Objective Endothelial dysfunction plays an important role in the development of diabetic retinopathy. The aim of this study was to evaluate endothelial dysfunction using different approaches in patients with type 1 diabete mellitus with early stages of diabetic retinopathy. For this purpose, we investigated the serum levels of cellular adhesion molecules, including intercellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1) and endothelin-1 (ET-1), which have emerged as specific markers of endothelial dysfunction, and measured the flow-mediated dilatation (FMD), a noninvasive technique used to evaluate endothelial dysfunction. Methods The study group included 59 patients with type 1 diabetes mellitus (DM) and 30 age-matched healthy control subjects. The diabetic patients were divided into two groups according to the ophthalmoscopic findings: Group 1, composed of type 1 diabetic patients having no signs of diabetic retinopathy (DRP), and Group 2, composed of type 1 diabetic patients having findings of the early stages of nonproliferative diabetic retinopathy (NPDR). Results The serum levels of ET-1 (fmol/mL), ICAM-1 (ng/mL) and VCAM-1 (ng/mL) were 8.52±0.699 vs. 478.39±46.22 vs. 728.64±35.081 in the patients without retinopathy, 8.91±1.354 vs. 451.79±48.262 vs. 863.59±62.37 in the diabetic patients with NPDR and 10.73±1.04 vs. 608.15±74.92 vs. 872.95±57.63 in the control group. There were no significant differences in the serum levels of the three molecules between the groups. The FMD values were 6.51±0.46% in the diabetic patients without retinopathy, 6.66±0.29% in the diabetic patients with NPDR and 6.68±0.51% in the control group. No significant differences were found between the groups. Conclusion The early stages of diabetic retinopathy cannot be considered in the evaluation of systemic markers of endothelial dysfunction.
The average RNFL thickness in the migraine patients was found to be thinner than that in the control group. In addition, we found a negative weak correlation between length of migraine history and the average RNFL thickness, supporting the possible association between these pathologies.
The results of the present study show that there is a significant increase in oxidative stress in AMD patients and significant decrease in antioxidant defence, in the total thiol level and in PON1 activity in AMD patients compared with controls. The increased oxidative stress and decreased antioxidant levels may have a synergistic role in AMD development.
ABSTRACT.Purpose: Topical steroid use is usually avoided in cases of corneal epithelial defect. We evaluated the effect of topical steroid treatment on corneal epithelial healing after epithelial debridement in vitreoretinal surgery. Methods: Our study population included 85 eyes undergoing vitreoretinal surgeries in our clinic. We prospectively compared the duration of corneal epithelial wound healing in 43 eyes in which topical dexamethasone was used with that in 42 eyes in which topical dexamethasone was not used in the early postoperative period after epithelial debridement. Factors that may retard corneal epithelial healing, including pre-and intraoperative topical solutions, median operative time, the presence of diabetes mellitus, prior ocular surgeries, pseudophakia, aphakia and the presence of intraocular gas or silicone oil in aphakic patients, were not significantly different between the two groups. Results: The mean corneal epithelial defect closure time was 59.7 ± 2.6 hours (mean ± SEM) in the group receiving topical steroid treatment, and 61.9 ± 2.6 hours in the group that did not receive steroids. Conclusion: Topical dexamethasone administered five times/day did not significantly retard corneal epithelial healing in subjects undergoing vitreoretinal surgery with postoperative topical steroid treatment, compared with subjects who did not receive steroid treatment.
Objective. To investigate the biomechanical characteristics of the cornea in patients with mitral valve prolapse (MVP) and the prevalence of keratoconus (KC) in MVP. Materials and Methods. Fifty-two patients with MVP, 39 patients with KC, and 45 control individuals were recruited in this study. All the participants underwent ophthalmologic examination, corneal analysis with the Sirius system (CSO), and the corneal biomechanical evaluation with Reichert ocular response analyzer (ORA). Results. KC was found in six eyes of four patients (5.7%) and suspect KC in eight eyes of five patients (7.7%) in the MVP group. KC was found in one eye of one patient (1.1%) in the control group (P = 0.035). A significant difference occurred in the mean CH and CRF between the MVP and control groups (P = 0.006 and P = 0.009, resp.). All corneal biomechanical and topographical parameters except IOPcc were significantly different between the KC-MVP groups (P < 0.05). Conclusions. KC prevalence is higher than control individuals in MVP patients and the biomechanical properties of the cornea are altered in patients with MVP. These findings should be considered when the MVP patients are evaluated before refractive surgery.
Background. Diabetic retinopathy (DR) is the leading cause of blindness in the world. Retinopathy can still progress despite optimal metabolic control. The aim of the study was to determine whether different degrees of DR (proliferative or nonproliferative) were associated with abnormally modulated hemostatic parameters in patients with T1DM. Method. 52 T1DM patients and 40 healthy controls were enrolled in the study. Patients were subdivided into three categories. Group I was defined as those without retinopathy, group II with NPRP, and group III with PRP. We compared these subgroups with each other and the control group (Group IV) according to the serum fibrinogen, plasminogen, alpha2-anti-plasmin (α2-anti-plasmin), and PAI. Results. We detected that PAI-1, serum fibrinogen, and plasminogen levels were similar between the diabetic and control groups (P = 0.209, P = 0.224, and P = 0.244, resp.), whereas α2-anti-plasmin was higher in Groups I, II, and III compared to the control group (P < 0.01, P < 0.05, and P < 0.001, resp.). There was a positive correlation between serum α2-anti-plasmin and HbA1c levels (r = 0,268, P = 0.031). Conclusion. To our knowledge there is scarce data in the literature about α2-anti-plasmin levels in type 1 diabetes. A positive correlation between α2-anti-plasmin with HbA1c suggests that fibrinolytic markers may improve with disease regulation and better glycemic control.
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