Evaluation of the Reliability and Quality of YouTube Videos on Congenital Nasolacrimal Duct Obstruction.

Introduction Congenital nasolacrimal duct obstruction (CNLDO) causes excessive eye tearing or mucoid discharge. Twenty percent of one-year-olds globally have CNLDO. There are many sources that offer information to parents. This study evaluates the quality and accuracy of CNLDO-related YouTube videos. Methods The first 100 videos that appeared after typing "congenital nasolacrimal duct obstruction" in the YouTube search engine were evaluated. These videos were also analyzed and scored using the DISCERN, Journal of the American Medical Association (JAMA), and Global Quality Scoring (GQS) systems. Results Forty videos met the inclusion criteria. The mean DISCERN score was 47.3 ± 9.15, JAMA was 1.72 ± 0.87, and GQS was 3.1 ± 0.81. The duration of the videos uploaded by the non-physician group was significantly longer (p = 0.04). In addition, the JAMA score of the videos uploaded by the physician group was significantly higher than that of the other group (p = 0.03). Theoretical videos were longer than surgical videos (p = 0.02). DISCERN, JAMA, and GQS scores were statistically higher in the theoretical video group (p = 0.002, p = 0.04, and p = 0.03, respectively). Conclusion According to our research, the quality of YouTube videos about congenital nasolacrimal duct obstruction is average. This information source can be improved by making videos with more detailed information about the disease and theoretical information, as well as by having health professionals look over the content that has been uploaded.

Effect of Intracameral Carbachol and Epinephrine Use on Choroidal Thickness After Uncomplicated Phacoemulsification.

BACKGROUND Safety concerns about drugs used intracamerally during cataract surgery have been the subject of many studies. In this study, the effect of using intracameral carbachol and epinephrine on choroidal thickness was evaluated. MATERIAL AND METHODS This prospective interventional study included 81 eyes of 81 patients undergoing cataract surgery. During cataract surgery, intracameral carbachol was administered to 27 eyes, intracameral epinephrine was administered to 20 eyes, and 34 eyes were the control group. Macular choroidal thickness measurement was performed before, 1 day, and 1 week after phacoemulsification surgery in all patients using optical coherence tomography. RESULTS Subfoveal choroidal thickness was significantly reduced at day 1 and week 1 in the group receiving intraoperative carbachol compared with preoperative measurement (P=0.016). In addition, choroidal thickness in the 500 µm nasal fovea was significantly reduced in the carbachol group at 1st week compared to the preoperative measurement (P=0.008). There was no significant difference in postoperative subfoveal thickness in the intraoperative epinephrine group and control group (P=0.179 and P=0.953, respectively). Choroidal thickness at 1000 µm nasal fovea was significantly higher in the epinephrine group at postoperative 1st day than preoperative and postoperative 1st week values (P=0.009). CONCLUSIONS The use of intracameral epinephrine caused an increase in choroidal thickness 1000 µm nasal of the fovea, while intracameral carbachol caused thinning in the subfoveal and 500 µm nasal quadrant. Intracameral drug administration during cataract surgery may be associated with posterior segment complications.

Evaluation of the efficacy of postoperative triamcinolone in endoscopic dacryocystorhinostomy using lacrimal symptom questionnaire.

PURPOSE: To evaluate the effect of postoperative nasal triamcinolone spray use in primary endoscopic dacryocystorhinostomy using The Lacrimal Symptom Questionnaire. METHODS: This study included a series of 50 consecutive retrospective cases with primary endoscopic dacryocystorhinostomy and with silicone stent implantation who were followed up for 6 months postoperatively. Patients using nasal triamcinolone spray for 3 months postoperatively were included in the triamcinolone group. Patients not using triamcinolone were included in the control group. Lacrimal stents were removed 3 months postoperatively. The Lacrimal Symptom Questionnaire (Lac-Q) was performed in the preoperative and postoperative 6th month. Anatomical success, functional success, and changes in lacrimal symptom and social impact scores were compared between the two groups 6 months after surgery. RESULTS: Results of 48 endoscopic dacryocystorhinostomies performed on 48 patients (23 triamcinolone group, 25 control group) meeting the inclusion criteria were analyzed. The anatomical success rate (95.7% vs. 84.0%, p = 0.350) and the functional success rate (91.3% vs. 76.0%, p = 0.249) were higher in the triamcinolone group, but this difference was not statistically significant. No complications were observed in the triamcinolone group, whereas complications developed in two patients in the control group (p = 0.490). The mean change in total lac-Q score was 11.0 in the triamcinolone group and 9.0 in the control group (p = 0.011). The mean change in social impact score was 4.0 in the triamcinolone group and 3.0 in the control group (p = 0.005). Mean change in lacrimal symptom score was 6.0 in the triamcinolone group and 6.0 in the control group (p = 0.368) CONCLUSIONS: Our study indicated that postoperative use of triamcinolone spray increases the success rate of endoscopic dacryocystorhinostomy and also revealed that triamcinolone may also lead to greater improvement in quality of life scores than the control group using a validated questionnaire.

Effect of oral citicoline therapy on retinal nerve fiber layer and ganglion cell-inner plexiform layer in patients with primary open angle glaucoma.

AIM: To evaluate the short-term effects of oral citicoline therapy on the retinal nerve fiber layer (RNFL) and the macular ganglion cell-inner plexiform layer (mGCIPL) in patients with primary open angle glaucoma (POAG). METHODS: Fifty-four eyes of 54 patients with POAG glaucoma included in the study. In addition to a topical hypotensive, 250-mg oral citicoline was administered to 27 patients, while 27 patients were assigned as the control group. RNFL and mGCIPL values were measured using optical coherence tomography (OCT) at 1d before treatment and 3mo after the initiation of treatment. At the third month visit, citicoline treatment was discontinued and drug-free control (wash-out) measurements were obtained at the fourth month in citicoline group. RESULTS: The average RNFL thickness was significantly higher at month 3 than the baseline (P=0.038) in citicoline group. However, this improvement partially regressed after a 1-month wash-out period. No statistically significant changes in RNFL were observed in the superior, nasal, temporal and inferior quadrants at months 3 and 4 (P>0.05). The change in the average and inferior quadrant RNFL thickness in the citicoline group at 3mo was significantly greater than the control group (P=0.006 and P=0.014, respectively). There were no significant differences between the groups according to the change in mGCIPL thickness and the superior, nasal and temporal quadrant RNFL thickness (P>0.05). CONCLUSION: With oral citicoline treatment, the loss in the average RNFL is prevented in POAG patients in the short-term. Study data show that citicoline may have a significant impact on slowing glaucoma progression, which could have a potential neuroprotective effect.

The impact of intravitreal dexamethasone implant (Ozurdex®) on retrobulbar hemodynamics in patients with diabetic macular edema and retinal vein occlusions.

Objective: To evaluate the effect of single intravitreal dexamethasone implant (Ozurdex®) on ocular blood flow velocities in patients with diabetic macular oedema (DME) and retinal vein occlusions (RVO). Methods: This prospective non-randomized interventional study included injected and fellow eyes of 12 patients with DME and of 16 patients with RVO treated with intravitreal Ozurdex®. Colour Doppler Ultrasonography (CDU) measures of the central retinal artery (CRA), posterior ciliary artery (PCA), ophthalmic artery (OA) those are peak systolic velocity (PSV), end diastolic velocity (EDV), resistive index (RI) and pulsatility index (PI) were performed in both injected and uninjected eyes before injection, at one week, one month after injection, and prior to re-injection. Results: Inter-eye comparison of all the measured CDU data (baseline, first week, first month, reinjection) showed no statistically significant difference in both DME and RVO group. PSV and EDV values of the CRA, OA, and PCA showed a decreasing trend in the first week and first-month visits and then increased at reinjection time. RI and PI measures of the CRA, OA, and PCA measures showed minimal alterations in the follow-up. But all these differences were not statistically significant. Significant visual gain and anatomic recovery were obtained by the intravitreal dex-implant both in the DME and RVO group. Conclusions: Single intravitreal dex-implant did not alter ocular blood flow in the treatment of macular oedema due to RVO and diabetes.

Effect of intravitreal aflibercept (Eylea®) on retrobulbar hemodynamics in patients with neovascular age-related macular degeneration.

PURPOSE: To investigate the short-term effect of single intravitreal aflibercept injection on retrobulbar blood flow in patients with neovascular age-related macular degeneration (nAMD). METHODS: Twenty eyes of 20 patients with nAMD scheduled for single intravitreal aflibercept (Eylea®) injection and 20 fellow eyes (uninjected) were enrolled in this prospective interventional study. The hemodynamic parameters of the ophthalmic artery (OA), central retinal artery (CRA) and posterior ciliary artery (PCA) comprising peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) were measured by using color Doppler ultrasonography (CDU) in both injected and uninjected fellow eyes at baseline and 1 week after the injection. RESULTS: The measured first-week values of PSV and EDV in the CRA, OA and PCA showed a statistically significant reduction when comparing baseline values in both injected and uninjected fellow eyes (p = 0.0001). Also, it was found a significant increase in the post-injection RI values of all the CRA, OA, PCA in injected eye and OA in the uninjected eye (p = 0.0001). There was any significant difference between pre- and post-injection RI values of the CRA and PCA in the fellow eyes (p = 0.137, p = 0.736, respectively). CONCLUSION: Single intravitreal administration of aflibercept alters retrobulbar blood flow velocities (BFVs) in both injected and uninjected fellow eyes in the short-term period.