Comparison of autofluorescence and optical coherence tomography findings in acute and chronic central serous chorioretinopathy

AIM:To discuss and compare the fundus autofluorescence(FAF)and optical coherence tomography(OCT)in acute or chronic central serous chorioretinopathy(CSCR).METHODS:Medical records of 100 cases of CSCR were reviewed.Acute and chronic cases were evaluated according to the duration of decreased visual acuity,serous retinal detachment(RD)and focal leakage on fluorescein angiography(FA).Chi-square test was used for statistical analysis.RESULTS:Forty cases had acute and 60 cases had chronic CSCR.FAF showed focal hypo-autofluorescence in 34(85%)and iso-autofluorescence in 6(15%)of acute cases and hypo-autofluorescence in 51(85%),hyperautofluorescence in 6(10%)and iso-autofluorescence in3(5%)of chronic cases.OCT showed serous RD with distinct borders correlated with FAF findings(hypoautofluorescence)in all acute CSCR cases.In chronic CSCR group,OCT showed serous RD with indistinct borders correlated with FAF findings.The differences between the OCT and FAF findings of the two groups were significant(P=0.000).CONCLUSION:OCT and FAF findings can support the clinical observations in differential diagnosis of acute and chronic CSCR and help clinicians to evaluate retinal pigment epithelium,outer segments of photoreceptors and the components of serous RD.

Comparison of total/active ghrelin levels in primary open angle glaucoma,pseudoexfoliation glaucoma and pseudoexfoliation syndrome

AIM：To investigate the levels of ghrelin（Gh）,acylated ghrelin（AGh） and AGh/Gh ratio in the humor aqueous（HA） of cases with pseudoexfoliation syndrome（PXS）,pseudoexfoliation glaucoma（PXG）,primary open angle glaucoma（POAG） and to compare these with control subjects.METHODS：A prospective examination was made of the total Gh,and AGh levels in HA of 67 patients undergoing cataract surgery.Patients were divided into 4 groups.HA samples were aspirated at the beginning of the surgery,stored at -70℃.Gh and AGh quantification was performed with ELISA kits and the AGh/total-Gh ratios were calculated.ANOVA,Kruskal-Wallis,Chi-square and post-hoc tests were used for statistical analysis.RESULTS：Total Gh levels in HA were 189.2±45.6 pg/mL in the control group,199.2±32.9 pg/mL in PXS,180.6±20.9 pg/mL in PXG and 176.8±21.4 pg/mL in POAG groups（P〉0.05）.AGh levels in HA were 23.09±5.01 pg/mL in the control group,24.13±5.22 pg/mL in PXS,22.29±1.55 pg/m L in PXG and 19.69±2.93 pg/mL in POAG groups（P〉0.05）.The ratio of AGh/Gh was 10.3%±2.34% in the control group,13.03%±2.58% in PXS,12.3%±1.54% in PXG and 11.79%±1.41% in POAG groups（P=0.044）.The difference between the PXS and control groups was significant（P=0.03）.CONCLUSION：In spite of statistically insignificant results,the HA total Gh levels were lower than those of the control subjects but not parallel with the AGh levels in glaucoma patients.The relative increase in the AGh/Gh ratio in glaucoma cases supports the view that proportional increases of AGh might play a role in the pathogenesis of glaucoma.

Oxidant/antioxidant balance in the aqueous humor of patients with glaucoma

AIM： To evaluate total antioxidant status （TAS）, total oxidant status （TOS）, and the oxidative stress index （OSI） of the aqueous humor （AH） in patients with glaucoma. METHODS： The prospective study was composed of a study group （n-31） and a control group （n=31）. Fifteen patients in the study group were diagnosed with primary open angle glaucoma （POAG）, and 16 patients were diagnosed with pseudoexfoliation glaucoma （PEG）. The control group was composed of non-glaucomatous patients with cataracts. AH samples were collected and analyzed for TAS, TOS, and OSI levels. RESULTS： Mean AH TAS level was significantly higher in patients with glaucoma than that in the control group （P〈0.01）. Mean TOS and OSI levels tended to increase in patients with glaucoma. No significant differences in TAS, TOS, or OSI levels were observed between patients with POAG and PEG. CONCLUSION： High levels of TAS were observed in patients with glaucoma, which was likely a response to the increased oxidative stress observed in these patients.

Corneal properties in children with congenital isolated growth hormone deficiency

AIM:To compare the corneal parameters of children with congenital isolated growth hormone deficiency and healthy subjects.METHODS:In this cross-sectional,prospective study,50 cases with growth hormone(GH)deficiency treated with recombinant GH and 71 healthy children underwent a complete ophthalmic examination.The corneal hysteresis(CH),corneal resistance factor(CRF),Goldmann-correlated intraocular pressure(IOPg)and corneal-compensated intraocular pressure(IOPcc)were measured with the Ocular Response Analyzer(ORA).Central corneal thickness(CCT)was measured by a ultrasonic pachymeter.RESULTS:The mean age was 13.0±3.0 years in the GH deficiency group consisting of 21 females and 29 males and 13.4±2.4 years in the healthy children group consisting of 41 females and 30 males.There was no statistically significant difference between the groups for gender or age(Chi-square test,P=0.09;independent ttest,P=0.28,respectively).The mean duration of recombinant GH therapy was 3.8±2.4y in the study group.The mean CH,CRF,IOPg and IOPcc values were 11.0±2.0,10.9±1.9,15.1±3.3,and 15.1±3.2 mm Hg respectively in the study group.The same values were 10.7±1.7,10.5±1.7,15.2±3.3,and 15.3±3.4 mm Hg respectively in the control group.The mean CCT values were 555.7±40.6,545.1±32.5μm in the study and control groups respectively.There was no statistically significant difference between the two groups for CH,CRF,IOPg,IOPcc measurements or CCT values(independent t-test,P=0.315,0.286,0.145,0.747,0.13 respectively).CONCLUSION:Our study suggests that GH deficiency does not have an effect on the corneal parameters and CCT values.This observation could be because of the duration between the beginning of disease and the diagnosis and beginning of GH therapy.

Electron Microscopic Investigation of Anterior Lens Capsule and Epithelium in Patients with Diabetes Mellitus

Purpose: To evaluate the histopathologic alterations of organelles in the epithelium of the anterior lens capsule. Methods: The interventional study included 26 eyes;of which 11 had non-proliferative diabetic retinopathy (diabetic group) and cataract, and 15 had age-related cataract (control group). We investigated the anterior lens capsule in patients with diabetes mellitus by using electron microscopy and to compare it between diabetic eyes and healthy eyes. Anterior capsule samples were obtained by circular continuous capsulorhexis during phacoemulsification procedures. All the samples were fixed and conventionally processed for electron microscopy analysis. Results: Demographic characteristics of the diabetic group and the control group were similar (p > 0.05). In the diabetic group, electron dense cells with an apoptotic appearance were seen and these cells had an apoptotic nucleus and prominent mitochondrial crystalysis. In addition, there was dilatation of the endoplasmic reticulum cistern. In the control group, lens epithelial cells and all their elements had a normal pattern. Neither cells with an apoptotic appearance nor mitochondrial crystalysis was seen, but there was dilatation of the endoplasmic reticulum cistern. Conclusions: Diabetes mellitus can engender structural abnormalities of organelles in the epithelium of the anterior lens capsule including mitochondrial crystalysis, dilatation of the endoplasmic reticulum cistern and apoptotic dense nucleus. It can be suggested that diabetes mellitus affects organelles of anterior lens epithelium in eyes with cataracts, while it causes non-proliferative changes in the retina.