The effects of non-invasive mechanic ventilator modes on intraocular pressure in COPD patients with hypercapnic respiratory failure.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is not fully reversible disease that is characterized by progressive restricting airflow. Non-invasive mechanical ventilation (NIMV) treatment can be used in COPD patients who had type 2 respiratory failure. This study aimed to determine the effect of BPAP S/T and AVAPS modes on intraocular pressure (IOP), central corneal thickness (CCT) in 40 type 2 respiratory failure patients with COPD. METHODS: Forty patients with type 2 respiratory failure who were hospitalized between June and December 2018 with the diagnosis of COPD exacerbations were included to the study. Patients followed up without NIMV for 12 hours after the end of exacerbations treatments end. After IOP, visual acuity and CCT were measured in all patients at the same time (11.00 am), same NIMV treatment was applied to the patients for 4 hours (AVAPS-BPAP S/T). Then the measurements were repeated. The effects of these NIMV modes on IOP were evaluated. RESULTS: After NIMV treatment, it was observed that the mean IOP increased statistically significantly (13.3 vs 12.3 mm Hg; P = 0.001). After treatment with NIMV, there was a decrease for CCT close to statistical significance (P = 0.057) CONCLUSION: As a result; increased IOP and thinning of CCT after NIMV treatment has been shown. The type of NIMV and the level of inspiratory pressure needed in hypercapnic respiratory failure seem to affect IOP and it should be cautiously used to increase IOP.

Keratoconus Could Be Associated With Psoriasis: Novel Findings From a Comparative Study.

PURPOSE: To explore the relationship between keratoconus (KC) and psoriasis. METHODS: One hundred ten eyes of 55 patients with psoriasis (study group, SG) and 110 eyes of age-sex-matched 55 healthy volunteers (control group, CG) were included in the study. All cases underwent a detailed dermatological and ophthalmological examination including corneal topography. Moreover, Psoriasis Area and Severity Index (PASI) scoring of the patients was carried out in the SG. A thorough comparison of pachymetric, aberrometric, and topometric values between the groups was performed, and the results were interpreted. A χ test, Mann-Whitney U test, and Pearson correlation test were used for statistical assessment. RESULTS: Although the average Kmax (44.6 in the SG; 44.5 in the CG; P = 0.613) and Belin/Ambrósio enhanced ectasia total deviation value (1.34 in SG; 1.20 in CG; P = 0.880) were similar between the groups, the mean index of vertical asymmetry value in the SG (0.14 mm) was significantly higher than that in the CG (0.11 mm) (P = 0.041). Moreover, 28 eyes from 16 patients with psoriasis were found to be associated with KC because 26 of those 28 eyes were KC suspects and 2 of them were definite KC. A positive correlation was found among topometric parameters, especially between duration of the disease and PASI score. A negative correlation was discovered between topometric parameters and the early beginning of psoriasis. CONCLUSIONS: Serious changes in topography maps may occur in psoriatic patients. The changes were found to be more evident in the presence of a higher PASI score and the early beginning and longer duration of the disease. The results hinted a potential relationship between psoriasis and KC.