Evaluation of Prognostic Factors in Adult Chemical Corneal Injury.

OBJECTIVE: The aim of this study was to evaluate prognostic factors that may be useful in predicting final visual acuity in patients admitted to the clinic with chemical corneal injuries. METHODS: Data on age, sex, time to admission, irrigation solutions (balanced salt solution or phosphate buffered saline) and type of substance causing chemical injury were recorded. On admission, all patients were evaluated according to Roper Hall and Dua classifications. At the twelfth month after treatment, all measurements were repeated. RESULTS: A total of 131 patients with chemical corneal injuries [group 1 (acid, n = 73) and group 2 (alkaline, n = 58)] were included. The initial best corrected visual acuity (BCVA) level was "20/40 and above" in 32 patients (43.8%) in group 1 and 14 patients (24.1%) in group 2. According to Roper Hall classification, the mean grade was 1.92 ± 0.9 in group 1 and 2.27 ± 1.1 in group 2. According to Dua classification, the mean grade of the patients in group 1 was 2.16 ± 0.9 and 2.58 ± 1.2 in group 2. Posttreatment BCVA level improved to "1/200 to 19/200" in 8 (66.7%) of the patients with an initial BCVA level of "perception of light or hand movements." In univariate analysis, initial visual acuity and posttreatment visual acuity were statistically significant ( P < 0.001). It was also statistically significant in multivariate analysis adjusted for sex and age ( P < 0.001). CONCLUSION: In conclusion, the treatment of chemical corneal injuries is a long and exhausting process. The use of initial visual acuity and Dua classification in prognosis prediction may provide high success.

Evaluation of Depression Levels in Patients With Primary Open-Angle Glaucoma Using the Geriatric Depression Scale.

Introduction Glaucoma is a chronic disease that can lead to severe visual impairment and blindness. Methods The study included 91 primary open-angle glaucoma patients aged 60 years and older (group 1) and 83 healthy controls (group 2) with similar age and gender distribution. The duration of the disease, the number of anti-glaucomatous drops used daily, and visual field parameters were recorded. All participants then underwent a comprehensive mental status examination by a psychiatrist and were administered the Geriatric Depression Scale (GDS). Results In Group 1, the mean duration of glaucoma was 10.2±6.0 years, and the mean number of drops used per day was 2.91±1.47 drops/day. According to visual field (24-2) data, the mean mean deviation (MD) was -7.76±4.78 dB and the mean pattern standard deviation (PSD) was 5.14±2.60 dB. According to the classification based on MD, 33 (36.3%) patients were in the early stage, 36 (39.5%) in the intermediate stage, and 22 (24.2%) in the advanced stage. The mean best-corrected visual acuity (BCVA) was 0.85±0.38 logMAR in group 1 and 0.34±0.19 logMAR in group 2. The mean GDS scores were 13.7±7.23 points in group 1 and 3.61±1.71 points in group 2. There were statistically significant differences between the groups in terms of BCVA and GDS scores (p=0.039 and p<0.001, respectively). Conclusion In conclusion, it is important that ophthalmologists provide adequate information about glaucoma to prevent the development of depression in patients with glaucoma. This information may protect patients from uncertainty. A multidisciplinary approach in the management of glaucoma, a chronic and vision-threatening disease, can positively affect patients' compliance with follow-up and treatment, increase the quality of healthcare, and improve treatment responses.

Comparison of the Cosmetic Efficacy of Extractum Cepae and Silicone-Based Gel in Upper Blepharoplasty.

BACKGROUND: Upper eyelid blepharoplasty is one of the most common surgeries performed worldwide. However, an important problem after surgery is scar formation. The authors aimed to compare the efficacy of extractum cepae and silicone-based gels on postoperative scar appearance in patients undergoing upper eyelid blepharoplasty. METHODS: After suture removal, patients were divided into 3 groups: group 1 [n=82, extractum cepae, sodium heparin, and allantoin mixture, Contractubex Gel (Merz Pharmaceuticals, Frankfurt, Germany)], group 2 [n=81, silicone-based gel (Dermatix Ultra Silicone Gel, Menarini, Singapore)], and group 3 (n=77, no additional treatment). Patients used the topical gels twice daily. All evaluations were performed on color photographs by 2 physicians during the postoperative first and third months. RESULTS: The mean visual analog scale scores were significantly higher in all 3 groups in the postoperative first month (4.39±2.03, 4.41±2.57, and 4.33±2.46, respectively) compared with the postoperative third month (2.22±1.24, 2.15±1.38, and 2.29±1.47, respectively) (P=0.014, 0.037, and 0.026, respectively). The "Is the scar more stiff" score was higher in the postoperative first month compared with the third month. CONCLUSIONS: In conclusion, blepharoplasty scars improved up to the postoperative third month, but the topical gels used did not significantly improve the cosmetic appearance of blepharoplasty scars compared with the control group.

Evaluation of peripheral blood inflammatory biomarkers in sickle cell disease with and without retinopathy.

BACKGROUND: The aim of this study was to evaluate the clinical significance of blood-cell associated inflammation markers in patients with sickle cell disease (SCD) and sickle cell retinopathy (SCR). METHODS: Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), systemic immune inflammation index (SIII), systemic inflammation response index (SIRI), systemic inflammation modulation index (SIMI) and aggregate systemic inflammation index (AISI) were calculated. This study included 45 healthy controls (Group 1) and 100 SCD (Group 2). Patients in Group 2 were then divided into two groups: without SCR (Group 3) and with SCR (Group 4), and patients with SCR (Group 4) were further divided into two groups: non-proliferative sickle cell retinopathy (NPSCR) (Group 5) and proliferative sickle cell retinopathy (PSCR) (Group 6). RESULTS: The mean values for NLR, PLR, SIII, SIRI, AISI, and SIMI were significantly higher in Group 2 compared to Group 1 (p = 0.011 for NLR, p = 0.004 for SIII, and p < 0.001 for others). Furthermore, AISI and SIMI parameters demonstrated statistically significant discriminatory power to distinguish Group 5 from Group 6 (p = 0.0016 and p = 0.0006, respectively). CONCLUSION: Given the critical role of inflammatory mechanisms in the pathogenesis of SCD and its related complications, the assessment of blood-cell-associated inflammatory markers may present a pragmatic and advantageous approach to the clinical oversight and therapeutic intervention of SCD.

Coexistence of Straatsma syndrome without macular extension and abnormal ellipsoid zone / Coexistência da síndrome de Straatsma sem extensão macular e zona elipsoide anormal

ABSTRACT Myelinated retinal nerve fibers are rare congenital anomalies that appear as gray-white patches. They may be present in a syndrome characterized by ipsilateral myelinated retinal nerve fibers, myopia and amblyopia. The author reported an ellipsoid zone defect on spectral domain optical coherence tomography in a case of Straatsma syndrome without macular extension.

RESUMO Fibras nervosas retinais mielinizadas são anomalias congênitas raras que aparecem como manchas branco-acinzentadas. Eles podem se apresentar em uma síndrome caracterizada por fibras nervosas retinais mielinizadas ipsilaterais, miopia e ambliopia. O autor relatou um defeito na zona elipsoide na tomografia de coerência óptica de domínio espectral em um caso de síndrome de Straatsma sem extensão macular.