Uveoretinal Adverse Effects Presented during Systemic Anticancer Chemotherapy: a 10-Year Single Center Experience

BACKGROUND: The present study describes our 10-year experience with uveoretinal adverse events that manifest because of chemotherapy. METHODS: A retrospective chart review was performed for all patients who presented to the ophthalmologic department while undergoing systemic chemotherapy between July 2005 and June 2015. RESULTS: A total of 55 patients (mean age, 51.2 years, 38 women [69.1%]) suspected of having uveoretinal disease owing to the use of chemotherapeutic agents alone were enrolled. Breast cancer was the predominant disease (36.4%); noninfectious anterior uveitis (21.8%) was the most common condition. Bilateral involvement was observed in 16 patients (29.1%). Although cisplatin (21.8%) was the most commonly used drug, daunorubicin, cytarabine, tamoxifen, toremifene, and imatinib were also frequently used. The median duration until ophthalmologic diagnosis was 208.5 days (range, 19–5,945 days). The proportion of patients with final visual acuity (VA) < 20/40 Snellen VA (0.5 decimal VA) was 32.7%. However, no relationship was observed between final VA < 20/40 and age, sex, therapeutic agents, and metastasis. CONCLUSION: Uveoretinal complications were mostly mild to moderate and exhibited a favorable response to conservative therapy. A considerable number of patients exhibited significant irreversible loss of vision after cessation of the causative chemotherapeutic agent. Ophthalmological monitoring is required during chemotherapy.

Bilateral Branch Occlusive Retinal Vasculitis Induced by Septic Embo-lism in Endogenous Klebsiella Endo-phthalmitis

No abstract available.

Relationship between Dry Eye Parameters and Anterior Corneal Higher-Order Aberrations Measured by Two Different Instruments

PURPOSE: To compare the corneal first surface higher-order aberrations (HOAs) of normal subjects and patients with dry eye using KR-1W(R) (Topcon Corp., Tokyo, Japan) and Pentacam(R) HR (Oculus Inc., Dutenhofen, Germany). We analyzed the relationship between the aberrations and the diagnostic parameters of dry eye. METHODS: We evaluated anterior corneal HOAs in 71 normal eyes and 71 dry eyes using KR-1W(R) and Pentacam(R). Dry eye patients were examined for fluorescein staining, tear break-up time (TBUT), and Schirmer I test. Ocular Surface Disease Index (OSDI) was used for assessment of subjective symptoms in dry eye patients. RESULTS: HOAs measured by both instruments were greater in the dry eye group than in the control group, although HOAs using KR-1W(R) only achieved statistical significance. The anterior corneal HOAs measured by the 2 instruments were significantly correlated with superficial punctate keratitis. Moreover, TBUT and the Shirmer I test negatively correlated, and OSDI positively correlated, with anterior corneal HOAs. CONCLUSIONS: The HOAs in patients with dry eye were significantly different from controls and tended to increase with disease severity. KR-1W(R) might be more useful than Pentacam(R) to detect tear film instabilities.

Diagnostic Availability of Ocular Response Analyzer in Korean Patients with Normal Tension Glaucoma

PURPOSE: To compare the parameters measured with the ocular response analyzer (ORA; Reichert Inc., Depew, NY, USA) between normal control subjects and patients with normal tension glaucoma (NTG) and to investigate clinical usefulness of ORA. METHODS: Intraocular pressure (IOP) and central corneal thickness (CCT) were measured using the Goldmann applanation tonometer (GAT) in 100 eyes of 100 normal subjects and 100 eyes of 100 NTG patients. Four types of ORA parameters, corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated IOP (IOPg), and corneal-compensated IOP (IOPcc) were also measured. RESULTS: The mean CH values were 11.2 mm Hg and 10.3 mm Hg and the mean CRF values were 10.8 mm Hg and 9.9 mm Hg in the normal subjects group and the NTG group, respectively. Mean CH and CRF were significantly lower in NTG patients (p < 0.001) and the IOPcc were higher than normal subjects (p = 0.004). IOPg was in agreement with the GAT IOP (ICC = 0.811) and IOPcc was not correlated with CCT. The cut-off value of 'IOPcc - IOPg' as the diagnostic standard parameter was -0.05 mm Hg (sensitivity; 76%, specificity; 55%). CONCLUSIONS: IOPg measurements were similar to GAT IOP, and other ORA parameters (CH, CRF, IOPcc) were significantly different between normal subjects and NTG patients. Consequently, the difference of IOPcc and IOPg could be a useful parameter in NTG diagnosis.

Anti-inflammatory effect of (-)-epigallocatechin-3-gallate on Porphyromonas gingivalis lipopolysaccharide-stimulated fibroblasts and stem cells derived from human periodontal ligament

PURPOSE: (-)-epigallocatechin-3-gallate (EGCG) has been reported to exert anti-inflammatory and antibacterial effects in periodontitis. However, its exact mechanism of action has yet to be determined. The present in vitro study evaluated the anti-inflammatory effects of EGCG on human periodontal ligament fibroblasts (hPDLFs) and human periodontal ligament stem cells (hPDLSCs) affected by bacterial lipopolysaccharide (LPS) extracted from Porphyromonas gingivalis. METHODS: hPDLFs and hPDLSCs were extracted from healthy young adults and were treated with EGCG and/or P. gingivalis LPS. After 1, 3, 5, and 7 days from treatment, cytotoxic and proliferative effects were evaluated using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and bromodeoxyuridine assay, respectively. And then, the gene expressions of hPDLFs and hPDLSCs were observed for interleukin (IL)-1beta, IL-6, tumor necrosis factor (TNF)-alpha, osteoprotegerin (OPG), receptor activator of nuclear factor kappa-B ligand (RANKL), and RANKL/OPG using real-time polymerase chain reaction (PCR) at 0, 6, 24, and 48 hours after treatment. The experiments were performed with the following groups for hPDLFs and hPDLSCs; 1) No treat, 2) EGCG alone, 3) P. gingivalis LPS alone, 4) EGCG+P. gingivalis LPS. RESULTS: The 20 microM of EGCG and 20 microg/mL of P. gingivalis LPS had the lowest cytotoxic effects, so those concentrations were used for further experiments. The proliferations of hPDLFs and hPDLSCs increased in all groups, though the 'EGCG alone' showed less increase. In real-time PCR, the hPDLFs and hPDLSCs of 'EGCG alone' showed similar gene expressions to those cells of 'no treat'. The gene expressions of 'P. gingivalis LPS alone' in both hPDLFs and hPDLSCs were highly increased at 6 hours for IL-1beta, IL-6, TNF-alpha, RANKL, and RANKL/OPG, except the RANKL/OPG in hPDLSCs. However, those increased gene expressions were down-regulated in 'EGCG+P. gingivalis LPS' by the additional treatment of EGCG. CONCLUSIONS: Our results demonstrate that EGCG could exert an anti-inflammatory effect in hPDLFs and hPDLSCs against a major pathogen of periodontitis, P. gingivalis LPS.

Effect of (-)-epigallocatechin-3-gallate on maintaining the periodontal ligament cell viability of avulsed teeth: a preliminary study

PURPOSE: Avulsed tooth can be completely recovered, if sound periodontal ligament (PDL) of tooth is maintained. Although a lot of storage solutions have been explored for the better storage of avulsed tooth, there is a shortcoming that the preservation time is much short. On the other hand, there has been studies that (-)-epigallocatechin-3-gallate (EGCG), the most abundant polyphenol in green tea, which is related to the anti inflammatory, antioxygenic, and antibacterial effects, allows the successful preservations of tissues and cells. This study evaluated the effect of EGCG on avulsed-teeth preservation of Beagle dogs for a period of time. METHODS: The atraumatically extracted teeth of Beagle dogs were washed and preserved with 0/10/100 microM of EGCG at the time of immediate, period 1 (4 days in EGCG-contained media and additional 1 day in EGCG-free media), period 2 (8 days in EGCG-contained media and additional 2 days in EGCG-free media) and period 3 (12 days in EGCG-contained media and additional 2 days in EGCG-free media). Then, the cell viabilities of preserved teeth was calculated by dividing optical density (OD) of 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay with OD of eosin assay to eliminate the measurement errors caused by the different tissue volumes. RESULTS: From the results, the immediately analyzed group presented the highest cell viability, and the rate of living cells on teeth surface decreased dependent on the preservation period. However, the 100 microM of EGCG-treated group showed statistically significant positive cell activity than EGCG-free groups throughout preservation periods. CONCLUSIONS: Our findings showed that 100 microM EGCG could maintain PDL cell viability of extracted tooth. These results suggest that although EGCG could not be a perfect additive for tooth preservation, it is able to postpone the period of tooth storage. However, further in-depth studies are required for more plausible use of EGCG.

Effect of (-)-epigallocatechin-3-gallate on maintaining the periodontal ligament cell viability of avulsed teeth: a preliminary study

PURPOSE: Avulsed tooth can be completely recovered, if sound periodontal ligament (PDL) of tooth is maintained. Although a lot of storage solutions have been explored for the better storage of avulsed tooth, there is a shortcoming that the preservation time is much short. On the other hand, there has been studies that (-)-epigallocatechin-3-gallate (EGCG), the most abundant polyphenol in green tea, which is related to the anti inflammatory, antioxygenic, and antibacterial effects, allows the successful preservations of tissues and cells. This study evaluated the effect of EGCG on avulsed-teeth preservation of Beagle dogs for a period of time. METHODS: The atraumatically extracted teeth of Beagle dogs were washed and preserved with 0/10/100 microM of EGCG at the time of immediate, period 1 (4 days in EGCG-contained media and additional 1 day in EGCG-free media), period 2 (8 days in EGCG-contained media and additional 2 days in EGCG-free media) and period 3 (12 days in EGCG-contained media and additional 2 days in EGCG-free media). Then, the cell viabilities of preserved teeth was calculated by dividing optical density (OD) of 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay with OD of eosin assay to eliminate the measurement errors caused by the different tissue volumes. RESULTS: From the results, the immediately analyzed group presented the highest cell viability, and the rate of living cells on teeth surface decreased dependent on the preservation period. However, the 100 microM of EGCG-treated group showed statistically significant positive cell activity than EGCG-free groups throughout preservation periods. CONCLUSIONS: Our findings showed that 100 microM EGCG could maintain PDL cell viability of extracted tooth. These results suggest that although EGCG could not be a perfect additive for tooth preservation, it is able to postpone the period of tooth storage. However, further in-depth studies are required for more plausible use of EGCG.