Purpose: To reveal the roles of proinflammatory cytokines within the process of pseudoexfoliation (PEX) production. Methods: Our study included 120 patients referred to cataract surgery (early and late stage of pseudoexfoliation syndrome (XFS), pseudoexfoliation glaucoma (XFG), and control group). Serum and humor levels of cytokines were measured in a sample with high sensitivity enzyme-linked immunosorbent assay (ELISA) kit. Results: Our findings revealed that TNF-α and IL-17, overlooked by IL-6 action in the early stage and in the phase of glaucoma, played the main role in the inflammation activation in the tissue in the early and late stage of XFS and in XFG. Conclusions: Local conditions cause chronic inflammation in the eye, subsequently activating fibrotic process with fibrotic tissue deposits in the eye.

To establish the role of nitric oxide (NO), ascorbic acid and tumour necrosis factor-α (TNF-α) in the pathogenesis of pseudoexfoliation glaucoma (XFG). Our study included 120 patients who were referred for cataract surgery. All patients were divided into four groups according to clinical findings: XFG, early and late pseudoexfoliation syndrome (XFS), and cataract (without pseudoexfoliation). Serum and aqueous humour levels of the ascorbic acid, NO and TNF-α were measured. The concentrations of the ascorbic acid and NO were measured by an appropriate spectrophotometric method. Enzyme-linked immunosorbent assay (ELISA) was used to determine TNF-α level. Aqueous humour concentration of ascorbic acid was significantly lower in patients with late XFS (0.61±0.11 mmol/L) and XFG (0.48±0.15 mmol/L) compared to patients with early XFS (0.9±0.15 mmol/L) and cataract (1.16±0.22 mmol/L), while there was no difference in serum concentration in all examined groups. Aqueous humour concentration of NO was significantly higher in patients with XFG (77.7±11.4 µmol/L) compared to patients with early XFS (50.27±9.34 µmol/L) and cataract (49.77±7.1 µmol/L), while serum concentration was increased in the early stage of XFS (73.26±8.29 µmol/L). Aqueous humour level of proinflammatory cytokine TNF-α was increased in patients with XFS (early 460.04±18.32 pg/mL; late 502.42±53.23 pg/mL) and XFG (510.34±43.07 pg/mL), while there was no difference in serum level in all examined groups of patients. Reduced ascorbic acid and elevated NO and inflammation related cytokine TNF-α level in aqueous humour of the patients with developed XFG suggest that oxidative stress induces local inflammation.

We present a patient with a corneal ulcer of the right eye, with eye protrusion and without anamnesis of cancer. On CT examination there was a bulky soft tissue mass in the cranial aspect of the right orbit, without increasing in signal intensity after injection of contrast. Open biopsy revealed undifferentiated tissue that stained strongly positive for breast carcinoma, confirming the diagnosis of metastases of breast carcinoma.

We described a patient with bilateral iris metastases resulted from prostatic cancer. Slit lamp and ultrasonography examination of the both eye demonstrated tumor of the iris, as an amelanotic vascular mass located on the superior temporal quadrant.

Background/Aim. Pseudoexfoliation syndrome (XPS) is an age-related systemic disorder characterized by increased production and accumulation of elastic microfibrillar material in different tissues of the body: skin, connective tissue portions of visceral organs, periphery blood vessels and the eye, as well. The aim of our study was to determine the significance of atherosclerotic changes in the carotid arteries in the development of XFS and pseudoexfoliation glaucoma (XFG). Methods. The study included 120 patients ? 40 patients per each of the three defined groups: XFS group, XFG group and age- and sex-matched control subjects (control group) without XFG. Blood samples were collected from the patients before cataract surgery. Serum levels of total cholesterol, low-density lipoprotein ? LDL, high density lipoprotein ? HDL and triglycerides were analyzed by standard laboratory techniques. Standard ultrasonography of the carotid blood vessels was performed in all the participants. Results. Lipid?s profile was disturbed in the patients with XFS and XFG with statistical significance p control group (p < 0.01). Systolic and diastolic pressure was elevated in the patients with XFS and XFG (p < 0.01). Resistance index was increased in the patients with XFG (p < 0.01). Intima-media thickness was prolonged in patients with XFG (p < 0.01). Conclusion. 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.

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.