Orbital myositis associated with celiac disease

A 26-year-old female patient presented with redness, lid edema on the right eye and diplopia on left gaze. There was a minimal limitation of adduction of the right eye, accompanied with pain and diplopia. Orbital magnetic resonance imaging confirmed the diagnosis of orbital myositis. Anti-endomysial immunoglobulin (Ig) A, anti-endomysial IgG, anti-gliadin IgA and anti-tissue transglutaminase IgG antibodies were positive, while other tests for autoimmune diseases were unremarkable. The patient stated that her diarrhea had been relieved by a gluten-free diet. Methylprednisolone therapy (1 mg/kg) was started and on her next visit her complaints were relieved. Later, methotrexate (15 mg/week) was added to the therapy as the patient became steroid-dependent, and she has been attack-free for the last 3 months under methotrexate and low-dose methylprednisolone (4 mg/day) treatment. Associations between orbital myositis and various autoimmune diseases have previously been reported. We report here the first case of associated orbital myositis and celiac disease

Serum Erythropoietin, Insulin-Like Growth Factor 1 and Vascular Endothelial Growth Factor in Ethiopathogenesis of Retinopathy of Prematurity

Pur po se: The aim of this study was to determine the serum levels of erythropoietin (EPO), vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF-1) that possibly play an important role in the pathogenesis of retinopathy of prematurity (ROP) and to investigate their relationship with each other. Ma te ri al and Met hod: In this study, 93 infants with gestational age of less than 32 weeks or had a birth weight of less than 2000 g were investigated prospectively. To determine levels of EPO, VEGF and IGF-1, samples were collected from cord blood and were reserved at -80°C. Serum levels of cytokines in babies with and without ROP (ROP+ and ROP-) were determined and their relationship with each other was investigated. Re sults: ROP was found in 57 (61.3%) babies. There was a significant difference between ROP- and ROP+ groups for birth weight (1678.06±326.03 g; 1383.95±343.23 g; p=0,001) and birth week (29.65±2.34 weeks; 32.22±1.49 weeks; p=0,001) correspondingly. Besides, IGF-1 levels correlated significantly with birth weight (r=0.509; p=0.001) and birth week (r=0.586, p=0.001). Median serum levels in ROP(-) group were 19.45 ng/ml (0-40 ng/ml) for IGF-1, 1159.5 pg/ml (396.59-2389.25 pg/ml) for VEGF, and 6.14 mU/ml (2.6-35.4 mU/ml) for EPO. The median serum levels in ROP+ group were 0 ng/ml (0-30.6 ng/ml) for IGF-1, 864.98 pg/ml (182.57-2133.05 pg/ml) for VEGF, and 6.07 mU/ml (2.4-90.2 mU/ml) for EPO. Levels of IGF-1 (p=0.008) and VEGF (p=0.011) were significantly lower in the ROP(+) group. Serum VEGF correlated with EPO levels (r=0.275; p=0.019). Dis cus si on: Serum IGF-1 and VEGF levels at birth may be measured to assess the risk for developing ROP. (Turk J Ophthalmol 2012; 42: 423-8

Diurnal Spikes of Intraocular Pressure in Uveitic Glaucoma: A 24-hour Intraocular Pressure Monitoring Study

Purpose The aim of this study was to document diurnal changes in intraocular pressure (IOP) in uveitic glaucoma (UG) and compare it with primary open angle glaucoma (POAG) patients. Methods Eight patients with UG and seven patients with POAG were included in this study. The patients were matched for age, gender, and glaucoma medications. None of the patients experienced angle closure, uveitis attack, and ocular surgery, and were not under steroid or immunomodulatory therapy within the last three months. The 24-hour IOP fluctuations were recorded with the help of a contact lens sensor (Sensimed Triggerfish (R), Switzerland). The diurnal IOP fluctuations were modeled with best-fit lines and statistical comparisons between the longitudinal responses of the two groups were determined with nonlinear regression. Results The comparison of mean 24-hour contact lens sensor (CLS) amplitudes revealed a significant difference between the fluctuation levels of UG and POAG groups (213 +/- 160 millivolt equivalents (mVeq) vs. 162 +/- 168 mVeq, respectivelyp= .003). The top level of the best-fit curves was significantly higher in the UG group (266 +/- 143 mVeq) compared to the POAG group (159 +/- 162 mVeq,p< .001). Both curves had their top levels between 5:00 PM and 8:00 AM. The longitudinal regression analysis revealed that the amplitudes of the 24-hour fluctuation waves were significantly different (p= .041). Conclusions This study demonstrated for the first time that the diurnal variation in IOP was significantly higher in UG patients. This difference was also more distinct between 5:00 PM and 8:00 AM clock-hours. The uveitis and glaucoma specialists should consider this potential for higher IOP fluctuations, while tailoring the glaucoma treatment in uveitic patients