Resolution of Pityriasis rubra pilaris induced ectropion with oral dexamethasone. A case report.

An 82-year-old male presented with generalised Pityriasis rubra pilaris (PRP) managed initially by dermatology team. The patient did not respond to first- and second-line treatment, including oral acitretin, steroid creams, and methotrexate, and developed bilateral cicatricial ectropion, for which he was referred to oculoplastic team for surgical management. A head injury resulting in subacute subdural haematoma, managed with a week course of low dose oral dexamethasone, resulted in the improvement of his skin condition and complete resolution of the cicatricial ectropion within a few weeks. Thus, systemic treatment of PRP with oral dexamethasone may be considered sooner in the treatment of cicatricial ectropion in similar cases.

Surgical treatment of a chronic foveal retinal detachment combined with staphyloma, foveoschisis, and macular hole.

To present a case of anatomical success and visual improvement after the treatment of a long-standing foveal retinal detachment in a staphylomatous myopic eye with foveoschisis and macular hole. A 60-year-old woman with high myopia presented with foveoschisis and a lamellar macular hole in her right eye. After 2 years of follow-up without deterioration, her eye developed a full-thickness macular hole and a foveal retinal detachment which caused a severe reduction in visual acuity. However, the patient had no surgical treatment for her condition at that time. Vitrectomy was performed 2 years after the retinal detachment formation. Regardless of the longstanding detachment, anatomical success, and visual improvement were evident after the surgery. Despite a 2-year longstanding foveal detachment on a highly myopic eye with foveoschisis and macular hole, surgical repair could still be satisfactory.

Preoperative dry eyes disease in cataract patients with deficient tear break up time: evaluation of OSDI questionnaire, its subcategories and Keratograph 5M device results.

PURPOSE: To evaluate preoperatively dry eye disease (DED) in patients with pathological Tear Break Up Time (TBUT), utilising subjective Ocular Surface Disease Index (OSDI) with its subcategories and objective Keratograph 5M characteristics. METHODS: Fifty-four cataract patients were included in this prospective study having a screening slit lamp TBUT of less than 10 s and more or equal to 5 s. Subjective evaluation of DED was performed with OSDI questionnaire and objective evaluation with Keratograph 5M. Tear Meniscus Height (TMH), bulbar and limbal redness and meibography grade were evaluated. Further analysis of OSDI subcategories, Visual Function Related (VFR), Ocular Symptoms related (OS) and Environmental Triggered (ET), was performed with linear and logistic multivariate regression models. Age, gender and logMAR visual acuity (VA) were also included in our models. RESULTS: Following the initial TBUT screening we identified 27(50%) normal and 27(50%) dry eye patients, using OSDI questionnaire. There was no statistical difference in TMH (p = 0.64), bulbar redness (p = 0.54), limbal redness (p = 0.72) and meibography grade (p = 0.25), between normal and dry eye OSDI group. In our regression analysis, average logMAR VA was highly associated with a higher total OSDI score (p < 0.001) and with a higher OSDI-VFR score (p < 0.001). Female gender was associated with a higher OSDI-ET score (p = 0.03). Multivariate logistic regression models were performed by sorting patients into 2 categories of normal and dry eye group according to their total OSDI,OSDI-VRF,OSDI-OS and OSDI-ET score. An increase in logMAR VA increased the odds of having abnormal total OSDI score (p = 0.007) and OSDI-VFR score (p = 0.006). Females had increased odds of having abnormal OSDI-ET score (p = 0.044). CONCLUSIONS: Clinicians should be aware of OSDI limitations when screening cataract patients for dry eyes, as there is high correlation with VA. Female patients were more susceptible to environmental factors. Keratograph results should be interpreted with caution when they are evaluated in conjunction with OSDI during preoperative assessment of DED in cataract patients.

Optical Coherence Tomography Angiography and Multifocal Electroretinogram Findings in Paracentral Acute Middle Maculopathy.

Paracentral acute middle maculopathy (PAMM) is an optical coherence tomography (OCT) finding seen in patients with retinal capillary ischemia. In this case report, we present a case of PAMM after a transient central retinal artery occlusion and the multifocal electroretinogram (mfERG) and other multimodal imaging findings. Clinical examination, OCT angiography, OCT en face, fluorescein angiography, and visual fields were performed at the baseline and follow-up examinations. As a result, we identified in this PAMM case evidence of hypoperfusion in both the choriocapillaris as well as the deep capillary plexus. To the best of our knowledge, the involvement of choriocapillaris has not been reported previously in the literature. Moreover, we concluded that mfERG constitutes a useful investigation in PAMM and this is the first mfERG findings to be presented for a PAMM case specifically.

Recovery of Corneal Clarity After DMEK Followed by Rebubbling Versus Uneventful DMEK.

PURPOSE: To evaluate the effect of a single rebubbling procedure after Descemet membrane endothelial keratoplasty (DMEK) on corneal backscatter and endothelial cell loss (ECL). METHODS: Medical records of 130 consecutive DMEK cases (118 patients) were reviewed and 3 groups were formed: group 1 (n = 32), consisting of DMEK cases followed by 1 rebubbling; group 2a (n = 55), including uneventful DMEK cases with complete graft attachment; and group 2b (n = 25), including uneventful DMEK cases with minor peripheral detachment, not requiring rebubbling. Scheimpflug corneal densitometry (CD) of the central (0-2 mm), paracentral (2-6 mm), and mid-peripheral (6-10 mm) zones, endothelial cell density, central corneal thickness, and corneal volume were measured preoperatively and at 3, 6, 12, and 24 months. RESULTS: Central CD in group 1 decreased from 32.3 ± 8.3 grayscale units preoperatively, to 21.2 ± 3.5 at 24 months. In group 2a, CD decreased from 37.0 ± 11.9 to 19.4 ± 3.0 and in group 2b from 32.5 ± 8.8 to 19.8 ± 3.1. No significant differences were observed among the 3 groups at any examination time point (P ≥ 0.12). At 3 months, paracentral CD of group 2a was significantly lower than that of group 1 (P = 0.047). Endothelial cell density at 3 months was higher in group 2a (1613 ± 503 cells/mm) than in group 1 (1350 ± 557 cells/mm; P = 0.033). ECL at 24 months was 56%, 43%, and 53% in groups 1, 2a, and 2b, respectively. Group 2a showed the lowest ECL, central corneal thickness, and corneal volume throughout the study period. CONCLUSIONS: A single rebubbling procedure does not increase the CD of the central cornea and but results in significantly higher ECL compared with uneventful DMEK with complete graft attachment.

Electroacupuncture Could Reduce Motion Sickness Susceptibility in Healthy Male Adults: A Double-Blinded Study.

Objective: Motion sickness is the main cause of nausea-related symptoms during passive motion in transportation. The aim of this study was to evaluate the effects of electroacupuncture (EA) for the reduction of motion sickness symptoms. Materials and Methods: Study participants were randomly assigned into three groups: Group A, therapeutic EA; Group B, sham EA; and group C, a control group. After an EA session, participants were exposed to a motion stimulus, using a rotating chair. Their symptoms were measured using the Greek version of the Gianaros Motion Sickness Assessment Questionnaire (MSAQ). Results: In this study 20 volunteers participated. All 3 groups of subjects showed increases in their motion sickness symptoms after exposure to the motion stimulus. The mean total symptom score for Group A was 59,375, for Group B it was 74,333, and in Group C was it 93,166. This difference is partially statistically significant when comparing Group A with Group C, especially in a peripheral group of symptoms, as measured by the Gianaros MSAQ. Conclusions: The results of the present study suggest that participants who received therapeutic EA prior to motion stimulation tended to have fewer motion sickness symptoms in comparison with their counterparts, who were not given any therapy.

Psychometric Properties of the Greek Version of the Gianaros Motion Sickness Assessment Questionnaire.

INTRODUCTION: The Motion Sickness Assessment Questionnaire (MSAQ) was developed in order to assess the multiple dimensions of the motion sickness syndrome (gastrointestinal, central nervous system, peripheral, and sopite-related symptoms). The aim of this study was to evaluate the psychometric properties of the Greek version of the MSAQ. METHODS: The MSAQ was translated into Greek and then translated back into English. Minor differences between the two texts were corrected. The Greek version was then administered to male subjects before and after nauseogenic motion stimulation. With the use of a motor driven rotating chair, the subjects were exposed to Coriolis cross-coupling stimulation. A battery of statistical tests was used to evaluate the psychometric properties of the MSAQ. RESULTS: There were 112 subjects who participated. Internal consistency, measured with Cronbach's alpha coefficient, was excellent for the total scale and subscales. The test-retest evaluation was done with Pearson's coefficient and Bland-Altman's plot for the total score and subscales and showed statistically significant results. Mean total MSAQ score was 19.04 before the exposure and 33.46 after the exposure, which was statistically significant. CONCLUSION: Results suggest the Greek-MSAQ is a valid instrument with satisfactory internal consistency, reliability, reproducibility, validity, and responsiveness and can be used in future studies of motion sickness in Greek speaking populations. Kousoulis P, Pantes A, Alevetsovitis G, Fydanaki O. Psychometric properties of the Greek version of the Gianaros Motion Sickness Assessment Questionaire. Aerosp Med Hum Perform. 2016; 87(11):954-957.