Variations Of Choroidal And Retinal Thickness Measurements Analyzed By Enhanced Depth Imaging Optical Coherence Tomography In Uveitis

Purpose : Choroidal thickness (CT) is considered a promising parameter to monitor the severity of inflammation. We hypothesize that inflammation of the iris and ciliary body in anterior uveitis might affect the CT, and inflammation of the choroid in intermediate, posterior and panuveitis might affect the retinal thickness.(RT) Methods : Prospective case-control study of 32 eyes with anterior, 5 eyes with intermediate, 24 eyes with posterior, 24 eyes with panuveitis, and 51 control eyes were performed with enhanced depth imaging (EDI) optical coherence tomography. Macular mapping was applied for automated RT measurements of subfoveal, 2mm temporal (T) and 2 mm nasal (N) to the fovea on the horizontal axis, and subfoveal, 2 mm superior (S) and 2 mm inferior (I) to the fovea on the vertical axis. Manual measurement of the CT was performed on EDI scans at the corresponding distances and axis. Statistical analysis was performed by using Kruskal-Wallis and Mann-Whitney tests. Results : CT 2 mm N to the fovea at the horizontal axis was significantly decreased in anterior uveitis (234.48 -/+ 56.96 µm) compared to control. (295.33 -/+ 83.56 µm) (p = 0.001) RT 2 mm I to the fovea on the vertical axis was significantly increased in intermediate uveitis (352.75 -/+15.17µm) compared to control, (308.17 -/+17.55 µm) (p < 0.001) and anterior uveitis. (314.09 -/+18.37µm) (p = 0.001) RT 2 mm S to the fovea on the vertical axis was significantly increased in intermediate uveitis (368.75 -/+ 24.59 µm) compared to control, (313.86 -/+ 13.34 µm) (p <0.001) anterior uveitis, (309.70 -/+17.57 µm) (p < 0.001) and posterior uveitis. (305.45 -/+ 49.21 µm) (p = 0.004) RT 2 mm S to the fovea on the vertical axis was significantly increased in panuveitis (349.00 -/+57.49 µm) compared to control, (p =0.004) and anterior uveitis. (p = 0.002) Conclusions : Our results are consistent with our hypothesis that anterior uveitis affects CT which might be related to the choroidal vascular changes secondary to inflammatory vasodilation or fibrosis of the iris and ciliary body vessels. Inflammation of the choroid causes increase in RT in intermediate, posterior and panuveitis. Further comparative studies will be needed to understand the changes in choroidal vasculature and RT in uveitis. This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016

Diagnostic Criteria And Clinical Manifestations Of Presumed Latent Tuberculosis-Related Uveitis In A Bacille Calmette-Guerin Vaccinatinated Community

Purpose: The wide range of clinical manifestations of presumed latent tuberculosis-related uveitis (TRU) make its diagnosis difficult in an endemic community. We described the ocular manifestations of patients with TRU, and we evaluated the correlation between skin induration value of tuberculin skin test (TST) and tuberculosis antigens tube value of QuantiFERON®-TB Gold (QFT) test in a Bacille Calmette-Guerin (BCG) vaccinated community. Methods: This was a prospective 1-year study in a tertiary referral center. 85 patients,47 (55.3 %) female diagnosed with TRU were included. Mean (standard deviation, SD) age was 52.9 (13.6) years. TST, QFT and pulmonary X-ray were performed. Other possible etiologies of uveitis were ruled-out. Standard anti-tuberculosis therapy (ATT) was started, and response to ATT was monitored. Statistical analysis was performed by using SPSS for Windows 13.0.1 (SPSS Inc., Chicago, IL, USA) Pearson correlation coefficient (r) was used for analysis. p Results: 43 patients (50.6%) had bilateral involvement. The most common ocular manifestation was anterior uveitis (78.8 %) followed by vitritis, panuveitis, papillitis, vasculitis, chorioretinitis and scleritis. The mean (SD) value of TST was 16.53 (6.05) mm and the mean (SD) value of QFT was 8.06 (4.53) IU/ml. Pulmonary X-ray results were normal. All the patients responded to ATT. No statistically significant correlation was found between TST and QFT. (r= 0.105, p=0.498) Conclusions: There is no pathognomonic clinical manifestation of TRU in an endemic, BCG vaccinated community. Presence of bilateral anterior uveitis, positive results for both TST and QFT, and positive response to ATT support the diagnosis of TRU in an endemic, BCG vaccinated community

The serum angiotensin converting enzyme and lysozyme levels in patients with ocular involvement of ankylosing spondylitis, behcet disease, sarcoidosis and latent tuberculosis

Purpose: To evaluate the significance of differences in serum angiotensin converting enzyme and lysozyme levels between the patient groups. Methods: This is a prospective study involving 37 patients with HLAB27+ ankylosing spondylitis, 47 patients with HLAB51+ behcet disease, 29 patients with sarcoidosis and 27 patients with quantiferon+ latent tuberculosis. The patients are included in the study according to the tenets of Decleration of Helsinki. The serum levels of angiotensin converting enzyme and lysozyme are analyzed by enzyme-linked immunosorbent assay. Krusal Wallis and Mann Whitney U tests are used for age distribution, and Chi Square test is used for sex distribution. Multivariate analysis of covariance is used to analyze the significance of differences in serum levels of angiotensin converting enzyme and lysozyme between the patient groups.Results: The increase in serum angiotensin converting enzyme level is significant for patients with sarcoidosis with respect to HLAB27+ankylosing spondylitis, (p<0.001) HLAB51+ behcet disease, (p<0.001) and quantiferon+ latent tuberculosis. (p=0.015) The increase in serum lysozyme level is significant for patients with sarcoidosis with respect to HLAB27+ ankylosing spondylitis,( p< 0.001) and HLAB51+ behcet disease. (p<0.001) However, there is no significant difference of increase serum lysozyme levels between patients with sarcoidosis and quantiferon+ latent tuberculosis. (p=0.051) Conclusions: The increase in serum angiotensin converting enzyme level is helpful for the diagnosis of sarcoidosis. The increase in serum lysozyme level is considered to be helpful for the diagnosis of both sarcoidosis and quantiferon+ latent tuberculosis

Factors effecting the model performance measures area under the ROC curve, net reclassification improvement and integrated discrimination improvement

The aim of this study is to investigate the impact of correlation structure, prevalence and effect size on the risk prediction model by using the change in the area under the receiver operating characteristic curve (Delta AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). In simulation study, the dataset is generated under different correlation structures, prevalences and effect sizes. We verify the simulation results with the real-data application. In conclusion, the correlation structure between the variables should be taken into account while composing a multivariable model. Negative correlation structure between independent variables is more beneficial while constructing a model

Plasma thiol levels are associated with disease severity in nonsegmental vitiligo

Background: Vitiligo is a depigmenting cutaneous disorder with complex pathogenesis. Thiol compounds are well-known organic structures that play a major role in melanogenesis. Aim: The aim of this study was to determine the association between plasma thiol level and disease severity in patients with nonsegmental vitiligo. Methods: A total of 73 patients with nonsegmental vitiligo (57 generalized and 16 localized type) and age- and sex-matched 69 healthy controls were enrolled in the study. Plasma levels of native thiols, disulfides, and total thiols were measured by a novel and automated assay. Disease severity of vitiligo was assessed with Vitiligo Area Scoring Index (VASI) score. The extent, stage, and spread of vitiligo of patients were evaluated according to the Vitiligo European Task Force (VETF) system. Results: The native and total thiol levels of vitiligo patients were higher than those of healthy control group (P≤0.001 and 0.001, respectively). The median VASI score of patients was 0.7 (0.02–28.30). Univariate analyses showed that plasma native thiol levels, VETF spread score, disease duration, and vitiligo type significantly correlated with VASI scores (r=0.237, P=0.043; r=0.458, P<0.001; and P<0.001, respectively). Stepwise multivariate analysis revealed that disease duration (β=0.017; P=0.005) and spread score (β=1.301; P=0.001) were found statistically significant as independent factors on VASI score. Conclusion: Although plasma native thiol level significantly correlated with VASI scores of patients, it is not a predictive factor for vitiligo severity

The relationship between sleep duration, sleep quality and dietary intake in adults

KILINC, FATMA/0000-0001-8297-958X; Karaismailoglu, Eda/0000-0003-3085-7809WOS: 000494785800001To determine the relationship of specific macro- and micro-nutrients and food groups with sleep duration and sleep quality in adults. This cross-sectional descriptive study was conducted on 2446 adults aged between 20 and 64 years in Turkey. The participants' socio-demographic characteristics, anthropometric measurements, and dietary intake (24-h recall) were taken. The Pittsburgh Sleep Quality Index was used to assess sleep quality. In the study, 48.9% of the participants were male and 51.1% were female, with an average age of 38.7 +/- 12.70 years. Total protein, meat, and processed meat product consumption rates of long sleepers were found to be lower than those of normal sleepers (p < 0.05). Saturated fat intake of short sleepers was higher than that of long sleepers (p < 0.018). Participants with good sleep quality were found to consume higher carbohydrate, fiber, beta-carotene, vitamin E, thiamine, vitamin B-6, total folate, vitamin C, calcium, magnesium, potassium, and iron compared to those with poor sleep quality (p < 0.05). When examined in terms of food groups, fruit consumption was higher in individuals with good sleep quality compared to those with poor sleep quality (p < 0.05). In this study, some macro- and micro-nutrients of the diet were found correlated with sleep duration and quality. Mechanisms mediating the relationship between sleep duration and dietary intake are multi-factorial. Because of the differences in appetite-related hormones, such as leptin and ghrelin, and hedonic factors, future studies will benefit from assessing sleep duration/quality and dietary intake

Endocannabinoids modulate apoptosis in endometriosis and adenomyosis

Adenomyosis that is a form of endometriosis is the growth of ectopic endometrial tissue within the muscular wall of the uterus (myometrium), which may cause dysmenorrhea and infertility. Endocannabinoid mediated apoptotic mechanisms of endometriosis and adenomyosis are not known. We hypothesized that the down regulation of endocannabinoid receptors and/or alteration in their regulatory enzymes may have a direct role in the pathogenesis of endometriosis and adenomyosis through apoptosis. Endocannabinoid receptors CB1 and CB2, their synthesizing and catabolizing enzymes (FAAH, NAPE-PLD, DAGL, MAGL) and the apoptotic indexes were immunohistochemically assessed in endometriotic and adenomyotic tissues. Findings were compared to normal endometrium and myometrium. Endometrial adenocarcinoma (Ishikawa) and ovarian endometriosis cyst wall stromal (CRL-7566) cell lines were furthermore cultured with or without cannabinoid receptor agonists. The IC50 value for CB1 and CB2 receptor agonists was quantified. Cannabinoid agonists on cell death were investigated by Annexin-V/Propidium iodide labeling with flow cytometry. CB1 and CB2 receptor levels decreased in endometriotic and adenomyotic tissues compared to the control group (p = 0,001 and p = 0,001). FAAH, NAPE-PLD, MAGL and DAGL enzyme levels decreased in endometriotic and adenomyotic tissues compared to control (p = 0,001, p = 0,001, p = 0,001 and p = 0,002 respectively). Apoptotic cell indexes both in endometriotic and adenomyotic tissues also decreased significantly, compared to the control group (p = 0,001 and p = 0,001). CB1 and CB2 receptor agonist mediated dose dependent fast anti-proliferative and pro-apoptotic effects were detected in Ishikawa and ovarian endometriosis cyst wall stromal cell lines (CRI, 7566). Endocannabinoids are suggested to increase apoptosis mechanisms in endometriosis and adenomyosis. CB1 and CB2 antagonists can be considered as potential medical therapeutic agents for endometriosis and adenomyosis