Background/Aim. Transforming growth factor-b1 (TGF-b1), oxidative stress and imbalance between matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) may play an important role in pathogenesis of pseudoexfoliation syndrome/glaucoma (PEX Sy/Gl). The aim of the study was to measure concentrations of TGF- b1, MMP-2, TIMP-2 in the aqueous humor in the examined group, as well as to compare the biochemical findings with the following clinical parameters: degree of chamber angle pigmantation, presence of pseudoexfoliation and the value of intraocular pressure (IOP). Methods. Aqueous samples from 30 patients with cataract, 30 patients with PEX Sy, 36 patients with PEX Gl, and 42 patients with primary open-angle glaucoma (POAG) were collected during phacoemulsification cataract surgery. TGF b1, MMP-2, TIMP-2 Fluotokine Multi Analyze Profiling kits and Luminex technology were used to simultaneously measure TGF b1, MMP-2 and TIMP-2. Results. TGF- ?1, MMP-2, TIMP-2 were detected in human aqueous from all the groups with the highest level in the group with PEX Gl. Statistically, a significant correlation between the levels of TGF b1, MMP-2, TIMP-2 in the aqueous humor of the patients with PEX Gl and the IOP value was confirmed (p < 0.05). In this group, the positive correlations between the TGF b1 concentration in the aqueous humor and the presence of pseudoexfoliation (p < 0.01), on the one hand, and between the TIMP-2 level and the presence of pseudoexfoliation (p < 0.05), on the other, were reported. A statistically significant positive correlation of TGF-b1 and MMP-2, and the degree of chamber angle pigmentation in the PEX Gl group was confirmed (p < 0.05). In the POAG group, TIMP-2 values were in a negative correlation with the degree of pigmentation (p < 0.05), and the IOP value (p < 0.05). Conclusion. TGF b1 and MMP-2 affect the degree of chamber angle pigmentation and the degree of pseudoexfoliation in patients with pseudoexfoliative glaucoma.

Introduction. This study was aimed at providing an update on most recent developments regarding ocular and systemic manifestations and complications, clinical diagnosis and management, and molecular patophysiology of pseudoexfoliation syndrome. Method. Review of recent literature and own clinical and laboratory studies. Results. Pseudoexfoliation syndrome is an age-related disease in which abnormal fibrillar extracellular material is produced and accumulated in many ocular tissues. Recent progress and advances have led to improvements in clinical management by understanding the effects of the pseudoexfoliation process on the ocular tissues, by refining diagnostic criteria and applying new treatment regimes, and by developing preventive strategies to reduce surgical complications. Increasing evidence of systemic associations of cardiovascular, cerebrovascular, abdominal aorta aneurysm can provide better understanding and management of this condition, and new therapeutic goal. The current pathogenesis concept describes psuedoexfoliation syndrome as an elastic microfibrillopathy involving transforming growth factor-b, matrix metalloproteinase oxidative stress. Conclusion. Despite extensive research, the exact chemical composition of exfoliation material remains unknown. The presence of pseudoexfoliation should alert the physician to the increased risks of intraocular surgery, most commonly zonular dehiscence, capsular rupture, and vitreous loss during cataract extraction. Its associated clinical signs are important in the detection and management of glaucoma.

Background and Objectives: It is well known that alterations in microvascular structure and function contribute to the development of ocular, renal, and cardiovascular diseases. Accordingly, the presence of fundus vascular changes in patients suffering from chronic kidney disease (CKD) and Balkan endemic nephropathy (BEN) may provide information of prognostic value regarding the progression of renal disease. This study aimed to examine the associations between clinical characteristics and retinal optical coherence tomography angiography (OCTA) parameters in patients with BEN and compare them with those in CKD. Materials and Methods: This pilot study, conducted from March 2021 to April 2022, included 63 patients who were divided into two groups: the first group consisted of 29 patients suffering from BEN, and the second was a control group of 34 patients with CKD. Demographic, laboratory, clinical, and medication data were noted for all the patients included in this study. Each eye underwent OCT angiography, and the results were interpreted in accordance with the practical guide for the interpretation of OCTA findings. Results: Statistically significantly higher levels of total serum protein and triglycerides were recorded in the BEN group than in the CKD group, while the level of HDL cholesterol was lower. Based on the performed urinalysis, statistically significantly higher values of total protein and creatinine were detected in patients with CKD compared to the BEN group. It was demonstrated that the OCTA vascular plexus density of certain parts of the retina was in significant association with systolic and diastolic blood pressure, creatinine clearance, urinary creatinine, total cholesterol, diabetes mellitus type 2, age, body mass index, total serum and urinary protein, sCRP, and diuretic and antihypertensive treatment. Conclusions: In comparison with CKD, BEN leads to more significant disturbances in retinal vasculature density.

Background and Objectives: Myopia is a rapidly growing global health burden driven primarily by axial elongation, which exerts mechanical stress on the inner retina, leading to progressive thinning of the retinal nerve fiber layer (RNFL) and the ganglion cell complex (GCC). The sector-specific pattern of these changes across the full spectrum of myopia remains incompletely characterized. This study aimed to provide a comprehensive, sector-level analysis of RNFL and GCC changes across four myopia severity grades using optical coherence tomography angiography (OCTA), and to quantify their correlations with axial length (AL) and central foveal thickness (CFD). Materials and Methods: A total of 260 eyes of 130 participants were enrolled in a prospective cross-sectional study. Eyes were classified into four groups: emmetropia (EM, n = 74), low myopia (LM, n = 68), moderate myopia (MM, n = 64), and high myopia (HM, n = 54). All participants underwent cycloplegic refraction, AL measurement, and RTVue XR Avanti OCTA imaging. RNFL thickness was assessed across five peripapillary sectors, and GCC thickness across twelve macular zones. Between-group differences were analyzed using one-way ANOVA with Bonferroni post hoc correction or Kruskal–Wallis/Dunn-Bonferroni tests. Pearson correlations were used to assess associations among structural parameters, AL, and CFD. Results: Both the RNFL and GCC showed progressive, statistically significant thinning with increasing myopia severity. The superior RNFL was the only peripapillary sector that differentiated EM from LM (p = 0.039), with total thinning of 18.8 μm from EM to HM. The paratemporal GCC zone showed the earliest macular structural signal (EM vs. LM, p = 0.049). Temporal and nasal RNFL sectors showed relative preservation, with differences restricted to comparisons involving HM. AL correlated negatively with the RNFL and GCC across all sectors (r = −0.46 to −0.71), with the strongest correlation observed for the superior RNFL in HM (r = −0.71, p < 0.001). CFD demonstrated progressively stronger coupling with GCC thickness as myopia severity increased, peaking in HM (r = 0.72, p < 0.001). Conclusions: The RNFL and GCC thinning in myopia follows a progressive, sector-specific pattern driven by axial elongation. The superior RNFL and paratemporal GCC are the earliest structural indicators of inner retinal change, detectable already at the low-myopia grade. These findings support a neural-first model of myopia-related retinal remodeling and advocate for multiparametric, stage-targeted structural monitoring in clinical practice.