Complete blood cell count-derived inflammation biomarkers and the need for laser capsulotomy due to posterior capsule opacification following cataract surgery

Background: Inflammation plays a significant role in the proliferation, migration, and differentiation of lens epithelial cells after cataract surgery, clinically manifested as posterior capsule opacification (PCO). This condition is typically treated with neodymium: yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy. Our objective is to evaluate the association between blood-derived inflammatory markers and the development of clinically significant PCO necessitating treatment with laser capsulotomy. Materials and Methods: We conducted a retrospective review of charts for all patients who underwent Nd:YAG laser capsulotomy in our department between January 2021 and December 2022. The study included 70 patients who diagnosed with clinically significant PCO requiring treatment with Nd:YAG laser capsulotomy following cataract surgery, as well as 70 pseudophakic controls with no signs of PCO. Complete blood cell count parameters were obtained from medical records and the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were calculated. Results: The mean age of the Nd:YAG laser capsulotomy and control group was 71.83 +/- 8.46 and 72.27 +/- 9.98 years, respectively. The preoperative NLR scores for the Nd:YAG laser capsulotomy group (mean rank = 34.43) were statistically significantly higher than those of the control group (mean rank = 25.41) (p = 0.044). However, after adjusting for preoperative measurements, no statistically significant differences were observed between the groups for the other parameters. Conclusion: Preoperative NLR scores were higher in patients who developed clinically significant PCO requiring treatment with Nd: YAG laser capsulotomy. This finding suggests that patients with elevated systemic inflammation may be at an increased risk of developing PCO following cataract surgery. Further research is needed to evaluate the role of systemic inflammation in the pathogenesis of PCO

Evaluation of personality features and mental state of keratoconus patients

Objectives: Keratoconus (KCN) is a disorder that usually appears during adolescence and progressively reduces visual acuity. KCN may lead to differences in personality features as a result of vision loss and the numerous clinical examinations and treatment methods used from a young age. The aim of this study was to better understand the psychological characteristics of KCN patients and to define possible correlations between corneal topographic parameters and psychological state. Methods: A total of 59 KCN cases were included in the study group and were compared with 65 age- and sex-matched healthy individuals. All of the participants underwent a routine ophthalmic examination that included corrected distance visual acuity (CDVA), biomicroscopy, and fundoscopy. The KCN patients were evaluated busing Scheimpflug corneal topography. Psychiatric evaluations were performed using the Eysenck Personality Questionnaire Revised-Short Form (EPQ), the Self-Confidence Scale, the Maudsley Obsessive-Compulsive Inventory (MOCI), and the Beck Depression Inventory (BDI). Results: The mean age of the case and control groups was 23.98±5.7 years and 25.82±5.4 years, respectively. The KCN cases had significantly higher EPQ neuroticism subscale scores; higher MOCI subscale scores, with the exception of the doubting subscale; and higher BDI scores. Analysis of the KCN duration revealed a positive correlation with the checking and slowness subscales of the MOCI, however, there was no significant correlation between the psychometric scale scores, corneal topographic parameters, and CDVA. Conclusion: A substantially asymmetrical course and a relatively long period for KCN to result in severe vision loss might explain the lack of correlations between psychological parameters and visual acuity. Nonetheless, the apparent effect of vision loss on emotional distress cannot be disregarded; the day-to-day progressive loss of visual acuity and multiple, costly interventions may initiate or contribute to a depressive mood in KCN patients. A vicious depressive cycle and the exhaustion of long-term coping mechanisms might be underlying factors for the higher neuroticism scores seen among KCN patients. Both the personality traits and mental state of KCN patients demonstrate distinguishing properties; clinicians working with these patients should consider their mental state in addition to other factors in order to achieve better treatment outcome

Evaluation of tear parameters and meibomian gland morphology in keratoconus patients after epithelial-on corneal cross-linking

Purpose To evaluate the variations in tear parameters and meibomian gland morphology after epithelial-on (epi-on) corneal collagen cross-linking (CXL) in keratoconus (KC) patients. Methods This prospective observational study included 38 KC eyes that underwent epithelium-on CXL. Thirty-three eyes of 33 stable KC patients with no prior CXL treatment formed the KC group and 35 eyes of 35 healthy volunteers were recruited as the control group. All participants were evaluated by Schirmer I test, first and average noninvasive tear break-up time (NITBUT), ocular surface disease index (OSDI) questionnaire, and meibography scores. The CXL patients were evaluated preoperatively and at the 1st, 3rd, and 6th months, and participants without any intervention (KC and control groups) were evaluated initially, at 1st, 3rd, and 6th months. Results The KC patients had significantly lower average NITBUT, higher OSDI scores, and impaired meibomian gland morphology than healthy individuals (NITBUT(seconds): KC, 12.8(2.4-17.6), healthy group (HG), 17.1(6.8-17.6); p = 0.012, OSDI: KC, 27.5(0.0-87.5), HG, 7.5(0.0-55.0); p < 0.001, p < 0.001, respectively). A significant difference was found in Schirmer values of the CXL group at 0-1st months, first NITBUT values at 1-6 months, and average NITBUT values at 1-3 and 1-6 months (p = 0.003, p = 0.001, p = 0.003, p = 0.001, respectively). All meibography parameters remained unchanged after CXL over a 6-month follow-up compared to initial measurements. Conclusions Even though the KC patients had lower NITBUT, higher OSDI scores, and increased meibomian gland disfunction, the CXL treatment did not significantly affect tear quantity, dry eye symptoms, and meibomian gland morphology

Tiamin Pirofosfatın Sıçanlarda Favipiravir ile İndüklenen Dejeneratif Kornea ve Skleral Hasarına Etkisinin Biyokimyasal ve Histopatolojik Değerlendirmesi : Araştırma Makalesi

Introduction: Favipiravir causes ocular toxicity at high doses. Thiamine pyrophosphate (TPP) therapy can prevent ocular damage by reversing oxidative damage. Objective: To investigate the ocular effect of favipiravir in rats and determine the protective effect of thiamine pyrophosphate (TPP) against the possible ocular toxicity of favipiravir. Method: The rats were randomly divided into three groups; healthy control (HC), favipiravir administered (FAV), and TPP + favipiravir administered (TFAV). In the TFAV group, TPP was intraperitoneally injected at a dose of 25 mg/kg. In the HC and FAV groups, distilled water was applied as a solvent. One hour later, favipiravir was administered to the FAV and TFAV groups at 200 mg/kg orally by gavage twice a day. TPP was injected once a day. This procedure was repeated for one week. All rats were sacrificed under anesthesia, and the biochemical parameters and histopathological levels were analyzed. Results: It was determined that the FAV group had higher blood MDA levels (p&lt;0.001) and lower tGSH, SOD, and CAT levels (p&lt;0.001) than the other groups. MDA levels of HC and TFAV groups were similar (p=0.407). It also inhibited the reduction in TPP, tGSH, SOD, and CAT (p&lt;0.001). There was no significant difference between HC and TFAV groups regarding tGSH and CAT (p&gt;0.05). In the histopathological examinations, severe collagen fiber degeneration and moderate hyperemia were observed in the corneal and scleral tissues in the FAV group. Conclusion: The findings of the study showed that favipiravir caused damage to the cornea and sclera tissue through oxidative damage and TPP reduced this damage. Our study results suggest that TPP may be beneficial in Favipiravir-induced ocular toxicity. Keywords: Favipiravir, Ocular Toxicity, Oxidative Stress, Thiamine Pyrophosphate.Giriş: Favipiravir yüksek dozlarda oküler toksisiteye neden olmaktadır. Tiamin pirofosfat (TPP) tedavisi oksidatif hasarı tersine çevirerek oküler hasarı önleyebilir. Amaç: Favipiravirin sıçanlarda oküler etkisini araştırmak ve favipiravirin olası oküler toksisitesine karşı TPP koruyucu etkisini belirlemek. Yöntem: Sıçanlar rastgele üç gruba ayrıldı; sağlıklı kontrol (HC), favipiravir uygulanan (FAV) ve TPP + favipiravir (TFAV) uygulanan. TFAV grubuna TPP intraperitoneal olarak 25 mg/kg dozunda enjekte edildi. HC ve FAV gruplarında çözücü olarak distile su uygulandı. Bir saat sonra FAV ve TFAV gruplarına günde 2 kez 200 mg/kg oral sonda ile favipiravir uygulandı. TPP günde bir kez enjekte edildi. Bu prosedür bir hafta boyunca tekrarlandı. Tüm sıçanlar anestezi altında sakrifiye edildi ve biyokimyasal parametreler ve histopatolojik seviyeleri analiz edildi. Bulgular: FAV grubunun diğer gruplara göre kan MDA düzeylerinin daha yüksek (p&lt;0.001), tGSH, SOD ve CAT düzeylerinin daha düşük olduğu (p&lt;0.001) belirlendi. HC ve TFAV gruplarının MDA düzeyleri benzerdi (p=0,407). Ayrıca TPP, tGSH, SOD ve CAT'deki azalmayı da inhibe etti (p&lt;0.001). tGSH ve CAT açısından HC ve TFAV grupları arasında anlamlı fark yoktu (p&gt;0,05). Histopatolojik incelemelerde FAV grubunda kornea ve sklera dokularında ileri derecede kollajen lif dejenerasyonu ve orta derecede hiperemi gözlendi. Sonuç: Çalışmanın bulguları, favipiravirin oksidatif hasar yoluyla kornea ve sklera dokusunda hasara neden olduğunu ve TPP'nin bu hasarı azalttığını gösterdi. Çalışma sonuçlarımız, TPP'nin favipiravirin neden olduğu oküler toksisitede faydalı olabileceğini düşündürmektedir. Anahtar Kelimeler: Favipiravir, Oküler Toksisite, Oksidatif Stres, Tiamin Pirofosfat

The prevalence of microalbuminuria and relevant cardiovascular risk factors in Turkish hypertensive patients.

Objectives: A growing body of data illustrates the importance of microalbuminuria (MAU) as a strong predictor of cardiovascular risk in the hypertensive population. The present study was designed to define the prevalence of MAU and associated cardiovascular risk factors among Turkish hypertensive outpatients. Study design: Representing the Turkish arm of the multinational i-SEARCH study involving 1,750 sites in 26 countries around the world, a total of 1,926 hypertensive patients from different centers were included in this observational and cross-sectional survey study. Patients with reasons for a false-positive MAU test were excluded. The prevalence of MAU was assessed using a dipstick test, and patients were inquired about comorbidities, comedication, and known cardiovascular risk factors. Results: The overall prevalence of MAU was 64.7% and there was no difference between genders. Most of the patients (82.5%) had uncontrolled hypertension, 35.6% had dyslipidemia, and 35.5% had diabetes, predominantly type 2. Almost one-third of the patients (26.4%) had at least one cardiovascular-related comorbidity, with 20.3% having documented coronary artery disease (CAD). Almost all patients (96.8%) had one or more risk factors for cardiovascular disease in addition to hypertension, including family history of myocardial infarction or CAD, diabetes, dyslipidemia, lack of physical exercise, and smoking. A trend towards higher MAU values in the presence of CAD was determined. Conclusion: Microalbuminuria tests should be routinely used as a screening and monitoring tool for the assessment of subsequent cardiovascular morbidity and mortality among hypertensive patients. © 2011 Turkish Society of Cardiology