The ocular hypotensive effect of saffron extract in primary open angle glaucoma: a pilot study

BACKGROUND: The progressive nature of glaucoma and its growing incidence make its therapy an important target for research. The role of oxidative damage in the pathogenesis of glaucoma makes antioxidants such as saffron extract an attractive target for potential clinical use. Herein, we evaluate the effect of aqueous saffron extract on intraocular pressure (IOP) in eyes with primary open-angle glaucoma (POAG). METHODS: Thirty-four eyes of 34 clinically stable POAG patients receiving treatment with timolol and dorzolamide eye drops were enrolled in this prospective, comparative, randomized interventional pilot study. Eligible subjects were randomized to receive 30 mg/day aqueous saffron extract orally (17 subjects, 17 eyes) or placebo (17 subjects, 17 eyes) for one month as an adjunct to timolol and dorzolamide. Following treatment, both study groups entered a one-month wash-out period. The main outcome measure was IOP during treatment and after the wash-out period. RESULTS: Mean baseline IOP was 12.9 ± 3.7 versus 14.0 ± 2.5 mmHg in the saffron and control groups, respectively (p = 0.31). After three weeks of treatment, IOP was significantly decreased to 10.9 ± 3.3 mmHg in the saffron group as compared to 13.5 ± 2.3 mmHg in the control group (p = 0.013). At four weeks, IOP was still significantly lower in the saffron group (10.6 ± 3.0 versus 13.8 ± 2.2 mmHg, p = 0.001). At the end of the wash-out period, IOP was 12.9 ± 3.0 in the saffron group versus 14.2 ± 2.0 mmHg in the control group (p = 0.175). None of the patients experienced side effects during the study and wash-out period. CONCLUSIONS: Oral aqueous saffron extract seems to exert an ocular hypotensive effect in primary open-angle glaucoma. This effect became evident after three weeks of therapy. The current study was registered at the International Clinical Trials Registry Platform (ICTRP) as IRCT201201278832N1

Bilateral photic maculopathy following pterygium excision: Spectral domain optical coherence tomography findings

Purpose: To report high resolution spectral domain optical coherence tomography (SD-OCT) findings in a case with bilateral photic maculopathy and resultant central scotoma following pterygium excision. Case Report: A 38-year-old man with a history of pterygium excision complained of visual disturbance and annoying central scotoma in both eyes. Although he had subtle funduscopic and angiographic changes, SD-OCT precisely showed disruption of the photoreceptors inner segment/outer segment in the foveal center. Conclusion: Phototoxic macular damage following ocular surgeries may be diagnosed with difficulty due to subtle funduscopic findings. SD-OCT is a precise imaging in revealing characteristic retinal alterations in different foveal injuries. Ophthalmologists should be aware of the possibility of photic maculopathy following various ophthalmic operations including pterygium surgery

Tumor necrosis factor gene polymorphisms in advanced non-exudative age-related macular degeneration

Purpose: To investigate tumor necrosis factor (TNF)-α gene polymorphisms in advanced dry-type age-related macular degeneration (AMD) in a population from Northeastern Iran. Methods: In this case-control study, 50 patients with geographic macular atrophy and 73 gender-matched controls were enrolled. Genomic deoxyribonucleic acid (DNA) was extracted from the peripheral blood. Polymerase chain reaction was performed to analyze 2 candidate single nucleotide polymorphisms in the TNF-α gene, namely −1031 thymine (T)/cytosine (C) and −308 guanine (G)/adenine (A). Results: The distribution of the - 1031 T/C genotype was TT, 62%; TC, 36%; CC, 2% in the patients and TT, 60%; TC, 36%; CC, 4% in the controls (P = 0.94). Genotype analysis of TNF-α −308 also revealed no significant difference in distribution between patients (G, 78%; GA, 22%; AA, 0%) and controls (GG, 74%; GA, 23%; AA, 3%) (P = 0.51). None of the haplotypes nor alleles of studied TNF-α polymorphisms were significantly associated with advanced dry-type AMD. Conclusion: The findings of this study show that polymorphisms in the TNF-α gene, do not play an important role in dry-type AMD in the studied population

Association of combined cigarette smoking and <i>ARMS2/LOC387715 A69S</i> polymorphisms with age-related macular degeneration: A meta-analysis

<p><i>Purpose</i>: The age-related maculopathy susceptibility2 (<i>ARMS2</i>)/<i>LOC387715 A69S</i> (rs10490924) polymorphism and cigarette smoking have been shown to have significant association with AMD. In this meta-analysis we used the results of available association studies of combined <i>ARMS2/LOC387715</i> genotypes and cigarette smoking with AMD to estimate the possible synergistic or multiplicative effects.</p> <p><i>Methods</i>: Heterogeneity of studies was evaluated using the Cochran Q-test and the I-square index. To compensate for the heterogeneity of the variables in the study we used a random effects model. Meta-analysis was performed using STATA. To estimate the additive or supra-additive effects, we calculated relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), synergy index (S), and multiplicative index (V).</p> <p><i>Results</i>: We could include four studies with 1982 AMD patients and 1797 control subjects. Considering the GG-no smoking as a reference line the meta-analysis result of AMD odds ratios for stratified combined factors was 3.05 (95% CI 2.32–4.02) for nonGG-no smoking, 2.24 (95% CI 1.39–3.63) for GG-smoking and 4.59 (95% CI 3.51–6.01) for nonGG-smoking. The meta-analysis of synergy analysis revealed RERI = 2.01 (95% CI 1.01–3.25), AP = 0.40 (95% CI 0.22–0.54), S = 2.02 (95% CI 1.35–3.01), and V = 1.31 (95% CI 0.94–1.83).</p> <p><i>Conclusion</i>: This analysis revealed the synergistic effect of these two factors indicating that there is a common pathway of <i>ARMS2/LOC387715</i> and smoking in AMD pathogenesis which may be the complement system pathway.</p