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Purpose: To evaluate the clinical features of and determine the risk factors for uveitis in patients with juvenile arthritis.Methods: The prevalence and clinical characteristics of uveitis were studied retrospectively in 90 children diagnosed with arthritis. Patients with uveitis were compared with those who did not have eye involvement.Results: Uveitis was diagnosed in 11 patients (12.2%). Of these, seven (63.6%) had oligoarticular, two (36.4%) had polyarticular, and one (9.1%) had systemic-onset juvenile rheumatoid arthritis (JRA). One patient (9.1%) was diagnosed with enthesitis-related arthritis (ERA) (9.1%). The prevalence of uveitis was significantly higher in patients with oligoarticular JRA. The mean age at onset of arthritis in the uveitis patients was 4.39 years, which was significantly lower than in the non-uveitis group. There was no gender difference in the risk of developing uveitis. Antinuclear antibodies (ANA) was positive in seven (63.6%) of the 11 uveitis patients, confirming ANA as a significant determinant for uveitis in juvenile arthritis. Rheumatoid factor was not found to be a risk factor. One (9.1%) of the 11 patients developed serious sight-threatening complications during the follow-up period.Conclusion: This study confirmed that oligoarticular onset, ANA positivity, and young age are risk factors for developing uveitis in patients with juvenile arthritis. Gender was not found to be a determining factor. Prompt treatment of uveitis effectively decreased the prevalence of visual impairment. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the relative frequency of type Ia in glycogen storage disease (GSD) with prominent liver involvement and to determine its clinical and laboratory findings and prognosis in Turkish children. From 1980 to 1998, 45 out of 100 GSD patients (27 male) with liver involvement had been diagnosed for type Ia. The files were retrospectively evaluated and clinical and laboratory features were documented. In addition to routine laboratory evaluations, urine albumin, calcium excretions, and plasma biotinidase activity were measured. Breast-feeding was continued in all infants. After 6 months of age, uncooked cornstarch was administered to the patients. The relative frequency of type Ia in GSD with liver involvement was 45%. The diagnosis was made in 71% of patients before 2 years of age (median 1 year). Main complaint was abdominal protruding (57.8%), and main physical finding was hepatomegaly (100%). Forty percent of the patients had growth retardation at diagnosis. Among laboratory parameters, hypertriglyceridemia (97.8%) and hypertransaminasemia (95.6%) were the most frequent findings following plasma biotinidase activity, which was elevated in all patients. Microalbuminuria was determined in 52.8% of the patients and hypercalciuria in 23.8%. Histopathological findings of the liver included fibrosis (75.6%), steatosis (37.8%), mosaicism (24.4%) and nuclear hyperglycogenation (15.6%). During follow-up period, the ratio of patients with growth retardation did not change. Transaminases were decreased in 48.7% of the patients. Although triglyceride and cholesterol levels decreased in the majority of the patients, they did not normalise. The prevalence of type Ia in GSD with prominent liver involvement was found higher than the other reports. Microalbuminuria was also higher than the previous reports. [ABSTRACT FROM AUTHOR]

The association of amyloidosis with Behçet's disease has infrequently been reported in published works. Twenty four such cases have been observed in the world, of which 12 are from Turkey, including eight of ours. In all our eight cases renal biopsy showed amyloidosis of type AA. Behçet's disease of male preponderance, long duration, complete type, multiple organ involvement, and positive skin pathergy test were the main characteristics of all 24 cases of Behçet's disease with amyloidosis. We conclude that amyloidosis associated with Behçet's disease is a secondary AA amyloidosis occurring as an intrinsic manifestation of Behçet's disease. [ABSTRACT FROM PUBLISHER]

Dildar Duman, Emine Aksoy, Meltem Coban Agca, Nagihan Durmus Kocak, Ipek Ozmen, Ulku Aka Akturk, Sinem Gungor, Fatma Merve Tepetam, Selma Aydogan Eroglu, Selahattin Oztas, Zuhal Karakurt Sureyyapasa Chest Diseases and Thoracic Surgery Teaching Hospital, Istanbul, Turkey Background: COPD exacerbations requiring hospitalization increase morbidity and mortality. Although most COPD exacerbations are neutrophilic, approximately 10%–25% of exacerbations are eosinophilic.Aim: We aimed to evaluate mortality and outcomes of eosinophilic and non-eosinophilic COPD exacerbations and identify new biomarkers that predict survival.Methods: A retrospective observational cohort study was carried out in a tertiary teaching hospital from January 1, 2014 to November 1, 2014. All COPD patients hospitalized with exacerbations were enrolled in the study at their initial hospitalization and followed-up for 6 months after discharge. Electronic data were collected from the hospital database. Subjects’ characteristics, hemogram parameters, CRP levels, neutrophil-to-lymphocyte ratio (NLR), platelet-to-mean platelet volume ratio on admission and discharge, length of hospital stay (days), readmissions, and mortality were recorded. Patients were grouped according to peripheral blood eosinophil (PBE) levels: Group 1, >2% PBE, eosinophilic; Group 2, non-eosinophilic ≤2%. Patient survival after hospital discharge was evaluated by Kaplan–Meier survival analysis.Results: A total of 1,704 patients hospitalized with COPD exacerbation were included. Approximately 20% were classified as eosinophilic. Six-month mortality was similar in eosinophilic and non-eosinophilic groups (14.2% and 15.2%, respectively); however, the hospital stay length and readmission rate were longer and higher in the non-eosinophilic group (P

Tc-99m dextran scintigraphy was performed on a 16-year-old male patient with protein losing enteropathy. Abnormal leakage of the radiotracer was observed in the right upper lumbar area that moved over time and excreted in the stool which was suggestive of protein loss. It is concluded that Tc-99m dextran is useful in the detection of protein losing enteropathy which is not detected by extensive radiological and endoscopic examination. [ABSTRACT FROM AUTHOR]

Duman D, Aksoy E, Agca MC, et al. International Journal of COPD. 2015;10(1):2469–2478.Page 2475, Table 4, the second column heading “Odds ratio” is incorrect. The correct column heading is “Hazard ratio”. Read the original article

Salvia species, the most important medical plants, are classified to be in Dicotyledonaeof Tubiflorae team of Lamiaceae family. The plants of Lamiaceae family are mostly herbs and weeds mainly spread on Mediterranean. This study is aimed to determine fatty acid composition of four Salvia species collected from cultivars grown in Cumra ecological conditions. Leaves of the plants were grinded in grinding mill in 1 mm sieve size. Soxhlet extraction was used for isolation of fatty acids, using hexane as a solvent. Analyses were done by gas chromatography/mass spectrometry. Significant difference was observed in the linolenic acid content of Salvia species. The highest content of linolenic acid was determined in S. sclarea (38.23%), while 28.69% and 8,52% were found for S. nomerosa, and S. officinalis, respectively. The lowest linolenic acid content was found in S.triloba (7.26%). The S. sclarea also had the highest polyunsaturated fatty acid (PUFA) content (51.72%). [ABSTRACT FROM AUTHOR]

From the Department of Infectious Diseases and Nephrology Service, Department of Internal medicine, Haydarpaşa Teaching Hospital, Gülhane Military Medical Academy, Istanbul, Turkey [ABSTRACT FROM PUBLISHER]

Increasing transnational cooperation in open and distance education provides opportunities for non-state actors to meet around common interests, objectives, values. Besides transnational cooperation, these actors also motivate intergovernmental cooperation processes. International organizations and professional networks in the field, share common normative values and lead to the construction of cooperation regimes. Project UZENET (A Comparative Analysis of the Communication Networks and Cooperation Regimes of the International Distance Education Organizations) aims to make comparative analyses of communication networks and regimes of international distance education organizations, with an eye to the conceptual framework of international regime theory. The major research question asks "the extent to which decision making procedures of organizations can be transformed into regimes and provide tools for sustainability of international cooperation". The institutionalization of cooperation under organizations within common norms, values and rules are determined and discussed, in order to project light to the a ctors that are active in regime structures. The theoretical framework is epistemic regime theory which concentrates on epistemic communities towards cognitive regime building processes. Twenty (20) different distance education organizations are taken as a sample in this comparative case-study. According to the findings, the developments in the information and communication technologies bring forth knowledge-based regime approaches in international cooperation. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the occurrence of acute insulin response and insulin sensitivity changes in patients with rheumatoid arthritis, and to evaluate the correlation of serum TNF- α a level changes with glucose metabolism abnormality such as insulin resistance and impaired acute insulin response. Methods: 36 subjects (22 women and 14 men, aged 51.5±17.1 years (range 21-80), BMI 27.1±5.0 kg/m2;) with varying degrees of disease activity and 20 healthy controls were studied. After a 12-h overnight fast, all subjects underwent a diagnostic protocol including serum insulin level, HOMA-IR estimated insulin sensitivity, AIR derived from IVGTT data and serum TNF- α a level measurements. Results: The fasting insulin levels, HOMA scores and serum TNF- a a levels were significantly higher in all patients with rheumatoid artritis than in control subjects (14.7±6.7 vs. 8.7±1.9 mIU/ml, p<0.001 and 3.3±1.5 vs. 1.9±0.5, p<0.001 and 368.4±649.2 vs. 3.6±5.0 pg/ml, p<0.001 respectively). Acute insulin responses were significantly lower in all patients with rheumatoid arthritis than in control subjects (35.8±17 vs. 85.2±17.9, p<0.001). Fasting insulin, HOMA-IR, TNF- a, AIR were correlated in the whole group. Conclusions: Insulin resistance seems to be the main metabolic abnormality which alters glucose metabolism, decreases the sensitivity of peripheral tissues to insulin in patients with rheumatoid arthritis, and complicating rheumatic disease via an increase in atherosclerotic disease risk and prediabetic state. [ABSTRACT FROM AUTHOR]

Purpose: To present a rare case of PASCAL photocoagulation-induced choroidal effusion and serous retinal detachment in a patient with diabetic retinopathy., Methods: A case report., Case Description: A 68-year-old man with type 2 diabetes mellitus presented with decreased vision in both eyes. His best corrected visual acuity (BCVA) was 0.39 logMAR units in both eyes. The patient underwent panretinal photocoagulation (PRP) in two quadrants of both eyes on the same day according to his fundus fluorescein angiography. Three days after the first session of PRP, the BCVA in his left eye deteriorated by 2.0 logMAR units. Fundoscopic examination detected a significant choroidal effusion in inferonasal quadrant of the left eye. A macular Spectral-Domain Optical Coherence Tomography (SD-OCT) scan showed a large macular serous retinal detachment in the left eye. Topical steroid, topical cycloplegic, and 64 mg oral methylprednisolone were initiated. Two weeks later, his BCVA returned to the level of the first visit with a completely resolved choroidal effusion and no subretinal fluid., Conclusion: Considering the inflammatory and destructive mechanism of PRP, the laser operator should use the minimum power necessary to avoid possible chorioretinal complications., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: To investigate the effects of exogenous testosterone treatment on the choroidal parameters in patients with androgen deficiency., Methods: Right eyes of 24 patients with androgen deficiency and 31 healthy volunteers were included in the study. The eyes were scanned for subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), choroid-stromal area (C-SA), choroid-luminal area (C-LA), choroid-stromal to luminal area ratio (CSLR), and the choroidal parameters within central 1500 µm of the macula (CVI 1500 , C-LA 1500 , C-SA 1500 , and CSLR 1500 ) by enhanced-depth imaging optical coherence tomography (EDI-OCT) at baseline, 6 th and 18 th weeks of the exogenous testosterone treatment., Results: The mean SFCT values of the androgen deficient groups and healthy controls were 307.7±27.0 and 303.2±37.2 µm ( P =0.8). However, CVI, C-SA, CSLR, CVI 1500 , C-LA 1500, and CSLR 1500 were significantly different between the groups (all P <0.01). At the 6 th week visit after exogenous testosterone treatment, SFCT, CVI, C-LA, and C-SA were significantly decreased, and these parameters returned to baseline levels at the 18 th -week visit (all P >0.05). However, CVI 1500 and LA 1500 significantly increased at the end of the follow-up period ( P <0.001)., Conclusion: CVI is lower in androgen-deficient patients than in healthy subjects. The alterations in the choroid during the testosterone peak are transient in the treatment of patients with androgen deficiency. However, the increase in CVI within the central 1500 µm of the macula persists even after 4mo., Competing Interests: Conflicts of Interest: Yeter V, None; Koçak N, None; Kalyoncu M, None; Aşçı R, None; Arıtürk N, None., (International Journal of Ophthalmology Press.)

Objective: The aim of this study was to investigate the relationship between Chitinase 3-Like 1 gene polymorphisms and the occurrence of preeclampsia in a selected cohort of pregnant women., Methods: A total of 75 pregnant women participated in the study, 35 of whom were diagnosed with preeclampsia, while 40 served as healthy controls. The preeclamptic group was subdivided based on severity. Real-time polymerase chain reaction was employed to analyze the serum samples for variations in Chitinase 3-Like 1 gene polymorphisms., Results: The rs880633 polymorphism was found to be significantly more frequent in the control group (80%) compared with the overall preeclamptic group (60%) (p<0.05). In the severity-based subgroups, rs880633 appeared in 57.1% of non-severe and 61.9% of severe preeclamptics. Contrarily, the heterozygous form of rs7515776 polymorphism showed a significantly higher prevalence in the preeclamptic cohort (p<0.05), without distinctions in severity subgroups., Conclusion: The study suggests that the rs880633 polymorphism may serve a protective role against the development of preeclampsia, whereas the rs7515776 polymorphism may be associated with an elevated risk. Further research is warranted to elucidate the clinical implications of these findings.

Merkel cell carcinoma (MCC) is an unusual skin tumor that has a significant rate of distant and local metastases. It is known that primary MCC of the eyelid usually occurs at the upper eyelid. Here we report an unusual case of MCC metastasis to the eyelid. A 63-year-old male was diagnosed with MCC three years earlier after initially presenting with a mass in his right thigh. After histopathological diagnosis, the patient received medical therapy. During treatment, he developed multiple distant metastases and a firm, purple, vascularized lesion on the upper eyelid. We confirmed the lesion was an eyelid metastasis of MCC by histopathological examination and imaging methods. This case shows that extraocular MCC can metastasize to the eyelids, particularly the upper eyelid, where primary periocular MCC usually appears., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2024 by the Turkish Ophthalmological Association / Turkish Journal of Ophthalmology published by Galenos Publishing House.)

Clinical Relevance: Proliferative vitreoretinopathy (PVR) is still the leading cause of surgical failure after rhegmatogenous retinal detachment (RRD) repair. The factors that can predict the development of PVR remain to be elucidated., Background: This study evaluates the predictive values of the systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio in patients with primary RRD with and without PVR., Methods: A total of 150 patients with RRD and 51 age- and sex-matched healthy participants were included in the study. Patients who developed PVR within three months after surgery were enrolled as PVR cases (n = 75, Group 1), and those who did not develop PVR were enrolled in RRD without the PVR group (n = 75, Group 2). Ocular examination findings and medical records of all participants were analysed retrospectively. Peripheral blood samples were collected, and systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratios were calculated. The systemic immune-inflammation index calculation formula is: (Neutrophil/lymphocyte) × Platelet., Results: The median neutrophil-to-lymphocyte ratio and systemic immune-inflammation index levels were significantly higher in Group 1 patients compared to Group 2 and the control groups (p = 0.01, for both). However, the groups were similar regarding median platelet-to-lymphocyte ratio (p = 0.917). The optimal cut-off values of neutrophil-to-lymphocyte ratio and systemic immune-inflammation index were calculated as 1.72 (with 72% sensitivity and 48% specificity) and 407.9 (with 72% sensitivity and 49.3% specificity), respectively, for predicting PVR development in patients with RRD., Conclusion: Neutrophil-to-lymphocyte ratio and systemic immune-inflammation index may be useful biomarkers for predicting the risk of PVR development in RRD patients.

Objectives: Ligneous conjunctivitis (LC) is a chronic conjunctivitis characterized by recurrent, firm, fibrin-rich, woody pseudomembranes on the palpebral conjunctiva. It is an ultrarare autosomal recessive disease associated with congenital plasminogen (PLG) deficiency due to mutations in the PLG gene (6q26). Immunoglobulin G4-related disease (IgG4-RD) is an idiopathic, systemic fibroinflammatory disease characterized by elevated serum IgG4 concentration and tissue infiltration of IgG4-positive plasma cells leading to organ enlargement, fibrosis and damage., Case Report: A 7-year-old girl with LC was hospitalized for recurrent pancreatitis and diagnosed as IgG4-RD. PLG activity level was 15% (normal range 55-145%). Co-segregation analysis indicated that the patient was homozygous for the c. NG&#95;016200.1(NM&#95;000301.5):c.1465 T>C mutation in PLG gene. c. NG&#95;016200.1(NM&#95;000301.5):c.1465 T>C PLG variant was found to be heterozygous by NGS analysis in both parents. She also had plasminogen activator inhibitor - 1 (PAI-1) NG&#95;013213.1(NM&#95;000602.5):c.-816A>G (4G/4G) homozygous polymorphism and a heterozygote NG&#95;001333.2 (NM&#95;002769.5):c.292&#95;293insC mutation in the serine protease 1 (PRSS-1) gene. However, heterozygous PRSS-1NG&#95;001333.2 (NM&#95;002769.5):c.292&#95;293insC variant was found in the mother of the patient. All detected variants are currently considered as a variant of uncertain (or unknown) significance (VUS) according to the American College of Medical Genetics and Genomics (ACMG) classification. Oral steroid, oral azathioprine, topical fresh frozen plasma, topical heparin, topical steroid and topical cyclosporine were given. After 3 years of follow-up, IgG4-RD is under partial remission and no pseudomembranes., Conclusion: She is the second case had both LC and IgG4-RD. We identified a NG&#95;016200.1(NM&#95;000301.5):c.1465 T>C novel homozygous mutation in PLG gene and a PAI-1 NG&#95;016200.1(NM&#95;000301.5):c.1465 T>C (4G/4G) homozygous polymorphism, which has been reported as a risk factor for thrombotic events., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: To compare the aqueous humor (AH) and serum levels of 4-hydroxynenal (4-HNE) and 8-hydroxy-2'-deoxyguanosine (8-OhdG) in patients with pseudoexfoliation syndrome (PES) and pseudoexfoliation glaucoma (PEG) with each other and with age- and sex-matched control group., Methods: This prospective study included 66 patients divided into three groups: PES (n = 24), PEG (n = 21), and a control group (n = 21). 4-HNE and 8-OhdG levels were analyzed using the enzyme-linked immunosorbent assay., Results: Aqueous and serum 4-HNE levels were significantly higher in the PEG (466.52 ± 62.12 pg/mL and 313.47 ± 47.41 pg/mL) and PES (290.69 ± 63.63 pg/mL and 201.53 ± 39.57 pg/mL) groups than the control group (144.02 ± 39.58 pg/mL and 99.10 ± 16.96 pg/mL; p < 0.001, for all). Both aqueous and serum levels of 4-HNE in the PEG group were significantly higher than in the PES group (p < 0.001, for both). Similar to 4-HNE, the AH 8-OhdG levels were higher in the PEG group (21.18 ± 2.23 ng/mL) compared to the PES (14.90 ± 3.37 ng/mL) and control (4.86 ± 1.94 ng/mL) groups (p < 0.001, for all). Serum 8-OhdG levels were significantly higher in the PEG and PES groups than the control (p < 0.001, for both); however, there was no significant difference between the PES and PEG groups (p = 0.097). There were strong significant correlations between the aqueous and serum levels of 4-HNE (p < 0.001, r = 0.857) and 8-OhdG (p < 0.001, r = 0.807) among all the patients., Conclusions: Aqueous humor and serum levels of 4-HNE and 8-OhdG increased in the PES and PEG patients. These findings are potentially significant and add to the growing body of evidence concerning oxidative stress in PES and PEG., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Mitochondrial defects are one of the common underlying causes of neuronal vulnerability in neurodegenerative diseases, such as amyotrophic lateral sclerosis (ALS), and TDP-43 pathology is the most commonly observed proteinopathy. Disrupted inner mitochondrial membrane (IMM) reported in the upper motor neurons (UMNs) of ALS patients with TDP-43 pathology is recapitulated in the UMNs of well-characterized hTDP-43 mouse model of ALS. The construct validity, such as shared and common cellular pathology in mice and human, offers a unique opportunity to test treatment strategies that may translate to patients. SBT-272 is a well-tolerated brain-penetrant small molecule that stabilizes cardiolipin, a phospholipid found in IMM, thereby restoring mitochondrial structure and respiratory function. We investigated whether SBT-272 can improve IMM structure and health in UMNs diseased with TDP-43 pathology in our well-characterized UMN reporter line for ALS. We found that SBT-272 significantly improved mitochondrial structural integrity and restored mitochondrial motility and function. This led to improved health of diseased UMNs in vitro. In comparison to edaravone and AMX0035, SBT-272 appeared more effective in restoring health of diseased UMNs. Chronic treatment of SBT-272 for sixty days starting at an early symptomatic stage of the disease in vivo led to a significant reduction in astrogliosis, microgliosis, and TDP-43 pathology in the ALS motor cortex. Our results underscore the therapeutic potential of SBT-272, especially within the context of TDP-43 pathology and mitochondrial dysfunction., Competing Interests: Declaration of Competing Interest M.R. and H.Z. are paid employees with an equity stake in Stealth BioTherapeutics. D.K. is a past employee of Stealth Biotherapeutics. P.H.O. and Ozdinler laboratory members have no competing interests., (Copyright © 2023. Published by Elsevier Inc.)

Objectives: To compare the functional and anatomical outcomes of ranibizumab and aflibercept monotherapies given according to a pro re nata (PRN) protocol in treatment-naive eyes with diabetic macular edema (DME) in a real-life clinical setting., Materials and Methods: The medical charts of treatment-naive patients with center-involved DME retrieved from our institutional database were reviewed in this retrospective cohort study. A total of 512 treatment-naive eyes with DME underwent either ranibizumab (Group I; 308 eyes) or aflibercept (Group II; 204 eyes) monotherapy and 462 patients were included. The primary outcome was visual gain over 12 months., Results: The mean number of intravitreal injections within the first year was 4.34±1.83 and 4.39±2.12 in Group I and II, respectively (p=0.260). The mean best corrected visual acuity (BCVA) improvement at 12 months was +5.7 and +6.5 ETDRS letters in Group I and II, respectively (p=0.321). However, among eyes with a BCVA score less than 69 ETDRS letters (54% of the study population), visual gain was more prominent in Group II (+15.2 vs. +12.1 ETDRS letters; p<0.001). Statistically significant decreases in central foveal thickness were observed with both ranibizumab and aflibercept monotherapy (p<0.001), with no significant difference between the groups. (p=0.148)., Conclusions: No statistically significant difference was found in visual outcomes at 12-month follow-up between ranibizumab and aflibercept monotherapies using a PRN protocol, although there was a tendency toward slightly better functional and anatomic prognosis in the aflibercept arm., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors., (©Copyright 2023 by Turkish Ophthalmological Association Turkish Journal of Ophthalmology, published by Galenos Publishing House.)

Objective: To investigate the choroidal vascularity index (CVI) in patients with thyroid-associated ophthalmopathy (TAO) and its relationship with clinical features and clinical activity score METHODS: Right eyes of 53 patients with TAO and 53 healthy subjects were scanned for subfoveal choroidal thickness (SFCT), CVI, choroid-stromal area (C-SA), choroid-luminal area (C-LA), choroidal stromal index (CSI), choroid-stromal-to-luminal-area ratio, and CVI and CSI within the central 1500 µm of the macula (CVI 1500 and CSI 1500 ) by enhanced-depth imaging optical coherence tomography. The results of the TAO group and the healthy controls were compared., Results: The SFCT was significantly greater in the TAO group than in the control group (p = 0.02). The values of C-LA, C-SA, and total choroidal area (TCA) in the TAO group were significantly higher than those in the control group (p = 0.01, p = 0.04, and p = 0.01, respectively). The increases in SFCT, C-LA, C-SA, and TCA were 12.1%, 12.2%, 16.2%, and 13.6%, respectively. There was no statistically significant difference between the groups for CVI, CSI, CVI 1500 , CSI 1500 , and choroid-stromal-to-luminal-area ratio (p > 0.05). CVI 1500 and CSI 1500 have displayed a statistically significant correlation with exophthalmometry and clinical activity score (p < 0.05)., Conclusion: The alterations in stromal and vascular structures are proportionally similar in TAO; thus CVI may not be affected significantly. However, CVI 1500 and CSI 1500 may be associated with disease activity. The choroidal thickening in TAO may be the result not only of vascular mechanisms but also by an increase in stromal contents., (Copyright © 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.)

Purpose: To compare the anatomical, morphological, and functional outcomes of the conventional internal limiting membrane (ILM) peeling versus temporal inverted ILM flap technique for large full-thickness macular holes (FTMHs)., Methods: Sixty eyes of 60 patients with a minimum base diameter >600 μm were included in this retrospective interventional study. Patients were divided into conventional ILM peeling (Group 1) and temporal inverted ILM flap (Group 2) groups. The hole closure rate, best-corrected visual acuity (BCVA), ellipsoid zone (EZ), and external limiting membrane (ELM) defects were analyzed at baseline and 6 months after surgery., Results: Hole closure was achieved in 24/32 (75.0%) cases of Group 1 and 27/28 (96.4%) cases of Group 2 (P = 0.029). The mean BCVA (logMAR) changed from 1.23 ± 0.47 to 0.70 ± 0.29 logMAR in Group 1 and from 1.03 ± 0.36 to 0.49 ± 0.24 logMAR in Group 2 at 6 months (P < 0.001 in both cases). U-shaped closure was observed in 5 (15.6%) eyes in Group 1 and 19 (67.9%) eyes in Group 2 (P < 0.001). The total restoration rates of ELM and EZ were significantly higher in the temporal inverted ILM flap group (P = 0.002, P = 0.001, respectively)., Conclusion: The study results suggested that the FTMH closure rate, recovery of the outer retinal layers, and, consequently, the post-operative BCVA were better with the temporal inverted ILM flap technique than with the conventional ILM peeling for larger than 600 μm macular holes.

Purpose: To provide consensus on the clinical use of intravitreal dexamethasone (DEX) implant for the treatment of diabetic macular edema (DME) in Turkey., Methods: A panel of 22 retina experts prepared 77 statements of recommendation, and 80 retinal specialists practicing in Turkey were chosen to vote either in support or against each one. A Delphi-based method was used through which the ophthalmologists were able to view all of the results anonymously after two rounds and modify their subsequent answers. The survey was conducted via a mini website, and statements without consensus were resent to the specialists with the latest vote results a week later., Results: A total of 72 ophthalmologists answered the first and second round questions. After the first stage, consensus was achieved on 55 of the statements, leaving 22 without agreement. After the second stage, consensus was reached on 11 of the remaining statements. Strong consensus was achieved on statements regarding the etiopathogenesis of DME and the first-line indications and safety of the DEX implant procedure. The panel recommended the use of DEX implant for patients with an arterial thromboembolic event in the last three months and also agreed that pro re nata DEX implant treatment not only provides better outcomes for DME patients but also reduces the treatment burden for those who could not receive an adequate number of anti-vascular endothelial growth factor (VEGF) injections., Conclusion: This study provides clinical consensus and recommendations about the use of DEX implant in the clinical practice of DME management in Turkey.

Objective: Coronavirus disease 2019 is an ongoing disease with high morbidity and mortality. We aimed to investigate the relationship between demographics, lymphocytes, eosinophils, and the coronavirus disease 2019 severity at hospital admission., Material and Methods: A retrospective, observational cross-sectional study was carried out with 5828 coronavirus disease 2019 patients between March 11, 2020, and November 30, 2020. Patients were divided into 3 groups according to where they were followed up as an indicator of disease severity, namely outpatients, inpatients, and critically ill patients. The patients' demographics and hemogram values on admission were recorded. The predictive accuracies of lymphocyte count, lymphocyte percentage, eosinophil count, and eosinophil percentage for predicting severity were determined using receiver operating characteristic curves. Logistic regression analysis was used to predict intensive care unit demand according to lymphocyte and eosinophil values., Results: Of the 5828 coronavirus disease 2019 patients, 4050 were followed up as outpatients, 1581 were hospitalized in a ward, and 197 were hospitalized in the intensive care unit. Lymphocyte count and lymphocyte percentage were significantly different between the groups, but the difference for eosinophil count and eosinophil percentage was not significant as it was for lymphocytes. Cutoff values for lymphocyte count (1.0 × 109 /L), lymphocyte percentage (22%), eosinophil count (0.052 × 109 /L), and eosinophil percentage (0.08%) were found to indicate a high risk for intensive care unit admission. Coronavirus disease 2019 patients >55 years of age, with a lymphocyte count <1.0 × 109 /L, a lymphocyte percentage <22%, and an eosinophil percentage <0.08% had a 2-fold higher risk of requiring intensive care unit management., Conclusion: Lymphocyte counts and percentages are quick and reliable biomarkers for predicting coronavirus disease 2019 severity and may guide physicians for proper management earlier.

Background: There is an increasing interest about the role of miRNAs in the pathogenesis of bipolar disorder (BD). In this study, we aimed to examine the role of miRNAs as potential diagnostic and clinical biomarkers in BD., Methods: Fifteen miRNAs in plasmas obtained from BD patients (n = 66) and from the healthy control group (n = 66) were analyzed by a qPCR test. Clinical variables including lithium treatment response were assessed with various test batteries. The correlation of the miRNA levels with the clinical variables and scale scores was examined. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed using the DIANA-miRPath v.3.0 software to identify the possible target genes., Results: The miR-132, miR-134, miR-152, miR-607, miR-633, and miR-652 levels were significantly increased, whereas the miR-15b and miR-155 levels were found to be significantly decreased in the patient group compared to the controls. The miR-15b-5p and miR-155-5p levels and increases in the miR-134-5p and miR-652-3p levels were calculated to have 83.3 % sensitivity and 78.8 % specificity in determining the risk of BD. miR-155-5p was associated with the disease burden and severity. Fatty acid biosynthesis and metabolism, viral carcinogenesis, the EBV infection, and extracellular matrix and adhesion pathways were highlighted as target pathways., Conclusion: We can conclude that miRNAs may play a role in the pathophysiology of BD through various biological pathways and that miRNAs may be used as a screening test to distinguish bipolar patients from healthy controls. Our findings will provide a basis for long-term follow-up studies with larger samples., (Copyright © 2022 Elsevier B.V. All rights reserved.)