Evaluation of Corneal Endothelium in Adolescents with Juvenile Glaucoma

Purpose. To evaluate the endothelial cell density (ECD) and central corneal thickness (CCT) in adolescents with juvenile open-angle glaucoma (JOAG) and ocular hypertension (OH) and to investigate the influence of topical antiglaucoma medications on ECD and CCT in adolescents with JOAG. Methods. ECD and CCT were investigated in 66 eyes of 33 adolescents with JOAG. Depending on the topical treatment the eyes were classified into 4 groups: (1) topical carbonic anhydrase inhibitor, (2) prostaglandin analogs, (3) beta-blocker, and (4) CAI-beta-blocker combination. ECD and CCT were also checked in 24 adolescents with OH and in control group (33 persons). Results. ECD was significantly lower in eyes with JOAG (2639.5 cells/mm2) compared with ECD in eyes with OH (2924.5 cells/mm2) and in control group (2955.5 cells/mm2). CCT was 0.554 mm in eyes with JOAG, 0.55 mm in eyes with OH, and 0.544 mm in control group. ECD in patients with JOAG was 2730 cells/mm2 (1 group), 2773.5 cells/mm2 (2 group), 2539.5 cells/mm2 (3 group), and 2551 cells/mm2 (4 group). CCT was 0.556 mm in 1 group, 0.558 mm in 2 group, 0.532 mm in 3 group, and 0.544 mm in 4 group. Conclusions. Our findings indicate that JOAG and OH did not affect CCT, but JOAG has influence on ECD in adolescents. There were no significant differences between ECD and CCT of eyes treated with different kinds of antiglaucoma medications

Evaluation of Corneal Endothelium in Children and Adolescents with Type 1 Diabetes Mellitus

Purpose. To evaluate the systemic and local factors that contribute to the damage of endothelial cells in diabetic patients and to compare the endothelial structure of the cornea in diabetic and nondiabetic patients. Materials and Methods. The endothelial cell density (ECD) and central corneal thickness (CCT) were investigated in 123 eyes of type 1 diabetic patients and in 124 eyes of nondiabetic patients. The mean diabetic patients age was 15.34 ± 3.06 years versus 14.58 ± 2.01 years in the control group. The mean duration of diabetes was 8.02 ± 3.9 years. The corneal endothelium was imaged by the Topcon SP-2000P. Results. The mean ECD in diabetic eyes was 2435.55 ± 443.43 cells/mm(2) and was significantly lower than in control group (2970.75 ± 270.1 cells/mm(2)). The mean CCT was 0.55 ± 0.03 mm in diabetic group versus 0.53 ± 0.033 mm in control group. ECD and CCT significantly correlated only with duration of diabetes. There was no correlation between ECD and CCT and patient age, sex, HbA1C level, and plasma creatinine level. Conclusions. ECD is decreased and CCT is increased in children and adolescents with diabetes mellitus. Duration of diabetes is the factor that affects ECD and CCT

Effect of Repeated Intravitreal Ranibizumab and Aflibercept Injections on the Cornea in Patients with Age-Related Macular Degeneration

Purpose. To assess the effect of repeated intravitreal ranibizumab injections (RI) and aflibercept injections (AI) on the corneal endothelium and central corneal thickness (CCT) in patients with age-related macular degeneration (AMD). Materials and Methods. In the retrospective study, 110 eyes of 106 patients, aged 52 to 93 years, were analyzed. Fifty eyes were treated only with RI (I group), and 60 eyes were treated only with AI (II group). Every patient received one intravitreal injection of 0.5 mg of ranibizumab once a month or 2 mg of aflibercept for 3 subsequent months. Each patient received only 3 injections during the whole observation period. Corneal analysis was obtained with the specular microscope. Examinations were performed before initial treatment, after each injection, and 6 months after the first injection. Analysis included corneal endothelial cell density (ECD), hexagonal cell percentage (% Hex), coefficient of variation (CoV), and CCT. Results. There was a statistically significant ECD loss, regardless of the type of the anti-VEGF agent. The mean ECD value in the I group was 2397 ± 459 cells/mm2 before RI, 2389 ± 459 cells/mm2 after the first RI, 2386 ± 467 cells/mm2 after the second RI, 2378 ± 475 cells/mm2 after the third RI, and 2357 ± 460 cells/mm2 6 months after the first RI. The mean ECD value in the II group was 2448 ± 493 cells/mm2 before treatment, 2456 ± 498 cells/mm2 after the first AI, 2426 ± 496 cells/mm2 after the second AI, 2402 ± 488 cells/mm2 after the third AI, and 2348 ± 473 cells/mm2 6 months after the first AI. In comparison with the group treated with RI, the group treated with AI presented a greater ECD loss at each measuring point. The percentage of hexagonal cells was decreased in both groups. There was a slight increase in polymegathism in both treated groups. Ranibizumab proved to cause a small increase in CCT, while CCT remained unchanged in the aflibercept group. Conclusions. Repeated intravitreal injections of 0.5 mg of ranibizumab or 2 mg of aflibercept can influence the morphology of the corneal endothelium but not CCT

Immune Recovery Uveitis: Pathogenesis, Clinical Symptoms, and Treatment

IRU is the most common form of immune reconstitution inflammatory syndrome in HIV-infected patients with cytomegalovirus retinitis who are receiving highly active antiretroviral therapy (HAART). Among patients with CMV in the HAART era, immune recovery may be associated with a greater number of inflammatory complications, including macular edema and epiretinal membrane formation. Given the range of ocular manifestations of HIV, routine ocular examinations and screening for visual loss are recommended in patients with CD4 counts <50 cells/μL. With the increasing longevity of these patients due to the use of HAART, treatment of IRU may become an issue in the future. The aim of this paper is to review the current literature concerning immune recovery uveitis. The definition, epidemiology, pathophysiology, clinical findings, complications, diagnosis, and treatment are presented

Immune Recovery Uveitis: Pathogenesis, Clinical Symptoms, and Treatment

IRU is the most common form of immune reconstitution inflammatory syndrome in HIV-infected patients with cytomegalovirus retinitis who are receiving highly active antiretroviral therapy (HAART). Among patients with CMV in the HAART era, immune recovery may be associated with a greater number of inflammatory complications, including macular edema and epiretinal membrane formation. Given the range of ocular manifestations of HIV, routine ocular examinations and screening for visual loss are recommended in patients with CD4 counts <50 cells/μL. With the increasing longevity of these patients due to the use of HAART, treatment of IRU may become an issue in the future. The aim of this paper is to review the current literature concerning immune recovery uveitis. The definition, epidemiology, pathophysiology, clinical findings, complications, diagnosis, and treatment are presented

The Effectiveness of Laser Peripheral Iridotomy in Adolescent Eyes with Ocular Hypertension and Concave Configuration of the Peripheral Iris

Purpose. To evaluate the efficacy of laser peripheral iridotomy (LPI) in preventing deterioration in eyes with ocular hypertension (OHT) and concave configuration of the iris. Materials and Methods. This was a retrospective study, which was carried out within a period of 3–5 years. Twenty-four patients with OHT and concave irises were treated with LPI and followed up periodically. IOP, central corneal thickness (CCT), anterior chamber depth (ACD), scleral spur angle (SSA), global neuroretinal rim (NRR) thickness, and global retinal nerve fiber layer (RNFL) were examined before and after LPI. Results. The average age of the 24 patients was 14.21 ± 1.41 (13–17.5) years on admission. The initial IOP of the 48 eyes was 23.21 ± 1.56 mmHg in RE and 22.96 ± 2.1 mmHg in LE before LPI. All 48 eyes had concave irises in both eyes. All eyes treated with LPI have shown iris flattening, which has persisted during follow-up (mean 1.54 ± 0.9 years). At the last follow-up visit, the average IOP was 17.58 ± 2.63 (14–21) mmHg in RE and 17.58 ± 2.86 (14–21) mmHg in LE, which was statistically lower than that of the baseline (p<0.001). There were significant changes in SSA in both eyes and global RNFL in RE after LPI. Conclusions. In the current study, LPI resulted in an IOP-lowering effect and iris flattening in adolescent eyes with a concave configuration of the peripheral iris

Występowanie wybranych genów HLA klasy I i II predysponujących do rozwoju młodzieńczego idiopatycznego zapalenia stawów u dzieci z idiopatycznym zapaleniem błony naczyniowej oka

Wstęp: Zapalenie błony naczyniowej oka (ZBNO) jest częstymobjawem młodzieńczego idiopatycznego zapalenia stawów (MIZS)i niekiedy pierwszym, izolowanym objawem MIZS. Celem pracybyła ocena częstości występowania wybranych alleli układu HLApredysponujących do rozwoju MIZS i zajęcia gałki ocznej u dzieciz idiopatycznym ZBNO. Materiały i metody: W grupie 30 dzieci z ZBNO określono obecnośćwybranych alleli DRB*, DQA*, DQB*, genu B27 i przeciwciał przeciwjądrowych(ANA). Wyniki: Średni wiek zachorowania na ZBNO wynosił 9,6 roku.Dziewczęta i chłopcy chorowali równie często. W porównaniuz grupą kontrolną stwierdzono znamiennie częstsze występowaniegenu B27 i przeciwciał ANA, co łączyło się z nawrotowym charakteremZBNO. Nie wykazano powiązania idiopatycznego ZBNOz obecnością alleli DRB*, DQA*, DQB*. Wnioski: Istnieje związek idiopatycznego ZBNO z obecnością genuB27 i przeciwciał ANA. Wyniki badań sugerują obserwację dzieciz idiopatycznym ZBNO pod kątem rozwoju spondyloartropatii

Pattern visual evoked potentials in the early diagnosis of optic neuropathy in the course of Graves&#8217; ophthalmopathy

Wstęp: Celem pracy była identyfikacja wczesnych objawów neuropatii nerwu wzrokowego u pacjentów z oftalmopatią Gravesa (GO, Graves&#8217; opthalmopathy) bez objawów klinicznych neuropatii przy zastosowaniu wzrokowych potencjałów wywołanych wzorcem (PVEP, pattern visual evoked potentials) i porównanie wartości pomiarów PVEP (latencje P100 i N75, amplituda P100) z ciśnieniem śródgałkowym i stopniem wytrzeszczu. Materiał i metody: U 15 pacjentów z GO bez klinicznych objawów neuropatii nerwu wzrokowego i 12 zdrowych osobników badano współzależności między latencjami N75 i P100 oraz amplitudą P100, a pomiarami ciśnienia śródgałkowego i stopniem wytrzeszczu. Wyniki: Średnie wartości pomiarów latencji N75 i P100 w grupie pacjentów z GO były istotnie dłuższe w porównaniu z kontrolą (LP100&#8211;106,2 &plusmn; 4,4 ms vs. 102,4 &plusmn; 2,7 ms; p < 0,01 i LN75&#8211;79,0 &plusmn; 3,7 ms vs. 73,9 &plusmn; 2,8 ms; p < 0,001). U chorych z GO obserwowano pozytywną korelację między latencją N75 a stopniem wytrzeszczu (R = 0,51; p < 0,01). Wartości LP100 i LN75 były wydłużone ponad normę w 5 na 30 oczu (17%) i w 3 na 30 (10%). Wnioski: Pomiary wzrokowych potencjałów wywołanych wzorcem (szczególnie latencją P100) u pacjentów z GO bez jawnych objawów neuropatii jest przydatnym narzędziem we wczesnej diagnostyce neuropatii nerwu wzrokowego.The aim of the study: to investigate by means of pattern visual evoked potentials (PVEPs) early neuropathic changes in Graves&#8217; ophthalmopathy (GO) patients without any clinical symptoms of optic neuropathy in order to evaluate the prevalence of subclinical optic neuropathy in GO patients and to elucidate whether there is a relationship between PVEP (P100 and N75 latency), intraocular pressure (IOP) and exophthalmometry. Material and methods. Two groups of patients were examined: 15 patients with GO without clinical signs of dysthyroid optic neuropathy (DON) and 12 healthy controls. The correlations between the N75 and P100 latencies, IOP and Hertel exophthalmometry were investigated. Results. The mean PVEP N75 and P100 latencies were significantly delayed in the GO uncomplicated with DON in comparison with controls (LP100- 106.2 &plusmn; 4.4 ms vs. 102.4 &plusmn; 2.7 ms, p < 0.01 and LN75- 79.0 &plusmn; 3.7 ms vs. 73.9 &plusmn; 2.8 ms, p < 0.001). In GO patients we documented a positive correlation between the LN75 latency and exophthalmometric readings (R = 0.51; p < 0.01). The value of LP100 and LN75 was above the normal limit in 5/30 eyes (17%) and in 3/30 eyes (10%) respectively. Conclusions: The assessment of PVEPs (especially the P100 latency) in GO patients without clinical signs of DON is a useful tool for the early diagnosis of optic nerve involvement