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To describe the management and outcome of two extremely rare and painful cases of Mooren's ulcer, an idiopathic peripheral autoimmune-associated ulcerative corneal disease. Case report with literature review on the management of ocular inflammation in Mooren's ulcer. A 47-year-old female and a 76-year-old female presented with progressive bilateral Mooren's ulcer that were refractory to conventional immunosuppressive therapy. Following treatment with infliximab, an anti-tumor necrosis factor alpha, a significant improvement in disease progression was observed, with no corneal thinning or perforation at follow-ups. This case report highlights how infliximab can be effective in cases with Mooren's ulcer refractory to conventional therapies. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate age-related differences in clinical patterns of ocular graft-versus-host disease (GVHD). Materials and Methods: In this cross-sectional study, patients diagnosed with ocular GVHD were evaluated in two groups: Group I included those aged 18 years or younger and Group II included those over 18 years of age. Demographic and clinical information were recorded and compared between the groups. Results: Forty eyes of 20 patients were included (11 patients were in Group I and 9 patients were in Group II). Follow-up was at least 6 months. All patients had burning, dryness, and foreign body sensation. Conjunctival hyperemia, cicatricial conjunctivitis, and limbal stem cell disease (LSCD) was observed more frequently in Group II. In addition to non-preserved artificial tears, cyclosporine A 0.05% (65%) and autologous/allogeneic serum eye drops (80%) were given and silicone plugs were inserted (28%). In Group I, an improvement in GVHD scoring and best corrected visual acuity was observed after 6 months of treatment (p<0.0005). Conclusion: In ocular GVHD, conjunctival cicatrization and limbal stem cell deficiency might be observed more often in adults. Topical cyclosporine, autologous/allogenic serum drops, and punctal plugs are helpful in moderate or more severe cases. With early diagnosis and treatment, an improvement in clinical signs and visual acuity might be observed, particularly in younger patients. [ABSTRACT FROM AUTHOR]

Purpose: To report the clinical characteristics, treatment modalities and long term follow-up of 16 pediatric ocular acne rosacea patients.Methods: The medical records of pediatric ocular acne rosacea patients were reviewed.Results: There were 16 patients with a mean age of 7.7 ± 5 (1-16) years. The mean follow-up period was 52.8 ± 52 (3-150) months. Eight patients had skin involvement. The mean duration of delay for diagnosis was 16.2 ± 5.1 (4-48) months. Nine patients had a delayed diagnosis. Meibomitis, blepharitis, lid telangiectasia, and conjunctival hyperemia were present in all cases. Systemic antibiotics were prescribed in 12 patients. The mean delay in diagnosis was longer in patients with conjunctival/corneal involvement (p = .001) and these patients required longer systemic treatment (p = .001). Complete remission was achieved in 87.5% of cases.Conclusion: Children presenting with a long history of ocular irritation, meibomian gland disease, recurrent chalazia and peripheral corneal infiltrates should alert ophthalmologists to consider the diagnosis of ocular acne rosacea even in the absence of skin changes. [ABSTRACT FROM AUTHOR]

Objectives: To report the clinical features, treatment options and complications in patients with ocular rosacea. Materials and Methods: The records of 48 eyes of 24 patients with ocular rosacea were retrospectively reviewed. Patients' ocular signs and symptoms were scored between 1 and 4 points according to disease severity; tear film break-up time (BUT) and Schirmer's test results were recorded before and after the treatment. Preservative-free artificial tears, topical antibiotic eye drops/ointments, short-term topical corticosteroids, topical 0.05% cyclosporine and oral doxycycline treatment were applied as a standard therapy to all patients. Additional treatments were given as needed. Complications were recorded. Results: Twenty-four patients with a mean age of 48.5±35.4 (32-54) years were followed for a mean 15±9.4 (8-36) months. Ocular findings included meibomitis in 100% of cases, anterior blepharitis in 83% (40 eyes), punctate keratopathy in 67% (32 eyes), chalazia in 50% (24 eyes), corneal neovascularization in 50% (24 eyes) and subepithelial infiltrates in 16.6% (8 eyes). Significant improvement of symptoms and clinical findings were achieved in all patients with treatment. The increases in Schirmer's test and BUT were 3.3±1.5 and 4.5±2.8, respectively (p<0.05). Descemetocele and small corneal perforation occurred in 2 eyes; re-epithelialization was achieved in both eyes with tissue adhesive application (1 eye) and additional amniotic membrane transplantation (1 eye). Four eyes of three patients showed significant regression of corneal neovascularization with topical bevacizumab therapy. Conclusion: Ocular rosacea may present with a variety of ophthalmic signs. It is possible to control the ophthalmic disease with appropriate therapeutic modalities including topical corticosteroids, topical cyclosporine and systemic doxycycline. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the clinical findings, treatment modalities and long-term prognosis of chemical and thermal burns of the cornea. Materials and Methods: Twenty-one patients (27 eyes) who were followed at two centers for corneal chemical and thermal burns between 2001 and 2013 were included. Eyes were grouped into four grades according to the severity of burn using Roper-Hall classification. Age, gender, type of burn, follow-up duration, corrected visual acuity before and after treatment, treatment modalities and complications were recorded. Patients received medical treatment or combined surgical treatment including amniotic membrane transplantation (AMT), conjunctivolimbal autograft/allograft (CLAU/CLAL) transplantation, keratolimbal allograft (KLAL) or penetrating keratoplasty (PKP). Results: Patients had a mean age of 27.1±15.5 years (range, 6 months-56 years) and were followed for a mean 63.2±58.6 weeks (4¬160 weeks). Significant improvement was achieved with medical treatment alone in patients with grade I (4 eyes) and 2 burns (8 eyes). Patients with grade III burns (11 eyes) underwent CLAU (6 eyes), combined AMT/CLAU (3 eyes), AMT/CLAL (1 eye), or CLAL+PKP (1 eye), while patients with grade IV burns (4 eyes) had keratectomy+CLAL/AMT (1 eye), keratectomy+CLAL+PKP after recurrence with CLAU/AMT (1 eye), CLAU+PKP (1 eye), and AMT/KLAL+PKP (1 eye). All patients except the latter showed ocular surface stabilization with these procedures. Conclusion: Ocular burns cause severe impairment of the ocular surface. It is possible to achieve good results with appropriate medical treatment and surgeries including ocular surface reconstruction. [ABSTRACT FROM AUTHOR]

In this case report we aimed to present a case of Lyme disease presenting as peripheral retinal vasculitis, intermediate uveitis and multifocal white dots in the posterior pole. The patient exhibited vitritis and snowball opacities in both eyes. A diagnosis of Lyme disease was made based on clinical, angiographic and laboratory findings. Fundus fluorescein angiography revealed optic nerve and retinal venous leakage as well as multiple hyperfluorescent foci in both eyes. The patient's symptoms and ocular findings significant improved after treatment with a combination of systemic antibiotics and steroids. Ophthalmologists should bear in mind that conditions presenting with uveitis and multifocal white dots may be related to Lyme disease. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the clinical characteristics and findings in patients with intermediate uveitis. Materials and Methods: The records of the 35 patients diagnosed as intermediate uveitis in our clinic between years 1996 and 2011 were reviewed retrospectively. Best-corrected visual acuity, intraocular pressure, slit lamp examination, dilated fundus examination, fundus fluorescein angiography, and systemic examination results of the patients were noted. Results: The mean follow-up time was 6.2 years (2-16 years). The mean age at diagnosis of intermediate uveitis was 32.4 years (8-68 years). 17.1% of patients were under 18 years old. 65.7% of patients were women, 34.2% were men, and both eyes were affected in 54.3% of patients. The most frequent findings were vitritis (100%), snowball opacities (97.1%), retinal vasculitis (65.7%), and snowbanking (45.7%). Concurrent iridocyclitis was determined in 71.4% of patients. Systemic association was found in 40.1% of patients, with disease being multiple sclerosis (22.9%), sarcoidosis (11.4%), tuberculosis (2.9%), or Lyme disease (2.9%). The most common complication that developed during the follow-up period included secondary glaucoma (22.9%), cataract formation (17.1%), and cystoid macular edema (17.1%). The visual acuity of 3 patients was less than 0.5 due to the optic atrophy, macular hole, and cystoid macular edema sequel, respectively. The mean final visual acuity of the remaining patients was 0.9±0.2. Conclusion: When the inflammation and complications are treated effectively in intermediate uveitis, the visual prognosis is fairly good. Detailed clinical evaluation of such cases may reveal systemic diseases at the initial examinations or follow-up visits. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the clinical characteristics and findings in patients with intermediate uveitis. Materials and Methods: The records of the 35 patients diagnosed as intermediate uveitis in our clinic between years 1996 and 2011 were reviewed retrospectively. Best-corrected visual acuity, intraocular pressure, slit lamp examination, dilated fundus examination, fundus fluorescein angiography, and systemic examination results of the patients were noted. Results: The mean follow-up time was 6.2 years (2-16 years). The mean age at diagnosis of intermediate uveitis was 32.4 years (8-68 years). 17.1% of patients were under 18 years old. 65.7% of patients were women, 34.2% were men, and both eyes were affected in 54.3% of patients. The most frequent findings were vitritis (100%), snowball opacities (97.1%), retinal vasculitis (65.7%), and snowbanking (45.7%). Concurrent iridocyclitis was determined in 71.4% of patients. Systemic association was found in 40.1% of patients, with disease being multiple sclerosis (22.9%), sarcoidosis (11.4%), tuberculosis (2.9%), or Lyme disease (2.9%). The most common complication that developed during the follow-up period included secondary glaucoma (22.9%), cataract formation (17.1%), and cystoid macular edema (17.1%). The visual acuity of 3 patients was less than 0.5 due to the optic atrophy, macular hole, and cystoid macular edema sequel, respectively. The mean final visual acuity of the remaining patients was 0.9±0.2. Conclusion: When the inflammation and complications are treated effectively in intermediate uveitis, the visual prognosis is fairly good. Detailed clinical evaluation of such cases may reveal systemic diseases at the initial examinations or follow-up visits. [ABSTRACT FROM AUTHOR]

Purpose: This study was carried out to determine the ocular pharmacokinetics, efficacy and potential endothelial toxicity of moxifloxacin (MF) after a single intracameral bolus injection of 500 µg/0.1 ml in a rabbit model. Materials and methods: Forty-eight eyes of 24 New Zealand White Rabbits were separated into six groups, each including four rabbits. 0.1 ml of 0.5% intracameral moxifloxacin (500 µg) injection was injected to the right eyes and 0.1 ml of balanced salt solution to the left eyes (control). Aqueous humor (AH) and vitreous samples were collected at the 0.5th, 1st, 3rd, 6th, 12th and 24th hours from both eyes of group 1, 2, 3, 4, 5 and 6, respectively. MF concentrations were determined by high performance liquid chromatography. These were compared with the minimum inhibitory concentrations (MIC) and mutant prevention concentrations (MPC) for frequent endophthalmitis pathogens. Electron and light microscopical evaluation of the corneas were performed. Results: Moxifloxacin reaches higher concentration than the MIC of all common endophthalmitis pathogens in the AH and exceeds the mutant prevention concentration levels for Streptococcus pneumonia, Streptococcus viridans, flouroquinolone susceptible Coagulase-negative staphylococcus and flouroquinolone susceptible Staphylococcus aureus for 6 h. The half-life of moxifloxacin in the AH was 2.2 h. Electron and light microscopic evaluation revealed no noticeable sign of toxicity. Conclusions: Peroperative intracameral moxifloxacin injection for endophthalmitis prophylaxis is a safe and effective method in uncomplicated phacoemulsification surgery. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical findings and outcomes of uveitis in patients with multiple sclerosis (MS). Material and Method: We retrospectively evaluated the medical records of eight MS patients who had presented with uveitis to the uveitis clinic between years 2005 and 2011. Results: The mean visual acuity of the thirteen eyes of eight patients (seven women, one man; mean age 39±7.5 years; mean follow-up 3.8±1.8 years) was 0.7±0.2 at the time of presentation. Two patients were diagnosed as anterior uveitis related with MS, five patients as intermediate uveitis and retinal vasculitis, and one patient as retinal vasculitis alone. All patients received interferon β-1a during the follow-up. The uveitis treatment was applied according to the localization of the disease. Except in one, the visual acuity was restored in all patients at the end of follow-up. Discussion: Uveitis can be taken under control and recurrences and permanent visual loss can be prevented in patients treated with interferon β-1a. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effects of intracameral drugs and dyes on rat corneal endothelial apoptosis and cell morphology. Materials and Methods: The right eyes of 72 rats were injected intracamerally with 1% lidocaine, 0.01% adrenaline, triamcinolone acetonide (TA) 4 mg/mL, 1% trypan blue (TB), 0.5% indocyanine green (ICG), and fortified balanced salt solution as control. Corneal samples were taken 1 day and 1 week post-injection. Corneal endothelial apoptosis was assessed by the TUNEL technique, and the ratio of apoptotic cells in each group was compared with the control. Corneal endothelial cell morphology was evaluated in each specimen by transmission electron microscopy. Results: The mean apoptotic endothelial cell ratio was significantly higher at 1 day and 1 week after intracameral adrenaline injection when compared to controls (p=0.03 and 0.021, respectively). TB caused a significantly higher apoptotic cell ratio when compared to controls at 1 week after injection (p=0.043). Lidocaine caused a higher apoptotic cell ratio compared to TA and ICG at 1 week, although not statistically significant (p=0.058, 0.09, 0.69, respectively). In all experimental specimens, transmission electron microscopy showed morphological changes associated with apoptosis. Conclusion: This study showed that intracameral adrenaline, TB, and lidocaine injections may have toxic effects on corneal tissue, as indicated by ultrastructural and histopathological alterations. Therefore, these agents should be used with caution in intraocular surgery. [ABSTRACT FROM AUTHOR]

The life expectancy of elderly cataract patients is increasing and intraocular lens (IOL) implantation is performed in pediatric cataract patients who will have an even longer life expectancy. Longer life expectancy has increased the implantation of blue-filtering IOLs, which are more protective against the harmful effects of light. Studies showed that these IOLs have no negative effect on visual acuity, contrast sensitivity, color vision, scotopic vision, or circadian rhythm. [ABSTRACT FROM AUTHOR]

Purpose: To report the results ofphacoemulsificarion and toric intraocular lens (lOl) implantation in patients with cataraer and high astigmatism. Material and Method; Medical records of 21 eyes of 17 patients (6 men, 11 women) with 1,5 diopter (D) or more corneal astigmatism who underwent phacoemulsificarion and foldable hydrophobic acrylic toric inrraocular lens implantation at Bajkent University, Deparrment of Ophthalmology between 2008 and 2011 were reviewed. Preoperative and postoperative I-month data were recorded and compated for best corrected log Mar visual acuity (BCVA). and corneal and refractive cylinder powers. Torle 10l axis shift was also evaluated at postoperative 3 monrhs. Results: The average age of the patients was 63.0±6.9 years. The mean follow. up duration was 17.9±4.8 monrhs (range, 12-28). The mean preoperative BCVA and refractive cylinder were 0.47 ±0.3 (range, 0.3-2.0, log-Mar) and 3.11 ± 1.32 D, respectively. Postoperative BCVA increased to a mean ofO.14',0.27 (range, 0.1-1.0, log-Mar). while refractive cylinder power decreased to a mean of 1.00±0.98 ar rhe end of follow· up. Discussion: Toric 10l implantation is an effective surgical alternative in patients with high astigmatism and cataract. It is possible to correct preexisring astigmatism and to achieve visual recovery with toric rOl implamation with a good preoperative planning and proper surgical technique. [ABSTRACT FROM AUTHOR]

Pur po se: To report the results of phacoemulsification and toric intraocular lens (IOL) implantation in patients with cataract and high astigmatism. Ma te ri al and Met hod: Medical records of 21 eyes of 17 patients (6 men, 11 women) with 1,5 diopter (D) or more corneal astigmatism who underwent phacoemulsification and foldable hydrophobic acrylic toric intraocular lens implantation at Başkent University, Department of Ophthalmology between 2008 and 2011 were reviewed. Preoperative and postoperative 1-month data were recorded and compared for best corrected log Mar visual acuity (BCVA), and corneal and refractive cylinder powers. Toric IOL axis shift was also evaluated at postoperative 3 months. Re sults: The average age of the patients was 63.0±6.9 years. The mean follow-up duration was 17.9±4.8 months (range, 12-28). The mean preoperative BCVA and refractive cylinder were 0.47±0.3 (range, 0.3-2.0, log-Mar) and 3.11±1.32 D, respectively. Postoperative BCVA increased to a mean of 0.14±0.27 (range, 0.1-1.0, log-Mar), while refractive cylinder power decreased to a mean of 1.00±0.98 at the end of follow-up. Dis cus si on: Toric IOL implantation is an effective surgical alternative in patients with high astigmatism and cataract. It is possible to correct preexisting astigmatism and to achieve visual recovery with toric IOL implantation with a good preoperative planning and proper surgical technique. [ABSTRACT FROM AUTHOR]

Toxic anterior segment syndrome (TASS) is a sterile intraocular inflammation caused by noninfectious substances, resulting in extensive toxic damage to the intraocular tissues. Possible etiologic factors of TASS include surgical trauma, bacterial endotoxin, intraocular solutions with inappropriate pH and osmolality, preservatives, denatured ophthalmic viscosurgical devices (OVD), inadequate sterilization, cleaning and rinsing of surgical devices, intraocular lenses, polishing and sterilizing compounds which are related to intraocular lenses. The characteristic signs and symptoms such as blurred vision, corneal edema, hypopyon and nonreactive pupil usually occur 24 hours after the cataract surgery. The differential diagnosis of TASS from infectious endophthalmitis is important. The main treatment for TASS formation is prevention. TASS is a cataract surgery complication that is more commonly seen nowadays. In this article, the possible underlying causes as well as treatment and prevention methods of TASS are summarized. [ABSTRACT FROM AUTHOR]

Aim To compare the aqueous humour penetration of moxifloxacin 0.5% and gatifloxacin 0.3% eye drops administered in two different dosing regimens during phacoemulsification surgery. Methods This prospective, randomised study included 97 patients. The patients were randomly divided into two treatment groups to receive either moxifloxacin or gatifloxacin. All patients received the topical antibiotics four times per day for 2 days prior to surgery. Patients in each group were further subdivided to receive additional doses of antibiotic drops as two drops 30 min apart (subgroup 1) versus four drops 10 min apart (subgroup 2) 1 h prior to the surgery. At the beginning of surgery, 0.1 ml of aqueous humour was aspirated, and the concentrations of moxifloxacin and gatifloxacin were analysed by high-performance liquid chromatography. Results The mean concentrations of moxifloxacin and gatifloxacin in the aqueous humour were 0.7260.40 mg/ml and 0.4760.29 mg/ml, respectively, in the first subgroup, and 1.9561.05 mg/ml and 0.7760.52 mg/ml, respectively, in the second subgroup. Both the inter-group (p=0.006 and p=0.000, respectively) and the intra-group (p=0.000 and p=0.035, respectively) differences between the aqueous humour concentrations of moxifloxacin and gatifloxacin subgroups were statistically significant. Conclusion Moxifloxacin, given in the same dosage, penetrated the aqueous humour better then gatifloxacin during cataract surgery. The penetration of both antibiotics increased significantly when the dosage of the agent was doubled. [ABSTRACT FROM AUTHOR]

To report peripheral retinal vasculitis in a case of Lyme disease. Peripheral retinal vasculitis was seen in a symptom-free patient, and a diagnosis of Lyme disease was made based on clinical, angiographic and laboratory findings. Lyme disease, although rarely encountered, should be taken into consideration when determining the etiology in cases of peripheral retinal vasculitis. [ABSTRACT FROM AUTHOR]

To report peripheral retinal vasculitis in a case of Lyme disease. Peripheral retinal vasculitis was seen in a symptom-free patient, and a diagnosis of Lyme disease was made based on clinical, angiographic and laboratory findings. Lyme disease, although rarely encountered, should be taken into consideration when determining the etiology in cases of peripheral retinal vasculitis. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the demographic, etiological and clinical features of uveitis patients followed at our clinic. Material and Method: In this retrospective study, medical charts of patients diagnosed with uveitis between 1996 and 2006 were reviewed. Analysis of age at onset, gender, family history, ophthalmological examination, laboratory findings and therapeutic approaches was made for each patient. Results: In the study group, a total of 275 patients were included-158 (57.5%) females and 117 (42.5%) males aged between 5 and 83 (mean 43.9±17.3). Behçet's disease was found to be the main cause of uveitis in the study group (n=64, 23.3%). Anterior uveitis, as seen in 127 cases (46.2%), was the most common anatomical type. Most cases tended to present bilaterally (n=150, 54.6%). In males, 26-40 years was the most common age interval for uveitis presentation, whereas uveitis in females predominantly occurred between 41-60 years. Discussion: Uveitis, as being associated with systemic diseases and having severe ocular complications, needs to be evaluated via a multidisciplinary collaboration. Larger future studies are necessary to identify the demographic, etiological and clinical features of the disease. [ABSTRACT FROM AUTHOR]

Punctate inner choroidopathy is an idiopathic, inflammatory disorder that is characterized by yellowish white spots at the level of retina pigment epithelium and inner choroid. It is associated with a high incidence of choroidal neovascularization (CNV). Vision loss occurs mainly due to CNV development, and treatment options include systemic steroids, laser photocoagulation, interferon ?1a, and submacular surgery. We report a case of punctate inner choroidopathy and discuss the results of intravitreal bevacizumab treatment for CNV. [ABSTRACT FROM AUTHOR]

Purpose: To present the treatment approach to ocular complications in two cases with autosomal recessive dystrophic epidermolysis bullosa (EB) and to review the literature. Material and Method: Two teenage girls with EB, one with symblepharon (case 1) and the other with corneal opacity and vascularization (case 2) presented to our clinic. Case 1 had symblepharon, extending from the left upper eyelid to the superotemporal cornea, restricting the globe movements. During surgery, symblepharon lysis and lamellar keratectomy were followed by amniotic membrane transplantation to cover the cornea and palpebral conjunctiva. At presentation, case 2 was using artificial tears and topical cyclosporin A. The right eye had visual acuity of counting fingers, and opacity with superficial and deep vascularization in the lower third of the cornea. Topical bevacizumab and autologous serum were added to her treatment. Results: In Case 1, 63 months after surgery the eyelid margin was smooth and the eye was fully mobile. A mild symblepharon of the temporal conjunctiva in both eyes was present. Stromal thinning, superficial vascularization and opacification were significant in the temporal cornea. During the 8-month follow-up period of case 2, the visual acuity increased to 20/50. Slit-lamp examination showed a decrease in corneal opacity and vascularization. Discussion: According to our cases, alternative treatments such as amniotic membrane transplantation to treat symblepharon, and topical bevacizumab and autologous serum in intractable vascularization and opacity can be considered in cases of EB. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the diagnosis, treatment, and visual outcome in patients with retinal vasculitis (RV). Materials and Methods: The clinical records of 71 patients diagnosed with RV between 1997 and 2007 were reviewed retrospectively. The diagnosis was made by slit-lamp examination and fundus fluorescein angiography. Results: Forty-one patients were diagnosed with Behçet's disease (57.7%), 7 patients with sarcoidosis (9.8%), 7 patients with primary RV (9.8%), 4 patients with pars planitis (5.6%), 4 patients with multiple sclerosis (5.6%), 3 patients with Eales' disease (4.2%), 2 patients with ocular toxoplasmosis (2.8%), 1 patient with Lyme disease (1.4%), 1 patient with idiopathic retinal vasculitis, aneurysm, and neuroretinitis (IRVAN) syndrome (1.4%), and 1 patient with tuberculosis (1.4%). Fluorescein angiography of these patients showed optic disc leakage in 60 patients (84.5%), diffuse vascular leakage in 59 patients (83.09%), cystoid macular edema in 21 patients (29.5%), peripheral segmentary vascular leakage in 12 patients (16.9%), peripheral retinal ischemia in 10 patients (14.08%), and macular ischemia in 5 patients (7.04%). Occlusive vasculitis was determined in 11 patients (15.4%). Visual acuity improved in 43 patients (60.5%), stayed at the same level in 19 patients (26.7%), and worsened in 9 patients (12.6%) after the treatment given according to the diagnosis. Conclusion: Retinal vasculitis may occur in isolated form or in association with other ocular and systemic inflammatory diseases. We can expect better visual outcomes with a multidisciplinary diagnostic and therapeutic approach. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the referral patterns, demographic and clinical features, and visual prognosis of patients with sarcoid uveitis seen at 2 tertiary eye care centers in Turkey. A retrospective study was made of 44 patients with uveitis associated with biopsy-confirmed or presumed sarcoidosis. Thirty-four patients (77%) were female and 10 (23%) were male. The mean age at onset of uveitis was 39.8 years. Twenty-seven patients (61%) were referred without a diagnosis of sarcoidosis and 17 (39%) patients were referred with a diagnosis of systemic sarcoidosis. The duration of uveitis prior to referral was 2-15 years in 52% of the patients in the former group. At presentation, 37 patients (84%) had bilateral and 7 patients (16%) had unilateral uveitis, and 17 patients (39%) had only anterior uveitis. The most common ocular findings were granulomatous keratic precipitates, persistent posterior synechiae, and snowball vitreous opacities. Kaplan-Meier survival analysis estimated the risk of recurrence as 30% at 6 months and 61% at 5 years. New complications developed in 18 patients. Potential visual acuity was better than 0.4 in 80% of eyes. The estimated risk of losing potential visual acuity by at least 2 lines was 7% at 6 months and 43% at 5 years. None of the eyes lost useful vision (> 0.1) under the authors' care. The referral patterns suggest underrecognition of sarcoidosis as a cause of uveitis in Turkey. The demographic and clinical features of these patients were mostly similar to those reported from other countries, suggesting that the diagnosis may not be difficult in Turkish patients but requires an increased awareness of the disease in this population. [ABSTRACT FROM AUTHOR]

Purpose: To monitor the development of graft vascularization by indocyanine green angiography (ICGA) after pterygium excision with limbal-conjunctival autograft transplantation (LCAT) and amniotic membrane transplantation (AMT). Design: Randomized prospective interventional case series. Methods: Anterior segment ICGA findings at one, seven, and 30 days after surgery were evaluated in eyes with primary pterygium treated by excision and LCAT (14 eyes of 14 patients) or AMT (13 eyes of 13 patients), and the results for graft vascularization were compared. Results: All conjunctival autografts showed early vascularization from underlying episcleral vascular bed as multiple hyperfluorescent foci at the graft margin on postoperative day 7; graft vascularization was complete on postoperative day 30. In contrast, all grafts in AMT group showed no graft vascularization at any stage after pterygium surgery. This delay of vascularization with AMT persisted until one month after surgery. Conclusions: Anterior segment ICGA is useful to monitor graft vascularization after pterygium surgery. Graft health after LCAT may be demonstrated by early graft vascularization and perfusion; however, there is a delay in graft vascularization after AMT that may be related to the antiangiogenic effects of the membrane. Further study is needed to demonstrate the relationship between this delay of graft perfusion and early postoperative pterygium recurrence. [Copyright &y& Elsevier]

Purpose : To investigate the additional benefit of indocyanine green angiography (ICGA) over fundus fluorescein angiography (FA) in patients with posterior uveal inflammation. Methods : The features of 19 patients with different forms of posterior uveitis (Vogt-Koyanagi-Harada disease [n = 5], serpiginous choroiditis [n = 5], multifocal choroiditis [n = 5], and sarcoidosis [n = 4]) were analyzed. Results : On ICGA, inflammatory lesions were hypofluorescent in all phases, and early choroidal vessel dilation and leakage was noted near the lesions. Conclusions : The combined use of FA and ICGA helps gauge the severity of inflammation in the choroid and the retina during active inflammation. In quiescent stages, however, ICGA does not give any additional information. [ABSTRACT FROM AUTHOR]

Purpose: To define the indocyanine green (ICG) and fundus fluorescein angiographic (FFA) features of Behçet's disease. Methods: The study included 49 eyes of 25 patients (19 males, 6 females; mean age: 34.1 years; age range: 14–68 years) with Behçet's disease and active ocular involvement that fulfilled the criteria of the International Study Group for Behçet's Disease. In each patient, FFA and ICG angiography were performed consecutively in the same session using a TRC-50I/A fundus camera (Topcon, Tokyo, Japan) coupled to an Image Net digitizing system. All images were analyzed and FFA, ICG, and clinical findings summarized. Results: The mean duration of ocular involvement was 52.4 months (range: 2–240 months). FFA showed staining and dye leakage at the optic disc in 44 (89.8%) eyes and diffuse vasculitis in 36 (73.5%) eyes. Macular edema and ischemia were observed in 31 (63.3%) and 3 (6.1%) eyes, respectively. Eight (16.3%) eyes exhibited detectable retinal FFA alterations, but no abnormalities on ICG angiography. Disc ICG hyperfluorescence was observed in 23 (46.9%) eyes. ICG angiography revealed choroidal fuzziness in 16 (32.6%) eyes, hyperfluorescent spots in 13 (26.5%) eyes, and hypofluorescent plaques in 12 (24.5%) eyes. Eleven eyes (22.4%) showed no abnormal findings on ICG angiography. Conclusion: ICG and FFA complement each other as tools for diagnosing patients with Behçet's disease. FFA often serves as a fairly reliable guide. Although some ICG findings cannot be demonstrated by FFA, they are not specific or pathognomonic. We do not recommend performing both procedures for Behçet's disease. [ABSTRACT FROM AUTHOR]

We report a case of an 18-year-old female, who was diagnosed as having systemic Behçet's disease with chief complaints of vision loss in the right eye and redness and pain in both eyes. In addition to an anterior necrotizing scleritis, she had several attacks of retrobulbar neuritis and lateral rectus myositis. She responded well to i.v. and topical prednisolone and her subsequent attacks were treated with i.v. cyclophosphamide (500 mg on presentation and on Days 7, 10, 12, 15, and 20; the cycle was repeated every 20 days). She benefited on this treatment and her vision improved dramatically. Her final acuity of 20/50 was thought to be due to presumed previous attacks of optic neuritis and anterior segment inflammation. During the five-month follow-up period, she had no other attacks. Ischemia and inflammation are common in Behçet's disease and sometimes thrombosis and vasculitic changes may cause a decrease in vision. In this case, the immunosuppressive therapy helped attenuate the inflammatory vasculitic episodes during the disease course. [ABSTRACT FROM AUTHOR]

Purpose: To assess indocyanine green (ICG) angiography as a method for evaluating the extent of choroidal involvement and to compare ICG angiography with fundus fluorescein angiography (FFA) in ocular tuberculosis. Methods: FFA and ICG angiography were performed on two patients who had ocular tuberculosis findings during fundus examination. The patients were given topical dexamethasone phosphate, topical cyclopentolate, and oral prednisolone acetate in addition to systemic antimicrobial therapy. Both examinations were repeated after treatment. Results: In one patient, two hypofluorescent lesions that corresponded to the choroidal tuberculomas were noted with ICG angiography. Only one lesion was found during ophthalmoscopic examination and FFA. After treatment, these lesions persisted, but became less hypofluorescent. In the other patient, ICG angiography showed a hypofluorescent choroidal lesion corresponding to the choroidal tuberculoma that was larger than its appearance on FFA. This lesion remained hypofluorescent in all phases of ICG angiography and became less hypofluorescent after treatment. Conclusions: ICG angiography is a useful method to determine the extent of the choroidal lesion and the stage of disease and to evaluate treatment results in tuberculosis patients. [ABSTRACT FROM AUTHOR]

Purpose: To review scleritis cases associated with sarcoidosis and to evaluate clinical features, medical treatment, and clinical course. Methods: Two cases of diffuse anterior scleritis and a nodular scleritis case associated with systemic sarcoidosis were evaluated. Scleritis was the first manifestation of sarcoidosis in two of the patients and the diagnosis of sarcoidosis was confirmed with a conjunctival biopsy. The third patient had the diagnosis of systemic sarcoidosis when she developed scleritis. Results: Based on the clinical and histological appearance, two patients presented with bilateral diffuse anterior scleritis and the third patient with an anterior nodular scleritis. One patient already had the diagnosis of systemic sarcoidosis at presentation, while ocular findings led to the diagnosis in the other two cases. Conjunctiva or skin biopsies revealed features compatible with the diagnosis of sarcoidosis. Scleritis attacks recurred in two patients. All patients responded well to systemic corticosteroid (prednisone) therapy. Conclusions: Scleritis associated with sarcoidosis has rarely been described and it may be the presenting sign of systemic sarcoidosis. [ABSTRACT FROM AUTHOR]

Background: Neuroretinitis is a clinical entity usually seen in young healthy adults, that is characterized by rapid profound unilateral loss of vision and includes optic nerve head edema, splinter hemorrhages, macular exudate in a stellate pattern, and variable vitreous inflammation. There are numerous entities that can cause a picture of neuroretinitis ranging from vascular to infectious to autoimmune.Patient and Methods: We report two patients with neuroretinitis, who presented with unilateral blurred vision and had serologic evidence of Toxoplasma gondii infection.Results: Both patients responded well to treatment with systemic antibiotics and corticosteroids. Visual acuity returned to 20/60 in one patient and 20/20 in the other.Conclusion: Although the etiology is usually idiopathic, infectious causes of neuroretinitis, including toxoplasmosis, should be kept in mind in order to maintain visual acuity by early diagnosis and appropriate therapy. [ABSTRACT FROM AUTHOR]

PURPOSE: Acute hydrops develops when Descemet's membrane and the endothelium of the ectatic cornea separates to allow aqueous humor to enter the stroma. The current study was done to determine if penetrating keratoplasty (PK) in keratoconus patients with resolved hydrops has a poor prognosis. METHODS: A retrospective chart review of 35 eyes of 35 patients with keratoconus who underwent PK after the resolution of acute hydrops (Group 1) and of 74 eyes of 69 patients who had PK without a previous history of acute hydrops (Group 2) was performed. The chi-square test was used for statistical analysis. RESULTS: The mean age in Group 1 was 21.1±11.0 years. The mean age in Group 2 was 23.2±14.4 years. Vernal keratoconjunctivitis was present in 11 patients in Group 1 (31%) and in 12 (17.4%) patients in Group 2. Loose sutures were present in two patients (6%) in Group 1; both resulted in loose suture-related corneal neovascularization. Loose sutures developed in five patients (7%) in Group 2. In Group 1, three patients (9%) had microbial keratitis. Microbial keratitis was seen in five patients (7%) in Group 2. Two patients (6%) in Group 1 developed late endothelial graft failure. In Group 2, one eye (1%) developed early and one eye (1%) late epithelial graft rejection; five eyes (7%) developed late endothelial graft rejection. There was no statistically significant difference between the two groups with respect to the incidence of graft rejection. At the last examination, 34 eyes in Group 1 had clear grafts; in the second group, graft clarity was achieved in 71 eyes. CONCLUSION: Penetrating keratoplasty in hydrops is successful in terms of graft clarity and visual outcome in patients with keratoconus after the resolution of hydrops. The patients should have preoperative and postoperative anti-allergic treatment and close follow-up for possible complications. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of long-term and low-dose prophylactic oral acyclovir therapy in preventing the recurrence of herpetic infection and increasing graft survival in patients who undergo penetrating keratoplasty (PK) for herpes simplex keratitis (HSK).Patients and Methods: Nineteen patients were included in the study, who underwent PK for herpes keratitis from July 1993 to November 1995, received oral acyclovir, and were followed at least 12 months. Group 1 included 12 patients with corneal scarring without perforation. These patients were free of inflammation for a mean of 4.1+/-2.2 months preoperatively, and received oral acyclovir 400 mg/day postoperatively for one year. Seven patients (Group 2) who developed corneal perforation due to necrotizing keratitis were treated with tissue adhesives, therapeutic contact lenses, and topical antiviral and oral acyclovir therapy for the resolution of active inflammation followed by PK after a mean of 3.8+/-2.1 months follow-up. They received oral acyclovir 400 mg/day postoperatively for one year in addition to standard postoperative therapy. The control group consisted of 16 patients (Groups 3 and 4) who underwent PK for herpes simplex keratitis and did not receive oral acyclovir. The indication for PK was corneal opacity and impaired visual acuity in 12 patients (Group 3) and corneal perforation in four (Group 4).Results: After an average of 25 months follow-up, there was only one recurrence (8.3%) in Group 1 and two cases (28.6%) of herpetic recurrence in Group 2. Recurrence occurred at two months in one patient while he was taking oral acyclovir. Two of these recurrences followed the withdrawal of oral acyclovir therapy after one year of therapy. In contrast, in control groups there were four cases of herpetic recurrence (33.3%) in Group 3 and two (50%) in Group 4 after a mean of 30.5 months postoperative follow-up. In the study groups, a rejection episode was seen in three patients (15.8%) which was successfully treated with medical therapy. One patient from Group 2 developed bacterial keratitis which subsequently resulted in graft failure. All grafts remained clear in the other patients (94.7%). In the control groups, rejection developed in seven patients. Three rejection episodes were treated successfully. The other four developed graft failure in spite of intensive medical therapy.Conclusions: Our results suggest that postoperative oral acyclovir therapy is effective in preventing the recurrence of herpetic infection. However, the recurrence may develop after cessation of oral acyclovir therapy, especially in patients who underwent PK for corneal perforation due necrotizing HSK. [ABSTRACT FROM AUTHOR]

Purpose: To report a pediatric case with presumed ocular sarcoidosis presented with bilateral corneal infiltrates and uveitis. Design: Single case report. Methods: A 9-year-old girl presented with a 1-month history of blurred vision and redness in both eyes. Ophthalmologic evaluation revealed midstromal infiltrates in cornea, granulomatous anterior uveitis, vitritis, snowball opacities, and localized perivenous exudates. Results: She was treated with topical and oral steroids. During steroid tapering, oral cyclosporine A therapy was added. Conclusion: In patients with corneal infiltrates and uveitis, sarcoidosis should be considered in the differential diagnosis. [ABSTRACT FROM AUTHOR]

Purpose: To report a case of presumed Eales disease that showed regression of retinal neovascularization after the use of intravitreal bevacizumab. Design: Retrospective, interventional case report. Methods: Broad retinal neovascularization in a patient with presumed Eales disease did not regressed despite adequate photocoagulation treatment, and bevacizumab (1.25 mg) was injected intravitreally. The patient was followed up for 1 year. Results: One week after injection, fluorescein angiography demonstrated dramatic regression of retinal neovascularization. After 12-months, visual acuity was improved and no signs of recurrence were observed. Conclusion: Intravitreal bevacizumab may be effective as an adjunctive treatment of retinal neovascularization in patients with Eales disease. [ABSTRACT FROM AUTHOR]

The CREST syndrome is a variant form of progressive systemic sclerosis. Apart from the occurrence of keratoconjunctivitis sicca, other types of ocular involvement associated with this variant are quite rare. We present the case of a 73-year-old woman with the CREST variant of progressive systemic sclerosis who developed unilateral granulomatous anterior uveitis. Systemic and laboratory testing failed to suggest evidence for any other associated systemic disease as a possible cause of the granulomatous uveitis. The inflammation was successfully controlled with topical steroids and mydriatics. While a small number of cases of uveitis have been reported in other variant forms of progressive systemic sclerosis, to date there have been no descriptions of uveitis associated with the CREST syndrome. [ABSTRACT FROM AUTHOR]

PURPOSE: To report the development of optic nerve head neovascularization during the recovery phase of cytomegalovirus (CMV) retinitis in a renal allograft recipient. CASE REPORT: A 46-year-old male renal allograft recipient developed CMV retinitis seven months after transplantation. At the time of the diagnosis, the patient was being immunosuppressed with prednisone, cyclosporine, and azathioprine, and was treated with repeated intravitreal and intravenous ganciclovir. Six weeks after the initiation of therapy, optic disk neovascularization developed. This was confirmed by fluorescein angiography, which showed no areas of retinal capillary nonperfusion. At this stage, active retinal lesions were partially resolved. Apart from intraocular inflammation, no other cause of neovascularization was detected. Over the following six months, optic disk neovascularization regressed spontaneously without causing vitreous hemorrhage or visual loss. There was no recurrence of CMV retinitis during follow-up. CONCLUSION: Optic disk neovascularization may develop in the healing phase of CMV retinitis in renal transplant recipients. [ABSTRACT FROM AUTHOR]

Varicella zoster virus (VZV)-induced anterior uveitis (AU) may complicate the course of primary varicella infection typically seen in children. In adults, especially with advanced age, VZV AU is more commonly associated with herpes zoster ophthalmicus (HZO) with or without skin rash affecting the distribution of the ophthalmic nerve due to reactivation of the latent VZV in the trigeminal ganglion. While it is typically a mild self-limiting AU in primary infection, HZO AU is often accompanied by keratitis, may have a chronic recurrent course, and lead to sectoral iris atrophy, pupillary distortion, and ocular hypertension. Diagnosis is often clinical and proven by analysis of aqueous humor for viral genome or antiviral antibodies. Systemic antiviral agents and topical steroids are the mainstay of treatment. Visual prognosis is favorable with timely diagnosis and appropriate treatment. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses the study on the impact of topical bevacizumab as an adjunctive therapy for neovascularization of cornea.

Purpose: To report our experience with four cases of pediatric ocular acne rosacea, including responses to long-term systemic treatment. Design: Retrospective interventional case series. Methods: The medical records of four consecutive cases diagnosed with pediatric ocular acne rosacea over a period of 36 months were reviewed. Diagnostic criteria were meibomian gland dysfunction, blepharitis, lid margin telangiectasia, punctate superficial keratopathy, and conjunctival hyperemia with or without inferior corneal vascularization. Results: The patients, aged between four and 12, were all females with bilateral disease. Meibomitis, blepharitis, conjunctival hyperemia, and punctuate epitheliopathy was evident in each case. Cutaneous involvement was seen in two cases (50%), and limbal vascularization with subepithelial or stromal infiltrates was present in three cases (75%). One case showed corneal ulceration at presentation. All four children received systemic doxycycline or erythromycin for at least 12 months and showed considerable improvement within the first month of therapy. No recurrence was noted within the mean 25.5 months of follow-up. None of the girls experienced any side effects during the long treatment duration. Conclusions: Ophthalmologists should consider acne rosacea as a potential diagnosis for any child who has any combination of meibomian disease, chronic blepharitis, recurrent chalazia, and chronic symptoms of photophobia, ocular irritation, and redness that does not respond to routine medical treatment. Such patients respond very well to long-term treatment with systemic erythromycin/doxycycline. [Copyright &y& Elsevier]

Introduction: To evaluate patient satisfaction with samfilcon A contact lenses (CLs) in intensive digital device users with myopia and to compare patient satisfaction with samfilcon A lenses to prior experience with senofilcon A or lotrafilcon B CLs. Methods: This was a comparative, prospective, national study conducted at 14 centers in Turkey. Subjects were adults aged 18 and 45 years with myopia (range −0.25 D to −6.00 D) who spend a minimum of 3 hours viewing digital devices (e.g., computer, smartphone). A subgroup of patients were habitual lens wearers (senofilcon A or lotrafilcon B lens wear for at least 6 months prior to enrollment). The primary assessment was patient satisfaction with samfilcon A lenses (0–100 Likert scale). Secondary assessments included patient satisfaction with samfilcon A lenses compared to patients' habitual lenses, investigator satisfaction with samfilcon A lenses and investigator-evaluated slit lamp examination findings. Results: Samfilcon A lenses were given high overall ratings from both patients and investigators, with a low incidence of ocular symptoms. Overall, patients were highly satisfied with samfilcon A lenses for comfort, vision and overall performance, and stated that they would consider wearing these lenses in the future. Among habitual senofilcon A or lotrafilcon B lens wearers, samfilcon A lenses were rated significantly better than the habitual lenses in regard to comfort, vision and overall performance. Investigator assessments were also highly favorable, both at initial fit and after 4 weeks of follow-up, with no significant findings noted on slit lamp examination. Conclusion: Samfilcon A lenses were rated highly by investigators in regard to fit, handling and slit lamp findings, and by novice and habitual lens wearers in regard to comfort, vision and overall performance. These results support the use of samfilcon A lenses among digital device users who seek day-long comfort and good visual acuity. [ABSTRACT FROM AUTHOR]

Purpose: To develop an algorithm for the diagnosis of Behçet's disease (BD) uveitis based on ocular findings. Methods: Following an initial survey among uveitis experts, we collected multi-center retrospective data on 211 patients with BD uveitis and 207 patients with other uveitides, and identified ocular findings with a high diagnostic odds ratio (DOR). Subsequently, we collected multi-center prospective data on 127 patients with BD uveitis and 322 controls and developed a diagnostic algorithm using Classification and Regression Tree (CART) analysis and expert opinion. Results: We identified 10 items with DOR >5. The items that provided the highest accuracy in CART analysis included superficial retinal infiltrate, signs of occlusive retinal vasculitis, and diffuse retinal capillary leakage as well as the absence of granulomatous anterior uveitis or choroiditis in patients with vitritis. Conclusion: This study provides a diagnostic tree for BD uveitis that needs to be validated in future studies. [ABSTRACT FROM AUTHOR]

Aims: To evaluate and compare the inhibitory effects of topical and subconjunctival bevacizumab on corneal neovascularization in a rat model. Methods: Twenty corneas of 20 rats were chemically cauterized with silver nitrate sticks. Animals were randomized into four groups: a control group that received only topical artificial tear drops twice daily, a subconjunctival injection group that received 1.25 mg (0.05 ml) of bevacizumab on the 1st, 4th, and 7th day, and two topical bevacizumab groups that received instillation of 4 or 12.5 mg/ml bevacizumab twice daily. Digital photographs of the cornea were taken and analyzed using an image analysis software program. On the 10th day, corneas were excised and examined histologically. Results: The mean percentage of the vascularized corneal area (%) in the control group was 63.32 ± 13.10 (mean ± SD), compared with 30.22 ± 15.73 in the subconjunctival injection group, 26.76 ± 10.23 in the 4-mg/ml topical group, and 25.52 ± 12.45 in the 12.5-mg/ml group. The differences between the control and each treatment group were significant (all p < 0.01). Further, histological examination revealed that each treatment group had fewer vessels than the control group (all p < 0.01). Conclusions: Both subconjunctival injection and topical use of bevacizumab are effective and safe in controlling corneal neovascularization. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Purpose: The aim was to evaluate tear osmolarity of patients with clinically unilateral pseudoexfoliation (PEX) syndrome and to compare the values with otherwise normal subjects. Methods: Sixty-two eyes of 31 patients with unilateral PEX syndrome and 31 eyes of 31 normal subjects were studied. The TearLab osmolarity system (OcuSense, Inc, San Diego, CA, USA) was used to measure tear osmolarity. Eyes were grouped as normal eyes of patients having unilateral PEX syndrome (group A), eyes of patients having unilateral PEX syndrome with deposits of PEX material (group B) and eyes of normal subjects (group C). Differences in tear osmolarity were compared among groups A, B and C. Independent t-tests and paired t-tests were used for statistical analysis. Results: The mean tear osmolarity was 298.7 ± 7.8 mOsm/l (range 285 to 306) in the control group (group C), 306.3 ± 6.6 mOsm/l (range 290 to 314) in the eyes of patients having PEX syndrome with deposits of pseudoexfoliative material (group B) and 301.4 ± 7.1 mOsm/l (range 284 to 305) in the fellow eye of these patients (group A). There was a significant difference between tear osmolarity of groups C and B (independent t-test, p = 0.011). Also, there was a significant difference between the osmolarity of each eye of patients with unilateral PEX syndrome (groups A and B) (paired t-test, p = 0.001). The difference between tear osmolarity of groups A and C was not statistically significant (independent t-test, p = 0.146). Conclusion: In conclusion, tear osmolarity is higher in both eyes of patients when compared with normal subjects, using the independent t-test (although highest in clinically positive eyes of these patients). Both eyes of patients having PEX syndrome could be more prone to the development of dry eye syndrome. [ABSTRACT FROM AUTHOR]

Parallel to the frequent application of anterior segment surgical techniques, the frequency of dry eye disease is increasing. Dry eye is a multifactorial condition that affects the surface of the eye and induces an inflammatory response. Corneal nerves play an important role in the maintenance of a healthy ocular surface. Intact corneal innervation is mandatory for normal blinking and tearing reflexes. Damage to this neural circuit interrupts the normal regulation of lacrimal gland secretion and causes dry eye disease. Anterior segment surgeries damage corneal innervation. Even after a successful cataract or refractive surgery, the occurrence of dry eye leads to discomfort and several complications. Because of these problems, we have to know the risk factors and the triggering mechanisms of dry eye disease, to take precautions during and after the surgery, and to choose the appropriate surgical technique. [ABSTRACT FROM AUTHOR]

Parallel to the frequent application of anterior segment surgical techniques, the frequency of dry eye disease is increasing. Dry eye is a multifactorial condition that affects the surface of the eye and induces an inflammatory response. Corneal nerves play an important role in the maintenance of a healthy ocular surface. Intact corneal innervation is mandatory for normal blinking and tearing reflexes. Damage to this neural circuit interrupts the normal regulation of lacrimal gland secretion and causes dry eye disease. Anterior segment surgeries damage corneal innervation. Even after a successful cataract or refractive surgery, the occurrence of dry eye leads to discomfort and several complications. Because of these problems, we have to know the risk factors and the triggering mechanisms of dry eye disease, to take precautions during and after the surgery, and to choose the appropriate surgical technique. [ABSTRACT FROM AUTHOR]

Glaucoma is a group of diseases with progressive optic disk and /or visual fields changes. The mainstays of current therapies (medical, laser, surgery) are focused of lowering intraocular pressure (IOP). The problems and failures with such therapies and the studies on physiopathology and genetics of glaucoma started explorations for new therapeutic modalities. Advances in our understanding of the genetic basis of glaucoma include the discovery of 14 linked sites (GLC 1A through GLC 1N) in primary open-angle glaucoma with three genes identified at these loci: myocilin, optineurin, and WDR 36. In the secondary glaucomas such as pseudoexfoliation syndromes, LOXL1 gene polymorphisms have been identified. Gene therapy can be used to replace a mutated gene that causes disease with a healthy copy of the gene, to inactivate or wipe out the aberrant gene that is responsible for the disease. This therapy can also be used to add or remove genes that are indirectly related to the pathophysiology of the disease. Ocular gene therapy can also provide the advantage of delivery of genes that express therapeutic proteins in a localized and sustained way. Gene therapy studies for the treatment of glaucoma are focused on lowering intraocular pressure and neuroprotection. An ideal gene delivery system is one that is able to efficiently deliver the genes to the target tissue with specificity and safety. Both viral and nonviral vector delivery systems have been tested in the animal eyes. The target tissues of gene therapy are trabecular meshwork, ciliary body, ciliary muscle, retina and optic disk. [ABSTRACT FROM AUTHOR]