Assessment of pupillary autonomic functions by dynamic pupillometry in different circadian arterial blood pressure patterns.

OBJECTIVE: The aim of the present cross-sectional study was to evaluate the autonomic nervous system by dynamic pupillometry (DP) in normotensive and hypertensive individuals with either a non-dipper-type or a dipper-type circadian rhythm of blood pressure (BP). PATIENTS AND METHODS: A total of 80 patients were allocated into four groups: normotensive/dipper (n=23), normotensive/nondipper (n=19), hypertensive/dipper (n=18), and hypertensive/nondipper (n=20). Pupil diameters (R0, R1, R2, and R%): latency (Lc), amplitude (Ac), velocity (Vc), and duration (Tc) of pupil contraction: latency (Ld), velocity (Vd), and duration (Td) of pupil dilatation were measured by DP. Among the DP parameters, Vc and Ac were known parasympathetic indices and R% was the major sympathetic index. RESULTS: Vc and Ac were higher in the dipper normotensives with respect to nondipper normotensives (Vc=5.19±0.85 vs. 4.58±0.71, P=0.017; Ac=1.66±0.27 vs. 1.49±0.28, P=0.048). Vc and Ac were higher in dipper hypertensives with respect to the nondipper subgroup of hypertensive cases (Vc=4.44±0.81 vs. 3.94±0.45, P=0.024; Ac=1.47±0.26 vs. 1.27±0.11, P=0.004). R% was higher in the nondipper subgroup of hypertensives than the dipper subgroup of hypertensive cases (36.7±4.8 vs. 33.5±3.8, P=0.033). Correlation analyses showed moderate positive correlations of night-time decline in BP with Vc (r=0.460, P=0.001) and Ac (r=0.420, P=0.001). There was also a negative correlation between night-time decline in BP and R% (r=-0.259, P=0.001). CONCLUSION: Nondipping in BP is associated with lower parasympathetic activity both in normotensive and in hypertensives cases. Furthermore, in the nondipper subgroup of hypertensive cases, there is higher sympathetic activity than the dipper subgroup.

Plasma coenzyme Q10 levels in type 2 diabetic patients with retinopathy.

AIM: To determine the relationship between proliferative diabetic retinopathy (PDRP) and plasma coenzyme Q10(CoQ10) concentration. METHODS: Patients with type 2 diabetes and PDRP were determined to be the case group (n=50). The control group was consist of healthy individuals (n=50). Plasma CoQ10 and malondialdehyde (MDA) levels were measured in both groups. RESULTS: Ubiquinone-10 (Coenzyme Q10) levels in PDRP and control subjects are 3.81±1.19µmol/L and 1.91±0.62µmol/L, respectively. Plasma MDA levels in PDRP and control subjects were 8.16±2µmol/L and 3.44±2.08µmol/L, respectively. Ratio of Ubiquinol-10/ubiquinone-10 in PDRP and control subjects were 0.26±0.16 and 1.41±0.68, respectively. CONCLUSION: The ratio of ubiquinol-10/ubiquinone-10 is found lower in patients with PDRP. High levels of plasma ubiquinol-10/ubiquinone-10 ratio indicate the protective effect on diabetic retinopathy.

Retinal nerve fiber layer thickness analysis in suspected malingerers with optic disc temporal pallor.

PURPOSE: To investigate the value of temporal retinal nerve fiber layer (RNFL(temporal)) thickness in the prediction of malingering. MATERIALS AND METHODS: This prospective, cross-sectional study was conducted on 33 military conscripts with optic disc temporal pallor (ODTP) and 33 age-and sex-matched healthy controls. Initial visual acuity (VA(i)) and visual acuity after simulation examination techniques (VA(aset)) were assessed. The subjects whose VA(aset) were two or more lines higher than VA(i) were determined as malingerers. Thickness of the peripapillary RNFL was determined with OCT (Stratus OCT, Carl Zeiss Meditec, Inc.). RNFL(temporal) thickness of the subjects were categorized into one of the 1+ to 4+ groups according to 50% confidence interval (CI), 25% CI and 5% CI values which were assessed in the control group. The VAs were converted to LogMAR-VAs for statistical comparisons. RESULTS: A significant difference was found only in the temporal quadrant of RNFL thickness in subjects with ODTP (P =0.002). Mean LogMAR-VA increased significantly after SETs ( P temporal thickness in diagnosing malingering were 84.6%, 75.0%, 68.8%, 88.2%, respectively. ROC curve showed that RNFL(temporal) thickness of 67.5 microm is a significant cut-off point in determining malingering (P =0.001, area under the curve:0.862). The correlations between LogMAR-VAs and RNFL(temporal) thicknesses were significant; the correlation coefficient for LogMAR-VA(i) was lower than the correlation for LogMAR-VA(aset) (r=-0.447, P =0.009 for LogMAR-VA(i); r=-0.676, P<0.001 for LogMAR-VA(aset)). CONCLUSIONS: RNFL(temporal) thickness assessment may be a valuable tool in determining malingering in subjects with ODTP objectively.