Histopathological view of benign essential blepharospasm: Orbicularis oculi hormone receptor levels

Objectives: Benign essential blepharospasm (BEB) is a focal dystonia characterized by involuntary contractions of the orbicularis oculi and periocular muscles. We aimed to investigate the effects of muscle receptor levels on the etiopathogenesis of blepharospasm by evaluating the orbicularis oculi estrogen receptor (ER) and androgen receptor (AR) levels. Methods: Four blepharospasm patients (2 females and 2 males) who underwent upper lid blepharoplasty and/or orbicularis myomectomy and 4 healthy cases (2 females, 2 males) that had upper lid blepharoplasty were included. The pretarsal, preseptal, and orbital parts of the orbicularis muscles of the patients who underwent orbicularis myomectomy and the waste muscle tissue materials taken from the preseptal orbicularis muscles of the patients who had only upper blepharoplasty were analyzed. Immunohistochemical staining was performed with estrogen alpha and androgen. Results: In healthy men, the orbicularis oculi muscle was stained with ER at a moderate intensity and with AR at a high intensity. In men with blepharospasm, the orbicularis oculi were not stained with ER at all, but at a high intensity with AR. In healthy women, the orbicularis oculi were stained with ER and AR at a high intensity (>50%). In women with blepharospasm, the staining intensities of both receptors were moderate. Conclusion: We determined a decrease in ER and AR in females and almost the absence of ER in males with BEB. This decrease in ER may be associated with a functional abnormality in mitochondria and the decrease in hormonal receptors may be associated with sarcopenia in orbicularis oculi muscle fibers

Factors affecting visual acuity after accelerated crosslinking in patients with progressive keratoconus

ABSTRACT Purpose: The present study aimed to report the outcomes of patients with progressive keratoconus who were treated via accelerated crosslinking (CXL) 6 months earlier and to determine the factors that promoted improved visual acuity after treatment. Methods: This retrospective study included 35 eyes of 34 patients with progressive keratoconus who underwent CXL. Topographical measurements were obtained preoperatively and in the first, third, and sixth months postoperatively using a rotating Scheimpflug camera. The uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), flat keratometry (K) value (K1), steep K value (K2), average K value (avgK), topographic cylindrical value (Cyl), apical keratoscopy front (AKf), apical keratoscopy back (AKb), symmetry index front (SIf), symmetry index back (SIb), and thinnest point of the cornea (ThkMin) were recorded. Results: At the 6-month follow-up, the mean UCVA and BCVA values were improved, and the K values remained stable. Statistically significant decreases in AKf (p=0.04) and the thinnest point of the cornea (p=0.001) and a statistically significant increase in AKb (p=0.01) were observed. A correlation analysis revealed that the preoperative BCVA, UCVA, K1, K2, avgK, AKf, and AKb values significantly affected visual acuity at the 6-month follow-up. Conclusions: Accelerated CXL is an effective treatment for the prevention or even reversal of keratoconus progression. The preoperative K values and apexes of the anterior and posterior cornea were found to affect visual acuity at 6 months after accelerated CXL. Both AKb steepening and AKf flattening appear to be important factors in the stabilization of keratometric values and improvement of visual outcomes

Alterations in biomechanical properties of the cornea among patients with polycystic kidney disease

WOS: 000439166500024PubMed ID: 28664236The aim of this study was to evaluate the corneal biomechanical features in polycystic kidney disease (PKD) patients and compare them with the healthy individuals. Totally 81 patients with a mean age of 48.46 +/- 14.51 years and 60 control cases with a mean age of 44.68 +/- 12.69 years were included in the study. All of the subjects underwent a complete ophthalmological examination, including visual acuity testing, biomicroscopic anterior and posterior segment examinations. Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated intraocular pressure (IOPcc) were evaluated with the ocular response analyzer, and the central corneal thickness was evaluated with Sirius(A (R)) corneal topography. PKD patients had significantly increased CH values, without any alterations in IOP or CCT values, compared with the control cases (p:0.001). Among PKD patients, 23 were having liver cysts accompanying renal cysts. There was not any statistically significant difference between PKD patients with or without liver cysts regarding biomechanical properties of the cornea. However, both patient groups had statistically significantly increased CH values compared with the control cases. Patients with PKD present with higher CH values than age-matched controls. Larger studies are warranted to elucidate the alterations in corneal biomechanical properties and their clinical relevance in PKD patients

The effects of hemodialysis on tear osmolarity

WOS: 000365249700001PubMed ID: 26640702Aim. To determine the effects of hemodialysis (HD) on tear osmolarity and to define the blood biochemical tests correlating with tear osmolarity among patients with end stage renal disease (ESRD). Material-Method. Tear osmolarity of ESRD patients before and after the hemodialysis program was determined as well as the blood biochemical data including glucose, sodium, potassium, calcium, urea, and creatinine levels. Results. Totally 43 eyes of 43 patients (20 females and 23 males) with a mean age of 53.98 +/- 18.06 years were included in the study. Tear osmolarity of patients was statistically significantly decreased after hemodialysis (314.06 +/- 17.77 versus 301.88 +/- 15.22mOsm/L, p = 0.0001). In correlation analysis, pre-HD tear osmolarity was negatively correlated with pre-HD blood creatinine level (r = -0.366, p = 0.016). Post-HD tear osmolarity was statistically significantly correlated with the post-HD glucose levels (r = 0.305 p = 0.047). Tear osmolarity alteration by HD was negatively correlated with creatinine alteration, body weight alteration, and ultrafiltration (r = -0.426, p = 0.004; r = -0.365, p = 0.016; and r = -0.320, p = 0.036, resp.). There was no correlation between tear osmolarity and Kt/V and URR values. Conclusion. HD effectively decreases tear osmolarity to normal values and corrects the volume and composition of the ocular fluid transiently. Tear osmolarity alteration induced by HD is correlated with body weight changes, creatinine alterations, and ultrafiltration

Alterations in corneal biomechanical and topographic features after accelerated crosslinking: 1-year results

Objectives: To determine the biomechanical and topographic alterations within the first year after accelerated crosslink-ing (CXL) treatment in patients with keratoconus. Methods: In this prospective study, 52 eyes of 52 patients with progressive keratoconus underwent accelerated CXL were included. All patients had a detailed preoperative ophthalmologic examination, including slit-lamp evaluation, Gold-mann tonometry, fundoscopy, topography by Scheimpflug imaging (Sirius), and corneal biomechanical evaluation with a biomechanical waveform analysis device (ORA). Alterations in visual acuity and topographic findings were evaluated before the treatment and at 12 months follow-up. Corneal biomechanical features were obtained before the treatment, and at 1st, 3rd, 6th and 12th months. Results: Uncorrected-visual acuity and best-corrected visual acuity both statistically significantly improved at 12th month (p=0.001). There were no statistically significant differences in keratometry values, whereas maximum K (AKfront) and symmetry index front (SIfront) decreased significantly (p=0.015 and p=0.009, respectively). Corneal thinnest point and volume also decreased significantly at 12th month (p=0.001 for both). Goldmann-correlated intraocular pressure (IOPg) and corneal compensated IOP (IOPcc) values transiently increased in the first three months, while corneal hysteresis (CH) and the corneal resistance factor (CRF) transiently decreased, with the difference not statistically significant (p>0.05). However, central corneal thickness significantly decreased at the end of the 12th month (p=0.001). Conclusion: Accelerated CXL seems to be effective in stopping the progression of keratoconus. Our findings showed transient alterations in biomechanical features, which will end with the preoperative values at the end of the 12th month. Further studies are needed to demonstrate the changes in corneal biomechanics in vivo

Comparision of optical low coherence reflectometry versus ultrasonic biometry in high hypermetropia

WOS: 000457837000021PubMed ID: 27898517Purpose: To compare anterior chamber depth (ACD), axial length (AL), and lens thickness (LT) measurements obtained by the Lenstar LS 900 (Haag-Streit AG) optical low-coherence reflectometry with those obtained by the A-scan contact ultrasound among patients with moderate and high hypermetropia. Methods: Fifty-two eyes of 52 patients with moderate and high hypermetropia (spherical equivalent of +4 D or more) were examined in this study measurements of ACD, AL, and LT obtained by Lenstar were compared with those obtained by applanation A-scan ultrasound. All measurements were obtained by two independent examiners. The interdevice agreements were evaluated with Bland-Altman analyses. Results: The mean age of the patients was 54.78 +/- 12.77 years (range 18-74 years). The mean spherical equivalent refractive power was +5.16 +/- 1.12 D (+4.0 to +8.75). The mean values of ACD, AL, and LT with A-scan were 3.05 +/- 0.34, 21.55 +/- 0.75, and 4.33 +/- 0.49 mm, respectively, whereas these values were 2.99 +/- 0.45, 21.58 +/- 0.78, and 4.20 +/- 0.44 mm, respectively, with Lenstar. There was statistically significant difference of LT between the two methods (P=0.02). The mean differences (lower/upper limit of agreement) of the ACD, AL, and LT values for A-scan ultrasound and Lenstar were -0.06 (-0.594/0.474), 0.04 (-0.380/0.459), and -0.12 (-0.739/0.502), respectively. Conclusion: Among patients with moderate and high hypermetropia, the biometric measurements of ACD, AL, and LT by ultrasound and optical biometry were determined to be correlated and there was a high degree of agreement between contact A-scan ultrasonic biometry and Lenstar

Comparision of Central Corneal Thickness between Patients with Pseudoexfoliation Syndrome and Normal Subjects

Amaç: Psödoeksfoliasyon sendromlu (PES) olguların santral kornea kalınlık (SKK) değerlerini normal bireylerle karşılaştırmayı amaçladık. Yöntemler: Glokomu olan ve olmayan PES'li 39 hastanın 58 gözü ile 30 kontrol olgunun 60 gözü prospektif çalışmamız kapsamına alındı. SKK değerleri ultrasonik pakimetri cihazıyla ölçülerek gruplar arasında karşılaştırıldı. Bulgular: Psödoeksfoliasyon sendromlu gözlerin ortalama SKK'ları (539,99±37,1 ?m) normal gözlerden (558,62±30,67 ?m) istatistiksel olarak anlamlı derecede düşük bulunmuştur (p=0,0001). Glokomu olan ve olmayan PES'li gözler arasında SKK ortalamaları açısından istatistiksel olarak anlamlı bir fark bulunmamıştır (541,94±29,32 ?m, 538,23±39,03 ?m sırasıyla) (p=0,724). Sonuç: Psödoeksfoliasyon sendromlu gözlerde SKK'nın daha ince olması, yapay düşük göz içi basıncı ölçüm sonucu olarak glokom tanısının gecikmesine ve hastalığın hızlı progresyonuna neden olabilir.Objective: We aimed to compare the central corneal thickness (CCT) measurements of the cases with pseudoexfoliation syndrome (PES) and normal subjects. Methods: Sixty eyes of 30 control cases and 58 eyes of PES patients with and without glaucoma were included in our prospective study. The CCT values were measured with ultrasound pachymetry and compared between groups. Results: Mean CCT was statistically significantly thinner in PES eyes (539.99±37.1 ?m) than in normal eyes (558.62±30.67 ?m) (p=0.0001). There was no statistically significant difference in mean CCT between the PES eyes with and without glaucoma (541.94±29.32 ?m, 538.23±39.03 ?m, respectively) (p=0.724). Conclusion: Thinner CCT in eyes with PES, as a result of artificially lower intraocular pressure readings, may cause late diagnosis of glaucoma and rapid progression of the disease