Evaluation of medication adherence of glaucoma patients during the COVID-19 pandemic.

PURPOSE: To evaluate changes in the medication adherence of glaucoma patients during the COVID-19 pandemic and the factors influencing medication adherence. MATERIALS AND METHODS: This cross-sectional study included a total of 197 glaucoma patients who were followed for at least six months in the Glaucoma Unit of the Ophthalmology Department of Inonu University, Faculty of Medicine. Patients were given a 28-item questionnaire, including the eight-item Morisky Medication Adherence Questionnaire, to evaluate medication adherence. Demographic and clinical data were recorded. P<0.05 was considered statistically significant. RESULTS: Interruption of glaucoma clinic visits during the pandemic was reported by 82 (41.6%) patients. Nonadherence was reported by 56 patients (28.4%) (95% confidence interval: 22.1-34.7). For these patients, the most common reasons for nonadherence were forgetfulness (50%), the inability to receive a prescription for the drug (10.7%) and being busy (10.7%). Factors influencing nonadherence were determined to be younger age, female gender, interruption of glaucoma clinic visits and high-income levels (P˂0.05). CONCLUSION: Interruption of glaucoma clinic visits during the COVID-19 pandemic and the resulting inability to have medications prescribed resulted in patient nonadherence with medication use.

Brain diffusion-weighted imaging in diabetic patients with retinopathy.

OBJECTIVE: Our aim was to detect whether there is any change in apparent diffusion coefficients (ADC) levels in different sites of the brain, particularly in areas associated with the vision, in diabetic patients with retinopathy by measuring diffusion-weighted imaging (DWI). MATERIALS AND METHODS: Conventional magnetic resonance imaging (MRI) and DWI of the brain were obtained from 45 diabetic patients (15 patients with proliferative diabetic retinopathy (group 1), 15 patients with nonproliferative diabetic retinopathy (group 2), 15 diabetic patients without retinopathy (group 3) and from 15 age-matched healthy volunteers (group 4). ADC values of visual cortex, cingulate gyrus, orbitofrontal, dorsomedial and dorsolateral frontal, corona radiate, and thalamus were obtained. RESULTS: The ADC values of visual cortex, cingulate gyrus and orbitofrontal cortex significantly increased in groups 1 and 2 compared to groups 3 and 4 (p < 0.001). The ADC values of visual cortex significantly increased in group 1 compared to group 2 (p < 0.001). The duration of disease and value of HbAlc positively correlated with ADC values of the visual and orbitofrontal cortexes, and cingulate gyrus. CONCLUSIONS: We found an increase in ADC values supporting the neuronal loss in some regions, especially in visual center by DWI in the diabetic patients with retinopathy. This result supports the association between diabetic retinopathy and brain injury.

The influence of soft contact lenses on the intraocular pressure measurement.

PURPOSE: To evaluate the influence of silicone hydrogel contact lenses on the intraocular pressure (IOP) measurement using Goldmann applanation tonometry (GAT), non-contact tonometry (NCT), and Pascal dynamic contour tonometry (DCT). METHODS: We included in the study 40 eyes of 40 patients who did not have any ocular or systemic diseases or contraindications to contact lens use. We measured and recorded the IOP values of each patient using NCT without and with contact lenses (groups 1 and 2, respectively), using DCT without and with contact lenses (groups 3 and 4, respectively), and using GAT without contact lenses (group 5). RESULTS: The mean IOP value of group 1 was 14.55 ± 2.95 mm Hg and 13.92 ± 2.58 mm Hg in group 2. We detected no statistically significant difference between group 1 and group 2 (P=0.053). The mean IOP values for group 3 and group 4 were 16.26 ± 2.33 mm Hg and 15.19 ± 2.40 mm Hg, respectively. We detected a statistically significant difference between groups 3 and 4 (P=0.005). Group 5's mean IOP value was 12.97 ± 2.65 mm Hg. IOP values measured with DCT were statistically significantly higher compared with IOP values measured with NCT and GAT (P<0.0001 and P<0.0001, respectively). Additionally, IOP values measured with NCT were statistically significantly higher compared with IOP values measured with GAT (P<0.0001). CONCLUSION: According to the results of our study, silicone hydrogel soft contact lens use does not significantly affect IOP values measured with NCT, but it affects IOP values measured with DCT.

Corneal hysteresis in patients with dry eye.

PURPOSE: To measure corneal hysteresis and intraocular pressure (IOP) in patients with dry eye and to compare with normal subjects. METHODS: This cross-sectional study consists of 70 eyes of 40 patients with dry eye (group 1) and 75 eyes of 40 normal subjects (group 2). Eyes were diagnosed as dry eye or normal according to the clinical symptoms, biomicroscopical evaluation, and Schirmer test. Corneal hysteresis (CH), corneal resistance factor (CRF), and cornea-compensated intraocular pressure (IOPcc) were measured by the Ocular Response Analyser (ORA). RESULTS: Mean CH values were 10.56±0.25 mm Hg and 10.34±0.26 mm Hg, mean CRF values were 10.75±0.28 mm Hg and 10.70±0.28 mm Hg, mean CCT values were 542±3.20 µm and 543±3.89 µm in group 1 and group 2, respectively. There was no statistically significant difference between the groups for these three parameters. IOPcc values measured with ORA were 15.73±0.36 mm Hg in group 1 and 16.60±0.33 mm Hg in group 2, and there was no statistically significant difference between the two groups. CONCLUSIONS: Corneal biomechanical parameters such as CH and CRF are not influenced in dry eye. Also statistical difference was not found between the two groups according to CCT and IOPcc values.

Sub-Tenon's Steroid Irrigation for Treatment of Intraorbital Capillary Hemangioma.

SUMMARY: A four-month-old male infant underwent sub-Tenon's steroid irrigation for treatment of orbital capilary hemangioma that was causing exposure keratopathy risk to the left eye from progressive proptosis. The temporal inferior sub-Tenon's space was irrigated with a mixture of triamcinolone acetonide (40 mg/ml) and betamethasone sodium phosphate (6 mg/ml) by a blunt-tipped sub-Tenon's cannula. We describe this procedure as irrigation because reflux of the mixture from the incision was permitted. Two weeks after treatment, a marked reduction of proptosis was noted. One month after treatment, the volume of the intraorbital hemangioma resolved significantly in MRI examination. Steroid treatment can be applied local or systemically to treat orbital capillary hemangioma but side effects must be considered carefully. Sub-Tenon's steroid irrigation may be a benefical, effective, pratical and safe application route in the treatment of orbital capillary hemangiomas.