Comparison of the Cosmetic Efficacy of Extractum Cepae and Silicone-Based Gel in Upper Blepharoplasty.

BACKGROUND: Upper eyelid blepharoplasty is one of the most common surgeries performed worldwide. However, an important problem after surgery is scar formation. The authors aimed to compare the efficacy of extractum cepae and silicone-based gels on postoperative scar appearance in patients undergoing upper eyelid blepharoplasty. METHODS: After suture removal, patients were divided into 3 groups: group 1 [n=82, extractum cepae, sodium heparin, and allantoin mixture, Contractubex Gel (Merz Pharmaceuticals, Frankfurt, Germany)], group 2 [n=81, silicone-based gel (Dermatix Ultra Silicone Gel, Menarini, Singapore)], and group 3 (n=77, no additional treatment). Patients used the topical gels twice daily. All evaluations were performed on color photographs by 2 physicians during the postoperative first and third months. RESULTS: The mean visual analog scale scores were significantly higher in all 3 groups in the postoperative first month (4.39±2.03, 4.41±2.57, and 4.33±2.46, respectively) compared with the postoperative third month (2.22±1.24, 2.15±1.38, and 2.29±1.47, respectively) (P=0.014, 0.037, and 0.026, respectively). The "Is the scar more stiff" score was higher in the postoperative first month compared with the third month. CONCLUSIONS: In conclusion, blepharoplasty scars improved up to the postoperative third month, but the topical gels used did not significantly improve the cosmetic appearance of blepharoplasty scars compared with the control group.

Evaluation of peripheral blood inflammatory biomarkers in sickle cell disease with and without retinopathy.

BACKGROUND: The aim of this study was to evaluate the clinical significance of blood-cell associated inflammation markers in patients with sickle cell disease (SCD) and sickle cell retinopathy (SCR). METHODS: Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte to lymphocyte ratio (MLR), systemic immune inflammation index (SIII), systemic inflammation response index (SIRI), systemic inflammation modulation index (SIMI) and aggregate systemic inflammation index (AISI) were calculated. This study included 45 healthy controls (Group 1) and 100 SCD (Group 2). Patients in Group 2 were then divided into two groups: without SCR (Group 3) and with SCR (Group 4), and patients with SCR (Group 4) were further divided into two groups: non-proliferative sickle cell retinopathy (NPSCR) (Group 5) and proliferative sickle cell retinopathy (PSCR) (Group 6). RESULTS: The mean values for NLR, PLR, SIII, SIRI, AISI, and SIMI were significantly higher in Group 2 compared to Group 1 (p = 0.011 for NLR, p = 0.004 for SIII, and p < 0.001 for others). Furthermore, AISI and SIMI parameters demonstrated statistically significant discriminatory power to distinguish Group 5 from Group 6 (p = 0.0016 and p = 0.0006, respectively). CONCLUSION: Given the critical role of inflammatory mechanisms in the pathogenesis of SCD and its related complications, the assessment of blood-cell-associated inflammatory markers may present a pragmatic and advantageous approach to the clinical oversight and therapeutic intervention of SCD.

The Effect of Hyperemesis Gravidarum on Macular Thickness, Corneal Thickness, and Intraocular Pressure in Pregnancy.

AIM: Physiological changes in intraocular pressure as well as in the cornea and macula may occur during pregnancy. Therefore, we decided to investigate the effect of hyperemesis gravidarum on macular thickness, corneal thickness and intraocular pressure (IOP). MATERIAL AND METHODS: A total of 110 people, 55 of whom were diagnosed with hyperemesis gravidarum and 55 of whom were in the control group, were included in the study. The inclusion criteria for the study were as follows: first trimester (8-14 weeks of gestation) pregnancy with positive fetal heartbeat and no history of systemic disease, no continuous use of medication, diagnosis of hyperemesis gravidarum (ketonuria and weight loss of more than 3 kilograms or 5% of body weight), body mass index (BMI) within normal limits, age between 18 and 40, no alcohol use or smoking. RESULTS: In the HG group compared to the control group, there was a difference between the CCT values of both the right and left eyes (p<0.01). There was a difference in both right and left IOP values in patients in the HG group compared to the control group (p<0.05), and there was no correlation between ketonuria scores and right and left eye CCT values, right and left eye macular thickness, and right and left eye pressure in patients diagnosed with HG (p>0.05). CONCLUSION: In hyperemesis gravidarum, changes occur in IOP, corneal thickness, and macular thickness. In ophthalmic examinations in the pregestational period, especially for women with systemic disease, it may be important for clinicians to take the necessary precautions in this regard.

Electrophysiological Evaluation of Macular Photoreceptor Functions in Patients with Choroidal Neovascular Membranes.

PURPOSE: To evaluate changes in cone functions using light-adapted (LA) 30 Hz flicker and LA 3.0 electroretinography (ERG) in intravitreal ranibizumab (IVR)-treated naïve neovascular age-related macular degeneration (nAMD) patients. MATERIALS AND METHODS: This retrospective interventional study reviewed the medical records of 32 nAMD patients (32 eyes) who received monthly IVR between January 2019 and January 2021. A comprehensive ophthalmic examination, including best-corrected visual acuity (BCVA) testing and slit-lamp biomicroscopy, was performed as part of their clinical care, followed by LA 30 Hz flicker and LA 3.0 ERGs, optical coherence tomography, and fundus fluorescein angiography. All measurements were taken before IVR (baseline), as well as at months 6 and 12 later. Treatment was resumed for up to 12 months if recurrence occurred. RESULTS: Compared to baseline, visual acuity improved significantly at months 6 and 12, respectively, coinciding with a significant decrease in central macular thickness (p < 0.05 for all). LA 30 Hz flicker ERG b-wave amplitude decreased significantly between baseline and months 6 and 12, respectively (p < 0.05 for both). There were no significant changes in LA 3.0 ERG a- and b-wave amplitudes between baseline and month 6 (p > 0.05 for both), but a significant decrease existed between baseline and month 12 (p < 0.05 for both). While LA 3.0 ERG a-wave implicit time increased significantly (p < 0.05 for both) between baseline and months 6 and 12, respectively, b-wave implicit time did not (p > 0.05 for both). Also, LA 30 Hz flicker ERG b-wave implicit times did not differ significantly between baseline and months 6 and 12, respectively (p > 0.05, for both). CONCLUSIONS: IVR was associated with long-term electrophysiological changes in cone functions, as measured by LA 30 Hz flicker and LA 3.0 ERGs.

Comparison of navigated laser and conventional single-spot laser system for induced pain during panretinal photocoagulation.

To compare the panretinal photocoagulation (PRP)-induced pain response between novel navigated laser (Navilas) and conventional single-spot laser. The eyes were randomly assigned to Navilas or conventional laser. Contralateral eyes underwent PRP with the other system with 30 min resting interval. Pulse duration was 100 ms in conventional laser and 30 ms or 100 ms in Navilas and power setting was enough to create gray-white light burn on both devices. Pain response was evaluated by verbal scale (VS) (0-4) and visual analog scale (VAS) (0-10) after each PRP application. The mean age of 70 patients (140 eyes) was 62.52 ± 9.49 years. Mean power and spot numbers for Navilas and conventional laser were 291.9 ± 85.3 mW vs 368.4 ± 72.0 mW, and 375.4 ± 108.4 vs 374.2 ± 105.0 (p < 0.001 and p = 0.53, respectively). Pain scores for Navilas and conventional laser were 1.19 ± 0.73 and 1.99 ± 0.84 for VS and 2.41 ± 1.65 and 4.74 ± 2.17 for VAS (p < 0.001 and p < 0.001). More comfortable PRP is achieved with Navilas system in comparison with conventional single-spot laser system. However, small number of patients treated with same pulse duration and different contact lenses used for two systems should be taken into consideration. Besides, we did not report comparative clinical efficiency of either laser system.

Long-term changes in retinal layers in patients undergoing intravitreal ranibizumab for neovascular age-related macular degeneration : Retinal layers after anti-VEGF therapy.

PURPOSE: To analyze long-term changes in individual retinal layers (RLs) after intravitreal injections of ranibizumab (IVRs) in patients with neovascular age-related macular degeneration (n-AMD). METHODS: The patients were treated with 0.5-mg IVRs based on an as-needed protocol after the first three monthly doses over a 12-month follow-up period. Patients underwent optical coherence tomography and best-corrected visual acuity (BCVA) evaluation at each visit. The ETDRS grid with central subfield (R1) (r 0.5 mm) and the inner ring (R2) (r 0.5-1.5 mm) was used for calculation of the mean thickness of each RL. Changes in the thickness of segmented RLs within the R1 and R2 of ETDRS circles at months-3, -6, and -12 were compared to baseline. RESULTS: The mean age was 72 ± 7.4 years. The mean number of injections was 9.08 (range 6-11). Mean BCVA improved from 49.7 ± 22.1 to 60.1 ± 19.8 letters. Central macular thickness decreased from 390.25 ± 149.6 to 312.74 ± 118.4 µm. Thicknesses of GCL (from 23.93 ± 13.73 to 19.50 ± 9.50 µm in R1; p 0.001, and from 44.5 ± 12.6 to 39.6 ± 10.6 µm in R2; p 0.005), IPL (from 28.90 ± 14.36 to 22.35 ± 6.23 µm in R1; p 0.001, and from 39.34 ± 8.53 to 35.58 ± 7.93 µm in R2; p 0.004), and total inner RL (ILM to ELM) (from 222.93 ± 93.09 to 180 ± 53 µm in R1; p 0.001, and from 255.06 ± 42.74 to 240.25 ± 40.37 µm in R2; p 0.003) in the central and parafoveal rings decreased statistically at month-12. Decrease in INL was limited to month-6 (from 34.80 ± 15.33 to 27.60 ± 12.59 µm in R1; p 0.001), while decreases in total outer RLs (ELM to RPE) (from 128.32 ± 26.92 to 115.54 ± 43.98 µm in R1; p 0.001, and 103.81 ± 16.73 to 96.38 ± 16.22 µm in R2; p 0.014) and RPE (from 39.12 ± 22.33 to 29.70 ± 22.05 µm in R1; p 0.001, and from 31.27 ± 13.11 to 24.40 ± 9.99 µm in R2; p 0.001) were limited to month-3. CONCLUSIONS: Significant changes were observed in the thickness of the inner RLs after 1-year treatment with IVRs for n-AMD. A significant decrease in RPE thickness confined to the first months disappeared at month-12.

Long-Term Changes in Submacular Choroidal Thickness after Intravitreal Ranibizumab Therapy for Neovascular Age-Related Macular Degeneration: 14-Mo Follow-Up.

Purpose: To study (i) the long-term effects of intravitreal ranibizumab treatment on changes in submacular choroidal thickness and (ii) the relationship between any resulting changes in choroidal thickness and visual outcomes following such treatment in patients with neovascular age-related macular degeneration (n-AMD). Methods: Reviewed were medical records of 30 consecutive, treatment-naïve, patients with unilateral n-AMD (n = 30 eyes) and unaffected fellow eyes (n = 26 eyes) (controls). Monthly injections of 0.5 mg ranibizumab were administered until stabilization of n-AMD, with additional injections as needed over the following 14-mo. Choroidal thickness was determined using enhanced-depth imaging-optical coherence tomography (EDI-OCT) before and after initiation of ranibizumab therapy. Choroidal thickness measurements were generated via manual segmentation. Results: The mean age of patients was 71.9 ± 7.4 (56-83) years; the mean best-corrected visual acuity (BCVA) of affected eyes improved from 51.1 to 59.4 letters (p < 0.001); and the mean number of injections was 9.16 ± 1.75. Subfoveal choroidal thickness decreased from 208.3 ± 73.7 µm at baseline to 185.3 ± 70.1 µm at mo-14 (p < 0.001), with significant (p < 0.001) decreases at all measured time points. Choroidal thickness also tended to decline in fellow eyes but was only statistically significant nasally 1,000 µm (p =0.04). Mean changes in choroidal thickness did not correlate with BCVA at mo-14 (p = 0.76). Disciform scars and geographic atrophy (p = 0.017), and BCVA (p < 001) at baseline were predictive of visual outcome. Age (p = 0.001), reticular drusen (p = 0.004), and size of choroidal neovascularized area (p = 0.042) were predictive of decreases in choroidal thickness. Conclusions: Submacular choroidal thickness appeared to decrease significantly in eyes with n-AMD over a 14-mo period of ranibizumab treatment. No corresponding decrease in choroidal thickness occurred in fellow eyes.

Comparison of pain scores between patients undergoing panretinal photocoagulation using navigated or pattern scan laser systems.

PURPOSE: To compare the pain responses of patients with proliferative diabetic retinopathy (PDR) undergoing panretinal photocoagulation (PRP) using either pattern scan laser (PASCAL) or navigated laser photocoagulation (NAVILAS). METHODS: Patients diagnosed with PDR were randomly assigned to undergo either PASCAL or NAVILAS photocoagulation treatment. PRP was performed using the multi-shot mode with a spot size of 200-400 µm and a pulse duration of 30 ms to obtain a white-grayish spot on the retina. Parameters were identical in both procedures. After 30 min of PRP application, patients were asked to verbally describe their pain perception as either "none," "mild," "moderate," "severe," or "very severe" using a verbal rating scale (VRS) and visual analog scale (VAS) by indicating a score from "0" to "10," representing the severity of pain from "no pain" to "severe pain." RESULTS: A total of 60 eyes of 60 patients (20 females and 40 males) diagnosed with PDR were treated. The mean age of patients was 62.22 ± 9.19 years, and the mean diabetes duration was 195.47 ± 94.54 months. The mean number of laser spots delivered during PRP was 389.47 ± 71.52 in the NAVILAS group and 392.70 ± 54.33 in the PASCAL group (p=0.57). The difference in pain responses between patients in the NAVILAS and PASCAL groups was significant with regard to the mean VRS (1.10 ± 0.67 and 1.47 ± 0.69, respectively; p=0.042) and mean VAS (2.13 ± 1.17 and 2.97 ± 1.35, respectively; p=0.034) scores. CONCLUSIONS: Pain responses in patients undergoing PRP with a 30-ms pulse duration were significantly milder in the NAVILAS group than in the PASCAL group.

Comparison of pain scores between patients undergoing panretinal photocoagulation using navigated or pattern scan laser systems / Comparação de graduação de dor entre os pacientes submetidos à panfotocoagulação usando sistemas de laser navegado ou de padrão de varredura

ABSTRACT Purpose: To compare the pain responses of patients with proliferative diabetic retinopathy (PDR) undergoing panretinal photocoagulation (PRP) using either pattern scan laser (PASCAL) or navigated laser photocoagulation (NAVILAS). Methods: Patients diagnosed with PDR were randomly assigned to undergo either PASCAL or NAVILAS photocoagulation treatment. PRP was performed using the multi-shot mode with a spot size of 200-400 µm and a pulse duration of 30 ms to obtain a white-grayish spot on the retina. Parameters were identical in both procedures. After 30 min of PRP application, patients were asked to verbally describe their pain perception as either "none," "mild," "moderate," "severe," or "very severe" using a verbal rating scale (VRS) and visual analog scale (VAS) by indicating a score from "0" to "10," representing the severity of pain from "no pain" to "severe pain." Results: A total of 60 eyes of 60 patients (20 females and 40 males) diagnosed with PDR were treated. The mean age of patients was 62.22 ± 9.19 years, and the mean diabetes duration was 195.47 ± 94.54 months. The mean number of laser spots delivered during PRP was 389.47 ± 71.52 in the NAVILAS group and 392.70 ± 54.33 in the PASCAL group (p=0.57). The difference in pain responses between patients in the NAVILAS and PASCAL groups was significant with regard to the mean VRS (1.10 ± 0.67 and 1.47 ± 0.69, respectively; p=0.042) and mean VAS (2.13 ± 1.17 and 2.97 ± 1.35, respectively; p=0.034) scores. Conclusions: Pain responses in patients undergoing PRP with a 30-ms pulse duration were significantly milder in the NAVILAS group than in the PASCAL group.

RESUMO Objetivo: Comparar as respostas de dor de pacientes com retinopatia diabética proliferativa (PDR) submetidos à panfotocoagulação retiniana (PRP) usando laser de padrão de varredura (PASCAL) ou fotocoagulação navegada a laser (NAVILAS). Métodos: Pacientes com diagnóstico de PDR foram aleatoriamente designados para submeter-se ao tratamento de fotocoagulação com PASCAL ou NAVILAS. A PRP foi realizada no modo "multi-shot" com diâmetro do laser de 200-400 µm e duração do pulso de 30 ms, utilizados para se obter uma mancha branca-acinzentada na retina. Os parâmetros foram idênticos em ambos os procedimentos. Após 30 minutos da PRP, os pacientes foram solicitados a descrever verbalmente a sua percepção da dor como quer "nenhuma," "leve," "moderada," "intensa" ou "dor muito intensa" por meio de uma escala de avaliação verbal (VRS) e também por meio de uma escala visual analógica (VAS), indicando uma pontuação de "0" a "10" representando a intensidade da dor de "nenhuma dor" a "dor intensa." Resultados: Um total de 60 olhos de 60 pacientes (20 mulheres e 40 homens) com diagnóstico de PDR foram tratados. A média de idade dos pacientes foi de 62,22 ± 9,19 anos e a média de duração da diabete foi 195.47 ± 94,54 meses. O número médio de pulsos de laser emitidos durante a PRP foi 389,47 ± 71,52 no grupo NAVILAS e 392,70 ± 54,33 no grupo PASCAL (p=0,57). A diferença nas respostas de dor entre os pacientes nos grupos NAVILAS e PASCAL foi significativa em relação às médias de VRS (1,10 ± 0,67 e 1,47 ± 0,69; p=0,042) e VAS (2,13 ± 1,17 e 2,97 ± 1,35; p=0,034). Conclusões: As respostas de dor em pacientes submetidos à PRP com pulsos de 30 ms de duração foram significativamente menores nos pacientes do grupo NAVILAS em relação ao grupo PASCAL.

Comparison of Anterior Segment Measurements Obtained by Aladdin Optical Biometer and Sirius Corneal Topography.

OBJECTIVES: To assess the agreement of anterior segment parameter measurements derived from Aladdin optical biometer using optical low coherence interferometer and Sirius corneal topography using combined Scheimpflug-Placido disk. MATERIALS AND METHODS: Data obtained using the Aladdin and Sirius systems from 110 eyes of 59 subjects who had no health problems other than refractive errors were retrospectively evaluated. Anterior chamber depth (ACD), flat (K1) and steep (K2) keratometry readings, and white-to-white distance (WTW) measurements taken with both devices were noted. RESULTS: The mean age of the patients was 47.31±18.57 years (range, 25 to 79 years). Mean ACD was 3.35±0.4 mm using Aladdin and 3.42±0.44 mm using Sirius. Mean difference in ACD was 0.075 mm greater with Sirius than Aladdin (p<0.001). K1 measurement obtained by Aladdin was an average of 0.409 D higher (p<0.001). No statistically significant differences were detected between the two devices in respect to K2 and WTW measurements (p=0.18, p=0.85 respectively). Pearson correlation analysis showed high correlation between the two devices for all measurements (r=0.985, 0.895, 0.961 and 0.766 for ACD, K1, K2 and WTW respectively; p<0.001). CONCLUSION: Anterior segment parameters obtained by Aladdin optical biometer and Sirius anterior segment analysis system correlated well with each other and measurement differences between the devices were clinically negligible except for K1 values.