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      Neutrophil/lymphocyte ratio and mean platelet volume in central serous chorioretinopathy

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          Abstract

          Purpose

          This study aimed to evaluate mean platelet volume (MPV) and neutrophil/lymphocyte ratio (NLR) values and their relationship with clinical findings in patients with central serous chorioretinopathy (CSCR).

          Methods

          Overall, 87 patients fulfilling inclusion criteria and 320 age- and sex-matched healthy individuals as controls were included in the study. The CSCR patients (n=87) were classified into 2 groups as acute CSCR (group 1, n=43) and chronic CSCR (group 2, n=44).

          Results

          It was found that NLR ( P<0.05) and C-reactive protein (CRP) ( P<0.05) values were higher in acute CSCR group than the other groups. MPV value was found to be higher in chronic CSCR group than the other groups ( P<0.001).

          Conclusion

          It seems that neutrophils play a major role in acute CSCR while platelets are involved in progression to chronic CSCR. Larger, prospective studies are needed on this topic.

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          Most cited references 37

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          Interleukin-8 as a macrophage-derived mediator of angiogenesis.

          Angiogenic factors produced by monocytes-macrophages are involved in the pathogenesis of chronic inflammatory disorders characterized by persistent angiogenesis. The possibility was tested that interleukin-8 (IL-8), which is a cytokine that is chemotactic for lymphocytes and neutrophils, is also angiogenic. Human recombinant IL-8 was potently angiogenic when implanted in the rat cornea and induced proliferation and chemotaxis of human umbilical vein endothelial cells. Angiogenic activity present in the conditioned media of inflamed human rheumatoid synovial tissue macrophages or lipopolysaccharide-stimulated blood monocytes was equally blocked by antibodies to either IL-8 or tumor necrosis factor-alpha. An IL-8 antisense oligonucleotide specifically blocked the production of monocyte-induced angiogenic activity. These data suggest a function for macrophage-derived IL-8 in angiogenesis-dependent disorders such as rheumatoid arthritis, tumor growth, and wound repair.
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            Central serous chorioretinopathy.

            Central serous chorioretinopathy (CSC) is a disease of the retina characterized by serous detachment of the neurosensory retina secondary to one or more focal lesions of the retinal pigment epithelium (RPE). CSC occurs most frequently in mid-life and more often in men than in women. Major symptoms are blurred vision, usually in one eye only and perceived typically by the patient as a dark spot in the centre of the visual field with associated micropsia and metamorphopsia. Normal vision often recurs spontaneously within a few months. The condition can be precipitated by psychosocial stress and hypercortisolism. Ophthalmoscopic signs of CSC range from mono- or paucifocal RPE lesions with prominent elevation of the neurosensory retina by clear fluid - typical of cases of recent onset - to shallow detachments overlying large patches of irregularly depigmented RPE. The spectrum of lesions includes RPE detachments. Granular or fibrinous material may accumulate in the subretinal cavity. Serous detachment often resolves spontaneously. From first contact, counselling about the potential relation to stress and glucocorticoid medication is warranted. After 3 months without resolution of acute CSC or in chronic CSC, treatment should be considered. Resolution of detachment can usually be achieved in acute CSC by focal photocoagulation of leaking RPE lesions or, in chronic CSC, by photodynamic therapy. The effect of therapy on long-term visual outcome is insufficiently documented. Reattachment within 4 months of onset is considered a relevant therapeutic target because prolonged detachment is associated with photoreceptor atrophy. This suggests that the value of treatment depends upon proper selection of cases that will not resolve without therapy. Chronic CSC may be difficult to differentiate from occult choroidal neovascularization secondary to CSC. Patients with chronic CSC who receive glucocorticoid treatment for systemic disease can often be managed without having to discontinue this medication.
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              Central serous chorioretinopathy: update on pathophysiology and treatment.

              Recent technological advances--new pathophysiological insights, new imaging techniques for diagnosis and management, and new treatments--have led to an improved understanding of central serous chorioretinopathy (CSC). The primary role of the choroid has become more widely accepted with widespread use of indocyanine green angiography. Optical coherence tomography (OCT), and particularly enhanced depth imaging OCT, demonstrate a thickened and engorged choroid. Adaptive optics, fundus autofluorescence, multifocal electroretinography, microperimetry, and contrast sensitivity testing reveal that patients with even a mild course suffer previously undetected anatomic and functional loss. Although focal laser and photodynamic therapy are the current standard of care for persistent subretinal fluid in CSC, they are not appropriate in all cases, and the optimal timing of intervention remains unclear. Published by Elsevier Inc.
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                Author and article information

                Journal
                Ther Clin Risk Manag
                Ther Clin Risk Manag
                Therapeutics and Clinical Risk Management
                Therapeutics and Clinical Risk Management
                Dove Medical Press
                1176-6336
                1178-203X
                2017
                28 July 2017
                : 13
                : 945-950
                Affiliations
                [1 ]Department of Ophthalmology
                [2 ]Department of Internal Medicine, Division of Rheumatology, Antalya Education and Research Hospital
                [3 ]Department of Ophthalmology, Akdeniz University Medical Faculty, Antalya, Turkey
                Author notes
                Correspondence: Berna Dogan, Department of Ophthalmology, Antalya Education and Research Hospital, Varlık Mah., Kazim Karabekir Caddesi, 07100 Antalya, Turkey, Tel +90 242 249 4400, Email bernadoga3@ 123456hotmail.com
                Article
                tcrm-13-945
                10.2147/TCRM.S138581
                5545637
                © 2017 Erol et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Categories
                Original Research

                Medicine

                central serous chorioretinopathy, mean platelet volume, neutrophil/lymphocyte ratio

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