Objective: Th e aim of our study was to establish a correlation between pseudoexfoliation and its systemic manifestation. Findings: Pseudoexfoliation syndrome is an agerelated systemic disorder that leads to the overproduction and accumulation of the pseudoexfoliated materials in the visceral organs and in the eye. Many vascular diseases are closely related with pseudoexfoliation manifestations. Our results indicated that there were no statistically significant diff erences (p>0.05) among patients regarding the presence of hypertension in all groups: PEX glaucoma - 45% (9 patients); PEX syndrome- 40% (8 patients); and control groups- 35% (7 patients). Ischemic heart disease was statistically significant present in the sPEX syndrome- 20% (5 patients) and PEX glaucoma- 25% (5 patients) patient groupss, in comparison with those of the control group-10%, (p<0.05). Aortic aneurism was statistically significant present in patients with PEX (syndrome-5% or glaucoma-15%), compared to those in the control group, which included no patients with aneurisms, (p<0.05). Our results indicated that a statistically significant number of patients with aneurism were in the group of patients who developed PEX glaucoma (p<0.05). Cerebrovascular diseases were detected in all groups of patients, but a significant decrease in this metric was noted in the control group- 5% (2 patients), compared with patients with PEX syndrome- 15% and PEX glaucoma-25%, (p<0.05). Hearing loss, as a concomitant sign of PEX manifestation, was recorded in all patients, but in the group with PEX (syndrome-55% or glaucoma-75%), these results showed a statistically significant increase (p<0.05) in comparison with those of patients in the control group (10%). Among the patients with PEX (syndrome and glaucoma), there were no statistically significant diff erences in the selected categories of systemic manifestations (p<0.05). Th is result indicates that the main risk for systemic manifestation is the presence of PEX and that other ocular and vascular complications are, in fact, consequences of PEX. Conclusion: Pseudoexfoliation is strongly related to systemic vascular disturbances. A detailed examination of patients with PEX by specialists in internal disease or by neurologists should be performed. Such recommended examinations can be helpful in the prevention of diff erent vascular diseasess among patients with PEX, especially atthose in the early stages.
A disturbed lipid profile with elevated resistancy index and intima-media thickness and increased systolic and diastolic pressure were compulsory findings in patients with developed XFG. So, these factors could be considered as risk. It seems to be difficult to inhibit the process of pseudoexfolation production in the whole body, but it appears that with proper therapy (antihypertnesive, cardiotoncs, etc.) and adequate nourishing, the process of XFG development could be interrupted.
Background: The purpose of this study is to reveal the participation of different regulatory cytokines within the process of pseudoexfoliation (PEX). Methods: Our study included 140 patients referred to cataract surgery with early and late stage of pseudoexfoliation syndrome (XFS) or pseudoexfoliation glaucoma (XFG). Humor and serum levels of cytokines: transforming growth factor beta (TGF-β), platelet-derived growth factor (PDGF), epidermal growth factor (EGF), insulin-like growth factor (IGF), IL-8 and interferon-inducible T cell alpha chemoattractant (ITAC) were measured in a sample using high sensitivity enzyme-linked immunoabsorbent assay (ELISA) kit. Results: Our results indicate that profibrotic action induced by increasing TGF-β and PDGF locally activates fibrous tissue production in the early XFS with a prolonged effect of PDGF (late XFS) and finally (XFG stage) it is dominantly controlled by EGF and IGF. ITAC overrides angiogenetic effects of IL-8 in XFG. Conclusion: Based on our findings, local chronic inflammation in the eye is accompanied by the secretion of different profibrotic cytokines (TGF-β, PDGF, EGF, IGF, IL-8) without angiogenesis due to effects of ITAC.
Background/Aim: Complications of diabetes mellitus (DM) in the eye are the leading cause of blindness in the world. Although research on DM is mainly focused on retinal damage, changes in the cornea are also associated with DM. Central corneal thickness (CCT) reflects the metabolic status of the cornea and is also affected by DM. Knowledge of CCT changes that occur within DM is important for accurate IOP measurement, diagnosis and monitoring of patients with glaucoma. The main goal of the study was to examine the effect of DM type 2 on central corneal thickness. Methods: The study was designed as a clinical, cross sectional, observational study. It consists of 96 patients, divided into two groups. The first group consisted of 49 patients diagnosed with DM type 2. The second group was the control group and consisted of 47 healthy subjects. The DM group is divided into subgroups depending on the status of diabetic retinopathy, the length of DM treatment, and the levels of glycosylated hemoglobin (HbA1C). Results: A statistically significant difference in CCT was observed among DM patients and the control group. Analyzing only DM patients, the highest CCT values were observed in patients who had HbA 1C > 7.0%, as well as those who treated DM for more than 15 years, with a statistically significant difference in relation to the corresponding patient subgroups (p=0.002 and p=0.037). No statistical significance was observed depending on the status of retinopathy. Intraocular pressure (IOP) was also statistically significantly higher in patients with DM compared to the control group. Conclusion: Previous research has mainly focused on the complications of diabetes in the posterior segment of the eye. Knowing that the increase in CCT also affects the measured IOP values, this research will be useful in better understanding and control of the patients who have glaucoma in addition to DM type 2.
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