<strong>ARVO</strong> 2013 Annual Meeting Abstracts by Scientific Section/Group - <strong>Biochemistry</strong>/<strong>Molecular</strong> <strong>Biology</strong>of intravitreal ranibizumab, there was no significant difference inchoroidal hypopermeability change when compared to low-fluencePDT (P=0.139).Conclusions: Using our novel method of analysis of change inchoroidal hyperpermeability with treatment in chronic CSC, greaterchange was found in eyes with good response, and the superioroutcome of low-fluence PDT over ranibizumab may be attributed togreater influence on choroidal hyperpermeability.Commercial Relationships: Jeong-Ah Kim, None; Joo YoungShin, None; So Hyun Bae, None; Jeeyun Ahn, None; Hum Chung,None; Jang won Heo, NoneClinical Trial: NCT01325181Program Number: 1136 Poster Board Number: D0040Presentation Time: 1:00 PM - 2:45 PMCentral serous chorioretinopathy associated with homeopathicadrenal medicationDerek Huang 1, 2 , Robert Millay 2 , Brian Kim 2 . 1 UCLA Olive View,Sylmar, CA; 2 Ophthalmology, University of Vermont College ofMedicine, Burlington, VT.Purpose: To report a case of central serous chorioretinpathy (CSC)associated with homeopathic adrenal medication. CSC ischaracterized by leakage of fluid into the subretinal space from thechoroid that can lead to serous retinal detachments. CSC is mostprevalent in males aged 20-50 years old. Its association with type Apersonality, stress, steroid use and hypercortisolism has beenreported. Elevated catecholamine levels have also been shown. Theprognosis is good with spontaneous resolution in weeks to months;however about 5% of patients fail to regain greater than 20/30 acuity.Methods: One case of central serous chorioretinopathy wasdescribed at the University of Vermont College of MedicineDepartment of Ophthalmology.Results: This is the first case report describing central serouschorioretinopathy in association with the use of homeopathic adrenalmedication. A 42 year old man presented with acute visualcomplaints characterized as “blurry, dark spot in his central vision” inhis left eye of two days duration. He acknowledged using 2 tablets ofADHS supplement for adrenal health. ADHS is a homeopathicadrenal support supplement, marketed to support desireddehydroepiandrosterone (DHEA), Secretory IgA and normal cortisollevels. Examination revealed best-corrected visual acuity was 20/20in the right eye (OD) and 20/30-2 in the left eye (OS). Slit lampexamination showed left retinal pigment epithelial mottling andsubretinal fluid. Angiographic examination revealed two areas ofleakage in the left eye. Optical Coherence Tomography (OCT) wasconsistent with a diagnosis of central serous chorioretinopathy.During a follow up examination (1 week later), he denied further useof his homeopathic medication and experienced improvement in thedark central spot. His visual acuity was 20/20 OD and 20/30+2 OS.OCT demonstrated improvement in his subretinal fluid.Conclusions: CSC has been linked to endogenous Cushing’ssyndrome, sympathomimetic use, and elevated catecholamine levels.ADHS supplies raw materials necessary for the synthesis of steroidhormones and epinephrine, the conversion of tyrosine tocatecholamines, and hormonal secretion. The ingredients and aminoacids contained in ADHS could play a role in its pathogenesis inCSC. Additional investigation into the mechanism of adrenalsupplementation would aid in establishing guidelines for their useand potential side effects.Commercial Relationships: Derek Huang, None; Robert Millay,None; Brian Kim, NoneProgram Number: 1137 Poster Board Number: D0041Presentation Time: 1:00 PM - 2:45 PMPlasma Kallikrein Deficiency is protective against diabetesinduced retinal vascular dysfunctionAllen Clermont 1, 2 , Qunfang Zhou 2 , Takeshi Kita 1, 2 , Jia Liu 2 , Lloyd P.Aiello 1, 3 , Edward P. Feener 2 . 1 Beetham Eye Institute, Joslin DiabetesCenter, Boston, MA; 2 Vascular Cell <strong>Biology</strong>, Joslin Diabetes Center,Boston, MA; 3 Ophthalmology, Harvard Medical School, Boston,MA.Purpose: Components of the kallikrein-kinin system (KKS)including plasma kallikrein (PK) were shown to increase in thevitreous of patients with diabetic macular edema (DME). Whilepharmacological inhibition of PK reduces retinal vascularpermeability (RVP) in diabetic rats the effects of PK gene deficiencyon retinal function and structure has not been reported. The currentstudy examines the effect of PK gene deletion upon systemicparameters, RVP, and retinal thickeness in diabetic and nondiabeticmice and on the neovascular response induced by oxygen-inducedretinopathy (OIR).Methods: Diabetes was induced in 3 month old male and femaleKlKb1 knockout (KO) and wildtype (WT) mice by injection ofstreptozotocin (45mg/kg) with age-matched non-diabetic controlgroups. Retinal scans were obtained by SD-OCT (Bioptigen) after 3months. RVP was determined by extravasation of Evans blue dye(90mg/kg). PK, FXII, and their endogenous inhibitor, C1 inhibitor,were measured from plasma by western blot. OIR was induced by75% oxygen for 5 days in p7 mice.©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the <strong>ARVO</strong> Office at arvo@arvo.org.
<strong>ARVO</strong> 2013 Annual Meeting Abstracts by Scientific Section/Group - <strong>Biochemistry</strong>/<strong>Molecular</strong> <strong>Biology</strong>Results: PPK deficiency in DM mice did not alter body weight gainand blood glucose. FXII was increased and C1-INH was decreased inDM-WT by 40% compared to NDM-WT, indicating KKS activationin diabetes. Retinal RVP was increased by 203% in DM-WT versusNDM-WT (p
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