The aim of the study was to investigate the correlation between the levels of C-reactive protein (CRP) and chitinase 3-like protein 1 (YKL-40) in blood samples with morpohometric parameters of retinal blood vessels in patients with diabetic retinopathy. Blood laboratory examination of 90 patients included the measurement of glycemia, HbA1C, total cholesterol, LDL-C, HDL-C, triglycerides and CRP. Levels of YKL-40 were detected and measured in serum by ELISA (Micro VueYKL-40 EIA Kit, Quidel Corporation, San Diego, USA). YKL-40 correlated positively with diameter and negatively with number of retinal blood vessels. The average number of the blood vessels per retinal zone was significantly higher in the group of patients with mild non-proliferative diabetic retinopathy than in the group with severe form in the optic disc and all five retinal zones. The average outer diameter of the evaluated retinal zones and optic disc vessels was significantly higher in the group with severe compared to the group with mild diabetic retinopathy. Morphological analysis of the retinal vessels on digital fundus photography and correlation with YKL-40 may be valuable for the follow-up of diabetic retinopathy.

High near visual demand could be the most important factor for higher incidence of myopia, worse convergence and fusion amplitude, higher degree of exophoria, and worse results in Titmus test in the student population.

Purpose: We present the rare case of a young male patient with asymmetric ocular findings: pigmentary ocular hypertension associated with nonischemic central retinal vein occlusion (CRVO) in the right eye and pigmentary glaucoma (PG) with progressive glaucomatous optic damage in the left eye. Patients and Methods: A 31-year-old man showed nonischemic CRVO in the right eye and the clinical triad of pigment dispersion syndrome in both eyes, however more marked in the left eye. Best-corrected visual acuity was logMAR 0.3 in the right eye and 1.0 in the left eye at presentation. The single risk for developing PG and CRVO was hyperhomocysteinemia. The patient was a carrier of the methylenetetrahydrofolate reductase C677 homozygous mutation. Results: At 18 months of follow-up, visual acuity remained stable, intraocular pressure was in the normal range, but retinal tomography indicated an increase in glaucomatous optic damage to the nerve fiber layer in almost the complete temporal-inferior sector of the left eye, but without visual field defects in the left eye. Retinal tomography and automated perimetry were normal in the right eye. The patient received topical antiglaucomatous therapy. Conclusion: Higher levels of plasma homocysteine, even mildly elevated ones, could be associated with nonischemic CRVO and PG, especially when related to genetic risk factors or C677T mutation.

Alström syndrome is a rare disorder typified by early childhood obesity, neurosensory deficits, cardiomyopathy, progressive renal and hepatic dysfunction, and endocrinological features such as severe insulin resistance, type 2 diabetes, hyperlipidemia, and hypogonadism. Widespread fibrosis leads to multiple organ failure. Mutations in ALMS1 cause Alström’s syndrome. Two age-matched, unrelated adolescent males of Serbian descent with Alström syndrome underwent an extensive workup of blood chemistries, and ophthalmological, audiological, and genetic evaluations. Although both showed typical features of Alström syndrome in childhood, several differences were observed that have not been reported previously. Patient 1 was first studied at the age of 13 years for multisystemic disease and re-evaluated at the age of 15.5 years. Patient 2 is a 15-year-old boy who presented at birth with epilepsy and psychomotor developmental delay and generalized tonic–clonic seizures with severe cognitive impairment, features not documented previously in this syndrome. Sequencing analysis indicated two novel ALMS1 mutations in exon 8: p.E1055GfsX4 and p.T1386NfsX15. Metabolic and physiological similarities were observed in both patients, including severe insulin resistance, and truncal obesity with fat loss suggestive of partial lipodystrophy, supporting evidence for a role for ALMS1 in adipose tissue function. The unusual phenotypes of clonic–tonic seizures and severe cognitive abnormalities and lipodystrophy-like adiposity pattern have not been documented previously in Alström syndrome and may be an under-reported abnormality.

We observed that a variety of well-known risk factors in metabolic syndrome may be involved in serious eye and cardiological complications. The early diagnosis and treatment of these patients can not only improve visual function but also prevent cardiovascular complications.