Neuroprotective effects of topical coenzyme Q10 + vitamin E in mechanic optic nerve injury model.

PURPOSE: We aimed to create mechanic optic nerve injury model in rats and investigate the neuroprotective effects of topical Coenzyme Q10 + Vitamin E (CoQ + Vit.E) molecules on retinal ganglion cells. METHODS: Mechanic optic nerve injury model was created in the right eyes of rats (n = 12). Rats were divided into two groups: glaucoma model with sham treatment and topical CoQ + Vit.E treatment. Treatment was applied for 4 weeks. Glial fibrillary acidic protein, Brn-3a antibody, and anti-Iba1 were examined by immunohistochemistry. Glial fibrillary acidic protein, Bax, Bcl-xL, and Tfam protein expression were measured by Western blot analysis. RESULTS: The number of Brn-3a-positive retinal ganglion cell was 15.0 ± 1.0 (min: 14, max: 16) in sham treatment group and 22.2 ± 4.8 (min: 18, max: 29) in topical CoQ10 + Vit.E treatment group. The protection of Brn-3a in CoQ10 + Vit.E was statistically significant (p < 0.05). Glial fibrillary acidic protein-positive astroglial counts were recorded as 11.7 ± 2.1 (min: 10, max: 14) in sham treatment and 2.5 ± 1.5 (min: 1, max: 4) in topical CoQ10 + Vit.E treatment group (p < 0.05). Topical CoQ10 + Vit.E treatment also decreased Iba1 expression in the retina of mechanic optic nerve injury groups. CoQ10 + Vit.E treatment prevented apoptotic cell death by increasing Bcl-xL protein expression. Also, CoQ10 + Vit.E preserved Tfam protein expression in the retina. CONCLUSION: This study has shown that in glaucoma treatment the neuron protecting effect of topical CoQ10 + Vit.E molecules can be valuable.

Optic Nerve Parameters in Obese Children as Measured by Spectral Domain Optical Coherence Tomography.

PURPOSE: To investigate whether an association exists between obesity and optic nerve parameters. METHODS: This was a prospective comparative study including 125 eyes of 63 obese and 122 eyes of 62 healthy pediatric subjects. Optic nerve measurements were performed using the Cirrus spectral domain optical coherence tomograph (SD-OCT). RESULTS: The disc area, cup volume, mean and vertical C/D ratio, inferior and temporal RNFL thickness values were significantly higher in the control group than the obese group; however, age, sex, mean, superior and nasal RNFL thickness and rim area measurements were not statistically significantly different between the two groups. Age was significantly negatively correlated with temporal RNFL thickness in the obese group. Girls had significantly higher rim area, mean and superior RNFL thickness, and lower cup volume and vertical C/D ratio than boys in the obese group. CONCLUSION: These results could be helpful in the diagnosis and follow-up of obese children.

Combined non-penetrating deep sclerectomy with phacoemulsification versus non-penetrating deep sclerectomy alone.

PURPOSE: To compare the results of combined non-penetrating deep sclerectomy with phacoemulsification (Phaco-NPDS) to those of non-penetrating deep sclerectomy (NPDS) alone. MATERIALS AND METHODS: Fifty-two eyes with cataract and primary open angle glaucoma (POAG) or pseudoexfoliative glaucoma (PXG) were randomly assigned to either Phaco-NPDS or NPDS. Follow-up was performed at regular intervals for up to 36 months. Complete success was defined as intraocular pressure (IOP) <21 mmHg without medication and qualified success was defined as IOP <21 mmHg with medication. RESULTS: Mean IOP in the Phaco-NPDS group decreased from 23.0 ± 7.8 mmHg to 14.1 ± 2.8 mmHg and in the NPDS group from 23.5 ± 5.1 to 14.6 ± 2.2 mmHg 24 months after surgery. The decreases of IOP in the postoperative period were statistically significant in both groups (p < 0.05). There was no significant IOP difference between Phaco-NPDS and NPDS patients postoperatively (p > 0.05). The mean number of glaucoma medications decreased from 1.8 ± 1.3 to 0.15 ± 0.4 and from 1.7 ± 1.4 to 0.22 ± 0.6 in the Phaco-NPDS and NPDS groups, respectively. The decreases in the mean number of the anti-glaucoma medications at the end of the postoperative, 24-month follow-up period were found to be statistically significant for both Phaco-NPDS and NPDS groups (p < 0.05). Mean BCVA increased significantly in both groups. However, the visual outcome was significantly better for the Phaco-NPDS group (p < 0.05). The complete and qualified success rates were 65.3% and 88.4% for Phaco-NPDS patients and 73.1% and 92.3% for NPDS patients, respectively (p > 0.05). CONCLUSION: Phaco-NPDS surgery achieved excellent IOP control, while also providing immediate visual recovery. The success rate was similar to that of the NPDS procedure alone. It is advisable to consider Phaco-NPDS as a primary surgery for patients with coexisting cataract and open angle glaucoma, including PXG.

Retrieval of a mispositioned Ex-PRESS glaucoma device.

The purpose of this article was to report the misposition and subsequent retrieval of an Ex-PRESS (Optonol Ltd., Neve Ilan, Israel) glaucoma drainage device implanted in an eye with pseudoexfoliative glaucoma. The formation of excessive fibrosis at the site of the implant, which was partly dislocated into the anterior chamber, was observed. The Ex-PRESS drainage device was removed from the anterior chamber and the intraocular pressure was relieved through trabeculectomy at the superotemporal part of the globe. The results suggest that trabeculectomy is a practical approach to alleviate intraocular pressure in the case of failed glaucoma drainage devices.

Plasma homocysteine levels and vitamin B status in patients with Pseudoexfoliation syndrome.

OBJECTIVE: To determine and compare the plasma levels of homocysteine and vitamin B (B6, B12 and folate) in patients with Pseudoexfoliation syndrome (PEXS), pseudoexfoliation glaucoma (PEXG), retinal vein occlusion with pseudoexfoliation (PEX+RVO) and in normal individuals. METHODS: The current study was conducted in the Third Eye Clinic, Ankara Numune Training and Research Hospital, Turkey, between August 2004 and February 2005. Twenty cases with PEXS (Group 1), 20 cases with PEXG (Group 2), 16 cases with PEX+RVO (central or branch retinal vein occlusion) (Group 3) and 20 normal individuals (control group) were included in the study. Those who use vitamin supplements or drugs affecting the plasma homocysteine levels were excluded from the study. RESULTS: Plasma homocysteine levels were 17.6+/-4.4 mmol/l in Group 1, 18.5+/-4.5 mmol/l in Group 2, 22.2+/-6.0 mmol/l in Group 3, and 14.0+/-3.1 mmol/l in the control group. It was highest in Group 3 (p<0.001). The ratio of hyperhomocysteinemia was calculated as 35% (Group 1), 45% (Group 2), 68.7% (Groups 3) and 15% (control). These values were statistically higher in the groups with PEXS than in the control group (p=0.009). We did not find any statistically significant difference between the groups with respect to the levels of vitamin B6 and B12 (p>0.05), but the level of folate was lowest in Group 3 (p<0.001). CONCLUSION: Hyperhomocysteinemia is a risk factor for thromboembolic vasculopathy in patients with PEXS and PEXG. Therefore, vitamin B supplementation should be considered in these patients when hyperhomocysteinemia is detected.

Causes of uveitis in a referral hospital in Ankara, Turkey.

PURPOSE: To evaluate the etiology of uveitis and its associated systemic findings in a referral hospital in Ankara, Turkey. MATERIALS AND METHODS: Clinical records of patients in our uveitis department were reviewed retrospectively and 419 eyes of 300 consecutive patients were included in the study. Cases of uveitis due to postoperative endophthalmitis, perforating injuries, and foreign bodies were excluded from the study. The data, including sex, age, clinical presentation, disease course and outcome, ocular involvement, etiology, and associated systemic findings, were entered into a computer database. Pearson chi-square statistical analysis was performed to analyze the data whenever necessary. RESULTS: The study subjects consisted of 162 males and 138 females, with a female to male ratio of 1:1.17 and an average age of 35.7 years. Anterior uveitis was the most common form of uveitis with 43.6%, followed by posterior uveitis (26.6%), panuveitis (20.6%), and intermediate uveitis (9%). Idiopathic uveitis (28.3%) was the most frequent cause of uveitis diagnosed, followed by Behçet's disease (26%) and rheumatic diseases (9%). In 215 (71.7%) out of 300 patients, a specific cause of uveitis with associated systemic findings was identified. Uveitis was attributed to an infectious etiology in only 41 patients (13.6%) of the entire study population. COMMENTS: The etiology of uveitis and its associated systemic findings may vary depending on the geographic distribution of patients and local factors. These results represent those of patients with uveitis referred to hospitals in central Anatolia.