Branch retinal vein occlusion: the importance of the topographical distribution of retinal vessels among risk factors.

PurposeTo investigate the role of the topographical distribution of temporal retinal vessels in anatomical predisposition to branch retinal vein occlusion (BRVO).Patients and methodsSixty patients with BRVO and 60 control subjects were included in this retrospective-observational study. The fundus images of the individuals were classified into four topographical vessel positions: P1, the superior and inferior temporal retinal veins were closer to the foveal center; P2, the superior and inferior temporal retinal arteries were closer to the foveal center; and P3 and P4, the superior temporal retinal vein and inferior temporal retinal artery were closer to the foveal center or vice versa. The groups were compared in terms of demographics and topographical vessel positions.ResultsThere were no significant differences between the groups in terms of age and gender (P>0.05). The topographical distribution of temporal retinal vessels among the BRVO and control eyes were significant (P<0.001). P1 was less common in BRVO eyes (5%) when compared with control eyes (33.3%); however, P2 was more common in BRVO eyes (46.7 vs 20%). There were no significant differences in terms of the distribution of P3 and P4 vessel positions in the BRVO and control groups (P>0.05). A logistic regression test revealed that the risk of BRVO increases 15-fold in P2, 6-fold in P3, and 8-fold in P4 when compared with eyes having P1.ConclusionP1 eyes are less likely to be affected by BRVO. Therefore, the topographical distribution of retinal vessels can be assessed as a risk factor for BRVO.

Postoperative visual impairment after spinal fusion surgery.

OBJECTIVE: The aim of this prospective study was to detect risk factors for visual impairment or changes in vision following spinal fusion surgery. METHODS: A total of 68 patients aged 18-65 years, scheduled for posterior spinal fusion surgery, were included. Ophthalmic examinations were performed by an ophthalmologist on the day before surgery and repeated after the second postoperative day, within the first postoperative week. Patient characteristics were compared according to two clinical outcomes following surgery: worsening of vision during the pre- and postoperative interval (group 1) and no change in pre- and postoperative examinations (group 2). RESULTS: The mean age of patients with postoperative visual changes was significantly higher than that for patients without postoperative visual changes. Total number of female patients and use of intraoperative ephedrine to treat hypotensive episodes were significantly higher in group 1 than in group 2 patients. CONCLUSION: Older age, female gender and intraoperative hypotensive episodes are potential risk factors for postoperative visual impairment in patients who have undergone spinal fusion surgery.

Illuminated endochopper in the management of posteriorly dislocated lens nucleus.

We describe the use of an illuminated endochopper (a prototype instrument produced by DORC International) in the management of a posteriorly dislocated lens nucleus or lens particles. This instrument helps to divide the lens nucleus or its fragments into small pieces and thus reduces time and ultrasound energy.

Anatomic outcome of scleral buckling surgery in primary rhegmatogenous retinal detachment.

PURPOSE: To evaluate the factors affecting the anatomic success of treatment of retinal detachments (RD) by scleral buckling surgery. METHODS: One-hundred and two eyes of 102 patients with rhegmatogenous RD operated on by scleral buckling surgery were included in the study. Results were analyzed according to the anatomic status of the retina at the most recent follow-up examination. The chi-squared test was used to determine the relationship between preoperative and intraoperative variables and anatomic results, and the relative risk of failure was determined for each variable. RESULTS: Retinal reattachment was achieved in 85 of 102 eyes (82.5%) after initial surgery. The success rate for anatomic reattachment was 95% after two operations. After three operations reattachment was achieved for 98 eyes (96%). Predictive factors for anatomic failure (P<0.05) were the presence of grade C(1) PVR and multiple breaks. CONCLUSION: Grade C(1) PVR and multiple breaks were found to be significant risk factors for anatomic failure in rhegmatogenous RD treated by conventional buckling surgery.