Anterior Chamber In Patients Research Articles

Morphometric analysis of the anterior chamber in patients with refractory glaucoma after micropulse cyclophotocoagulation

PURPOSE. To evaluate the anatomical-topographic parameters of the anterior chamber of the eye before and after micropulse cyclophotocoagulation (mCPC) in patients with refractory glaucoma in pseudophakic and phakic eyes.METHODS. The study included 60 patients (62 eyes) with moderate (7 eyes) and advanced (55 eyes) refractory glaucoma. Study groups were formed as follows: the 1st group consisted of 31 pseudophakic eyes (32 patients), the 2nd group included 31 phakic eyes (30 patients). All patients underwent mCPC according to a modified technique. To assess anatomical parameters patients underwent optical coherence tomography of the anterior segment (AS-OCT). Anterior chamber angle (ACA) and anterior chamber depth (ACD) were measured at specific follow-up time points after mCPC.RESULTS. Hypotensive effect by the end of 12-month follow-up was achieved in the patients of the first group in 83.1% of cases, in the second group — in 80.6% of cases (p<0.05). According to OCT findings, anterior chamber depth in patients with phakic eyes during the 12-month follow-up remained the same as before surgery — 2.43±0.21 (mm). In the other group with pseudophakic eyes, anterior chamber depth also did not change during the observation period, with an average value of 3.27±0.12 (mm). No significant changes (p>0.05) were found in the irido-corneal angle measurements in the 4 meridians over the entire follow-up period in both groups.CONCLUSION. Micropulse cyclophotocoagulation performed at fluence rate F=121 J/cm2 does not result in changes of structures of the anterior segment of the eye. The stability of anterior chamber anatomy as well as the absence of postoperative complications in early and longterm follow-up proved the minimal traumatic effect of this surgery in patients with refractory glaucoma.

Comparative analysis of the anterior chamber changes after intravitreal injections of aflibercept and brolucizumab

BACKGROUND: Currently, the information is insufficient about the effect of multiple intravitreal injections (IVI) of brolucizumab in comparison with aflibercept on the parameters of iridolenticular diaphragm. AIM: The aim of this study is using optical coherence tomography of the anterior segment (AS-OCT) to evaluate changes in the parameters of the anterior chamber in patients with multiple intravitreal injections of aflibercept and brolucizumab in the treatment of the neovascular form of age-related macular degeneration (nAMD). MATERIALS AND METHODS: In total, 60 patients (60 eyes) were included into the study. The follow-up period duration was 12 months. Patients were divided into 2 groups: group 1 — 30 patients receiving intravitreal injections of aflibercept, group 2 — 30 patients receiving intravitreal injections of brolucizumab. Using a Revo NX tomograph, AS-OCT was performed, the depth of the anterior chamber and the dimensions of the anterior chamber angle were examined. The measurement was performed before intravitreal injections, one month after the first, one month after the third intravitreal injections, and one year after treatment. RESULTS: In both groups, a shift of the iridolenticular diaphragm was noted according to AS-OCT data — a significant decrease in depth of the anterior chamber, anterior chamber angle parameters before treatment and after 4 months of treatment, as well as after a year of treatment. In group 1, in contrast to group 2, a greater number of intravitreal injections led to a greater decrease in the depth of the anterior chamber (rxy = 0.415, p = 0.02) and to a greater narrowing of the anterior chamber angle on the nasal and temporal sides (rxy = 0.37, p = 0.049 and rxy = 0.424, p = 0.02, respectively). CONCLUSIONS: For the first time, changes of the anterior chamber of the eye were determined against the background of multiple intravitreal injections of aflibercept and brolucizumab in the treatment of the neovascular form of age-related macular degeneration using AS-OCT.

Helicobacter pylori and Uveitis: A Brief Narrative Literature Review

Helicobacter pylori (H. pylori) is a gram-negative bacterium that typically infects the mucosa of the stomach. H. pylori is the most frequent causative infectious agent of chronic gastritis and peptic ulcer disease. It has also been associated with a number of extra-gastric diseases-neurological, ocular, hematologic, cardiovascular, rheumatologic, metabolic, and allergic. The possible role of H. pylori in the pathogenesis of uveitis is still unclear. High H. pylori seroprevalence has been found in some studies in patients with other ocular diseases like blepharitis, central serous chorioretinopathy, ocular adnexal lymphoma, and glaucoma. Its seroprevalence in uveitis has been investigated in very few studies. In all of them, however, it was increased. Antibodies have also been found in the anterior chamber of patients with anterior uveitis. Besides, seropositivity was also increased in studies with hypertensive uveitis. Eradication of the bacterium has anecdotally led to the subsidence of anterior uveitis in one patient. In any case, a causal relationship, either infectious or autoimmune, cannot be made at this time due to the scarcity of available research on the problem.

Изменения морфо-анатомических параметров передней камеры глаза при различных видах коррекции иридохрусталикового барьера у пациентов с силиконовой тампонадой витреальной полости

In case of combined pathology, in particular aphakia and regmatogenic retinal detachment, an important point is the leveling of changes in the iridocrustal apparatus. When analyzing the morpho-anatomic parameters of the angle and depth of the anterior chamber using optical coherence tomography, distinctive features were revealed in patients with various methods of correcting the defect of the iridohrustal barrier. Purpose. of the study was to evaluate anatomical changes in the angle and depth of the anterior chamber in patients with various types of intraocular correction of the defect of the capsule-binding apparatus under conditions of tamponade of the vitreal cavity with silicone oil. Material and methods. Studies were conducted on 74 eyes of patients aged 56 to 75 years with various methods of correction of aphakia and silicone tamponade of the vitreal cavity. Results. There was a significant decrease in the anterior chamber angle in various sectors in patients with aphakia, in contrast to patients with anterior chamber and transclerally fixed intraocular lenses. A similar trend is observed in patients with anterocameral intraocular lenses, relative to the group of patients with artifacia. A decrease in the depth of the anterior chamber was revealed in patients with anterior chamber lenses relative to patients with transcleral fixation and articulation was revealed in the upper sector. In the temporal sector, there is a decrease in this indicator in patients with aphakia relative to patients with artifakia. Conclusion. In the conditions of silicone tamponade of the vitreal cavity, the technique of transcleral fixation of intraocular lenses provides the most physiological indicators of the anterior chamber angle comparable to single-format indicators of patients with artifacia. Keywords: intraocular lens, aphakia, regmatogenic retinal detachment

Определение цитокинов в сыворотке крови и во влаге передней камеры у пациентов с глаукомой и катарактой на фоне псевдоэксфолиативного синдрома

Purpose. To investigate changes in proinflammatory cytokines Interleukin (IL 1β) and Tumor necrosis factor (TNF-α) before surgery in anterior chamber moisture and in blood serum in cataract and in its combination with glaucoma due to pseudoexfoliative syndrome (PES). Material and methods. The results of the examination included 61 patients aged 56 to 86 years (average age 72.2 years) who were hospitalized for cataract surgery. Among them, 12 (19.7 %) people had primary open-angle pseudoexfoliative glaucoma with normalized intraocular pressure (IOP). A group of 34 patients were diagnosed with PES, but without the presence of glaucoma. The control group consisted of 15 patients with cataracts of comparable age without signs of PES. The analysis of the results took into account the data of ophthalmological examination, immunological studies, namely measurements of the concentration of IL-1ß and TNFa in blood serum and in the moisture of the anterior chamber, as well as somatic status. Results. PES, in general (i.e. in the study of 46 patients), occurred in 23.9 % of cases, stage II — in 43.5 % and stage III — in 32.6%. With a combination of cataracts and glaucoma (in the advanced stage), PES stage I was diagnosed more often — in 33.3 %.Inflammatory postoperative complications were diagnosed only in stages II or III of PES, and more often with a combination of glaucoma and cataract (in 33.3 % of cases) than with isolated surgical treatment of cataract (11.8 %). There was a statistically significant (p < 0.05) increase in the indicators of proinflammatory cytokines IL- 1ß and TNF-α in blood serum and especially in the moisture of the anterior chamber in patients with PES in comparison with the age control group. Various concomitant somatic pathologies in patients with PES, especially in the presence of glaucoma, occurred more often (93.5 %) than in patients without pseudoexfoliation (73.3 %). Conclusion. Significantly increased, in comparison with the control rate, concentrations of proinflammatory cytokines IL-1β and TNFa in blood serum and moisture of the anterior chamber of the eyes with unoperated cataract, and especially when combined with glaucoma due to PES, correlated with the degree of its development and the risk of postoperative, including inflammatory, complications. Taking into account more frequent presence of somatic pathology in patients with PES, it is necessary to have more frequent dynamic follow-up after surgery of patients with PES for the purpose of early diagnosis and timely treatment of potential complications. Keywords: cataract, glaucoma, surgical treatment, pseudoexfoliative syndrome, proinflammatory cytokines Interleukin (IL-1β) and Tumor necrosis factor (TNF-α), postoperative, inflammatory complications

Alternatives for corneal endothelial tissue engineering

AbstractCorneal endothelial diseases are common almost everywhere in the world and have 3 main origins: primary diseases, largely dominated by Fuchs' endothelial corneal dystrophy (FECD), iatrogenic diseases which mainly complicate lens surgery, whether cataract or clear lens, but also other surgeries. The frequency of these complications is very low but the number of these surgeries being gigantic (probably around 50 million cases/year/worlwide), the number of post‐surgical bullous keratopathy remains important. Post‐keratoplasty endothelial failure (early or late) is the 3rd cause.All these diseases “consume” 50% of corneal grafts in the world and a large part of the population does not have access to any graft. The number of corneal donors is absolutely insufficient to meet the world demand and corneal bioengineering appears to be a realistic solution to complete the offer. Because of its relative simplicity and the demonstrated effectiveness of endothelial keratoplasty, endothelial bioengineering is logically the first to be developed. The Japanese team of 2 Kyoto universities (Prof. S. Kinoshita, N. Koizumi and N. Okumura) is a pioneer in this field and has demonstrated the effectiveness of injection therapy, which consists of cultivating mature endothelial cells from a small number of corneas from young donors, then injecting them into the anterior chamber of patients. The industrialization of the process is underway in 2 different start‐ups, one in the United States, the other in Japan. In addition to injection therapy, the bioengineering of endothelial grafts (Tissue engineered endothelial keratoplasty, TEEK), which consists of cultivating endothelial cells on a “corneo‐compatible” carrier to exactly reproduce a DMEK or a DSAEK, has passed the preclinical stage. This presentation will detail these different processes, their current limitations and the short, medium and long term perspectives. These Advanced Therapy Medicinal products (ATMP) are clearly revolutionizing corneal transplantation. By offering a new treatment for endothelial diseases, they will make it possible to redirect donor corneas to other corneal diseases that have no therapeutic alternative. Finally, this paper will also discuss the prospects of medical and medico‐surgical treatments for FECD, which are at the frontier of endothelial bioengineering.

Penetrating Keratoplasty With Sutureless Intrasclerally Fixated Intraocular Lens.

In this retrospective study, we reviewed the use of penetrating keratoplasty with sutureless intrasclerally fixated intraocular lens implantation in a closed anterior chamber in patients with several corneal pathologies and aphakia. The medical records of 6 patients, who underwent the procedure, were reviewed. In the procedure, lamellar scleral tunnels at the 2- and 8-o'clock positions were created with a microvitreoretinal blade, 1.5 mm away from the limbus. Two 27-gauge bent needles were passed, first horizontally, through these tunnels, and then vertically, which allowed them to enter the posterior chamber and to be left in position. Partial thickness trephination was made, and anterior stroma was removed where necessary. An incision was made at the 11-o'clock position, where the trephination was made, which was then extended to both sides for about 6 mm with corneal scissors. From the superior incision, the anterior haptic of a 3-piece intraocular lens was pushed through the needle at the 2-o'clock position, then the posterior haptic was pushed through the needle at the 8-o'clock position, and both haptics were removed through the sclera. Both ends were cauterized and placed into the sclera. Residual stroma was removed, and the donor graft was sutured. At the last follow-up visit, the mean bestcorrected visual acuity was significantly increased. No serious complications were seen, with the exception of increased intraocular pressure in 3 patients. Penetrating keratoplasty with sutureless intrasclerally fixated intraocular lens implantation can be used safely in patients with aphakia. With this technique, the globe stabilization can be maintained, and the trauma to the donor graft endothelium can be minimized.

Intraindividual comparison of cytokine and prostaglandin levels with and without low-energy, high-frequency femtosecond laser cataract pretreatment after single-dose topical NSAID application.

To investigate interleukin (IL)-1β, IL-6, and total prostaglandin (PG) levels in the anterior chamber in patients undergoing low pulse energy femtosecond laser-assisted cataract surgery. Forty patients undergoing immediate sequential cataract surgery received randomized low-energy femtosecond laser pretreatment in 1 eye and conventional phacoemulsification in the other. Aqueous humor was collected precisely 5 minutes after femtosecond laser pretreatment and before conventional phacoemulsification from all 80 eyes. IL-1β, IL-6, and total PG (including PGE1, PGE2; PGF1a, PGF2a) levels were analyzed using enzyme-linked immunoassay kits. One drop of ketorolac 0.5% was administered 30 minutes preoperatively. Mean concentrations of IL-1β, IL-6, and total PG were 0.87, 0.67, and 32.19 pg/mL in the femto group compared with 0.10 (P = .36), 0.78 (P = .79), and 19.66 pg/mL (P < .05) in the nonfemto group. Levels of IL-1β and IL-6 were not statistically significantly different when compared between groups. There was a small but statistically significant increase of PG levels in the femto group. There were no statistically significant correlations between levels of 1β, IL-6, or total PG and suction time or lens density (P > .05). Low pulse energy femtosecond laser pretreatment did not trigger any additional IL and only a small but statistically significant increase of PG release in the anterior chamber after a single-dose of topical nonsteroidal antiinflammatory drug administered 30 minutes before the start of cataract surgery. The findings indicated that the minor inflammatory reaction was due to the lower pulse energy concept applied by the femtosecond laser.

Diyabetik Makuler Ödem Tedavisinde İntravitreal Aflibercept ve Ranibizumab Enjeksiyonunun Kornea Endoteline ve Ön Kamaraya Etkisi

Amaç: İntravitreal ranibizumab ve aflibercept enjeksiyonu yapılan gözlerdeki kornea endotel sayısı ve morfolojisinin ve ön kamara anatomisinin incelenmesidir. Gereç ve Yöntemler: Bu prospektif ve kesitsel çalışmaya, diyabetik makuler ödem nedeni ile tedavi edilen 51 hastanın 102 gözü dâhil edildi. Hastaların tek gözüne 1 ay ara ile üç doz intravitreal ranibizumab ya da aflibercept enjeksiyonu uygulandı. Ranibizumab enjeksiyonu yapılan hastalar ranibizumab grubuna (n=26), aflibercept enjeksiyonu yapılan hastalar aflibercept grubuna (n=25) dâhil edildi. Her iki grupta da hastaların tedavi edilmeyen gözleri kontrol grubu olarak alındı. Hastaların endotel hücre sayısı (EHS), hücre alanı değişim katsayısı (CV), altıgen şekilli hücre (HKZ) yüzdesi, merkezi kornea kalınlığı (MKK), ön kamara derinliği (ÖKD), ön kamara hacmi (ÖKH), iridokorneal açı (İKA) ve horizontal ön kamara çapı (HÖKÇ) değerlendirmeleri yapıldı. Bulgular: Aflibercept ve ranibizumab grubunda hem tedavi edilen gözlerde hem de kontrol gözlerde tedavi öncesi ve sonrasında ortalama korneal endotel hücre sayısı, CV ve HKZ yüzdesi bakımından istatistiksel olarak anlamlı fark yoktu. Her iki gruptaki ortalama MKK değeri hem tedavi edilen gözlerde hem de kontrol gözlerde tedavi öncesinde tedavi sonrasına göre anlamlı olarak daha fazla idi (p<0,05). Her iki grupta, tedavi edilen ve kontrol gözlerde ortalama ÖKD, ÖKH, İKA ve HÖKÇ değerleri arasında tedavi öncesi ve sonrası anlamlı bir fark izlenmedi. Sonuç: Çalışmamız, intravitreal aflibercept ve ranibizumab enjeksiyonunun kornea endotelinde ve ön kamara yapısında herhangi bir değişikliğe sebep olmadığını göstermiştir.

Study of angle of anterior chamber in patients with Type 2 Diabetes Mellitus

Introduction: Open angle Glaucoma is one of the causes of blindness in diabetic patients. Whether diabetes is a risk factor for angle closure glaucoma also is less thoroughly studied. Objectives: To assess the angle of anterior chamber in patients with type 2 diabetes mellitus. Materials and Method: 125 patients (250 eyes) who met the inclusion criteria were taken up for the study. Patients of both sexes and more than 40 years of age with Type 2 Diabetes Mellitus who do not come under the exclusion criteria were included. Results: In subjects with duration of diabetes &lt;5 years, Grade 4 angle was found in 47.41% of eyes which was comparatively more than the other grades. When the duration of Diabetes was 5-10 years, 40% of the eyes had Grade 4 angle and 37.27% had Grade 3 angle. In subjects with &gt;10 years duration of diabetes, 33.33% had Grade 3 angle. Grade 2 and Grade 4 angles were of equal distribution with 29.16% and Grade 1 was found to be less. The association of Grade 1 and Grade 3 angle with severe non-proliferative diabetic retinopathy was found to be statistically significant. Whereas, in patients with mild diabetic retinopathy and in moderate non-proliferative diabetic retinopathy Grade 4 angle is statistically significant. Conclusion: This study thus concludes the grade of angle of the anterior chamber decreases as the diabetic retinopathy advances.

Correlation between intraocular pressure and the biometric structure of the anterior chamber in patients of chronic renal failure with hemodialysis

Correlation between intraocular pressure and the biometric structure of the anterior chamber in patients of chronic renal failure with hemodialysis

Application of Rho Kinase Inhibitors for the Treatment of Corneal Endothelial Diseases.

ROCK (Rho kinase) signaling regulates a wide spectrum of fundamental cellular events and is involved in a variety of pathological conditions. It has therefore attracted research interest as a potential therapeutic target for combating various diseases. We showed that inhibition of ROCK enhances cell proliferation, promotes cell adhesion onto a substrate, and suppresses apoptosis of corneal endothelial cells (CECs). In addition, we reported that a ROCK inhibitor enhances wound healing in the corneal endothelium in animal models and in pilot clinical research. We also demonstrated the usefulness of a ROCK inhibitor as an adjunct drug in tissue engineering therapy as it enhances the engraftment of CECs onto recipient corneas. In 2013, we initiated a clinical trial to test the effectiveness of injection of cultured human CECs into the anterior chamber of patients with corneal endothelial decompensation. This paper reviews the accumulating evidence supporting the potency of ROCK inhibitors in clinical use, both as eye drops and as adjunct drugs in cell-based therapies, for the treatment of corneal endothelial decompensation.

Role of immunological factors in the development of myopic choroidal neovascularization

To study the concentration of cytokines in the aqueous humor of the anterior chamber in patients with myopic choroidal neovascularization (mCNV) and to compare the results to their ophthalmic status. A total of 19 patients (19 eyes) with mCNV treated with intravitreal ranibizumab were included in the study. The control group consisted of 15 patients (15 eyes) with myopia who had cataract surgery. Age, sex, and refractive error distribution were similar to that in the study group. All patients underwent a detailed ophthalmic examination as well as immunological study of the aqueous humor for cytokines concentrations using flow fluorometry (Bio-Plex Pro Human Cytokine Panel, 27-Plex, Bio-Rad Laboratories, USA). Significant differences in concentrations of 10 cytokines were found between the mCNV and study groups. Vascular endothelial growth factor (VEGF) level was twice as low in patients with mCNV as that in the controls (191.15±142.3 pg/ml and 320.06±170.05 pg/ml, respectively) (p<0.05). The other 9 cytokines were higher in mCNV, namely, platelet-derived growth factor (PDGF-BB), inflammatory and anti-inflammatory cytokines (IL-2, IL-15, IL-17А and IL-5, IL-13, respectively), tumor necrosis factor (TNFα), and chemokines (IL-8, RANTES). The degree of myopia as well as morphological and functional changes in the macular zone were shown to be in close correlation with cytokines involved in inflammation and VEGF. VEGF level appeared to be negatively related to axial eye length, refractive error, and three cytokines: IL-13, INF-γ, and RANTES. At the same time, numerous (6, 8 and more) close correlations were established between inflammatory and anti-inflammatory cytokines, chemokines, and growth factors. Patients with mCNV have been found to have higher than usual levels of inflammatory and anti-inflammatory cytokines, chemokines, and growth factors as well as a significantly decreased VEGF concentration. Immunological status of these patients differs from that in other ocular neovascular diseases suggesting possible involvement of alternative pathogenetic mechanisms.

Evaluation of Ocular Side Effects in the Patients on Topiramate Therapy for Control of Migrainous Headache.

Topiramate, a sulfa-derivative monosaccharide, is an antiepileptic drug which is administered in the control of migraine. It is reported to cause various ocular side effects such as visual field defect and myopic shift. To investigate the alterations in refractive error, properties of the cornea and changes in the anterior chamber in patients that receive Topiramate for migraine control. This is a hospital-based, non-interventional, observational study that is conducted at Imam Hossein Hospital, affiliated to Shahid Beheshti University of Medical Sciences, Department of Neurology, in collaboration with the department of Ophthalmology. Thirty three consecutive patients with the diagnosis of migraine that were candidate for Topiramate therapy were recruited. Patients with history of ocular trauma or surgery, keratoconus, glaucoma, congenital ocular malformations and any history of unexplained visual loss were excluded. After thorough ophthalmic examination, all the patients underwent central corneal thickness (CCT) measurement, and Pentacam imaging (Scheimpflug camera) at the baseline. Various parameters were extracted and used for analysis. Anterior chamber volume (ACV), anterior chamber depth (ACD), and anterior chamber angle (ACA) measurement was performed. These measurements were repeated on day 30(th) and 90(th) after the initiation of Topiramate therapy. According to the normality tests, parameters with normal distribution were analysed using the repeated measures test and the remaining parameters (with non-normal distribution) were analysed using the non-parametric k-sample test. A p-value< 0.05 was considered statistically significant, according to Bonferroni post hoc correction. There were 66 eyes of 33 patients under the diagnosis of migrainous headache, that Topiramate was initiated for headache control, included in the study. The mean value of refractive error had a statistically significant myopic change, from -0.23 diopters (D) at the baseline to -0.61 D at the 90(th) day of follow-up period (p-value < 0.001). Mean CCT was 531.43 μm at the baseline and increased to 534.72 μm at the 30(th) day, and 537.51 μm at the 90(th) day after the administration of Topiramate (p-value=0.001). Mean value of other parameters, ACV, ACD, and ACA, did not reveal statistically significant change. Myopic shift and gradually increasing CCT in the patients after Topiramate administration should be considered before any refractive surgery. We found no gradual change in the anterior chamber and angle parameters in our patients in the 90 days of follow up. More studies with a longer duration of follow-up are needed to elucidate dose-dependent ocular manifestations.

Glaucoma Schlemm's canal stent insertion: a systematic review

Schlemm's canal stent insertion is a procedure for controlling the intraocular pressure by inserting a stent in the anterior chamber in patients with open-angle glaucoma. The objective of this review is to evaluate the safety and effectiveness of Schlemm's canal stent insertion for glaucoma. Searches of key databases, including 8 Korean databases, Medline, Embase, and Cochrane Library, were searched. Among 249 articles located in the search, a total of 14 studies (4 randomized controlled trials and 10 case series) were included in this review. Two review authors independently selected the studies and assessed their quality. On the basis of current data, we recommend that Schlemm's canal stent insertion is safe and effective for reducing intraocular pressure and the number of anti-glaucoma medications being administered for patients with open angle glaucoma.

The injection of air/oxygen bubble into the anterior chamber of rabbits as a treatment for hyphema in patients with sickle cell disease.

Purpose. To investigate the changes of partial oxygen pressure (PaO2) in aqueous humour after injecting air or oxygen bubble into the anterior chamber in sickle cell hyphema. Methods. Blood samples were taken from the same patient with sickle cell disease. Thirty-two rabbits were divided into 4 groups. In group 1 (n = 8), there was no injection. Only blood injection constituted group 2 (n = 8), both blood and air bubble injection constituted group 3 (n = 8), and both blood and oxygen bubble injection constituted group 4 (n = 8). Results. The PaO2 in the aqueous humour after 10 hours from the injections was 78.45 ± 9.9 mmHg (Mean ± SD) for group 1, 73.97 ± 8.86 mmHg for group 2, 123.35 ± 13.6 mmHg for group 3, and 306.47 ± 16.5 mmHg for group 4. There was statistically significant difference between group 1 and group 2, when compared with group 3 and group 4. Conclusions. PaO2 in aqueous humour was increased after injecting air or oxygen bubble into the anterior chamber. We offer to leave an air bubble in the anterior chamber of patients with sickle cell hemoglobinopathies and hyphema undergoing an anterior chamber washout.

Дослідження впливу діодної лазерної трабекулопластики у режимі мікроімпульсу аЬ ехіето на вміст трансформуючого фактору росту р2 у волозі передньої камери ока пацієнтів із відкритокутовою первинною глаукомою

Дослідження впливу діодної лазерної трабекулопластики у режимі мікроімпульсу аЬ ехіето на вміст трансформуючого фактору росту р2 у волозі передньої камери ока пацієнтів із відкритокутовою первинною глаукомою

INTRAOCULAR PHARMACOKINETICS AFTER A SINGLE INTRAVITREAL INJECTION OF 1.5 mg VERSUS 3.0 mg OF BEVACIZUMAB IN HUMANS

To compare the concentration of unbound bevacizumab in the anterior chamber of patients with macular edema, who received a single intravitreal injection of two different dosages. This was a comparative, interventional case series. Twenty-nine nonvitrectomized eyes of 29 patients with significant lens opacities and concurrent macular edema were included in the study. All patients were treated by a single dose of intravitreal injection of bevacizumab 1.5 mg (Group A, n = 13) or 3.0 mg (Group B, n = 16). Subsequent phacoemulsification and aspiration of an aqueous humor samples were performed at various intervals (1-60 days). The axial length of the globe was measured using the IOLMaster to calculate the total volume and corresponding globe size-corrected half-time. The concentration of unbound bevacizumab was measured by enzyme-linked immunosorbent assay and pharmacokinetic parameters including half-time of elimination. The mean peak concentration was observed in both groups on the first day after intravitreal bevacizumab injection. The mean concentration of unbound bevacizumab ranged in Group A from 17.5 μg/mL at baseline to 0.66 μg/mL at Day 57 and in Group B from 28.3 μg/mL at baseline to 0.00 μg/mL at 54 days. The axial lengths of all injected eyes were not significantly different between Group A (mean values, 23.026 mm, SD 1.21) and Group B (mean, 23.313 mm, SD 1.00; P = 0.31). Regression analysis determined elimination half-time values of 7.85 days (R2 = 0.75) in Group A and 11.67 days (R2 = 0.91) in Group B. Similar half-times were calculated for globe size-corrected concentrations with 8.21 days (R2 = 0.81) in Group A and 11.17 days (R2 = 0.88) in Group B. Single- and double-dose injections have similar pharmacokinetic characteristics in a first-order exponential decay function. The globe size-corrected concentration and half-time did not affect the calculated half-time in both groups. Doubled dosing induced a higher peak concentration at baseline, but the presumed extended biologic active concentration was no longer statistically significant after 6 weeks. The application of twice the dosage does not double the duration of its efficacy; it rather appears to extend the pharmacological duration by 1 half-time or approximately 8 days to 11 days.

Morphologic changes in the anterior chamber in patients with cortical or nuclear age-related cataract

To assess and compare the morphologic changes in the anterior segment in eyes with nuclear or cortical age-related cataract using Scheimpflug imaging. Peking University People's Hospital, Beijing, China. Case-control study. Patients with nuclear or cortical age-related cataract were recruited. The grade of nuclear opalescence or cortical opacity was assessed using the Lens Opacities Classification System III (LOCS III). A group of elderly subjects with a clear lens and normal vision served as the control group. Anterior chamber depth (ACD), anterior chamber volume (ACV), and lens thickness were evaluated using Scheimpflug imaging (Pentacam). Two hundred sixty-nine patients (330 eyes) were recruited. Thirty eyes were enrolled for each nuclear opalescence and cortical grade. The control group comprised 30 eyes (19 subjects). In eyes with age-related cataract, lens thickness increased with an increase in cortical opacity, whereas the ACD and ACV values decreased. The ACD was inversely correlated with LOCS III grades for nuclear opalescence (r = -0.197, P = .004), nuclear color (r = -0.195, P = .005), and cortical opacity (r = -0.508, P<.005). There were significant differences in lens thickness, ACD, and ACV between nuclear color, nuclear opalescence, and cortical opacity for LOCS III grades 3, 4, and 5, respectively. There were significant differences in lens thickness, ACD, and ACV between nuclear and cortical age-related cataracts. The ACD decreased more in eyes with cortical cataract, suggesting that the risk for angle-closure glaucoma may be greater in cases of cortical opacity in which lens expansion is greater. No author has a financial or proprietary interest in any material or method mentioned.

Measurement of Angiogenesis Promotors and Cytokines Concentrations in Intraocular Fluid of Patients with Proliferative Diabetic Retinopathy

Introduction: To prove the suitability of multiplex analysis for measurement of changes of cytokines and angiogenetic factors in intraocular fluid of patients with proliferative diabetic retinopathy (PDR) and to determine its clinical applicability for future routine use in ocular medicine. Patient cohort: Patients with proliferative diabetic retinopathy. Control group patients before cataract surgery without any ocular pathology Methods: Intraocular fluid samples were aspirated from anterior chamber of patients with PDR. Concentrations of IL8, VEGF, EGF, IL 6, IP10, MCP1, PDGF, Rantes, BDNF, CNTF TGFb1 and IL 10 were measured simultaneously in intraocular fluid using multiplex panel kits from Millipore comp. (USA) and Luminex 100 instrument (Luminex corp., USA). Levels of biomarkers were compared between groups by Wilcoxon test. Results: Multiplex analysis is a suitable method for angiogenesis promotors measurement, because concentrations were generally measurable through the use of multiplex analysis. Complete results will be presented but a most important observation we confirmed were significantly increased concentrations of VEGF in PDR patients in comparison to control group. Conclusion: Multiplex analysis enables an easy simultaneous measurement of multiple markers in a very small sample volume and so enables the use of biomarker analyses in intraocular fluid in a future as a standard method. Prospective: To confirm the right choice of analytes and the system of results interpretation for multiplex panel in larger patient cohorts and to evaluate the possibilities of use in diagnosis patient monitoring in ocular medicine. Measurement of Angiogenesis Promotors and Cytokines Concentrations in Intraocular Fluid of Patients with Proliferative Diabetic Retinopathy Jindra Vrzalova*, Kozova Marketa, Rusnak Stepan, Ricarova Renata, Topolcan Ondrej Immunoanalytic Laboratory and Eye Department of University Hospital and Medical Faculty in Pilsen,Plzen,Czech Republic doi:10.4172/2155-9929.1000014