Effectiveness of Topical Cyclosporin-A 0.1% Compared to Combined Topical Cyclosporin-A 0.1% with Topical Sodium Hyaluronate on Interleukin-6 Levels in the Tears of Patients with Dry Eye Disease.

INTRODUCTION: Pro-inflammatory cytokines are important contributors to dry eye disease (DED). The cytokine interleukin (IL)-6 has become a therapeutic target in several DED drug studies. This randomized controlled trial aimed to determine the effectiveness of topical cyclosporin-A 0.1% compared to the combination of topical cyclosporin-A 0.1% and sodium hyaluronate in reducing tear IL-6 levels in DED patients. METHODS: The participants were 20 patients, each with two eyes, who had moderate-to-severe DED. Before and after treatment, the clinical degree of DED was examined in each group, using ocular surface disease index (OSDI) scores, tear break-up time (TBUT), fluorescent tests, and Schirmer I tests. In addition, tear samples were taken to examine IL-6 levels through the ELISA method. The results were analyzed using the t-test, Wilcoxon test, and Mann-Whitney test. The correlation between tear IL-6 levels and the severity of DED was analyzed using the Spearman correlation test. RESULTS: The study showed a significantly lower tear IL-6 level, OSDI score, and degree of ocular staining after either topical cyclosporin-A 0.1% or a combination of topical cyclosporin-A 0.1% and sodium hyaluronate (all values p < 0.05). CONCLUSIONS: The combination therapy was superior in reducing tear IL-6 levels. In addition, a correlation existed between tear IL-6 levels and the severity of DED based on the TBUT, although it was weak and not statistically significant.

Human Ocular Thelaziasis: A Case Report from Indonesia.

Thelaziasis is a parasitic disease caused by a nematode of genus Thelazia, which is rare in the world, including Indonesia. The definitive hosts for Thelazia are canids, felids, mustelids, and other mammals, while the vector is drosophila flies. Consequently, this study reported an uncommon occurrence of human ocular thelaziasis in Indonesia. Based on the patient's complaints and physical examination, we found a living worm that move actively in the anterior chamber; then documentation is carried out both during the examination at the polyclinic and in the operating room. The surgery was performed using topical anaesthesia, clear corneal incision, and removing worm through the main port. Morphological examination from the parasitology laboratory showed that the worm was Thelazia callipaeda species. Following this intervention, the patient was given an oral anti-helminthics drug, topical and oral antibiotics, topical steroid, and surgical treatment. There was no recurrence or appearance of any other symptoms reported in 2 months of follow-up.

Choroidal Thickness in Correlation with Axial Length and Myopia Degree.

Background: Myopia is a condition in which the visual images come to a focus in front of the retina of the eye. This disease is a major cause of visual disability, which presents in 108 million persons globally. Purpose: This study aims to determine the relationship between the degree of myopia, the axial length, and the choroidal thickness (CT). Methods: This is an observational analytical study that made use of a cross-sectional design. A total of 59 participants with refractive errors underwent treatment at Hasanuddin University Hospital and 116 eyes were measured and analyzed. The choroidal thickness was measured using the Enhance Depth Imaging OCT (EDI-OCT) tool, which is divided into nine observational areas. Furthermore, all data obtained were compared using statistical analysis, such as the one-way ANOVA and Pearson correlation test (p < 0.05). Results: There was a significant relationship between the choroidal thickness with axial length (p < 0.05) and myopia degrees (p < 0.05). Conclusions: The thickness of the choroid decreases with an increase in the axial length and degree of myopia, which further indicates that the higher the myopia degree, the thinner the choroidal vasculature.

Orbital cellulitis clinically mimicking rhabdomyosarcoma.

INTRODUCTION: Proptosis in children with acute-onset accompanied by signs of inflammation is commonly caused by orbital cellulitis, however, the possibility of rhabdomyosarcoma should always be considered by the clinician. This is a case report of a five-year-old boy presenting with an acute-onset of proptosis without a history of trauma and systemic infection. Our clinical differential diagnosis included orbital cellulitis and orbital rhabdomyosarcoma. PURPOSE: To report a case of orbital cellulitis that clinically and radiologically mimics rhabdomyosarcoma. CASE PRESENTATION: A five-year-old boy presented with rapid-onset proptosis, periorbital edema, pain and visual loss in the left eye for two weeks without a history of trauma, upper respiratory tract infection, sinusitis or immunosuppression. Our clinical differential diagnosis includes rhabdomyosarcoma and orbital cellulitis. Complete blood count reveals a leukocytosis. Multislice computed tomography (MSCT) scan shows lesions involving the lateral orbit and the retro bulbar space. Antibiotics combination and adjunct anti-inflammatory intravenously shows excellent clinical resolution. CONCLUSIONS: The study demonstrates difficulty in differentiating acute orbital cellulitis from rhabdomyosarcoma based on clinical findings. In addition, the case highlights that antibiotic combination of cephalosporin and aminoglycosides together with an adjuvant corticosteroid as an anti-inflammatory was effective in the case of acute orbital cellulitis.