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Long-term macular function in eyes with central serous chorioretinopathy.

Background:  This study aimed to investigate the long‐term effects of central serous chorioretinopathy (CSCR) on macular function.

Corneal bee sting-induced endothelial changes.

Purpose: To report the acute management and clinical findings of a case of corneal bee sting and to report the outcome of corneal endothelial cell analysis 1 year after trauma. Methods: Clinical findings, anterior segment photographs, corneal endothelial images, and medical treatment of a case of right corneal bee sting are presented. Right and left central corneal endothelial cell analysis was performed by noncontact specular microscopy. Results: The stinger was removed from the cornea. Systemic, subconjunctival, and topical steroids and systemic and topical antibiotics were given. One year later, a corneal scar and anterior capsular opacity of the lens in the right eye were shown by slit-lamp examination. Endothelial cell analysis determined that the endothelial cell density of the right eye was substantially decreased compared with the left eye. Conclusion: Corneal infiltration gradually decreased, presumably because of the systemic, topical, and subconjunctival steroids. Late complications observed in this case included a substantial decrease in cornea endothelial cell density, a corneal scar, and anterior capsular opacity.

Effects of different contact lens materials and contact lens-wearing periods on conjunctival cytology in asymptomatic contact lens wearers.

Purpose. To investigate the conjunctival cytologic changes induced by different contact lens materials and contact lens–wearing periods in asymptomatic contact lens wearers. Methods. Seventy-five patients (150 eyes) who were to wear contact lenses for the first time were evaluated in this study. Forty eyes of 20 soft hydroxyethylmethacrylate (vinyl pyrrolidone copolymer) contact lens wearers, 70 eyes of 35 soft Polymacon contact lens wearers, and 40 eyes of 20 hard gas-permeable contact lens wearers used the lenses on a daily-wear basis. Conjunctival cytologic changes were investigated by using impression cytology. Impression cytologic samples were obtained before contact lens fitting and after contact lens wear (mean evaluation time, 6.9 ± 2.6 months; range, 4–12 months). The samples were appropriately stained and were assessed by using the Nelson grading system and for the presence of snakelike chromatin. The Kruskal–Wallis test, the Wilcoxon test, and logistic regression were used for statistical analysis. Results. There were statistically significant differences in impression cytologic findings for all three materials before versus after contact lens wear (P=0.00, P=0.00, P=0.00, Wilcoxon test). The contact lens–wearing period produced a statistically significant effect on conjunctival cytologic changes and snakelike chromatin formation (P=0.00, P=0.00, logistic regression analysis), but the effects of different contact lens materials were insignificant (P=0.88, P=0.62). Conclusions. Conjunctival cytologic changes occurred in asymptomatic contact lens wearers and were related to the duration of lens wear. For this reason, asymptomatic contact lens wearers may be followed up because of conjunctival cytologic changes.

Diagnostic occlusion test in intermittent exotropia

PURPOSE We sought to determine the ideal length of time to use the diagnostic occlusion test (DOT) in the evaluation of patients with intermittent exotropia. METHODS Eighty-two consecutive intermittent exotropia patients were prospectively evaluated. After the routine ophthalmic examination, the DOT was applied for 1, 3, and 24 hours. The mean distance and near deviations, obtained with the DOTs, were compared, and the DOT periods at which deviations were stabilized were determined. The Nonparametric Tukey HSD test was used for statistical analysis. RESULTS Before occlusion, the mean distance exotropia was 28.4 +/- 14.5, and the mean near exotropia was 25.7 +/- 15.5. After 1 hour of DOT, the exotropia measured 30.0 +/- 14.8 (p = 0.023) and 31.2 +/- 14.0 (p = 0.000), respectively. A clinically and statistically significant difference was not found after 3-hour and 24-hour DOT at either distance or near. CONCLUSIONS Although the distance deviation stabilized after the 1-hour DOT and the near deviation was stabilized after the 3-hour DOT in intermittent exotropia cases, the change of mean near deviation between 1 and 3 hours was clinically negligible. The 1 hour DOT was at least as effective as the 3- and 24-hour DOT in most cases. Therefore, we recommend that the 1 hour DOT is sufficient for clinical applications.

Systemic and topical fresh-frozen plasma treatment in a newborn with ligneous conjunctivitis.

Purpose: We report the results of systemic and topical fresh-frozen plasma (FFP) treatment and conjunctival membrane excision of a newborn with ligneous conjunctivitis. Methods: The newborn, referred because of bilateral membranous conjunctivitis, was hospitalized with the preliminary diagnosis of gonococcic conjunctivitis. The conjunctival membranes were excised on the fourth day of topical antibiotherapy. Plasminogen deficiency and ligneous conjunctivitis were diagnosed from the hematology consultation after recurrence of the conjunctival membranes. Results: FFP was used systemically and topically. After this medical treatment period, the conjunctival membranes were excised with electrocautery under general anesthesia. Topical FFP was gradually decreased after surgery and ended in the third postoperative month. Recurrence was not seen through the first postoperative year. Conclusions: Topical and systemic FFP treatment and conjunctival membrane excision may help rapid rehabilitation and prevent recurrence in cases with ligneous conjunctivitis.

Elevated Neutrophil Lymphocyte Ratio in Recurrent Optic Neuritis

Purpose. To demonstrate the relation between optic neuritis (ON) and systemic inflammation markers as neutrophil lymphocyte ratio (N/L ratio), platelet count, mean platelet volume (MPV), and red cell distribution width (RDW) and furthermore to evaluate the utilization of these markers to predict the frequency of the ON episodes. Methods. Forty-two patients with acute ON and forty healthy subjects were enrolled into the study. The medical records were reviewed for age, sex, hemoglobin (Hb), Haematocrit (Htc), RDW, platelet count, MPV, white blood cell count (WBC), neutrophil and lymphocyte count, and neutrophil lymphocyte ratio (N/L ratio). Results. The mean N/L ratio, platelet counts, and RDW were significantly higher in ON group (p = 0.000, p = 0.048, and p = 0.002). There was a significant relation between N/L ratio and number of episodes (r = 0.492, p = 0.001). There was a statistically significant difference for MPV between one episode group and recurrent ON group (p = 0.035). Conclusions. Simple and inexpensive laboratory methods could help us show systemic inflammation and monitor ON patients. Higher N/L ratio can be a useful marker for predicting recurrent attacks.

Effects of cisplatin-5-fluorouracil combination therapy on oxidative stress, DNA damage, mitochondrial apoptosis, and death receptor signalling in retinal pigment epithelium cells

Abstract Aim: Combination therapies of cisplatin with 5-FU (PF) are an effective solution and have been widely used for the treatment of various categories of cancer including anal, gastrointestinal, and oral cancer, as well as head and neck tumors. The effects of combined PF treatment on vital intracellular signalling pathways in nontargeted cells remain unclear. The aim of this study is to explain the possible mechanisms by which combined PF treatment results in retinal toxicity and to investigate the effects of PF on important vital signalling pathways in ARPE 19 retinal pigmented epithelial cells. Materials and methods: We analysed the cellular and molecular effects of PF on cell viability, oxidative stress, gene repair response, and induction of apoptosis in ARPE 19 cells using molecular probe fluorescent staining, cell cytometer, RAPD, qRT-PCR, and western blot assays. Results: We determined that PF causes excessive generation of reactive oxygen species (ROS) and prevents ROS scavenging by suppressing antioxidant systems. We found induction of DNA damage, particularly mismatch and double strand break repair, in ARPE 19 cells treated with PF. In this study, PF also induced both the intrinsic apoptosis pathway and death receptor signalling in ARPE 19 cells. Conclusions: Our data proved that PF causes cytotoxicity and genotoxicity, at both the cellular and molecular levels, in ARPE 19 cells following particularly prolonged treatment (48 h). Additionally, our results suggest key molecular signals for prevention strategies that can be developed to reduce the severe side effects of PF chemotherapy.

Thickness Changes in Foveal, Macular, and Ganglion Cell Complex Regions Associated with Behçet Uveitis during Remission:

Purpose To investigate foveal, macular, and ganglion cell complex (GCC) thickness in patients with Behçet uveitis during remission. Methods We included patients with panuveitis attacks caused by Behçet disease. Patients were taking immunosuppressive therapy and had no active ocular inflammation. After complete ophthalmologic examination, optical coherence tomography (OCT) was performed with a macula multi-cross protocol. The OCT images were evaluated for structural changes. Patients with no structural changes were imaged with the macula map protocol to obtain parafoveal and perifoveal macular and GCC thicknesses. Patients were compared to an age-matched control group with the Mann-Whitney U test. In correlation analyses, we examined relationships among visual acuity (logMAR), disease duration, and the number of attacks. Results The study included 27 eyes of 21 patients (mean age 38.14 ± 9.18 years; mean disease duration 65.4 ± 74.6 months; mean number of attacks 2.5 ± 1.9). The OCT showed foveal thicknesses of 260.29 ± 34.17 µm in patients and 280.58 ± 19.54 µm in controls (p = 0.010). Foveal thickness was not related to visual acuity (p = 0.485), but was negatively correlated to disease duration (p = 0.016) and number of attacks (p = 0.001). Patients and controls showed similar macular thickness in parafoveal quadrants (p = 0.294, p = 0.096, p = 0.88, p = 0.111) and perifoveal quadrants (p = 0.241, p = 0.517, p = 0.53288, p = 0.241). Patient parafoveal GCCs were significantly thinner than in controls in the inferior temporal quadrant (p = 0.041), but not in other quadrants (p = 0.867, p = 0.832, p = 0.390). Patient perifoveal GCCs were significantly thicker than in controls in the superior and inferior temporal quadrants (p = 0.008, p = 0.008) and somewhat thicker (but not significantly) in the superior and inferior nasal quadrants (p = 0.052, p = 0.138). Conclusions Patients with Behçet uveitis in remission showed insignificant decreases in foveal and macular thickness and significant increases in perifoveal GCC thickness compared to controls. The increased perifoveal GCC thickness may result from macular ischemia persisting in remission.

Central Retinal Artery Occlusion in Takayasu’s Arteritis as the First Presentation of the Disease

Takayasus arteritis (TA) is a chronic inflammatory granulomatous vasculitis which affects large and medium arterial vessels. The disease involves especially subclavian arteries and aortic branches but it can consist of any arteries. The major pathology is granulomatous panarteritis with intima proliferation and defects of the elastic lamina of the vessels. We present a case of central retinal artery occlusion in TA as the first presentation of the disease. To the best of our knowledge, the present case is the first case that demonstrates central retinal artery occlusion as an initial manifestation in TA. A 48-year-old woman was admitted to our clinic with the complaint of sudden and painless vision loss in her right eye for one day. Although retinal artery involvement is a very rare presentation in TA, it is important to recall TA particularly in young patients with retinal artery occlusion.

Metabolic Syndrome May Exacerbate Macular and Retinal Damage in Psoriasis Vulgaris

ABSTRACT Purpose: To evaluate whether cases with both psoriasis and metabolic syndrome are prone to retinal and macular changes. Materials and Methods: A total of 174 eyes of 87 subjects were evaluated. Of the 87 subjects, 24 had psoriasis, 19 had psoriasis and metabolic syndrome, 18 had metabolic syndrome only and 26 were healthy subjects. Biochemical analysis, anthropometric, blood pressure and optical coherence tomography measurements and thickness analysis were obtained for each case. Results: The superior retinal nerve fibre layer thickness was significantly lower in the psoriasis and metabolic syndrome group than in the psoriasis group. For all parafoveal quadrants, the ganglion cell complex thickness was statistically significantly lower in the psoriasis group than in the healthy group. The central macula was thinnest in the healthy group among the four groups. Conclusions: Psoriasis can cause retinal changes, and metabolic syndrome may cause additional damage in the retina and macula in cases with psoriasis.