The diabetic retinopathy clinical research network (DRCR.net), founded by the National Eye Institute, was formed in 2002. Currently it includes over 400 ophthalmologists in 115 clinical centers in 37 states of the United States. Since then, it has conducted several studies on various points of interest about diabetic retinopathy and diabetic macular edema. To date, the DRCR.net has published about 80 articles, including clinical trials (named with alphabetic letters), observational studies and various sub analyses derived from the primary studies. The results obtained provide retina specialists with substantial evidence regarding the treatment protocols classically proposed. Also, they evaluate new treatment guidelines and information concerning other important points about the disorders studied. The large amount of information provided by the protocols and the corresponding sub analyses make understanding them a difficult task. In this work, we intend to emphasize and summarize the essential points and conclusions of each of the protocols already published by the DRCR.net, highlighting their importance in clinical practice, which will result in better decisions for the individualized treatment of diabetic patients.

pdf/diabetic-retinopathy-clinical-research-network-diabetic-2wj1e50ym3.pdf

Diabetic Retinopathy Clinical Research Network: Diabetic retinopathy and diabetic macular edema

ABSTRACT Ocular rosacea is a chronic potentially sight-threatening inflammatory condition, which can occur in approximately 20% of patients without skin involvement. However, an accurate diagnosis of ocular rosacea has not been defined yet due to its rather nonspecific symptoms and clinical findings. Therefore, this article updates the current recommendations for diagnosis and treatment of ocular rosacea and the previously published consensus recommendations from the ROSCO expert panel on the management of rosacea.

Rosacea and Dry Eye Disease

Background: Obtaining a definitive neurofibromatosis type-1 (NF1) diagnosis may take years. The natural history of choroidal neurofibromas in NF1 is unknown. This study evaluates a predominantly pe...

The presence and progression of choroidal neurofibromas in a predominantly pediatric population with neurofibromatosis type-1.

Inflammation may play a significant role in Keratoconus (KC), but the relationship between inflammatory markers and choroidal thickness (CT) is unknown. The purpose of this study was to evaluate serum inflammatory markers and correlate them with the choroidal profile of KC patients and control subjects. Forty patients with KC and 26 age-matched control subjects were enrolled in a cross-sectional case-control study. Choroidal profile was studied with a Spectralis Heidelberg apparatus and venous blood samples were collected. Neutrophil/lymphocyte ratio (NLR), monocyte/HDL ratio (MHR), platelet/lymphocyte ratio (PLR) and systemic immune inflammation index (SII) were calculated. Serum inflammatory biomarkers IL-1, IL-6 and TNF-alfa were also analyzed. KC group presented thicker choroids in each evaluated point when compared to the control group (subfoveal CT 417.38 ± 79.79 vs 299.61 ± 76.13, p < 0.001 for all measured locations). Mean values of NLR, PLR and SII were significantly higher in patients with KC (NLR p = 0.001; PLR p = 0.042; SII p = 0.007). Although KC patients presented higher mean levels of MHR, IL-1, IL-6 and TNF-α than control group, no significant differences were achieved. Positive correlations were found between subfoveal CT and NLR and SII (0.408, p = 0.001 and 0.288, p = 0.019 respectively). The results presented are in favor of a relationship between the increased CT and inflammatory mechanisms in KC patients. The elevated serum inflammatory indices NLR, SII and PLR provide additional evidence of a role for systemic inflammation in the pathophysiology of KC. 

/pdf/serum-inflammatory-biomarkers-are-associated-with-increased-negdeqsl.pdf

Serum inflammatory biomarkers are associated with increased choroidal thickness in keratoconus

New findings in early-stage keratoconus: lamina cribrosa curvature, retinal nerve fiber layer thickness and vascular perfusion.

Purpose: This study reports the effects of combined use of oral doxycycline and topical cyclosporine on ocular signs, symptoms, and tear film parameters in rosacea patients. Methods: Fifty-four right eyes of 54 patients were included in this study. All patients underwent full ophthalmologic examination-including best corrected visual acuity measurement, slit-lamp anterior segment and fundus examination, tear film break-up time, and Schirmer test-before treatment and six months post-treatment. Patients were divided into two treatment groups. The first group was treated with oral doxycycline 100 mg twice daily for the first month and once daily for the following two months. The second group received topical 0.05% cyclosporine emulsion drops twice daily for six months in addition to the oral doxycycline treatment regimen. All patients received preservati ve-free artificial tear drops, warm compress, eyelash cleaning, and topical corticosteroid drops three times daily for one month. Results: A significant improvement in ocular signs and symptoms was recorded for all patients in groups 1 and 2 after treatment. There was not a significant difference in terms of itching, burning, meibomian gland inspissation, corneal neovascularization, and conjunctival hyperemia score changes between groups 1 and 2. The increases in Schirmer test and break-up time scores were significantly higher in group 2 than in group 1. Conclusions: Our results support the finding that topical cyclosporine in addition to the standard regimen improves tear function, as shown by Schirmer test and break-up time scores, in ocular rosacea patients.

/pdf/effects-of-combined-oral-doxycycline-and-topical-43rzhj9q25.pdf

Effects of combined oral doxycycline and topical cyclosporine treatment on ocular signs, symptoms, and tear film parameters in rosacea patients.

Amac: Bu calismada, keratokonus hastalarinda korneal kollajen capraz baglama tedavisinin gorme keskinligi ve merkezi kornea kalinligina etkilerinin gosterilmesi amaclanmistir. Gerec ve Yontem: Korneal kollajen capraz baglama islemi uygulanan 26 hastanin 51 gozu calismaya dahil edildi. Merkezi kornea kalinlik olcumleri ve en iyi duzeltilmis gorme keskinlikleri islemden once ve sonrasindaki 1. ay ve 6. ayda kayit altina alindi. Bulgular: Ortalama merkezi kornea kalinlik olcumleri islem oncesi, islem sonrasi 1. ay ve islem sonrasi 6.ay olmak uzere sirasiyla 435,43±44,35μm, 376,68±66,55μm ve 392,62±64,21 μm olarak kaydedildi. Islem oncesi ve islem sonrasi 1. ay, islem oncesi ve islem sonrasi 6.ay ve islem sonrasi 1. ay ve islem sonrasi 6.ay merkezi kornea kalinligi olcumleri arasinda istatistiksel olarak anlamli fark bulundu. Ayni zamanda,  islem sonrasi gorme keskinligi artisi istatistiksel olarak anlamli bulundu. Sonuc: Islem oncesi, islem sonrasi 1.ay ve islem sonrasi 6. ay merkezi kornea kalinlik olcumleri ve en iyi duzeltilmis gorme keskinligi olcumlerinde istatistiksel olarak anlamli degisiklikler bulundu.

/pdf/keratokonus-hastalarinda-uva-riboflavin-korneal-kollajen-1lfmfdri9f.pdf

Keratokonus hastalarında UVA-Riboflavin korneal kollajen çapraz bağlama tedavisinin sonuçları

Cockayne syndrome is a rare autosomal recessive, neurodegenerative disorder characterized by a broad spectrum of clinical symptoms. Herein, we will describe a patient diagnosed with Cockayne syndrome by genetic testing who was also determined to be having Dandy–Walker malformation in brain imaging. In this article, we aimed to highlight the general characteristic findings of Cockayne syndrome and to report the togetherness of these two rare entities.

A Rare Syndrome and a Rare Association: Dandy–Walker Malformation and Cockayne Syndrome in a Child

Aim: To compare the blood renalase and cerebellin-1 levels of acute central serous chorioretinopathy (CSC) patients with healthy subjects.
Method: A total of 33 eyes with acute naive CSC (less than 2 months duration) and 31 healthy subjects were enrolled in this study. Idiopathic CSC was diagnosed based on the presence of a serous detachment of the neurosensory retina involving the macula that was confirmed using optical coherence tomography and leakage at the retinal pigment epithelium level using fluorescein angiography. Blood samples were collected and centrifuged at 4000 g for 10 minutes. The serum samples were collected and stored at -80 °C until required for analysis. Serum renalase and cerebellin-1 levels were measured using an ELISA kit.
Results: In CSC group 11 patients were female and 22 patients were male. In control group 10 participants were female and 20 were male. The sex was similar between groups. Mean age in CSC group was 41, 04±5, 94, in control group was 40, 67±6, 53. Mean ages were similar between groups. Mean renalase levels in CSC group was 27, 19±14, 01 ng/ml and in control group was 19, 12±15, 57 ng/mL. Mean renalase level was higher in CSC group. Mean cerebellin levels were 57, 76±29, 72  pg/mL and 52, 50±29, 25 pg/mL in CSC and in control groups, respectively. Mean cerebellin levels were similar in groups.
Conclusion: Comparing with healthy subjects serum renalase levels were higher and cerebellin-1 levels were similar in CSC patients.

https://experimentalbiomedicalresearch.com/ojs/index.php/ebr/article/download/77/47

Serum renalase and cerebellin levels in acute central serous chorioretinopathy

PURPOSE: The aim of this study was to compare the pain scores of the patients during intravitreal injection of ranibizumab and aflibercept based on patient feedback.
MATERIALS AND METHODS: Seventy-two eyes of 72 patients, who had not previously undergone any intravitreal injection procedures, were included in this study. Thirty-eight patients received ranibizumab, and 34 patients received aflibercept injections. The pain was measured by visual analog scale (VAS). Patients were asked to rate their pain experienced during the injection between 0 (no pain) and 10 (worst pain ever felt) on VAS just after the injection.
RESULTS: VAS pain scores in ranibizumab and aflibercept groups were 3.28 ± 2.45 and 4.20 ± 2.30, respectively. There was a significant difference in average VAS pain scores between groups (P = 0.04).
CONCLUSION: VAS pain scores in aflibercept group were found to be significantly higher than the scores in the ranibizumab group.

Assessment of Patient Pain Experience During Intravitreal Ranibizumab and Aflibercept Injection.

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