Microvascular changes in obese adults detected by Optical Coherence Tomography Angiography.

Aim: The aim of this prospective, controlled, non-randomized study was the comparison of the retinal microvascular parameters of obese and nonobese adults. Methods: 184 eyes of 92 subjects were separated to 3 groups. 68 eyes were in the normal weight group, with a body mass index between 18.5 and 24.5 kg/ m2, 60 eyes were in the overweight group, with a body mass index between 25-29.9 kg/ m2, and 56 eyes were in the obese group, with a body mass index ≥ 30 kg/ m2. All the volunteers were applied visual acuity, ocular motility testing, and slit lamp and mydriatic fundus examination. Optical Coherence Tomography Angiography (OCT-A) scanning was practiced with Optovue (Optovue, Inc; Fremont, CA) on a 6.00 x 6.00 mm macular region, in the central fovea. Results: 184 eyes of ninety-two patients were involved in this prospective study. The vessels' density (VD) in the optic nerve head (ONH) were significantly lower in the overweight and obese adult volunteers compared to the normal weight control group. However, other OCTA parameters (including macular VDs, Foveal avascular zone (FAZ), choriocapillaris plexus (CCP) area) did not demonstrate any significant difference between groups. Subfoveal choroidal thickness (SCT) was higher in the overweight and obese patients when compared to the normal weight control group. Central macular thickness (CMT) did not reveal any significant difference between groups. Conclusion: Even though clinicians are limited in pointing out any differential findings in obese patients only by fundus examination, OCT-A provides a predictable view of the microvascular changes in the retina and choroid in obese patients. Abbreviations: BMI = Body mass index, WHO = World Health Organization, AMD = Age-related macular degeneration, CT = Choroidal thickness, OCTA = Optical Coherence Tomography Angiography, (W/H) ratio = Waist-hip ratio, ETDRS = Early Treatment Diabetic Retinopathy Study, VD = Vessel density, SCP = Superficial capillary plexus, DCP = Deep capillary plexus, CCP = Flow area of the choriocapillaris, FAZ = Avascular zone, CMT = Central macular thickness, ONH = Optic nerve head.

Medium Cut-Off Membrane Can Be a New Treatment Tool in Amanita phalloides Poisoning.

Mushroom poisoning is a common health problem that can be seen seasonally and geographically. Most mushroom poisoning requiring treatment worldwide is due to Amanita phalloides. Although liver failure and kidney injury are frequent, poisoning can also lead to more serious clinical situations, such as shock, pancreatitis, encephalopathic coma, cardiac failure, disseminated intravascular coagulation, and multiple organ dysfunction syndrome, and may cause death. In addition, when standard treatment approaches fail, extracorporeal treatment methods are often used. We report 2 cases in which hemodialysis with medium cut-off membrane was performed. We observed an improvement in liver and kidney function in both of our cases. The first case recovered, but the second case proved fatal owing to Acinetobacter sepsis, despite an improvement in renal function. Medium cut-off membrane hemodialysis may be an alternative option in the treatment of Amanita phalloides poisoning.