Tongabay Cumurcu

Serum homocysteine, vitamin B 12 and folic acid levels in different types of glaucoma

BackgroundThis study was performed to compare levels of serum homocysteine (Hcy), vitamin B12 and folic acid in patients with primary open-angle glaucoma (POAG), pseudoexfoliative glaucoma (PEXG), normotensive glaucoma (NTG) and healthy controls.MethodsTwentyfive patients with POAG, 24 with PEXG, and 18 with NTG, along with 19 control healthy subjects were included this prospective study. Levels of serum Hcy were measured using immunoassay, and those of serum vitamin B12 and folic acid were measured using competitive chemiluminescent enzyme immunoassay.ResultsThe mean Hcy concentration in the PEXG group was significantly higher (P < 0.001) as compared to the other groups. There were no significant differences with respect to the mean Hcy concentrations among other groups (P > 0.05). There were no statistical differences in serum vitamin B12 levels among POAG, PEXG, NTG and control subjects (P > 0.05).The mean serum folic acid level was significantly lower in the subjects with PEXG (P < 0.009). However, the mean folic acid concentrations among the other groups did not differ significantly (P > 0.05).ConclusionElevated levels of Hcy in PEXG may explain the role of endothelial dysfunction among patients with PEXG.

Craniofacial Anthropometry in a Turkish Population

OBJECTIVE To present norms and demonstrate the anthropometric variations in fronto-occipital circumference, inner and outer canthal distances, near and distant [far] anatomical interpupillary distance, canthal index, and circumference-interorbital index across age and sex in urban Turkish subjects. PARTICIPANTS Three thousand four hundred forty-eight subjects (1852 male, 1596 female) aged 7 to 40 years were included in this study. METHODS Three age groups were studied: children aged 7 to 15 years, young adults aged 16 to 25 years, and adults aged 26 to 40 years. Mean values for each measured parameter were determined at each age between 7 and 25 years. Subjects were also divided into nine age subgroups to observe the change of each parameter with advancing age. RESULTS The fronto-occipital circumference and outer canthal distance of males was significantly (p <.001) wider than females in all age groups. The near and distant interpupillary distances of male subjects were, on average, wider than the female subjects with greater differences with advancing age. Across all subjects aged 7 to 40 years, the mean of all measured parameters and calculated indexes of men and boys was significantly different from girls and women (p <.001). The mean for interpupillary distances in our study in both sexes were found to be similar to Arabian, Hong Kong, and British children; larger than those of Chinese, Black, Indian, and Caucasians; and smaller than those of Mexican children and a mixed European population. CONCLUSION This study clearly shows the anthropometric variation for fronto-occipital circumference, inner canthal distance, outer canthal distance, near and distant interpupillary distance, canthal index, and circumference-interorbital index with age. These developmental data and the normal values of these measurements in healthy subjects are useful for dysmorphologists in the early identification of some craniofacial syndromes, hyper- and hypotelorism, and congenital or posttraumatic telecanthus and of planning surgical intervention. We suggest that the comparison of craniofacial dimensions of a patient must be performed with normal standards specific for age as well as sex and race.

Comparison of dose-related ocular side effects during systemic isotretinoin administration.

Purpose To compare the effects of high- (Group 1) and low-dose (Group 2) isotretinoin treatments for acne vulgaris on lacrimal functions and other ocular complications. Methods Twenty-six patients receiving high-dose (>0.5 mg/kg per day) systemic isotretinoin treatment and 25 patients treated with low-dose systemic isotretinoin (<0.5 mg/kg per day) underwent complete ophthalmologic assessment of both eyes before treatment, at days 45 and 90 of treatment, and 1 month after the completion of treatment, together with a microbiologic evaluation of conjunctival flora, tear film break-up time (BUT), and anesthetized Schirmer test of the right eye of each patient. Results When the results of the anesthetized Schirmer test for Groups 1 and 2 were compared (pretreatment, days 45 and 90 of treatment, and 1 month after treatment), there was no statistically significant difference between the groups (p > 0.05). Although BUT did not differ significantly between the two groups before treatment (p > 0.05), there was a statistically significant decrease in BUT in Group 1 when compared with Group 2 at days 45 and 90 of treatment (p < 0.05). One month after the completion of treatment, there was no difference in BUT between the two groups (p > 0.05). No difference in Staphylococcus aureus colonization was detected between the two groups at days 45 and 90 of treatment (p > 0.05). Conclusions During systemic isotretinoin treatment, eye dryness was related to the dose used, at least during the period of treatment. Conversely, the rate of conjunctival S aureus colonization was unrelated to the dose of isotretinoin.

Aqueous humor erythropoietin levels in patients with primary open-angle glaucoma.

PurposeTo evaluate the levels of erythropoietin (EPO) in the aqueous humor in eyes with primary open-angle glaucoma (POAG) and without glaucoma. MethodsLevels of EPO were measured using a sandwich enzyme-linked immunosorbent assay kit in aqueous humor aspirates taken during anterior segment surgery from 45 patients, of whom 20 had POAG and 25 had senile cataract only. ResultsThe mean aqueous humor EPO concentration in eyes with POAG (10.91±4.32 mU/mL) was significantly higher than that from eyes with cataract (8.24±1.77 mU/mL, P=0.008). There was no significant difference between the serum EPO concentrations of POAG (26.46±10.36 mU/mL) and the control group (24.50±7.59 mU/mL, P=0.468). There was no correlation (P=0.165) between the EPO aqueous humor concentration and the EPO serum concentration while there was no correlation between the EPO aqueous humor concentration and the EPO serum concentration in the control group (P=0.819). ConclusionsThe aqueous humor EPO level is increased in eyes with POAG.

Evaluation of peripapillary retinal nerve fiber layer, macula and ganglion cell thickness in amblyopia using spectral optical coherence tomography

AIM To investigate peripapillary retinal nerve fiber layer (RNFL), macula and ganglion cell layer thicknesses (GCC) in amblyopic eyes with spectral domain optical coherence tomography (SD-OCT). METHODS Thirty six patients with a history of unilateral amblyopia and thirty two children who had emmetropia without amblyopia were included in this study. In this institutional study, 36 eyes of 36 patients with amblyopia (AE), 36 fellow eyes without amblyopia (FE), and 32 eyes of 32 normal subjects (NE) were included. RNFL, GCC and macular thickness measurements were performed with RS-3000 OCT Retina Scan (Nidek Inc CA. USA). RESULTS The mean global thicknesses of the RNFL were 113.22±21.47, 111.57±18.25, 109.96±11.31µm in the AE, FE, and NE, respectively. There was no statistically significant difference for mean global RNFL thickness among the eyes (P=0.13). The mean thicknesses of the macula were 258.25±18.31, 258.75±19.54, 248.62±10.57µm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of macula among the eyes (P=0.06). The GCC was investigated into two parts: superior and inferior. The mean thicknesses of superior GCC were 102.57±13.32, 103.32±10.64, 100.52±5.88µm in the AE, FE, and NE, respectively. The mean thicknesses of inferior GCC were 103.82±12.60, 107.82±12.33, 105.86±10.79µm in the AE, FE and NE, respectively. There was no statistically significant difference for thickness of superior and inferior GCC between the eyes (P=0.63, P=0.46). CONCLUSION The macular thicknesses of AE and FE were greater than the NE, although it was not statistically significant. Amblyopia does not seem to have a profound effect on the RNFL, macula and GCC.

Levels of Iron, Zinc, and Copper in Aqueous Humor, Lens, and Serum in Nondiabetic and Diabetic Patients Their Relation to Cataract

The purpose of this study was to investigate iron (Fe), zinc (Zn), and copper (Cu) levels of aqueous humor, lens, and serum in nondiabetics and diabetics and to determine the effects of diabetes on Fe, Zn, and Cu contents in the lens. Fe, Zn, and Cu contents of aqueous humor, lens, and serum samples of 19 patients (9 nondiabetic patients with a mean age of 62.3±5.4 yr, and 10 diabetic patients with a mean age of 59.5±5.9 yr) were analyzed by atomic absorption spectrometry using a prospective study design. The lens levels of Cu in diabetic patients were significantly higher compared with nondiabetic patients (p=0.02); however; there was no difference in the other elements (Zn, Fe; p=0.28, p=0.74, respectively). The levels of Fe, Zn, and Cu in the aqueous humor and serum of diabetic patients were not found to be statistically significant when compared to nondiabetics (p=0.46, p=0.11, p=0.18, and p=0.22, p=0.43, p=0.72, respectively). These results demonstrate that increased Cu content of the lens presumably has a greater association with the development of lens opacification in diabetics than Zn and Fe content.

Endoscopic Transcanalicular Diode Laser Dacryocystorhinostomy: Is It an Alternative Method to Conventional External Dacryocystorhinostomy?

Purpose: To compare the success rates of endoscopic transcanalicular diode laser dacryocystorhinostomy (EL-DCR) and external DCR. Materials and Methods: Operations were performed on 55 eyes of 54 patients who had distal nasolacrimal canal obstruction. External DCR was performed on 29 of the eyes and EL-DCR on 26 of them. Success was defined based on subjective relief of patients reported at their final examinations. Results: There were 23 women and 6 men in group 1 and 19 women and 6 men in group 2 (p = 0.77). The mean ages of groups were 45.24 ± 12.08 (range, 15–74) and 43.2 ± 17.01 (range, 11–72) years, respectively (p = 0.63). The mean follow-up times were 8.82 ± 5.51 (range, 3–18) and 7.12 ± 2.96 (range, 2–12) months, respectively in groups (p = 0.58). The success rates based on symptoms were measured at 25 of 29 (86%) and 17 of 25 (68%) for 2 groups. The difference in the success rates was higher but not found to be statistically significant (p = 0.202). The authors found various conditions related to nasal passage in 4 of 8 unsuccessful EL-DCR, including allergic rhinitis, nasal crust, silicone tube reaction, and unsuitable passage for endoscopic surgery. Conclusions: The success rate of EL-DCR was lower than that of the external DCR; however, no statistically significant difference was observed. Endoscopic transcanalicular diode laser DCR may be considered as an alternative method to external DCR with these results.

Conjunctival flora in Behçet patients

BACKGROUND To determine the difference in conjunctival flora in Behçet patients compared with the normal population. METHODS This study was carried out on a study group of 50 patients in the inactive period of Behçets disease and a control group of 50 age- and sex-matched healthy subjects with no systemic or ocular disease. A swab was taken from the lower fornix using a sterile swab and inoculated into bloody eosin methylene blue, chocolate, and Sabouraud dextrose agar media. RESULTS The mean age was 36.04 (SD 2.16) years for the Behçet group and 35.64 (SD 1.96) years for the control group. Bacterial growth was observed in 92% (n = 46) of the Behçet group and 56% (n = 29) of the control group. The Behçet group results were Staphylococcus aureus in 12 (24%), coagulase negative staphylococci (CNS) in 32 (64%), Moraxella spp in 8 (16%), Streptococcus spp in 8 (16%), Bacillus spp in 4 (8%), Neisseria spp in 4 (8%), Candida spp in 3 (6%), and Haemophilus spp in 1 (2%). In the control group, the results were S. aureus in 2 (4%), CNS in 24 (48%), Moraxella spp in 2 (4%), Streptococcus spp in 1 (2%), Bacillus spp in 3 (6%), Neisseria spp in 3 (6%), and Candida spp in 1 (2%). INTERPRETATION S. aureus, Moraxella spp, and Streptococcus spp colonization was significantly higher in the conjunctival flora of Behçet patients than in that of the control group. A bacterial etiology may be involved in the pathogenesis of Behçets disease.

Increased oxidative stress in patients with pseudoexfoliation syndrome.

Purpose: The objective of this study was to investigate the antioxidant/oxidant status of serum in patients with pseudoexfoliation syndrome (PEX). Methods: Forty-seven patients with PEX and 32 healthy controls were included in the study. Serum total antioxidant capacity (TAC) and total oxidant status (TOS) levels were determined by using a novel automated method. Results: A significant increase in serum TOS (p < 0.001) and a significant decrease in serum TAC (p < 0.0001) were observed in PEX patients compared to control subjects. Conclusion: TAC decreases while the oxidative stress increases in PEX.

Serum alpha-1-antitriypsin levels in patients with pseudoexfolative syndrome.

Purpose: To evaluate the levels of serum α 1-antitrypsin in patients with pseudoexfoliation syndrome (PEX) and healthy control subjects without PEX. Material and Methods: Forty-four patient with PEX and 40 healthy control subjects (84 subjects total) were enrolled into the study. Serum ATT levels were measured using nephelometry. Results: The mean serum AAT concentration in PEX group was significantly higher than in the controls (p = 0.0001). Conclusion: Serum AAT levels were found to be increased in patients with PEX. Increased serum AAT levels in PEX may explain the role of inflammation in this group of patients.