Exploring the Novel Dimension of Immune Interactions in Pain: JAK Inhibitors' Pleiotropic Potential.

This review explores the link between immune interactions and chronic pain, offering new perspectives on treatment. It focuses on Janus kinase (JAK) inhibitors' potential in pain management. Immune cells' communication with neurons shapes neuroinflammatory responses, and JAK inhibitors' effects on pain pathways are discussed, including cytokine suppression and microglial modulation. This review integrates studies from rheumatoid arthritis (RA) pain and central sensitization to highlight connections between immune interactions and pain. Studies on RA joint pain reveal the shift from cytokines to sensitization. Neurobiological investigations into central sensitization uncover shared pathways in chronic pain. Clinical evidence supports JAK inhibitors' efficacy on pain-related outcomes and their effects on neurons and immune cells. Challenges and future directions are outlined, including interdisciplinary collaboration and dosing optimization. Overall, this review highlights JAK inhibitors' potential to target immune-mediated pain pathways, underscoring the need for more research on immune-pain connections.

Trabeculectomy with ExPress - an effective solution to Posner-Schlossman syndrome.

Posner-Schlossman syndrome (PSS) is a unilateral ocular disease, characterized by recurrent non-granulomatous anterior uveitis and increased intraocular pressure (IOP), leading to chronic secondary glaucoma.

Relationship between visual field changes and optical coherence tomography measurements in advanced open-angle glaucoma.

AIM: To assess relationships between functional changes in visual field and structural changes in advanced open-angle glaucoma (OAG) found using spectral-domain optical coherence tomography (SD-OCT). METHODS: Thirty-one eyes of 25 patients with OAG were included in this study. Besides the routine ophthalmological exam the patients underwent standard automated perimetry (SAP) (Humphrey Field Analyzer) and SD-OCT (RTVue-100) performed within 6 months. The global perimetric indices in the study group were as follows: mean deviation (MD) 12.33±6.18 dB and pattern standard deviation (PSD) 9.17±3.41 dB. The relationship between OCT measurements and MD and PSD was evaluated by correlation analysis (Pearson's correlation coefficient) and regression analysis (linear and nonlinear regression models). RESULTS: Thickness measurements of the lower halves of ganglion cell complex (GCC) and retinal nerve fiber layer by two scanning protocols (ONH and 3.45) showed these to be thinner than the upper halves, but the difference failed to reach statistical significance. The correlations between global indices MD/PSD and most of the analysed quantitative OCT measurements were moderate (r in the range between 0.3 and 0.6). The correlation between MD and GCC showed nonlinear cubic regression (R2=0.417, P=0.004). Good correlation was found between MD and GLV (R2=0.383; P=0.008). Linear regression (P<0.05) was found only between MD and Cup area (R2=0.175, P=0.024) and between MD and RNFL by 3.45 protocol (R2=0.131, P=0.045). CONCLUSION: Nonlinear regressive models appear to be more appropriate in the assessment of the correlations between functional and structural changes in eyes with advanced glaucoma. The correlations we found were moderate.

Surgical treatment of glaucomas by trabeculectomy--indications and early results.

AIM: To evaluate the indications for surgical treatment of glaucomas, the stage of the disease in which it was performed, and the intraoperative and early postoperative complications. PATIENTS AND METHODS: We studied retrospectively 106 eyes of 106 consecutive patients who received trabeculectomy for refractory glaucoma between 2001 and 2007. RESULTS: Sixty-three (59.4%) of the patients had had the disease for at least two years before it was detected. The majority of the patients were in advanced stage of the disease with their intraocular pressures exceeding 25 mm Hg. The most common intraoperative complications were hyphaema--9 patients (8.5%), flat anterior chamber--7 patients (6.6%), vitreous loss--1 (0.9%), phacodonesis--1 (0.9%). The early postoperative complications included hyphaema--8 patients (7.5%), flat anterior chamber--24 (22.6%), choroidal effusion--16 (15.1%), leakage--2 (1.9%), striate keratitis--3 (2.8 %), posterior synechia--2 (1.9%), hypotony--15 (14.2%), high IOP--4 (3.8%). These results are consistent with those reported elsewhere for similar groups of patients. CONCLUSIONS: The postoperative complication rate can be lowered significantly if the indications for surgery, the type and stage of glaucoma are accurately assessed and the technique of trabeculectomy is well mastered. Trabeculectomy is a reliable alternative to unsuccessful medical or laser treatment.

Central corneal thickness measurements in ocular hypertension, primary open angle glaucoma, glaucoma suspects and control subjects.

PURPOSE: To compare central corneal thickness (CCT) in patients with ocular hypertension (OH), primary open-angle glaucoma (POAG), glaucoma suspects and control subjects and to determine if there is a correlation between CCT and age. DESIGN: Prospective study. PATIENTS AND METHODS: CCT was evaluated in 50 eyes of 25 OH patients (mean age 52.4 +/- 1.6 yrs, x +/- Sx) who were allocated into group 1, in 26 eyes of 13 glaucoma patients (mean age 64.1 +/- 1.0 yrs)--group 2, 46 eyes of 23 glaucoma suspects (mean age 60.1 +/- 1.3 yrs)--group 3, and 144 eyes of 72 control subjects (mean age 61.4 +/- 0.9 yrs)--group 4. CCT was measured using an ultrasonic pachymeter (Pach IV, Accutome). RESULTS: The OH patients had a mean CCT of 582.88 +/- 5.51 microm. The mean CCT for the glaucoma patients was 552.38 +/- 5.90 microm, for the glaucoma suspects--551.04 +/- 4.23 microm and for the controls--549.47 +/- 3.07 microm. There was significant difference in age between group 1 and group 2 patients (P = 0.007) and between group 1 and group 4 patients (P = 0.001). CCT in the eyes with OH was significantly greater than that in POAG eyes (P = 0.003), in glaucoma suspects eyes (P < 0.001) and in control eyes (P < 0.001) (ANOVA, with Bonferroni correction). CONCLUSIONS: The comparative evaluation of CCT in patients with OH, POAG, glaucoma suspects and controls shows that CCT is the thickest in patients with OH. There is a correlation between CCT and age--younger patients possess thicker corneas. Our results suggest that CCT should be taken into account when assessing the risk for the development of glaucoma in OH patients.

Central corneal thickness in patients with normal-tension glaucoma.

PURPOSE: To compare the central corneal thickness of eyes with proved normal-tension glaucoma with that of eyes without glaucoma. DESIGN: A prospective study. METHODS: The study included 30 consecutive patients with normal-tension glaucoma (60 eyes, group I), and 30 age- and gender-matched non-glaucoma patients (60 eyes, group II). Central corneal thickness was measured using an ultrasonic pachymeter (Pach IV, Accutome). The mean central corneal thickness of normal-tension glaucoma patients and controls were compared using independent samples t-test. RESULTS: The mean (+/- SD) central corneal thickness of normal-tension glaucoma and non-glaucoma patients was 517.4 +/- 19.2 microm and 549.0 +/- 39.4 microm, respectively. There was a significant difference in this parameter between the groups (P < 0.001). The mean intraocular pressure was higher in glaucomatous eyes (17.1 +/- 2.3 vs. 16.3 +/- 1.4 mm Hg, P = 0.028). The visual acuity in normal-tension glaucoma eyes was lower than that in controls, but the difference failed to reach statistical significance (P = 0.069). CONCLUSIONS: The results indicate that corneas of patients with normal-tension glaucoma are thinner than those of non-glaucoma patients.

Reproducibility and agreement between three methods of intraocular pressure measurement.

OBJECTIVE: The aim of the present study was to establish reproducibility between consecutive intraocular pressure measurements using the same method of tonometry as well as to assess agreement between 3 different methods of tonometry. MATERIALS AND METHODS: The study included 55 patients. Intraocular pressure of 94 eyes was measured, using Goldman applanation tonometry, Maklakoff applanation tonometry and indentation tonometry according to Schioetz method. The mean values and the differences in intraocular pressure measurements were calculated (using Bland and Altman method) in order to assess agreement between Goldman and Maklakoff applanation tonometry and Goldman and Schioetz tonometry. Reproducibility of the methods was assessed based on three consecutive intraocular pressure measurements on three groups of 20 eyes at 5-minute intervals. RESULTS: The mean intraocular pressure (Po) measured by Goldman method was 23.26 +/- 0.78 mmHg, the mean pressure estimates (Po) according to Maklakoff method were 19.4 +/- 0.64 mmHg and it (Po) was 21.18 +/- 0.74 mmHg using Schioetz tonometry. The correlation (Pearson) between Goldman Po and Maklakoff Po was 0.74 and between Goldman and Schioetz Po - 0.93. Mean differences were 4.12 +/- 0.53 and 2.08 +/- 0.3 mmHg respectively. Variation coefficients between consecutive measurements were: for Goldman tonometry - 2.00%, for Maklakoff - 7.90% and for Schioetz - 5.72%. CONCLUSIONS: According to Bland and Altman method there is low agreement between intraocular pressure estimates obtained by Goldman and Maklakoff tonometry, i.e. these methods are not interchangeable. This fact might be explained by the high variation coefficient of Maklakoff method. The low variation coefficient of Goldman tonometry makes it the most accurate of the three methods.