Glycoproteomic analysis of plasma from patients with atopic dermatitis: CD5L and ApoE as potential biomarkers

Atopic dermatitis (AD) is an inflammatory skin disorder that is both uncomfortable and distressing to patients, and its prevalence has been steadily increasing. It is obvious that the identification of efficient markers of AD in plasma would offer the possibility of effective diagnosis, prevention, and treatment strategies. In this study, a proteomic approach was used to analyze plasma glycoproteins from both children with AD and healthy child donors. Several protein spots showing significant quantitative changes in the AD patients were identified. Through sequential studies, it was confirmed that CD5L and ApoE were significantly up-regulated or down-regulated, respectively, in the plasma from AD patients compared with that from healthy donors. In addition, we suggest that the up-regulated CD5L in AD patients causes eosinophilia by inhibiting apoptosis or promoting the proliferation of eosinophils either in combination with or without IL-5. The glycoproteomic data in this study provides clues to understanding the mechanism of atopic alterations in plasma and suggests AD-related proteins can be used as candidate markers for AD.

Treatments of Stage 1 Retinal Angiomatous Proliferation

PURPOSE: To evaluate the results of single or combined treatment methods administered to patients with stage 1 retinal angiomatous proliferation (RAP). METHODS: A retrospective clinical study was performed in 9 eyes of 8 patients with stage I RAP. According to fundus angiography findings taken regularly after treatment, the results were categorized as closure of stage 1, recurrence of stage 1, or progress to stage 2. RESULTS: The mean follow-up period was 25 (14~40) months. In two eyes treated with laser photocoagulation only, the lesions progressed to stage 2. In two eyes treated with laser photocoagulation and intravitreal triamcinolone injection, the lesions also progressed to stage 2. In four eyes treated with photodynamic therapy and intravitreal triamcinolone injection, stage 1 lesions recurred in 3 eyes, and the lesion progressed to stage 2 in one eye. In one eye treated with photodynamic therapy, intravitreal triamcinolone injection, and laser photocoagulation, the stage 1 lesion recurred. Final visual acuity was stable in the case of stage 1 recurrence but was lower than the pretreatment level when the lesion progressed to stage 2. CONCLUSIONS: With either single or combined therapy, temporary closure of the stage 1 RAP lesion was possible, but complete closure could not be achieved for a long period because the lesion either recurred or progressed.

The Effect of Photodynamic Therapy in Chronic Central Serous Chorioretinopathy

PURPOSE: To determine whether photodynamic therapy (PDT) is effective and safe for the treatment of chronic central serous chorioretinopathy (CSC) in Korean patients. METHODS: Eleven eyes of 11 patients with chronic CSC underwent PDT. The laser spot size was chosen to cover the hyperfluorescent area on indocyanine green (ICG) angiography principally and to cover wide area including leaking point or detachment of retinal pigment epithelium on fluorescein angiography. We analyzed the medical records retrospectively to know the changes in visual acuity and serous detachment. RESULTS: The mean follow-up was 14.2+/-6 months and exudative macular detachments resolved completely in 11 eyes within 1 month. In addition, eight weeks after treatment, the visual acuity improved in 3 eyes, and remained unchanged in 7 eyes and decreased in one eye. However, in 2 eyes, visual acuity decreased immediately after PDT due to choroidal hypoperfusion, and in one of them, the final visual acuity did not recover to the pre-treatment level. CONCLUSIONS: In Korean patients, PDT seems to be effective for treatment of chronic CSC in the short term, but the long-term efficacy still must be determined. In addition, in PDT used for treatment of choroidal neovascularization (CNV), there was a possibility of irreversible occlusion in normal choroidal capillaries. Further studies are needed to determine the treatment parameters of PDT.

Progression of Retinal Angiomatous Proliferation after Surgical Ablation

PURPOSE: To describe the clinical course of three eyes of three patients that underwent surgical ablation as treatment of retinal angiomatous proliferation (RAP). METHODS: Surgical lysis of the retinal feeding arteriole and draining venule was done in two eyes that had stage 2 RAP with serous pigment epithelial detachment (PED). It was done as the first treatment modality in one eye, and after failure of laser photocoagulation in the other. It was also performed in another eye presumed to have very early stage RAP that showed only retinal-retinal anastomosis without any definite intraretinal or subretinal angiomatous lesion. RESULTS: PED decreased within 1 month after ablation in the two eyes with stage 2 RAP, but new anastomoses eventually developed after 1 month, followed by progression of the lesions. In the eye with presumed early stage RAP, successful lysis of retinal-retinal anastomosis was maintained and initially showed no signs of further proliferation at the original lesion site; however, four months later, hemorrhagic PED developed distally and progressed further to retinal pigment epithelial tear and massive subretinal hemorrhage. CONCLUSIONS: Surgical ablation may be unable to halt the progressive nature of neovascular proliferations in RAP.

Changes of Network Vessels after Photodynamic Therapy in Polypoidal Choroidal Vasculopathy

PURPOSE: To evaluate whether the branching vascular network component of polypoidal choroidal vasculopathy (PCV) could be occluded after photodynamic therapy (PDT). METHODS: A retrospective clinical study based upon indocyanine green angiogram was performed in 26 eyes of 26 patients having PCV and treated with PDT. RESULTS: Of the 19 eyes which received a single session of PDT, none showed complete occlusion of the vascular network and 16 (84%) showed, at least in part, a persisting vascular network. Of the 7 eyes which had two session of PDT, 1 (14%) showed complete occlusion of the vascular network, and 3 (43%) showed, at least in part, a persisting vascular network. Changes in the vascular network could not be evaluated with exactness in 6 eyes. Of the 18 eyes achieving clinical improvement after single PDT, 3 had recurrence of hemorrhagic or exudative changes from new polypoidal lesions which originated from the persisting vascular network. CONCLUSIONS: It is difficult to expect complete occlusion of branching vascular network after PDT, which means future recurrence may not be prevented even though occlusion of polyps accompanied with clinical improvement can be achieved with PDT.

Ophthalmological and Histopathological Diagnosis of Penetrating Keratoplasty Patients

PURPOSE: To evaluate the current status of pathological report in the accurate diagnosis of recipient cornea following penetrating keratoplasty. METHODS: We performed a chart review of the hospital records of 174 patients (191 eyes) who had received keratoplasty in between January, 1994 and March, 2002. RESULTS: Pathologists described pathological diagnoses in 64 cases (33.5%). Pathological diagnosis seemed to be made according to patients' clinical diagnosis. Pathologists described the same disease in various forms. Special staining was used in 9 cases (4.71%). CONCLUSIONS: In most cases, pathologists described pathological findings without a definite diagnosis. We suggest a new form of pathological report for better description of corneal disease. There should be a system for active interchange between ophthalmologists and pathologists.

Photodynamic Therapy with Verteporfin in Polypoidal Choroidal Vasculopathy

PURPOSE: To evaluate the effect of photodynamic therapy in polypoidal choroidal vasculopathy. METHODS: A retrospective review of eighteen patients (18 eyes) with polypoidal choroidal vasculopathy treated with photodynamic therapy was done. Follow-up period was more than 6 months after therapy. The change of visual acuity, exudative lesion on fundus examination, abnormal vasculature in indocyanine green angiography, and adverse effects of treatment were evaluated. RESULTS: Photodynamic therapy was performed to the entire lesion in 12 eyes, and to the active polypoidal lesions selectively in 6 eyes. In 15 eyes (83%), polyps were occluded with resolution of exudative change. The best corrected visual acuity improved in 8 eyes (44%), unchanged in 6 eyes (33%), and worsened in 4 eyes (22%). Visual acuity did not improve in spite of resolution of exudative change due to retinal pigment epithelium atrophy and fibrous change. Connecting vascular network was occluded after second photodynamic therapy in only one eye out of 12 eyes that received photodynamic therapy to the entire lesion. CONCLUSIONS: In polypoidal choroidal vasculopathy, photodynamic therapy with verteporfin was effective in occlusion of the symptomatic polypoidal lesions and resolution of exudation. But it was not effective in occlusion of the branching vascular network.

The Comparison of Astigmatism According to The Incision Size In Cataract Operation

PURPOSE: We compared the amount of surgically induced astigmatism according to the incision size in cataract operation. METHODS: One hundred one eyes of 82 patients underwent cataract operation with temporal clear corneal incision. The eyes were classified into 3 groups according to IOL types and incision size: Group I; after 3.2mm sized incision, acrylic IOL was inserted using the injector. Group II; after 3.6mm sized incision, acrylic IOL was inserted using forceps. Group III; after 3.2mm sized incison, silicone IOL was inserted using the injector. The visual acuity and astigmatism was evaluated at preoperation, 1 week, 1 month and 2 months after the operation. RESULTS: In all groups, visual acuity was significantly improved at 1 week after the operation. Only in group II, astigmatism was increased statistically significantly at 1 week after the operation. The change of astigmatism in group I was statistically less than that in group II at 1 week after operation. In any groups, the change of astigmatism showed no difference at 1 month and 2 months after the operation. CONCLUSIONS: The 3.2 mm clear corneal incision for injector shows significantly smaller surgically induced astigmatism than that of 3.6 mm clear corneal incision for forcep in cataract surgery.