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PURPOSE: The aim of this study was to investigate the peripapillary choroidal vascular changes in thyroid orbitopathy (TO). METHODS: The study included 20 eyes of 10 patients with active TO (aTO), 30 eyes of 15 patients with inactive TO (inaTO) and 30 eyes of 30 healthy subjects. The peripapillary choroidal vascular change was assessed with peripapillary choroidal vascular index (pCVI), peripapillary choroidal luminal area (pLA), peripapillary choroidal stromal area (pSA), peripapillary total choroidal area (pTCA). RESULTS: Compared to the control group, there was a reduction in the nasal and temporal areas of pCVI in both the aTO and inaTO groups (aTO vs control: nasal p = 0.001 and temporal p = 0.004; inaTO vs control: nasal p = 0.007 and temporal p < 0.001), while the inferior area was lower only in the inaTO group (p = 0.001). Compared to the other groups, the inaTO group exhibited a decrease pSA (vs aTO: total p = 0.004, inferior p = 0.02 and vs control: total p = 0.01, inferior p = 0.03), pLA (vs aTO: total p = 0.02, inferior p = 0.02, temporal p < 0.001 and vs control: total p = 0.002, inferior p < 0.001, temporal p < 0.001) and pTCA (vs aTO: total p = 0.009, inferior p = 0.01, temporal p < 0.001 and vs control: total p = 0.003, inferior p = 0.001, temporal p < 0.001). CONCLUSION: The horizontal area (nasal and temporal area) of the peripapillary choroidal vascular structure may be more sensitive than the vertical area in TO patients. The first affected quadrant of RPC-VD in the active TO may be the inferior quadrant. Structural or vascular choroidal changes may occur during the chronic or post-active phase of the disease.
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Coroides , Oftalmopatía de Graves , Disco Óptico , Tomografía de Coherencia Óptica , Humanos , Coroides/irrigación sanguínea , Coroides/patología , Coroides/diagnóstico por imagen , Masculino , Femenino , Oftalmopatía de Graves/diagnóstico , Oftalmopatía de Graves/patología , Persona de Mediana Edad , Tomografía de Coherencia Óptica/métodos , Adulto , Disco Óptico/irrigación sanguínea , Disco Óptico/patología , Vasos Retinianos/patología , Vasos Retinianos/diagnóstico por imagen , Agudeza Visual , Angiografía con Fluoresceína/métodosRESUMEN
PURPOSE: The purpose of the study was to investigate the parapapillary choroidal microvasculature in thyroid eye disease (TED) using optical coherence tomography angiography (OCTA). METHODS: Only one eye of each subject was included in the study. Patients with TED and controls were included in the study. Participants were divided into three groups: control, inactive TED (ITED) and active TED (ATED). OCTA scans of the optic discs were obtained in a 4.5 × 4.5-mm rectangular area. Radial peripapillary capillary (RPC) density and peripapillary retinal nerve fibre layer (pRNFL) thickness were automatically calculated by the device software. Parapapillary choroidal microvasculature (PPCMv) density was automatically calculated using MATLAB software. RESULTS: Forty-one patients with TED and 40 controls were included in the study. RPC density was significantly decreased in the ATED and dysthyroid optic neuropathy (DON) group compared to the controls and ITED group. There was significant increase in pRNFL in the ATED group. PPCMv density increased in the ATED group compared to the controls in whole ring area. The RPC density was significantly correlated with the TSHr Ab level (r < - 0.396, p < 0.001). Clinical activity score correlated positively with PPCMv density (r = 0.349, p = 0.001) but negatively with RPC density (r = - 0.321, p = 0.004). CONCLUSION: Changes in peripapillary microvascular perfusion may play a role in the development of DON. As the severity of TED increases with clinical activity, so do the changes observed in peripapillary parameters. The decrease in RPC density may be due to compression caused by optic disc oedema, which may result in reduced blood flow. The increase in PPCMv density may be related to factors such as orbital congestion.
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Oftalmopatía de Graves , Enfermedades Orbitales , Humanos , Oftalmopatía de Graves/diagnóstico , Microvasos , Coroides , Densidad MicrovascularRESUMEN
OBJECTIVES: To investigate the correlation between the clinical grading of the severity of meibomian gland dysfunction (MGD) and meibomian gland area (MGA) loss detected using Sirius meibography in the upper and lower eyelids and to correlate these parameters with dry eye signs and symptoms. METHODS: One hundred thirty eyes of 130 volunteer patients were enrolled. Meibomian gland dysfunction was defined as the presence of signs consistent with meibomian gland terminal duct obstruction and categorized between grades 1 and 4. Upper and lower MGA loss percentages were evaluated using Sirius meibography by two blinded examiners. Patients were categorized into two groups (positive and negative for MGD) based on their Ocular Surface Disease Index (OSDI) scores (≥15 and <14, respectively) and MGD grades (≥1 and 0, respectively). RESULTS: The MGA loss percentage and ocular surface test results of the MGD group were greater than in the non-MGD group in both eyelids (P=0.001). Meibomian gland dysfunction grade and MGA loss for the lower eyelid was greater than that of the upper eyelids (P=0.002 and P<0.001, respectively). The OSDI score, tear film break-up time, and lissamine green staining were all significantly correlated with MGD grade and MGA loss in both eyelids (P<0.001). For the average measures of the MGA loss percentage in each scan, the intraclass correlation value was found as 0.994 (95% confidence interval [CI]: 0.992-0.995) for reader 1 and 0.988 (95% CI: 0.982-0.992) for reader 2. CONCLUSIONS: Our findings suggest that Sirius meibography, a noncontact imaging device, is a reliable tool for evaluating meibomian gland structure in patients with MGD and non-MGD of various ages and regardless of sex.
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Técnicas de Diagnóstico Oftalmológico , Disfunción de la Glándula de Meibomio/diagnóstico , Glándulas Tarsales/diagnóstico por imagen , Lágrimas/química , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Disfunción de la Glándula de Meibomio/metabolismo , Glándulas Tarsales/metabolismo , Glándulas Tarsales/fisiopatología , Persona de Mediana Edad , Reproducibilidad de los ResultadosRESUMEN
A 53-year-old woman with hemiparesis and poor dexterity, underwent cosmetic blepharopigmentation on the both upper eyelids in the dermatology clinic of a private hospital. She was not asked for any information on her medical history and no informed consent was obtained and the procedure was performed without any protective ocular shields. The patient experienced severe lacrimation, discomfort, and increased sensitivity to light during and after the procedure. She also noticed blurred vision after the procedure. Ophthalmologic examination revealed tender and oedematous eyelids and corneal abrasions in both of her eyes. Topical antibiotics and preservative-free lubricants were able to recover her from her signs and symptoms at 1-week follow-up. It is recommended that cosmetic blepharopigmentation should be applied cautiously with patient's informed consent after obtaining a thorough medical history and with protective ocular shields to avoid potential complications.
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Lesiones de la Cornea/etiología , Párpados , Tatuaje/efectos adversos , Lesiones de la Cornea/tratamiento farmacológico , Femenino , Humanos , Persona de Mediana EdadRESUMEN
PURPOSE: There have been ongoing clinical trials of therapeutic agents in Huntington's disease (HD) which requires development of reliable biomarkers of disease progression. There have been studies in the literature with conflicting results on the involvement of retina in HD, and up to date there is not a study evaluating the single retinal layers in HD. We aimed to evaluate the specific retinal changes in HD and their usability as potential disease progression markers. METHODS: This cross-sectional study used spectral-domain optical coherence tomography with automatic segmentation to measure peripapillary retinal nerve fiber layer (pRNFL) thickness and the thickness and volume of retinal layers in foveal scans of 15 patients with HD and 15 age- and sex-matched controls. Genetic testing results, disease duration, HD disease burden scores and Unified HD Rating Scales motor scores were acquired for the patients. RESULTS: Temporal pRNFL, macular RNFL (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer and outer plexiform layer thicknesses and IPL, retinal pigment epithelium and outer macular volume were found lower in HD compared to controls, while outer nuclear layer and outer retinal layer thickness were increased (p < 0.05). We found significant correlations between inner retinal layer thicknesses, most significantly with mRNFL and GCL and disease progression markers. CONCLUSION: The outcomes of this study points out that retinal layers, most significantly mRNFL and GCL, are strongly correlated with the disease progression in HD and could serve as useful biomarkers for disease progression.
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Enfermedad de Huntington/diagnóstico , Fibras Nerviosas/patología , Células Ganglionares de la Retina/patología , Tomografía de Coherencia Óptica/métodos , Adulto , Anciano , Estudios Transversales , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Disco Óptico/patología , Pronóstico , Estudios ProspectivosRESUMEN
PURPOSE: To define the alterations in retinal vessel diameter in Parkinson's disease (PD) by optical coherence tomography (OCT). METHODS: This is a case-control study including 41 eyes of 41 patients with diagnosis of PD and 35 eyes of 35 age- and sex-matched control subjects. All subjects underwent complete neurological and ophthalmological examinations before measurements. Retinal vessel diameters and peripapillary retinal nerve fiber layer (pRNFL) thicknesses were evaluated with spectral domain OCT (SD-OCT) with a circular scan centered at the optic disc. The diameters of the superior nasal and temporal arteries and veins, and inferior nasal and temporal arteries and veins were measured and then compared between the groups. Correlations with the duration of the disease, usage of levodopa, and pRNFL thicknesses between retinal vessel diameters were examined with Pearson and Spearman correlation analysis. RESULTS: Average pRNFL thickness is significantly decreased in PD compared to age- and sex-matched controls (p < 0.05). At all measurement points, retinal artery diameter measurements were decreased in the PD group compared to controls, but the differences did not reach statistical significance. Diameters of the retinal veins also did not show any significant difference in the PD and control groups. Superior temporal artery diameter was significantly decreased in patients using levodopa compared to nonusers (p = 0.022). There were no statistically significant correlations between pRNFL thicknesses or disease duration with retinal vessel diameters in PD group. CONCLUSIONS: Parkinson's disease does not seem to have an impact on the retinal vessel diameters obtained by SD-OCT.
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Enfermedad de Parkinson/patología , Vasos Retinianos/patología , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fibras Nerviosas/patología , Estudios Prospectivos , Reproducibilidad de los Resultados , Células Ganglionares de la Retina/patología , Tomografía de Coherencia Óptica/métodosRESUMEN
PURPOSE: This prospective clinical case series aimed to investigate the safety and efficacy of suprachoroidal adipose tissue-derived mesenchymal stem cell (ADMSC) implantation in patients with optic nerve diseases. METHODS: This prospective, single-center, phase 1/2 study enrolled 4 eyes of 4 patients with optic atrophy of various reasons who underwent suprachoroidal implantation of ADMSCs. The best-corrected visual acuity (BCVA) in the study was HM at 1 m. The worse eye of the patient was operated. Patients were evaluated on the first day, first week, first month, third and sixth months postoperatively. BCVA, anterior segment and fundus examination, color photography, optical coherence tomography (OCT) and visual field examination were carried out at each visit. Fundus fluorescein angiography and multifocal electroretinography (mfERG) recordings were performed at the end of the first, third and sixth months and anytime if necessary during the follow-up. RESULTS: All 4 patients completed the six-month follow-up. None of them had any systemic or ocular complications. All of the patients experienced visual acuity improvement, visual field improvement and improvement in the mfERG recordings. We found choroidal thickening in OCT of the 4 patients. CONCLUSION: Even though the sample size is small, the improvements were still encouraging. Stem cell treatment with suprachoroidal implantation of ADMSCs seems to be safe and effective in the treatment for optic nerve diseases that currently have no curative treatment options.
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Tejido Adiposo/citología , Coroides/citología , Trasplante de Células Madre Mesenquimatosas/métodos , Atrofia Óptica/cirugía , Adulto , Electrorretinografía , Femenino , Angiografía con Fluoresceína , Humanos , Masculino , Persona de Mediana Edad , Atrofia Óptica/fisiopatología , Estudios Prospectivos , Tomografía de Coherencia Óptica , Agudeza Visual/fisiologíaRESUMEN
To assess the correlation between functional and anatomical evaluations with multifocal electroretinography (mfERG) and spectral-domain optical coherence tomography (SD-OCT) in patients with Parkinson's disease (PD). This cross-sectional study involved 116 eyes of 58 patients with PD and 30 age- and sex-matched control subjects. All study participants underwent a comprehensive neuro-ophthalmic examination, retinal single-layer thicknesses and volumes, and peripapillary retinal nerve fiber layer (pRNFL) measurements with SD-OCT, and the patients' mfERG recordings were evaluated. The macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), outer nuclear layer (ONL), retinal pigment epithelium (RPE), and photoreceptor layer (PR) thicknesses, and mRNFL, RPE, and PR volumes were found lower in PD compared to those of controls, while outer plexiform layer (OPL) volumes were increased (p < 0.05). We found delayed implicit times and decreased amplitudes in the mfERG of PD patients versus those in control subjects (p < 0.05). We found significant correlations between outer macular volumes, PR thicknesses, and N1 amplitudes of rings 2 and 3and P1 amplitudes of rings 3, 4, and 5. Our study revealed thinning of both inner and outer retinal single layers, increased OPL volume, and delayed implicit times and decreased amplitudes in the mfERG of PD patients versus control subjects and correlation between structural and functional parameters. Our findings point out that SD-OCT and mfERG could both serve as non-invasive tools for evaluating ophthalmic manifestations of Parkinson's disease.
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Electrorretinografía , Enfermedad de Parkinson/diagnóstico por imagen , Retina/diagnóstico por imagen , Tomografía de Coherencia Óptica , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tamaño de los Órganos , Enfermedad de Parkinson/patología , Enfermedad de Parkinson/fisiopatología , Retina/patología , Retina/fisiopatologíaRESUMEN
PURPOSE: To compare corneal wetting performances of different dispersive ophthalmic viscosurgical devices. METHODS: Three different types of dispersive ophthalmic viscosurgical devices, hydroxypropyl methylcellulose %2 (HPMC), sodium hyaluronate %3-sodium chondroitin sulphate %4 (HACS), and sodium hyaluronate %3 (HA), were applied on corneal surfaces of 10 healthy volunteer subjects repeatedly at 3 different time points. Corneal wetting properties of the ophthalmic viscosurgical devices were compared qualitatively and quantitatively by anterior segment optical coherence tomography for 30 minutes. RESULTS: Sodium hyaluronate 3% and HACS applications had a higher mean precorneal ophthalmic viscosurgical device thickness than HPMC application at all time points (seventh minute HPMC: 105.2 ± 25.3 µm, HA: 561.4 ± 115.8 µm, HACS: 481.2 ± 55 µm, P < 0.001). All HPMC applications were terminated by the 12th minute because of insufficient corneal wetting. Mean survival estimate time was significantly shortest for HPMC (11.5 ± 0.5 minutes, P < 0.001) and longest for HA (29.7 ± 0.28 minutes). It was slightly shorter for HACS (26.9 ± 0.87 minutes, P = 0.007) than the HA application. CONCLUSION: Sodium hyaluronate 3% and HACS provide superior corneal covering compared with HPMC with an effect that can be maintained up to 30 minutes. They may be an effective option for corneal wetting during long vitreoretinal surgeries with longer duration of effect and fever number of applications.
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Sulfatos de Condroitina/farmacología , Córnea/metabolismo , Ácido Hialurónico/farmacología , Derivados de la Hipromelosa/farmacología , Complicaciones Posoperatorias/prevención & control , Tomografía de Coherencia Óptica/métodos , Adolescente , Adulto , Córnea/diagnóstico por imagen , Combinación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Soluciones Oftálmicas , Facoemulsificación , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/metabolismo , Propiedades de Superficie , Viscosuplementos/farmacología , Adulto JovenRESUMEN
A 25-year-old woman underwent diode laser application on the both upper eyelids in the dermatology department of a private hospital to obtain a cosmetic healing of the reddish look on her eyelids without any protective lenses. The patient experienced severe uveitis, atonic pupils, raised intraocular pressure, and increased sensitivity to light in her eyes on the following day of the procedure. Topical steroids and pressure-lowering agents were able to treat the acute uveitis and glaucoma, unfortunately the patient suffered from irreversible atonic and atrophic pupils and photosensitivity. It is recommended that cosmetic laser application on the periocular area should be avoided, and if it is still to be performed, it should be applied cautiously and the patient should be informed of the potential ocular complications.
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BACKGROUND: Differentiating Parkinson disease (PD) from progressive supranuclear palsy (PSP) can be challenging early in the clinical course. The aim of our study was to see if specific retinal changes could serve as a distinguishing feature. METHODS: We used spectral domain optical coherence tomography (SD-OCT) with automatic segmentation to measure peripapillary nerve fiber layer thickness and the thickness and volume of retinal layers at the macula. RESULTS: Thicknesses of superior peripapillary retinal nerve fiber layer (pRNFL), macular ganglion cell layer, inner plexiform layer, inner nuclear layer, and macular volume were more affected in PSP compared with PD (P < 0.05). Thicker inferotemporal pRNFL and lower macular volume were detected in levodopa users compared with nonusers in patients with PD. CONCLUSIONS: PD and PSP are associated with distinct changes in retinal morphology, which can be assessed with SD-OCT.
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Fibras Nerviosas/patología , Enfermedad de Parkinson/diagnóstico , Enfermedades de la Retina/diagnóstico , Células Ganglionares de la Retina/patología , Parálisis Supranuclear Progresiva/diagnóstico , Anciano , Antiparkinsonianos/uso terapéutico , Femenino , Humanos , Levodopa/uso terapéutico , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados no Aleatorios como Asunto , Disco Óptico/patología , Enfermedad de Parkinson/tratamiento farmacológico , Estudios Prospectivos , Tomografía de Coherencia Óptica/métodosRESUMEN
PURPOSE: To evaluate the effect of fluorescein angiography on retinal vessel diameter with Optical Coherence Tomography (OCT). METHODS: In this cross-sectional study, a total of 81 eyes of 81 patients who were performed fluorescein angiography (FA) procedure were included. Retinal vessels were examined with the Spectral-domain OCT at baseline and immediately after FA procedure. A cube scan consisting of seven horizontal scans were placed at the inferior border of the disk to include the inferior temporal retinal vessels. Vessels diameters were measured at five measurement points (480-1440 µm inferiorly from the optic disk border). RESULTS: The mean age of the study subjects was 58.02 ± 14.1 years. At baseline, the mean diameter of the retinal artery was 120.16 ± 24.56 µm and of the vein 157.94 ± 32.34 µm at the measurement point of 480 µm, with a gradual decrease to 114.91 ± 25.59 and 152.17 ± 28.17 µm, respectively, at 1440 µm. After FA procedure, the mean diameter of the retinal artery was 122.85 ± 26.35 and of the vein 158.30 ± 32.21 µm at the measurement point of 480 µm, with a gradual decrease to 115.22 ± 22.91 and 151.94 ± 28.93 µm, respectively, at 1440 µm. There were no statistical differences for either of these comparisons at any of the points of both artery and vein measurements. CONCLUSION: There was not any clinically significant change in retinal artery diameter such as a dilatatory response after FA procedure in patients with hypertension, diabetes, and age-related macular degeneration (AMD).
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Angiografía con Fluoresceína , Fluoresceína/farmacología , Enfermedades de la Retina/diagnóstico por imagen , Vasos Retinianos/efectos de los fármacos , Adulto , Anciano , Estudios Transversales , Femenino , Angiografía con Fluoresceína/métodos , Humanos , Masculino , Persona de Mediana Edad , Tomografía de Coherencia ÓpticaRESUMEN
PURPOSE: To emphasize the importance of anticipation of pressure-induced stromal keratopathy (PISK) in eyes with a previous history of LASIK. CASE REPORT: A 40-year-old man developed LASIK-related pressure-induced stromal keratopathy after uneventful phacoemulsification (Phaco) and intraocular lens (IOL) implantation in his left eye. With immediate discontinuation of the steroid drops and initiation of antiglaucoma medication, his visual acuity, interface edema, and haze improved rapidly. One year later, during Phaco with IOL implantation in his other eye, with anticipation of a similar LASIK-related pressure-induced stromal keratopathy, a very brief course of soft steroid therapy was given together with antiglaucoma medication. Intraocular pressure elevation was avoided, and no interface edema or haze was observed. CONCLUSIONS: This case illustrates that the risk for LASIK-related pressure-induced stromal keratopathy may be reduced with appropriate precautions.
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Edema Corneal/tratamiento farmacológico , Sustancia Propia/efectos de los fármacos , Presión Intraocular/efectos de los fármacos , Queratomileusis por Láser In Situ , Hipertensión Ocular/tratamiento farmacológico , Complicaciones Posoperatorias , Acetazolamida/uso terapéutico , Adulto , Antiinflamatorios no Esteroideos/uso terapéutico , Antihipertensivos/uso terapéutico , Combinación Tartrato de Brimonidina y Maleato de Timolol/uso terapéutico , Edema Corneal/etiología , Sustancia Propia/patología , Diuréticos/uso terapéutico , Humanos , Implantación de Lentes Intraoculares , Masculino , Hipertensión Ocular/etiología , Facoemulsificación , Agudeza VisualRESUMEN
We report on a patient with Frank-Ter Haar syndrome that is associated with high intraocular pressures. A 21-day-old male patient was referred to our clinic for surgical treatment of congenital glaucoma. On ophthalmic examination, he had buphthalmos, mild corneal edema and high IOP readings in both eyes. The patient underwent uneventful trabeculotomy surgery, bilaterally. Marked bilateral anterior iris insertion was noted during the surgery. Childhood glaucoma may be associated with Frank-Ter Haar syndrome.
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Anomalías Craneofaciales , Glaucoma/congénito , Cardiopatías Congénitas , Osteocondrodisplasias/congénito , Discapacidades del Desarrollo , Glaucoma/cirugía , Humanos , Masculino , Trabeculectomía , Resultado del Tratamiento , Adulto JovenRESUMEN
PURPOSE: To compare superficial and deep vascular characteristics of the optic disc in retrobulbar optic neuritis using optical coherence tomography angiography (OCT-A). METHODS: Nineteen patients with unilateral non-infectious retrobulbar neuritis were included in the study. The contralateral eyes of each patient were served as controls. OCT-A scans of the optic discs were performed in a 4.5 × 4.5 mm rectangular area, while macular OCT-A scans were performed in a 6 × 6 mm rectangular area. Various parameters, including radial peripapillary capillary (RPC) density, peripapillary retinal nerve fibre layer (pRNFL) thickness, cup volume, rim area, disc area, cup-to-disc (c/d) area ratio, and vertical and horizontal c/d ratios were automatically obtained using the instrument software. The density for superficial capillary plexus (SCP) and deep capillary plexus (DCP) were assessed using macular OCT-A. Parapapillary choroidal microvascular (PPCMv) density was calculated using MATLAB software. RESULTS: Parafoveal inferior, perifoveal total and inferior SCP densities were significantly decreased in eyes with optic neuritis when compared with contralateral control eyes in OCT-A measurements (respectively, p = 0.027, p = 0.041, p = 0.045). The axial lengths, (p = 0.72), vertical and horizontal cup-disc ratios, and disc area, cup-disc areas, cup volumes, and pRNFL thicknesses between the groups were similar (for each, p>0.05). CONCLUSIONS: This study demonstrated for the first time that patients with retrobulbar optic neuritis had decreased SCP densities, though it did not cause any changes in PPCMv density.
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Neuritis Óptica , Tomografía de Coherencia Óptica , Humanos , Células Ganglionares de la Retina , Neuritis Óptica/diagnóstico por imagen , Angiografía , Microvasos/diagnóstico por imagen , Angiografía con Fluoresceína/métodos , Vasos Retinianos/diagnóstico por imagenRESUMEN
OBJECTIVE: To evaluate optic nerve head changes in patients with thyroid orbitopathy (TO) and investigate the effects of intravenous methylprednisolone (IV MTP) on these changes. METHODS: Eighty-two eyes of 41 patients with TO with and without dysthyroid optic neuropathy (DON) and 40 eyes of 40 healthy control subjects were included in the study. Lamina cribrosa thickness (LCT) and depth (LCD) measurements, peripapillary retinal nerve fibre layer thickness (RNFLT), and radial peripapillary capillary vascular density were measured using optical coherence tomography and optical coherence tomography angiography. Visual field examination and proptosis were evaluated. Patients with DON and active non-DON received IV MTP for 12 weeks, and the effect of this treatment was evaluated. RESULTS: Peripapillary vascular density decreased in patients with DON compared with the other groups (p < 0.001 for all); there was no difference in the total, superior hemi-sector, and inferior hemi-sector of the RNFLT between the groups. LCT was decreased in the TO group (p < 0.001). After IV MTP treatment, the LCT and best-corrected visual acuity were increased. Thyroid-stimulating hormone receptor antibody levels, intraocular pressure, the superior hemi-sector of the RNFLT, and proptosis were decreased compared with the control subjects (pâ¯=â¯0.012, pâ¯=â¯0.008, pâ¯=â¯0.043, and p < 0.001, respectively). CONCLUSIONS: The RNFLT may not always increase in DON. Lamina cribrosa morphology may change in patients with TO. IV MTP therapy has a positive effect on the LCT but not on radial peripapillary capillary vascular density or LCD.
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Objective: Basal cell carcinomas (BCC) mostly originate from the head and neck region. Main goal in BCC treatment is to achieve both aesthetic and functional results while observing the principles of tumor surgery. We report our experience regarding the clinical, histopathological features and surgical treatment results of head and neck basal cell carcinomas in the light of the literature. Methods: Files of patients with head and neck BCCs treated surgically in two university hospitals were retrospectively analyzed. Sociodemographic variables, location and size of tumor, pathological subtype, recurrence ratio, complications and technique of reconstruction were evaluated. Results: We analyzed 119 tumoral lesions in 105 patients of whom 55 (52.4%) were male and 50 (47.6%) were female. Their mean age was 67.3±12 years. The nasal region was the most common location area (n=42, 35.3%). Mean tumor size was 12.6 mm and tumor size range was 2-85 mm. The most commonly used reconstruction techniques were flap surgery, followed by primary closure, and skin grafts. Conclusion: It is important to remove the tumor with a clear surgical margin at least 4 mm and evaluate the five surgical margins with frozen sections intraoperatively. Operations are often performed under local anesthesia and are well tolerated by patients. The most common flaps used in the reconstruction are not only easy to learn but also sufficient in most cases. Skin grafts are good choices in defects located in the cavum concha and the external meatus.
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PURPOSE: In the present study, antifungal activity of ozonated olive oil (OZO) and ozonated distilled water (ODW) in the treatment of experimentally induced keratitis with C. albicans in rabbits were investigated. METHODS: The Groups were composed of as 1, 2, 3, 4, 5, 7 (n = 5 rabbits, 10 eyes/in each group) and Group 6 (n = 10 rabbits, 20 eyes/in the group). Fourty-eight hours after C. albicans inoculation; Group 1 received fluconazle (FLU)+OZO drops, Group 2 received FLU drop, Group 3 received OZO drop, Group 4 received FLU+ODW drops, Group 5 received ODW drop, Group 6 (infected control group) and Group 7 received PBS drop (negative control group). Treatment continued in all groups for 22 days for every 8 hours. RESULTS: Cornea cultures made 24 days post inoculation revealed statistically significant differences (p < 0,05) with concern to C. albicans amounts between Group 6 and Group 1-5. Statistical comparison of corneal opacity and corneal ulcer and conjunctivitis values among the Group 6 and Group 1-5 were also different significantly (p < 0,05) on days 20 and 24 post inoculation. CONCLUSION: OZO and ODW were found to be effective in treating C. albicans keratitis in the present study. It has also been proven by this study that ODW contain 26 µg/ml was the most effective in the treatment of C. albicans keratitis.
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Candidiasis , Infecciones Fúngicas del Ojo , Queratitis , Ozono , Animales , Candida albicans , Candidiasis/tratamiento farmacológico , Córnea , Infecciones Fúngicas del Ojo/tratamiento farmacológico , Humanos , Queratitis/tratamiento farmacológico , ConejosRESUMEN
INTRODUCTION: Polyarteritis nodosa is a systemic vasculitis characterized by necrotizing inflammatory lesions affecting the middle and small arteries. CASE PRESENTATION: A 23-year-old male presented to our ophthalmology clinic with a 1-day history of sudden vision loss in his left eye. Posterior segment examination the left eye showed optic disc borders were faint, hyperemic and fluffy with cilioretinal artery occlusion signs present. Optical coherence tomography revealed the presence of localized intracellular edema from optic disc to superior-hemi of fovea, including fovea. On optical coherence tomography angiography, there was a decrease in vessel density in the superficial and deep capillary plexus in the area matching the cilioretinal artery trace, and choroidal vessel density decreased. Wide field fundus fluorescein angiography showed a large choroidal filling defect (ischemia area) and the cilioretinal artery were not filled in the temporal quadrant. These findings made us think that short ciliary arteries were affected and were the causal of the choroidal ischemia and infarction of optic nerve. DISCUSSION: PAN-associated choroidal ischemia, cilioretinal artery occlusion and ischemic optic neuropathy are rare. If ischemic retinal condition is seen in young patients, PAN should be considered in the differential diagnosis as it may cause life-threatening complications in its advanced stages.
Asunto(s)
Neuropatía Óptica Isquémica , Fotoquimioterapia , Poliarteritis Nudosa , Oclusión de la Arteria Retiniana , Arterias Ciliares , Angiografía con Fluoresceína , Humanos , Masculino , Neuropatía Óptica Isquémica/diagnóstico , Neuropatía Óptica Isquémica/tratamiento farmacológico , Neuropatía Óptica Isquémica/etiología , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Oclusión de la Arteria Retiniana/diagnóstico , Oclusión de la Arteria Retiniana/etiología , Adulto JovenRESUMEN
This prospective clinical case series aimed to investigate the safety and efficacy of suprachoroidal adipose tissue-derived mesenchymal stem cell (ADMSC) implantation in patients with dry-type age-related macular degeneration (AMD) and Stargardt's macular dystrophy (SMD). This study included four patients with advanced-stage dry-type AMD and four patients with SMD who underwent suprachoroidal implantation of ADMSCs. The best-corrected visual acuity (BCVA) in the study was 20/200. The worse eye of the patient was operated on. Patients were evaluated on the first day, first week, and first, third, and sixth months postoperatively. BCVA, anterior segment and fundus examination, color photography, fundus autofluorescence, optical coherence tomography, and visual field examination were carried out at each visit. Fundus fluorescein angiography and multifocal electroretinography (mf-ERG) recordings were performed at the end of the first, third, and sixth months and anytime if necessary during the follow-up. All eight patients completed the sixth month follow-up. None of them had any systemic or ocular complications. All of the eight patients experienced visual acuity improvement, visual field improvement, and improvement in mf-ERG recordings. Stem cell treatment with suprachoroidal implantation of ADMSCs seems to be safe and effective in the treatment of dry-type AMD and SMD.