Peripapillary retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness in adult-onset familial Mediterranean fever.

OBJECTIVE: The purpose of the present study was to evaluate the thickness of the peripapillary retinal nerve fiber layer (RNFL) and retinal ganglion cell-inner plexiform layer (GCIPL) in adult-onset familial Mediterranean fever (FMF). METHODS: Forty two adult-onset FMF patients and forty two healthy controls were included in the present study. Detailed ocular examination was performed, and then the thickness of the peripapillary RNFL and GCIPL was measured by Spectral domain optical coherence tomography. The patients were divided into two groups according to their disease severity score, M694V gene mutation, colchicine dosage used per day, colchicine usage time period and number of FMF attacks per year. RESULTS: There were no statistically significant differences in peripapillary RNFL and retinal GCIPL thickness in patients with adult-onset FMF and controls. CONCLUSION: According to our study, it looks like that neither adult-onset FMF nor colchicine has any effect on the RNFL and GCIPL thicknesses. Further studies with a large sample size are needed.

Retinal nerve fiber layer and ganglion cell-inner plexiform layer thickness in children with obesity.

AIM: To evaluate retinal nerve fiber layer (RNFL) thickness analysis of peripapillary optic nerve head (PONH) and macula as well as ganglion cell-inner plexiform layer (GCIPL) thickness in obese children. METHODS: Eighty-five children with obesity and 30 controls were included in the study. The thicknesses of the PONH and macula of each subject's right eye were measured by high-resolution spectral-domain optic coherence tomography (OCT). RESULTS: The RNFL thicknesses of central macular and PONH were similar between the groups (all P>0.05). The GCIPL thickness was also similar between the groups. However, the RNFL thickness of temporal outer macula were 261.7±13.7 and 268.9±14.3 µm for the obesity and the control group, respectively (P=0.034). CONCLUSION: Obesity may cause a reduction in temporal outer macular RNFL thickness.

Duration of the depressive episode is correlated with ganglion cell inner plexifrom layer and nasal retinal fiber layer thicknesses: Optical coherence tomography findings in major depression.

Optical coherence tomography (OCT) is a relatively new, noninvasive imaging technique that has been used increasingly to diagnose and manage a variety of retinal diseases. Since the axons in retinal nerve fiber layer (RNFL) are nonmyelinated within the retina, OCT has been used in various neurodegenerative diseases to visualize the process of neurodegeneration. Decreases in RNFL and ganglion cell inner plexiform layer (GCIPL) thicknesses were observed in patients with schizophrenia. To date, there is no clinical research investigating OCT parameters in patients with MD. We compared the RNFL thickness, GCIPL thickness in 58 MD patients and 57 healthy controls, and investigated their correlation with clinical variables of depression. Depressed patients were not different from the healthy controls with regard to OCT parameters. GCIPL and nasal RNFL were correlated with the duration of the latest depressive episode. Some measures of OCT were negatively associated with clinical variables like a family history of psychiatric diagnosis and the duration of the latest episode. Larger studies including depressed patients of different severity, including structured interviews and controlling for the effect of antidepressant treatment will provide better results.

Peripapillary Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layer Thickness in Children with Familial Mediterranean Fever.

PURPOSE: To evaluate the thickness of the peripapillary retinal nerve fiber layer (RNFL) and retinal ganglion cell-inner plexiform layer (GCIPL) in children with familial Mediterranean fever (FMF). METHODS: The study included 39 FMF patients and 36 healthy controls. After detailed ocular examination, the thickness of the peripapillary RNFL and GCIPL were measured by spectral domain optic coherence tomography (SD-OCT). All measurements were taken from the right eye of the patients and controls. According to their disease severity score (DSS), the patients were divided into two groups: patients with DSS ≤5 and those with DSS >5. RESULTS: There were no statistically significant differences in peripapillary RNFL and retinal GCIPL thickness between patients with FMF and controls. CONCLUSION: It appears that FMF does not affect the RNFL and GCIPL thickness.

Effect of obstructive sleep apnea syndrome on corneal thickness.

Obstructive sleep apnea syndrome (OSAS) might be a risk factor for the development of eye disorders. The aim of the study was to evaluate the effect of OSAS on central corneal thickness (CCT). A total of 195 patients were enrolled in the study, and underwent polysomnography. Patients were divided according to their apnea-hypopnea index (AHI) scores into control group (AHI < 5), mild (AHI, 5-15), moderate (AHI, 15-30), and severe OSAS (AHI > 30) groups. In ophthalmological examinations, CCT, auto refractometer measurement, tear break-up time, and Schrimer's test results were evaluated. Central corneal thickness was significantly decreased in patients with OSAS compared to the control group (542.14 ± 31.21 vs. 569.92 ± 13.46, p < 0.001). As the severity of OSAS increased, CCT decreased (mild OSAS = 567.48 ± 23 mm, moderate OSAS = 530.21 ± 30.2 mm, and severe OSAS = 557.97 ± 16.52 mm, respectively, p < 0.001). The mean values of auto refractometer, tear break-up time, and Schrimer's test were similar between the groups (p > 0.05). CCT was negatively correlated with AHI, oxygen desaturation index, desaturation percentages, and positively correlated with minimum oxygen saturation values (p < 0.05). This study showed that central corneal thickness is inversely correlated with the severity of OSAS. OSAS affects all organ systems particularly cardiovascular and neurological mechanisms. Further studies are warranted to evaluate the effect of OSAS treatment on CCT.

GENETIC ASSOCIATION BETWEEN ARTERIAL STIFFNESS-RELATED GENE POLYMORPHISMS IN BRVO AND CRVO PATIENTS IN A TURKISH POPULATION.

PURPOSE: To investigate possible associations between five different single-nucleotide polymorphisms, from genes associated with arterial stiffness and branch retinal vein occlusion (BRVO), or central retinal vein occlusion. METHODS: A total of 187 patients with retinal vein occlusion (133 with BRVO and 54 with central retinal vein occlusion), and 167 controls, were enrolled in this study. All subjects were screened for hypertension, diabetes, smoking status, body mass index, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, total cholesterol, and very low-density lipoprotein. The genotyping of adiponectin +276 G/T, ACE I/D, AGTR1 A1166C, eNOS E298D, and p22phox -242 C/T polymorphisms was performed using real-time polymerase chain reaction. RESULTS: The percentage of the adiponectin +275 T allele carriers was significantly higher in the BRVO patients (37%) than in the controls (23%, P < 0.001). Similarly, the percentage of AGTR1 1166 C allele carriers was significantly higher in the BRVO patients (38%) than in the controls (24%, P < 0.001). At the multiple logistic regression analysis, the adiponectin +275 T allele carrier and AGTR1 1166 C allele carrier status were found to be associated with an increased risk of BRVO (TT vs. GG and TG: odds ratio = 2.278, P = 0.002, 95% confidence interval: 1.370-3.789; CC vs. AA and AC: odds ratio = 1.804, P = 0.025, 95% confidence interval: 1.079-3.017). The genotype distributions or allelic frequencies of ACE I/D, eNOS E298D, and p22phox -242 C/T did not significantly differ between the patients with BRVO and the control subjects. There was no significant difference between the central retinal vein occlusion patients and controls for the genotype or the allele frequency distributions of all evaluated single-nucleotide polymorphisms. CONCLUSION: Adiponectin +276 G/T and AGTR1 A1166C single-nucleotide polymorphism are likely to be risk factors for BRVO.

Isolated upgaze palsy in a patient with vertebrobasilar artery dolichoectasia; a case report.

PURPOSE: To report isolated upgaze palsy in a patient with a dolichoectatic vertebrobasilar artery. CASE REPORT: We report a 48-year-old man who showed upgaze palsy and convergence insufficiency. The left vertebral artery and basilar artery were shown to be greatly expanded, elongated and tortuous in cranial magnetic resonance imaging (MRI). The vertebrobasilar artery runs along the sulcus basilaris superior to the pontomesencephalic junction. CONCLUSION: A dolichoectatic basilar artery may result in compression of midbrain structures related to vertical gaze.

Central corneal thickness and its relationship to Parkinson's disease severity.

OBJECTIVE: To investigate the effect of Parkinson's disease (PD) on blink rate (BR), tear breakup time test (TBUT), Schirmer's test, and corneal thickness, and the relationship of these effects with disease severity. DESIGN: Prospective controlled study. PARTICIPANTS: Fifty-five eyes from 55 patients with PD and 40 eyes from 40 healthy subjects were analyzed in the study. METHODS: The patients were divided into 2 groups according to their Hoehn-Yahr (H-Y) scores; patients classified as H-Y 1-2 were designated as the mild group, and those classified as H-Y 3-5 were designated as the moderate group. Subjects were screened for BR, TBUT, and Schirmer's test, and the central corneal thickness (CCT) was measured. RESULTS: The BR, Schirmer's test, TBUT, and CCT values of the patient group were significantly lower than those of the control group. The BR and TBUT of the mild group were significantly lower than those of the control group, but the decreases in the Schirmer's test values and CCT were not statistically significant. In addition, significant decreases in the BR, TBUT, Schirmer's test scores, and CCT were observed in the patient group as the H-Y score increased. CONCLUSIONS: A reduced BR and poor tear quality in the early stages of PD, as well as decreased tear production as the disease progresses, can result in reduced CCT. The possibility of a thin cornea should be taken into consideration while measuring the intraocular pressure in patients with severe PD.

VKORC1 C1173T and VKORC1 G-1639A gene polymorphisms in Turkish Behçet's patients with ocular and non-ocular involvement.

BACKGROUND: Behçet's disease (BD) is a multisystemic vasculitis with unknown etiology. Vitamin K epoxide reductase complex subunit 1 (VKORC1) is the key enzyme in the formation of active vitamin K that is a cofactor of various coagulation factors. Polymorphisms of the VKORC1 may affect the levels of active forms of vitamin K-dependent coagulation proteins and the tendency to thrombosis. The current study aimed to evaluate the role of VKORC1 gene polymorphisms in ocular and non-ocular Behçet's disease. METHODS: VKORC1 C1173T (rs 9934438) and G-1639A (rs 9923231) gene polymorphisms were evaluated by real-time polymerase chain reaction-based DNA analysis. The frequency of alleles and distribution of genotypes were assessed by the chi-squared test. Genotype distribution and Hardy-Weinberg equilibrium were tested with the χ(2) test for quality of fit. RESULTS: The distribution of GG, GA and AA and CC, CT, TT genotypes and the frequency of G,A and C,T alleles were not found to be different between patients and controls (p = 0.5651; p = 0.335 respectively), as well as patients with or without eye involvement (p = 0.9267; p = 0.384 respectively). CONCLUSION: VKORC1 polymorphisms seem not to be related with the thrombotic state of systemic and ocular Behçet's disease.

Decreased central corneal thickness in ankylosing spondylitis.

Central corneal thickness and dry eye tests were evaluated in a study population consisting of 68 ankylosing spondylitis patients diagnosed according to the modified New York criteria, and 61 age-matched controls without ankylosing spondylitis. A full ophthalmological evaluation was performed on each subject. All subjects were screened for age, gender, HLA-B27, tear break-up time test, Schirmer test, and duration of disease. Central corneal thickness was measured under topical anesthesia with an ultrasonic pachymeter. The mean central corneal thickness was 537.3 ± 30.6 µm, range 462-600 µm, in ankylosing spondylitis patients, whereas it was 551.7 ± 25.2 µm, range 510-620 µm, in controls (p = 0.005). The Schirmer test result was 7.3 ± 5.9 mm for the ankylosing spondylitis patients and 11.7 ± 5.8 mm for the control group (p = 0.002). Tear break-up time was 7.3 ± 3.2 s for the ankylosing spondylitis patients and 14.0 ± 4.5 s for the control group (p < 0.001). The possibility of a thinner cornea should be taken into consideration in ankylosing spondylitis. In addition, attention must be given to lower dry eye tests in surgical interventions such as photorefractive keratectomy and laser in situ keratomileusis in ankylosing spondylitis patients.

Mapping corneal thickness using dual-scheimpflug imaging at different stages of keratoconus.

PURPOSE: To map the thickness of the entire cornea using dual-Scheimpflug imaging and to evaluate the changes in the corneal thickness over the entire cornea at different stages of keratoconus. METHODS: Corneal pachymetry was performed using the Galilei dual-Scheimpflug analyzer. The thinnest (TCT), central (CCT), paracentral (PaCT), and peripheral corneal thicknesses (PeCT) were also analyzed. The study examined 150 eyes of 150 patients who had myopia or myopic astigmatism and 107 eyes of 75 patients with keratoconus. Of these 107 eyes, 48 were evaluated at stage I keratoconus, 32 at stage II, 12 at stage III, and 15 at stage IV keratoconus. The level of severity of the keratoconus was based on the Amsler-Krumeich classification. RESULTS: There were significant decreases in the thickness values of the entire corneas at all the different stages of progression defined in the Amsler-Krumeich classification. Analysis of the receiver operating characteristic curve showed that the TCT provided a better parameter than did the CCT, PaCT, and PeCT for distinguishing between keratoconus at its different stages and myopic eyes. Although the TCT and CCT parameters provided an effective distinction of eyes with stage II, III, and IV keratoconus from normal eyes, they were not effective for discriminating eyes with stage I keratoconus from eyes with myopia. But, PaCT and PeCT parameters enabled the effective discrimination between eyes with stage IV keratoconus and those with myopia only. CONCLUSIONS: The data obtained by dual-Scheimpflug imaging for the corneal thicknesses of the entire cornea provide useful information for grading the severity of keratoconus.

Increased Expression of Aquaporin-1 and Aquaporin-3 in Pterygium.

PURPOSE: Recent studies have shown that aquaporins (AQPs) play an important role in proliferating tumor microvessels and angiogenesis. In this study, the authors investigated the expression of aquaporin-1 (AQP1) and aquaporin-3 (AQP3) in pterygial and normal conjunctival tissues. METHODS: Fifteen patients with pterygium were enrolled in the study. Pterygium was excised, and a conjunctival rotational flap or autograft was inserted. Normal conjunctival tissue was obtained from the flap or graft. Western blot analysis was performed to assess the expression of AQP1 and AQP3 in pterygial and normal conjunctival tissues. Tissue localization of AQP1 and AQP3 was determined by immunohistochemical analysis. RESULTS: AQP1 and AQP3 are localized in the epithelial and subepithelial regions in pterygial and normal conjunctival tissues. Protein expression of both AQP1 and AQP3 was elevated in pterygia when compared with conjunctival tissues. The significant increase in protein expression of AQP1 was 3-fold in pterygium over normal conjunctiva (P = 0.004) and 2-fold increase in AQP3 expression of pterygium was detected (P = 0.02) according to densitometric analysis. CONCLUSIONS: Elevated protein expression of AQP1 and AQP3 was observed in pterygial tissues when compared with normal conjunctiva. The data suggest that the increased expression of AQP1 and AQP3 in pterygial tissues may be involved in the pathogenesis of pterygia, and therefore, AQP1 and AQP3 are potential therapeutic targets for preventing or delaying the progression of the disease.

Association of MMP2-1306C/T and TIMP2G-418C polymorphisms in retinal vein occlusion.

Matrix metalloproteinases (MMPs) are large groups of zinc-dependent proteases that play an important role in many diseases and pathological processes such as cancer, angiogenesis, atherosclerosis, and vascular disease. Also, it was found that the expression of MMPs was high during the initial period of thrombosis in a rat model of traumatic deep vein thrombosis. Moreover, the presence of metalloproteinase activity and endogenous inhibitor activity in vitrectomy samples are associated with neovascularization of several retinal diseases such as exudative age related maculopathy, proliferative diabetic retinopathy, and central retinal vein occlusion. In this study, we aimed to investigate the possible association of the matrix metalloproteinase 2-1306C/T (rs 243865) and tissue inhibitors of matrix metalloproteinase 2 G-418C (rs 8179090) polymorphisms with the risk of retinal vein occlusion (RVO). Genomic DNA was extracted from peripheral leukocytes from ethylenediaminetetraacetic acid anticoagulated blood. Genotyping of the MMP2-1306C/T and TIMP2G-418C polymorphisms were performed using real-time polymerase chain reaction. The MMP2-1306 T allele carriers (CT + TT) had a significantly increased risk of RVO compared with the CC homozygotes (p < 0.001, odds ratio = 4.78; 95% CI = 2.85-8.09). After adjusting for hypertension, diabetes, hypertriglyceridemia, and hypercholesterolemia, MMP2-1306 T allele carriers (CT + TT) also had a significantly increased risk of RVO (B = 1.453; p < 0.001; odds ratio = 4.275; 95% CI:2.529-7.224). MMP2-1306C/T, but not TIMP2G-418C, gene variants are a risk factor for the development of retinal vein occlusion.

Comparison of normal and keratoconic corneas by Galilei Dual-Scheimpflug Analyzer.

BACKGROUND AND OBJECTIVE: To determine the efficacy of different Galilei Scheimpflug-Analyzer (GSA) parameters in discriminating between keratoconic and myopic eyes. PATIENTS AND METHODS: GSA measurements were obtained for 67 patients (67 eyes) with keratoconus and 151 patients (151 eyes) with myopia or myopic astigmatism. Several parameters, provided by the software or derived from the elevation maps, were evaluated and compared for the two groups. RESULTS: Between the two groups, statistically significant differences were observed for all corneal parameters obtained by GSA (P<0.001) except for the anterior chamber depth (P=0.149). ROC analysis determined that posterior corneal elevation was the best predictive parameter (area under the curve: 0.99). The posterior corneal elevation, at a cut-off value of 18.5µm, had 98.5% sensitivity and 98.3% specificity in discriminating keratoconus from myopic eyes. CONCLUSION: Elevation, pachymetric and keratometric parameters measured by the GSA, as well as the specific predictive GSA software parameters can effectively distinguish advanced keratoconus from myopic corneas. Also, keratoconus that is easily diagnosed by other means can be diagnosed easily by GSA software parameters.

Retinopathy of prematurity in extremely low birth weight infants in Turkey.

PURPOSE: This study was designed to determine the incidence rate of retinopathy of prematurity (ROP) in extremely low birth weight (ELBW) infants in the middle Black Sea region of Turkey. METHODS: The charts of 1,719 preterm infants were reviewed between January 2003 and September 2011. Of them, 225 (13.1%) infants with birth weights of less than 1,000 g were enrolled in the study. ROP was classified according to the international classification of retinopathy. RESULTS: Of the 225 ELBW infants, 47.6% had advanced ROP, 23.1% had mild ROP, and 29.3% did not have ROP; 30.2% infants required treatment. ROP was detected in 75.6% of multiple births versus 69.6% of singleton births; there were no significant differences between the two groups (P = .388). CONCLUSION: Extremely premature infants with low gestational ages had high incidence rates of advanced ROP. Most ELBW infants require ROP treatment. In addition, increased survival of ELBW infants owing to advancements in neonatal care warrants the specialization of ophthalmologists in regard to improved diagnosis and treatment of ROP.

The role of MMP2 (-1306C>T) and TIMP2 (-418 G>C) promoter variants in age-related macular degeneration.

PURPOSE: To investigate the possible association between the matrix metalloproteinase 2 (-1306C>T) (rs 243865) and tissue inhibitors of matrix metalloproteinase 2 (-418 G>C) (rs 8179090) polymorphisms and the risk of age-related macular degeneration. METHODS: This case-controlled prospective study included 144 age-related macular degeneration patients and 172 control subjects. All subjects were screened for age, gender, hypertension (HT), diabetes (DM), and body mass index (BMI). Serum levels of high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), total cholesterol (TC), and smoking were also determined. Genomic DNA was extracted from peripheral leukocytes from ethylenediaminetetraacetic acid anticoagulated blood. Genotyping of the MMP2 (-1306C>T) and TIMP2 (-418 G>C) polymorphisms was performed using real-time polymerase chain reaction. RESULTS: Genotype distributions or allelic frequencies of MMP2 (-1306C>T) and TIMP2 (-418 G>C) did not significantly differ between patients with AMD and control subjects. Similarly, no significant differences in either genotype distributions or allelic frequencies of MMP2 (-1306C>T) and TIMP2 (-418 G>C) were found between dry and wet AMD. CONCLUSION: MMP2 (-1306C>T) and TIMP2 (-418 G>C) promoter variants are unlikely to have a major role in age-related macular degeneration risk susceptibility.

Association of paraoxonase 1 L55M and Q192R single-nucleotide polymorphisms with age-related macular degeneration.

PURPOSE: To determine if paraoxonase 1 (PON1) gene polymorphisms have an effect on the risk of having age-related macular degeneration (AMD). METHODS: The study population consisted of 142 patients who were diagnosed with either exudative or atrophic AMD and 138 sex- and age-matched controls without AMD. Genotyping of the PON1 L55M and Q192R single-nucleotide polymorphisms was performed using real-time polymerase chain reaction and commercially produced kits. A full ophthalmic evaluation was performed in each subject, and all subjects were screened for hypertension, diabetes, hypercholesterolemia, and smoking history. RESULTS: The PON1 MM and QQ genotypes were less frequent in patients with AMD than in control subjects (MM: 4 vs. 13%, P = 0.015; QQ: 15 vs. 27%, P = 0.020). A multivariate logistic regression analysis was also conducted. After adjusting for age, gender, and the prevalence of smoking, hypertension, diabetes, and hypercholesterolemia, the MM and QQ genotypes (MM/QQ vs. LL + LM/QR + RR) were found to be associated with a decreased risk of AMD (MM: odds ratio = 0.24, P = 0.007, 95% confidence interval: 0.09-0.68; QQ: odds ratio = 0.46, P = 0.013, 95% confidence interval: 0.25-0.85). CONCLUSION: The authors found that subjects with the PON1 MM and QQ genotypes had a lower risk of AMD.

Protective effect of paraoxonase 1 gene variant L55M in retinal vein occlusion.

PURPOSE: To determine if the paraoxonase 1 L55M and paraoxonase 1 Q192R gene polymorphisms have an effect on the risk of having a retinal vein occlusion (RVO). METHODS: This case-control prospective study included 120 patients with RVO and 84 control subjects. All subjects were screened for age, gender, hypertension, diabetes, body mass index, fibrinogen, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, total cholesterol, and very low-density lipoprotein. Subjects were also questioned about their smoking habits. Genomic DNA was extracted from peripheral leukocytes from EDTA anticoagulated blood. Genotyping of the paraoxonase 1 L55M and paraoxonase 1 Q192R polymorphisms was performed using real-time PCR. RESULTS: The frequency of the paraoxonase 1 (PON1) 55 LL genotype was significantly lower in patients with RVO than in the control subjects (28% versus 55%; p = 0.005). Logistic regression analyses were also conducted. After adjusting for gender, diabetes, hypertension, plasma fibrinogen levels, and high-density lipoprotein cholesterol, the lower LL genotype was found to be an independent predictor of RVO (ß = 1.755; odds ratio = 5.783; p < 0.001; 95% confidence interval = 2.579-12.967). CONCLUSIONS: Subjects with a lower frequency PON1 55 LL genotype had a higher risk of RVO. These results indicate that paraoxonase gene polymorphisms may be a possible risk factor for RVO. We suggest that the LL genotype may have a protective role in the pathogenesis of RVO in the Turkish population.

Age-related changes of aquaporin expression patterns in the postnatal rat retina.

Previous studies revealed that the rat retina contains numerous membrane-located water channels, the aquaporins (AQPs). Protein expression patterns of AQP1-4, 6 and 9 were examined by immunohistochemistry. In the present study, we investigated the immunolocalization of AQP1-4, 6 and 9 during postnatal development in the rat retina and examined the effect of age on the tissue distribution of these channels. AQP1, 3, 4, 6 and 9 showed gradually increased expression in rat retinas from postnatal week 1 to week 12, and decreased in the 40-week-old rat retinas. AQP2 expression was barely seen in the first week in rat retinas and displayed a significant increase from week 1 to week 4, however no significant alteration of AQP2 was observed after 4weeks of development. AQP1 and 4 immunoreactivities were present in the inner limiting membrane (ILM), the ganglion cell layer (GCL), inner nuclear layer (INL) and retinal pigment epithelium (RPE) in the 4-, 12- and 40-week-old rat retinas. The RPE, OLM and ILM showed a remarkable expression of AQP1-4, 6 and 9 in the 4, 12 and 40-week-old rat retinas. The reduced expression of AQPs in aged rat retinas may indicate the involvement of AQPs in the pathogenesis of age-related retinal diseases.