Serum Cystatin C Concentrations in Patients with Graves' Ophthalmopathy.

PURPOSE: To evaluate the concentration of serum cystatin C (CysC) in patients with Graves' ophthalmopathy (GO) and the usability of the serum CysC concentrations in the follow-up of the disease. METHODS: Thirty patients with GO and 30 healthy age-matched volunteers were included in this cross-sectional study. GO was diagnosed based on the European Group on Graves' Orbitopathy consensus. Serum thyroid-stimulating hormone, free triiodothyronine, free thyroxine, and CysC concentrations were measured in the participants. The serum CysC concentrations were compared between patients with GO and controls. Patients with GO were subdivided into hyperthyroid and euthyroid patients, and their serum CysC concentrations were compared. In addition, the CysC concentrations in hyperthyroid and euthyroid patients with GO were compared separately with those of healthy subjects. Kruskal-Wallis test and Student's t-test were used for statistical evaluation. RESULTS: The mean serum CysC concentrations in GO patients and controls were 1.04 ± 0.36 and 0.74 ± 0.09 mg/L, respectively. There was a statistically significant difference in the serum CysC concentrations between patients with GO and control subjects (p < 0.001). Fifteen patients had hyperthyroid status, and 15 patients had euthyroid status. The mean serum CysC concentrations in hyperthyroid and euthyroid patients with GO were 1.35 ± 0.22 and 0.72 ± 0.13 mg/L, respectively. Serum CysC concentrations were significantly higher in hyperthyroid patients than in euthyroid patients (p = 0.001). In addition, hyperthyroid patients had significantly higher serum CysC concentrations than healthy subjects. Among patients with GO, 21 and nine had mild and moderate-to-severe GO, respectively. Active and inactive GO were observed in eight and 22 patients, respectively. CONCLUSIONS: The serum CysC concentrations in hyperthyroid patients were higher than those in healthy subjects. Moreover, hyperthyroid patients had higher serum CysC concentrations than euthyroid patients. Further studies with a larger sample size are needed to confirm these results.

Evaluation of Central Macula, Retinal Nerve Fiber Layer, and Ganglion Cell Complex Thickness in Congenital Color Vision Deficiency.

OBJECTIVES: This study was designed to evaluate the thickness of the central macula, the retinal nerve fiber layer (RNFL), and the ganglion cell complex (GCC) in individuals with congenital red-green color vision deficiency (CVD) using spectral-domain optical coherence tomography (SD-OCT). METHODS: This study included 22 males with a red-green CVD (Group 1) and 22 males with normal color vision (Group 2). The Ishihara test was used to determine CVD. SD-OCT was used to evaluate the central macula, RNFL, and GCC measurements of all of the study participants. The quantitative data of the 2 groups were compared. The Kruskal-Wallis test was used for the statistical analysis and a p value <0.05 was considered significant. RESULTS: The mean central macula thickness observed in Group 1 and 2 was 255.00±25.50 µm and 248.95±24.70 µm, respectively. The mean RNFL thickness of Group 1 and 2 was 110.66±14.70 µm and 109.49±9.90 µm, respectively, and the mean GCC thickness of Group 1 and 2 was 97.70±10.80 µm and 97.56±5.10 µm, respectively. There were no significant differences between the groups in the assessment of the central macula, RNFL, or GCC thickness (p=0.20, p=0.34, p=0.37). CONCLUSION: The results of this study suggested that congenital red-green CVD does not affect the thickness of the central macula, RNFL, or GCC. To the best of our knowledge, this is the first study to evaluate the thickness of the GCC in individuals with congenital red-green CVD.

Neuroprotective and antioxidant effects of ghrelin in an experimental glaucoma model.

Damage to retinal ganglion cells due to elevation of intraocular pressure (IOP) is responsible for vision loss in glaucoma. Given that loss of these cells is irreversible, neuroprotection is crucial in the treatment of glaucoma. In this study, we investigated the possible antioxidant and neuroprotective effects of ghrelin on the retina in an experimental glaucoma model. Twenty-one Sprague-Dawley rats were randomly assigned to three groups comprising seven rats each. The rats in the control group were not operated on and did not receive any treatment. In all rats in the other groups, IOP was increased by cauterization of the limbal veins. After creation of the IOP increase, saline 1 mL/kg or ghrelin 40 µg/kg was administered intraperitoneally every day for 14 days in the vehicle control group and ghrelin groups, respectively. On day 14 of the study, the eyes were enucleated. Levels of malondialdehyde (MDA), nitric oxide (NO), and nitric oxide synthase-2 (NOS2) in anterior chamber fluid were measured. The retinas were subjected to immunohistochemistry staining for glial fibrillary acidic protein (GFAP), S-100, and vimentin expression. Mean levels of MDA, NO, and NOS2 in the aqueous humor were higher in the vehicle control group than in the control group (P<0.05). Mean levels of MDA, NO, and NOS2 in the ghrelin group did not show a significant increase compared with levels in the control group (P>0.05). Retinal TUNEL and immunohistochemistry staining in the vehicle control group showed an increase in apoptosis and expression of GFAP, S-100, and vimentin compared with the control group (P<0.05). In the ghrelin group, apoptosis and expression of GFAP, S-100, and vimentin was significantly lower than in the vehicle control group (P<0.05). This study suggests that ghrelin has antioxidant and neuroprotective effects on the retina in an experimental glaucoma model.

Impact of trastuzumab on wound healing in experimental glaucoma surgery.

BACKGROUND: To investigate the effects of subconjunctivally administered trastuzumab on wound healing in experimental glaucoma filtration surgery. DESIGN: Comparative, experimental study. SAMPLES: Twenty eight eyes. METHODS: Twenty-eight male New Zealand white rabbits were randomly assigned to four groups, each including seven rabbits: The rabbits in the control group were not operated on and did not receive any treatment. The rabbits in the sham group underwent trabeculectomy and had one drop of saline instilled four times a day for 14 days. The rabbits in the mitomycin-C group underwent trabeculectomy, and a sponge soaked in 0.4 mg/mL mitomycin-C was applied intraoperatively to the scleral surgical site for 3 min. The rabbits in the trastuzumab group underwent trabeculectomy and were injected subconjunctivally once with 1.2 mg/0.1 mL of the drug. On day 14 of the experiment, the operated and control eyes were enucleated and immunohistochemically analyzed. MAIN OUTCOME MEASURES: Mean values of fibroblast, mononuclear cell and immunostaining intensities of the transforming growth factor-ß, fibroblast growth factor-ß, and platelet derived growth factor. RESULTS: The mean cell numbers and immunostaining intensities in the sham group were higher than those of the control group (P < 0.01). The mean cell numbers and immunostaining intensities in the mitomycin-C group and trastuzumab group were statistically significantly lower than those of the sham group (P < 0.01) while mean cell numbers and immunostaining intensities in the mitomycin-C group and trastuzumab group were similar (P > 0.05). CONCLUSION: Subconjunctival trastuzumab injection effectively suppressed subconjunctival scarring after experimental glaucoma filtration surgery.