% ciprofloxacin drops along with the ethanolic extract of propolis drops; group 2 received topical 0.3% ciprofloxacin drops; group 3 was administered the ethanolic extract of propolis drops, and group 4, the control group, was treated with phosphate-buffered saline (PBS) drops. Drugs were instilled 8 times/day for 72 h. Twenty-four and 96 h after inoculation of bacteria, the eyes were examined by slit lamp to assess corneal opacity. Corneas were removed to count bacteria. Results: Slit lamp examination showed that the corneal opacity scores were significantly lower in eyes that received propolis plus ciprofloxacin than in those treated with ciprofloxacin (p = 0.041) or propolis (p = 0.006) or control eyes treated with PBS (p = 0.0001). There was no significant difference in eyes treated with ciprofloxacin and propolis (p = 1.00). There were significantly fewer bacteria in eyes that received propolis plus ciprofloxacin than in those treated with ciprofloxacin (p = 0.0001) or propolis (p = 0.0001) or control eyes treated with PBS (p = 0.0001). There was no significant difference in eyes treated with ciprofloxacin and propolis (p = 0.38). Conclusions: Taking these findings into consideration, we suggest that the ethanolic extract of propolis has antimicrobial and anti-inflammatory properties for S. aureus keratitis. The combination of ciprofloxacin and propolis had better therapeutic effects than either agent alone.

Androgen Status of the Nonautoimmune Dry Eye Subtypes

Purpose: To evaluate androgen levels of patients diagnosed with nonautoimmune dry eye, either with meibomian gland dysfunction (MGD) or without MGD (non-MGD), and normal control subjects. This is a prospective, comparative, case-control study. Methods: Sixty-four (32 men and 32 women) subjects were enrolled for each of the three diagnostic groups. All dry eye patients were symptom positive. Nonfasting testosterone (T), sex hormone-binding globulin, serum albumin, dehydroepiandrosterone (DHEA), and DHEA sulphate levels of all study participants were determined using either automated immunoenzymatic assay, or standard radioimmunoassay. Analysis of variance was used to compare androgen levels among the three diagnostic groups in a gender-based design, followed by post-hoc multiple comparisons with the Tukey honestly significant difference test. Results: Mean T levels in men and women of the three diagnostic groups were not significantly different (p = 0.808, p = 0.156, respectively; ANOVA). Statistical analyses of the three diagnostic groups revealed a significant difference for men and women in bioavailable T levels (p = 0.002, p = 0.014, respectively; ANOVA), DHEA levels (p = 0.009, p = 0.004, respectively; ANOVA), and DHEA sulphate levels (p = 0.001, p = 0.001, respectively; ANOVA), whereas there was no statistically significant difference between non-MGD dry eye patients and controls for any of the measured androgen levels according to the post-hoc tests. Conclusion: This study demonstrates that the androgen pool of nonautoimmune dry eye patients with MGD is significantly depleted compared with that of non-MGD and control cases.

Appointment of New Section Editors

Pinar Aydin O’Dwyer, Professor of Ophthalmology and neuroophthalmologist, is a member of the Advisory Committee and Assessment Committee and Head of the Ethics Subcommittee of the International Council of Ophthalmology. She serves as Executive Board Member and Treasurer of the Turkish Board of Ophthalmology and General Secretary of the Postgraduate and Continuing Education Committee. Since 2000 she has been Program Secretary of the Scientific Section for Neuroophthalmology of the European Association for Vision and Eye Research (EVER); since 2002 she has been a Regional Representative on the EVER Board and is currently the treasurer of EVER. She has held conferences, and organized and given courses in America, Europe, Asia and Africa. She has authored approximately 150 scientific publications in peer-reviewed ophthalmology journals and edited seven books in ophthalmology. Since 2004 she has served on the Editorial Board of Ophthalmic Research . Ophthalmic Research is pleased to announce the appointment of new section editors for the field of Neuroophthalmology and Glaucoma. In addition, a new section – Clinical Retina – is introduced to manage the growing number of submissions in this field. Section editors have important duties and are responsible for guiding a submission through the peer review process. They are assigned to a particular article and are responsible for selecting reviewers for that submission, communicating with the authors and reviewers throughout the process, making a decision in favor of acceptance or rejection, and finally managing the successful papers through the editing process. Drs. Aydin (Neuroophthalmology) and Wiedemann (Clinical Retina) have already served as board members of Ophthalmic Research . Dr. Orgül (Glaucoma) begins his tenure on the board this year. We hope to continue the success of the journal and to provide useful information to the medical and scientific communities. At the same time, I personally would also like to thank Drs. Tsukahara and van den Berg for their time and commitment as section editors for many years. Uwe Pleyer, Editor-in-Chief Published online: December 11, 2006

Latanaprost Treatment of the Heterochromia in a Patient with Acquired Horner Syndrome

Horner syndrome results from either congenital or acquired causes of sympathetic denervation. Heterochromia, a clinical feature of congenital Horner syndrome, is quite rare in acquired Horner syndrome, especially after the age of two. There were only a few cases reported previously. We reported a 24-year-old man who was diagnosed up on pharmacological tests and clinical findings as acquired Horner syndrome with heterochromia. The main complaint of the patient was hypochromia on the affected side, which was obviously improved after 19 months of latanoprost treatment.