Transforming Growth Factor-beta Levels in Human Aqueous Humor of Glaucomatous, Diabetic and Uveitic Eyes

PURPOSE: Transforming growth factor-beta2 is known to be present at elevated levels in the aqueous humor of patients with primary open angle glaucoma (POAG) and diabetes but not in uveitis-related secondary glaucoma. We investigated total TGF-beta2 levels and levels of the active form of TGF-beta2 in the aqueous humor of eyes with different types of glaucoma. METHODS: The concentration of the total and active form of TGF-beta2 was measured in 63 patients with primary open angle glaucoma, neovascular glaucoma complicated with diabetes (NVG), and secondary open angle glaucoma complicated with uveitis (SOAG) using a double antibody 'sandwich-indirect' ELISA method. RESULTS: The levels of total TGF-beta2 in the aqueous samples of POAG, NVG, and SOAG were elevated. The levels of active TGF-beta2 in the aqueous samples of POAG, and NVG were also elevated, whereas the level of active TGF-beta2 was within the normal range in the aqueous samples of SOAG. CONCLUSIONS: These results suggest that the level of TGF-beta2 may play a role in the pathology of various types of glaucoma.

Neovascular Glaucoma: Diode Laser Trans-Scleral Cyclophotocoaculation Versus Ahmed Glaucoma Valve Implant

PURPOSE: To retrospectively study the clinical outcomes of diode laser trans-scleral cyclophotocoagulation and Ahmed glaucoma valve implant in eyes with neovascular glaucoma. METHODS: We reviewed the medical records of patients who had undergone diode laser trans-scleral cyclophotocoagulation (group 1) and Ahmed glaucoma valve implant (group 2) with a follow-up period of 6 months or longer. The treatments were carried out to control high intraocular pressure (IOP) and ocular pain in the patients with visual acuity less than hand motions. RESULTS: Group 2 had a significantly lower IOP during the first postoperative month. The cumulative probability of success was higher in group 2 than group 1 throughout the follow-up period. The postoperative complications in most cases were transient and improved with conservative management in both groups. However, 3 cases in group 1 required evisceration secondary to phthisis. Subjective relief of ocular pain was higher in group 2. CONCLUSIONS: The Ahmed glaucoma valve implant group showed a higher success rate and fewer serious complications than the diode laser trans-scleral cyclophotocoagulation group in patients with high IOP and ocular pain with poor visual acuity. Diode laser trans-scleral cyclophotocoagulation may be considered in patients with poor general health.

Bilateral Spontaneous Dislocation of Intraocular Lenses within the Capsular Bag in a Retinitis Pigmentosa Patient

A 45-year-old man with retinitis pigmentosa (RP), who had undergone uneventful extracapsular cataract extraction (ECCE) in his right eye eight years previously, and phacoemulsification in his left eye six years previously, had spontaneously dislocated intraocular lenses (IOL) within the capsular bag in both eyes one month apart. We removed the dislocated IOLs, and performed anterior vitrectomy and scleral fixation of the new IOLs. Mild contraction of the capsular bags and uneven distribution of the zonular remnants' clumps along the equator of the capsules were found by scanning electron microscopic (SEM) examination. In this study, we propose the correlation between RP and zonular weakness. To our knowledge, this is the first case report of bilateral spontaneous dislocation of IOLs within the capsular bag of an RP patient.