Comparison of Intravitreal Dexamethasone Implant and Intravitreal Ranibizumab Efficacy in Younger Patients with Branch Retinal Vein Occlusion.

Objectives: This study aimed to compare the effects of dexamethasone (DEX) implants and ranibizumab (RAN) injections in younger patients with macular edema due to branch retinal vein occlusion (RVO) in a 6-month follow-up. Methods: The treatment-naive patients with macular edema secondary to branch RVO were included retrospectively. Medical records of patients who were treated with intravitreal RAN or DEX implant were evaluated before and at the 1st, 3rd, and 6th months after the injection. Primary outcome measures were the change in best-corrected visual acuity (BCVA) and central retinal thickness. The level of statistical significance was set at 0.05/3=0.016, according to the Bonferroni correction. Results: Thirty-nine eyes of 39 patients were included in the study. The mean age of the study population was 53.82±5.08 years. Median BCVA in the DEX group (n=23) at baseline, 1st, 3rd, and 6th month was 1.1, 0.80 (p=0.002), 0.70 (p=0.003), and 1 (p=0.018) logarithm of the minimum angle of resolution (log-MAR), respectively (p<0.05). Median BCVA in the RAN group (n=16) at baseline, 1st, 3rd, and 6th months was 0.90, 0.61, 0.52, and 0.46 logMAR, respectively (p<0.016 for all comparisons). Median central macular thickness (CMT) in the DEX group at baseline, 1st, 3rd, and 6th months was 515, 260, 248, and 367 µm, respectively (p<0.016 for all comparisons). Median CMT in the RAN group at baseline, 1st, 3rd, and 6th months was 432.5 (p<0.016), 275 (p<0.016), 246 (p<0.016), and 338 (p=0.148) µm. Conclusion: There is no significant difference in treatment efficacies in both visual and anatomical outcomes at the end of the 6th month. However, RAN can be considered the first choice in younger patients with macular edema secondary to branch RVO because of the lower side effect profile.

Respiratory problems and associated factors following endoscopic balloon dilatation procedure in children with acquired subglottic stenosis.

OBJECTIVES: Endoscopic balloon dilatation (EBD) offers a safe and non-invasive surgical option for the treatment of subglottic stenosis. Patient selection is important to achieve good results and to detect which patients are more prone to the development of complications. The aim of this study was to determine predictors of postoperative problems and early complications in primary EBD surgeries. METHODS: A retrospective analysis was made of patients with acquired subglottic stenosis who were operated on with the EBD technique between January 2010 and December 2019 in the Otolaryngology-Head and Neck Surgery Department of Baskent University Hospital. Demographic data including the age and sex of the patients were collected together with etiology, presence of chromosomal or craniofacial anomaly (C/CA), duration of prolonged intubation (DPI), and extubation dilatation timeframe (EDT). Intra and postoperative follow-up data were recorded of the need for intubation or tracheotomy, development of desaturation, and grade and type of stenosis. RESULTS: The male to female ratio was 2:1. The patients comprised 42 males and 22 females with a mean age of 296.52 ± 551.93 days. The cause of prolonged intubation was surgery for congenital heart disease in 50 (78.1%) patients and prematurity in 14 (21.9%). The type of lesion was acute granulation in 44 (72.1%) and chronic granulation in 17 (27.9%) patients. C/CA was determined in 13 patients, the mean grade of stenosis was 76.33 ± 15.21%, mean DPI was 25.25 ± 35.49 days, and mean EDT was calculated as 78.23 ± 373.82 days. Desaturation following endoscopic balloon dilatation developed in 26 (40.6%), orotracheal intubation was required in 10 (15.6%), tracheotomy in 10 (15.6%), and cardiopulmonary arrest occurred in 4 (6.25%). Prematurity, a longer duration of preoperative intubation, longer time from extubation to dilatation, older age, and higher grade of stenosis were determined as factors associated with postoperative early respiratory complications. CONCLUSION: EBD indication should be carefully considered in children with acquired subglottic stenosis. To achieve better results and minimise complications, EBD should be performed without delay.

Vestibular Illusions and Alterations in Aerospace Environment.

As the aerospace industry has grown rapidly over the years, aviators and astronauts have been exposed to some abnormal physiological changes arising from the dynamics of the aerospace environment. The vestibular system, encoding linear and angular movements of the head, is one of the main affected systems in which those abnormal changes can occur during flight. Despite the intricate and solid organization, vestibular units are such delicate structures that they can easily be deceived by aerial dynamics and gravity changes. Therefore, it is of vital importance for the continuity of flight safety to be aware of the detrimental alterations and impairments regarding the vestibular system and its reflex pathways. The aim of this paper was to present a review about how a healthy vestibular system is negatively affected within the aerospace environment and how some vestibular disorders become exaggerated or impaired during aviation and space activities.

Assessment of the choroidal thickness, central macular vascular and optic disk perfusion in migraine patients with optical coherence tomography angiography.

BACKGROUND: Comparing the central choroidal thickness (CCT) and the perfusion of the macula and optic disk in patients with migraine and control group participants using optical coherence tomography angiography (OCTA). METHODS: A total of 38 patients diagnosed with migraine and 32 healthy controls were recruited. OCTA scans were performed on all participants. Optic disk, central macular vascular perfusions, and CCT were measured. RESULTS: Thirty-eight eyes of 38 participants (34 female and 4 male) in the migraine group and 32 eyes of 32 participants (19 female and 13 male) in the healthy control (HC) group were evaluated. The mean age was 42.74 ± 8.14 and 43.09 ± 14.28 years in the migraine group and HC group, respectively. The mean CCT were 314 ± 103 µm and 301 ± 71 µm in the migraine and HC group, respectively (p = 0.54). The mean optic disk perfusions were 44.77 ± 1.93% and 45.25 ± 1.43% in migraine and HC group, respectively (p = 0.25). The mean central macular vascular perfusions were 20.50 ± 8.20% and 18.65 ± 7.46% in migraine and HC group, respectively (p = 0.32). There was a significant negative correlation between CCT and the duration of migraine history (p = 0.004). CONCLUSIONS: The macular and peripapillary microvasculature were not significantly different in patients with migraine than in HC. As the duration of migraine prolonged, a significant decrease in choroidal thickness was observed.

May ganglion cell complex analysis be a marker for glaucoma susceptibility in unilateral Fuchs' uveitis syndrome?

PURPOSE: To compare retinal nerve fiber layer (RNFL) thickness and ganglion cell-inner plexiform layer thickness (GCIPLT) in the affected eyes to fellow unaffected eyes of patients with unilateral Fuchs' uveitis syndrome (FUS) and analyze their change over time. METHODS: Twenty seven unilateral FUS patients who did not have concomitant systemic or ocular disease were retrospectively enrolled. Central macular thickness (CMT), RNFL thickness, and GCIPLT measurements were evaluated. Data was analyzed using the non-parametric Brunner-Langer model (LD-F2 design) and Wilcoxon signed-rank test. RESULTS: The mean age of the patients was 40.2 ± 10.2 years. The median disease duration was 11 (2-62) months. The median best-corrected visual acuity (BCVA) of the affected eyes and the fellow eyes was 0.22 (0.00-2.50) vs. 0.00 (0.0-0.10) logMAR at the initial visit and 0.05 (0.00-2.50) vs. 0.00 (0.0-0.30) logMAR at the final visit. The change in BCVA was found significant in the affected eyes, but not in the fellow eyes (p < 0.001 and p = 0.287, respectively). The median CMT in the affected eyes at the final visit was not statistically different from the value at the initial visit (255 (157-306) vs. 245 (140-310) µm, p = 0.256). The change in RNFL thickness over time in the affected eyes was similar to the fellow unaffected eyes of the patients with unilateral FUS at all quadrants, with non-significant time and group effects (p > 0.05). However, median GCIPLT in all quadrants (except superonasal) in the affected eyes was statistically lower than the fellow eyes at the initial and final visits (p < 0.05). The most affected quadrant of the ganglion cell complex was inferonasal in the involved eyes (79 (42-97) vs. 75 (43-87) µm) at initial and final visits (p = 0.033 for time effect and p < 0.001 for group effect, respectively). CONCLUSION: Median CMT and RNFL thickness did not change during follow-up in the affected eyes of patients with unilateral FUS. Median GCIPLT in the affected eyes declined over time in all quadrants. Ganglion cell loss was also most prominent in the inferonasal quadrant in the affected eyes. FUS patients should be followed up long-term in terms of ganglion cell loss, especially in the inferonasal quadrant.

Optical Coherence Tomography Biomarkers in Bilateral Diabetic Macular Edema Patients with Asymmetric anti-VEGF Response.

Background: This study aimed to identify optical coherence tomography (OCT) biomarkers for predicting response to anti-VEGF treatment in diabetic macular edema (DME)Methods: Bilateral DME patients with asymmetric response to a loading dose of anti-VEGF (ranibizumab/aflibercept) treatment were retrospectively studied. The morphologic response criterion was central subfield thickness (CST) ≤300 µm; asymmetric response was defined as ≥10% difference in CST reduction between the eyes. The functional response criterion was an increase in logMAR acuity of ≥3 lines, with an increase below this threshold in the fellow eye considered asymmetric response. Relationships between final morphologic and functional responses to anti-VEGF therapy and baseline values of the following OCT-derived biomarkers were evaluated: DME subtype, CST, vitreoretinal interface anomalies, disorganization of the inner retinal layers (DRIL), external limiting membrane (ELM) disruption, ellipsoid zone (EZ) disruption, and subretinal fluid (SRF).Results: After a loading dose of anti-VEGF, 31 eyes that met both morphologic and functional response criteria were classified as responders (RR) and 27 eyes that did not respond morphologically or functionally based on the defined criteria were classified as resistant (RT). Eyes that showed only functional (n = 5) or morphological response (n = 1) were excluded due to their small number. The presence of SRF or simple epiretinal membrane (ERM) was not associated with any difference in treatment responses (p > .05), while tractional ERM, extensive DRIL (≥500 µm), and ELM and EZ disruptions in the fovea-centered 1000-µm zone were important OCT biomarkers in predicting resistance (p < .001). A multilayer perceptron model ranked predictive power as 100% for ELM disruption, 51.7% for tractional ERM, 25.4% for DRIL, and 24.5% for EZ disruption.Conclusion: Extensive ELM disruption was the strongest OCT biomarker to predict anti-VEGF resistance, followed by tractional ERM. EZ disruption and DRIL had relatively lower predictive value.

Reattachment of Rhegmatogenous Retinal Detachment via Fibrin Tissue Adhesive.

PURPOSE: To manage reattachment of rhegmatogenous retinal detachment using tissue adhesive (fibrin glue) in five patients. METHODS: Five eyes of five patients with rhegmatogenous retinal detachment were treated with 23-gauge pars plana vitrectomy and the application of fibrin glue (Tisseel Lyo) into the break under air without laser photocoagulation or cryopexy. RESULTS: The median age of patients was 64 (range, 46-82) years, and the median duration of symptoms was 15 (range, 7-60) days. Three eyes had inferior and two had superior rhegmatogenous retinal detachments. Successful retinal reattachment was achieved in all cases and maintained during the following 10 to 24 months. The median best-corrected visual acuity improved from 2 / 100 preoperatively to a Snellen visual acuity of 20 / 50 by 6 months postoperatively. No postoperative complications were detected during the follow-up period. CONCLUSIONS: Excellent adhesive effects of fibrin glue with respect to sealing retinal tears with no side effects were seen in our study. With further prospective studies, this technique could be an alternative method to conventional retinopexy.

The Impact of Serum 25-Hydroxyvitamin D3 Levels on Allergic Rhinitis.

We aimed to clarify the relation between allergic rhinitis and the serum levels of 25-hydroxivitamin D in the adult population. The study group consisted of 86 patients with allergic rhinitis who were diagnosed with the help of history of allergy, positive signs for allergy, blood samples, and positive skin prick tests; while the control group included 43 age- and sex-matched healthy volunteers with negative skin prick tests. The demographic data, medical history, findings in the physical examinations, serum levels of total immunoglobulin E (IgE) and 25-hydroxyvitamin D, and skin prick test results of the groups were noted. A total of 129 patients fulfilling the necessary criteria were enrolled. The median serum 25-hydroxyvitamin D levels in the study group were significantly lower compared to the control group (P = .014). In the study group, median serum vitamin D levels were significantly higher in men, compared to women (P = .03). There was a significant negative correlation between IgE and vitamin D levels in the allergic rhinitis group (P = .028, r = -0.246). This study showed that patients with allergic rhinitis might be more vulnerable to have lower serum levels of vitamin D. Thus, vitamin D supplementation as an adjunctive therapy may be considered in those patients.

Analysis of central macular thickness and choroidal thickness changes in patients with cardiovascular risk factors.

OBJECTIVES: The aim of this study was to evaluate central macular thickness (CMT) and choroidal thickness (CT) in the eyes of patients with cardiovascular risk factors (CVRF). METHODS: A cross-sectional, prospective observational study of 92 patients with CVRF and 21 healthy individuals was conducted. Patients were divided into four groups according to the SCORE system. CMT was evaluated via spectral-domain-optical coherence tomography (SD-OCT). CT at five defined points (subfoveal) [SF] and nasal 500 µm [N0.5] and 1500 µm [N1.5] and 500 µm [T0.5] and temporal 1500 µm [T1.5] from the center of the fovea were measured via enhanced depth imaging (EDI)-OCT. RESULTS: Mean SFCT at right eyes (RE) and left eyes (LE) were 311.21 ± 77.7 µm and 303.5 ± 49.6 µm, respectively, in patients with mild CVRF (Group 1); 266.5 ± 63.2 µm and 267.0 ± 62.6 µm, respectively, in patients with moderate CVRF (Group 2); 264.7 ± 57.5 µm and 272.3 ± 64.6 µm, respectively, in patients with high CVRF (Group 3); 272.3 ± 64.6 µm and 271.2 ± 63.4 µm, respectively, in patients with very high-risk CVRF (with coronary arterial disease (CAD) (Group 4); and 352.0 ± 74.4 µm and 363.1 ± 89.0 µm, respectively, in the control group. CT (at both eyes) was significantly lower at the subfoveal location in all study groups (P < 0.05), but at nasal and at temporal quadrants of group 3 and group 4 (P < 0.05). No significant difference in CMT was detected between the study and control groups. CONCLUSIONS: This study demonstrated that CVRF might result in a remarkably thinner CT. Furthermore, subretinal drusenoid deposits were detected at a higher rate in the patients with CVRF than controls, and that rate increased in accordance with the severity of CAD. In the future, changes in CT may be used as a promising novel biomarker as part of the SCORE system prior to the development of CAD.

Proliferating Trichilemmal Tumor of the Auricula: A Very Rare Locus.

Proliferating trichilemmal tumor (PTT) is a rare but morphologically characteristic tumor, derived from the external root sheath. They are commonly localized as a solitary lesion on the scalp. They rarely occur in other regions. PTTs generally behave in a benign fashion, up to 20% of the lesions may undergo malignant transformation into squamous carcinoma. We present an elderly woman with a cystic swelling on the crus of auricular helix diagnosed as PTT. To our knowledge, this is the first case in the English literature, of PTT of the auricula.

The effect of the smoking on choroidal thickness, central macular vascular and optic disc perfusion.

OBJECTIVES: To compare choroidal thickness, central macular vascular perfusion and optic disc perfusion in smokers and non-smokers. METHODS: Smoker participants defined group I and non-smoker participants(group II) Optical coherence tomography angiography (OCTA) performed to all volunteers and choroidal thickness, central macular vascular and optic disc perfusion were measured. RESULTS: In group I, 30 eyes of the 30 participants (6 male and 24 female) evaluated and in group II, 32 eyes of the 32 participants (13 male and 19 female) evaluated. The mean age of the volunteers were 43.09 ±â€¯14.28 and 42.2 ±â€¯8.24 year-old in group I and group II, respectively. The mean choroidal thickness were 345 ±â€¯74 µm and 301.6 ±â€¯71 µm in group I and group II, respectively (p = 0.022). The mean optic disc perfusions were 45.17 ±â€¯1.46% and 45.25 ±â€¯1.43% in group I and group II, respectively (p = 0.82). The mean central macular vascular perfusions were 20.20 ±â€¯7.17% and 18.65 ±â€¯7.46% in group I and group II, respectively (p = 0.4). There are a negative correlation between macular vascular perfusion, optic disc perfusion and smoking period (p = 0.32 and 0.62, respectively.) CONCLUSION: Our study revealed that smoking statistically significantly effected choroidal thickness but effected central macular vascular and optic disc perfusion changes were not statistically significant.

Central Serous Chorioretinopathy: A Complication Associated with Behçet's Disease Treatment

Central serous chorioretinopathy (CSCR) is characterized by a well-defined serous choroidal detachment of the retinal pigment epithelium with one or more focal lesions of the neurosensory retina. Risk factors for CSCR are psychosocial stress, increased endogenous catecholamine, and increased endogenous cortisol. Systemic steroids can cause ocular side effects such as cataract development, increased intraocular pressure, and less frequently the development of CSCR, which can resolve spontaneously with close follow-up and simple treatment modification. CSCR should be considered in patients who complain of worsening vision under steroid treatment for pathologies requiring steroid therapy. In this study we present two patients, one man and one woman, who developed acute CSCR while under systemic steroid treatment for Behçet's disease.

Assessment of Parotid and Submandibular Glands With Shear Wave Elastography Following Radioactive Iodine Therapy for Papillary Thyroid Carcinoma.

OBJECTIVES: Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Radioactive iodine (RAI) therapy is used for remnant ablation following thyroidectomy. Side effects such as dysphagia, xerostomia, and sialoadenitis may occur. We aimed to determine the differences in the parotid and submandibulary glands between healthy patients and patients with PTC who had undergone RAI therapy and have dry mouth symptoms using both shear wave elastography and ultrasonography. METHODS: We enrolled 30 patients with PTC who had undergone RAI therapy following surgery and 30 healthy controls. Ultrasonography and shear wave elastography of submandibular and parotid glands were performed. The volume of the submandibular glands and the thickness of parotid glands were determined. Ten independent measurements were obtained from each gland, with the region of interest placed at different points on the glands. The mean shear wave velocities (SWVs) were calculated and compared between the patients and controls. RESULTS: In the PTC group, there was a significant reduction in the volume of the submandibular glands (P < .05) and in the thickness of the parotid glands (P < .05) compared with the control group. The mean SWVs of the parotid glands and submandibular glands were significantly higher in the PTC group compared with the control group (P < .0001). The SWVs of the parotid glands were higher than the SWVs of the submandibular glands (P < .0001). CONCLUSIONS: Shear wave elastography could be a noninvasive and easy assessment method of parotid and submandibular glands in patients who had undergone RAI therapy and experience dry mouth.

Relationships among retropalatal airway, pharyngeal length, and craniofacial structures determined by magnetic resonance imaging in patients with obstructive sleep apnea.

BACKGROUND: The integration of anatomical and nonanatomical parameters will improve our ability to predict the outcomes of OSA treatment. Currently, no standardized, quantitative classification of upper airway anatomical traits is available. The retropalatal (RP) airway is the most important area to consider when planning anatomical treatment. However, current evaluation methods feature qualitative conventional endoscopy. Here, we describe a quantitative magnetic resonance imaging (MRI) method used to classify RP airway patterns. METHODS: We recruited 117 males; 20 simple snorers and 97 patients with OSA. Lateral/anteroposterior ratios were calculated in three parallel planes and RP patterns were classified accordingly. Lateral wall soft tissue structures, skeletal dimensions representing those planes, pharyngeal lengths, and skeletal and vertical axis ratios were also measured. RESULTS: Both the cross-sectional area at the hard palate level and the RP lateral dimension were associated with OSA. OSA patients had longer pharynges than controls. The oblique pattern was associated with narrow lateral dimensions. The vertical pattern was associated with a narrow nasopharynx but a longer pharynx. The airway ratio at the hard palate level and the skeletal ratios of all three planes were negatively correlated with the vertical axis ratio and together explained 40.8% of the variance in the vertical axis ratio. CONCLUSIONS: The data suggest that anatomical imbalances between the craniofacial skeletal and soft tissue structures affect pharyngeal airway morphology in all three dimensions. The dimensions of the nasopharynx, the cross-sectional area at the hard palate level, and pharyngeal length were associated not only with the RP patterns but also with OSA severity. This study affords insights into upper airway anatomy and RP patterns and may help diagnose OSA patients and aid in the selection of an appropriate therapy.

The Increment of Choroidal Thickness in Euthyroid Graves' Ophthalmopathy: Is It an Early Sign of Venous Congestion?

OBJECTIVE: Clinical manifestations of Graves' ophthalmopathy (GO) are caused by the overcompression of orbital tissues within the restricted orbital bone cavity. Impaired ocular blood flow may disrupt the retinal microstructure and functions. In this study, we aimed to investigate the macular and choroidal thickness changes in GO compared with healthy subjects. MATERIALS AND METHODS: The study group comprised 50 adult patients with previously diagnosed Graves' disease with ophthalmopathy who were on antithyroid treatment. For the assessment of GO activity, the VISA (vision, inflammation, strabismus, and appearance) inflammatory score was used. When euthyroidism was achieved without side effects, the patients were referred to the ophthalmology clinic for spectral-domain optical coherence tomography (SD-OCT) evaluation. RESULTS: Subfoveal, mean, and temporal choroidal thicknesses were increased significantly in the study group according to the controls. The mean choroidal thickness was elevated. CONCLUSIONS: This elevation is because of the intraorbital inflammation even in this nonsevere GO group. Choroidal thickness might be affected from the venous obstruction and congestion in patients with GO. The elevation of the choroidal thickness might be an early sign of venous congestion that occurs before the elevation of intraocular pressure.

Effect of mometasone furoate nasal spray on the DNA of nasal mucosal cells

Background/aim: Allergic rhinitis (AR) is a respiratory disease caused by inflammation of the nasal mucosa. Intranasal corticosteroids (ICs) are an effective treatment for AR; however, their use has been associated with atrophy in nasal mucosae. Because DNA damage has been linked to several chronic diseases, we hypothesize that use of ICs could cause DNA damage in nasal mucosa cells, leading to mucosal atrophy and septal perforation. Materials and methods: Sixty patients with moderate or severe AR were divided randomly into two groups. Mometasone furoate (MF) and antihistamine tablets (desloratadine) were given to the study (IC) group. Physiologic saline and desloratadine were given to the control ((serum physiologic (SP)) group. Nasal irrigation fluid was taken from patients before study commencement and after 4 weeks of treatment. The comet assay was applied to detect DNA damage in nasal mucosa cells. Results: Nineteen patients were excluded, leaving a study population of 41 patients (IC group: 17 patients; SP group: 24 patients). Genotoxic damage was evaluated by comet assay. Conclusion: Treatment with MF spray for 4 weeks does not cause DNA breaks within cells in the nasal mucosa. These results could form the basis of clinical trials involving treatment with different ICs over longer treatment periods.

Shrinkage of Nasal Mucosa and Cartilage During Formalin Fixation.

BACKGROUND: After resection, specimens are subjected to formalin fixation during histological processing. This procedure can result in tissue shrinkage, with the amount of shrinkage related to tissue composition and tissue type. AIMS: To evaluate the shrinkage of nasal mucosa and cartilage tissue and compare differences in shrinkage after resection, after formalin fixation, and during microscopic examination to understand differences in the rate of shrinkage of different tissue types. STUDY DESIGN: Animal experimentation. METHODS: Fresh nasal septa were excised from sheep (10 mm diameter in 40 sheep and 20 mm diameter in 40 sheep). The mucosa was separated from one side of the cartilage, with the contralateral mucosa remaining attached to the cartilage. Specimen diameters were measured in situ, after resection, after fixation for 6 or 24 hours (10% formalin), and during microscopic examination. RESULTS: There were no differences between the in situ and after resection diameters of any tissue components (free mucosa, mucosa attached to cartilage, and cartilage) of all nasal specimens (10- or 20-mm diameter and 6- or 24-hour fixation). However, significant shrinkage occurred between resection and after-fixation. Regarding tissue specimens that were fixed for different durations (6 or 24 hours), we observed a significantly smaller mean tissue diameter in specimens fixed for 24 hours versus those fixed for 6 hours for mucosa attached to cartilage (in the 10-mm diameter after-fixation samples), free mucosa (in the 20-mm diameter after-fixation samples), mucosa attached to cartilage (in the 20-mm diameter after-fixation and microscopic measurement samples), and cartilage (in the 20-mm diameter after-fixation samples). Tissue shrinkage was greatest in free mucosal tissue and least in cartilage. CONCLUSION: These results should be considered when evaluating patients undergoing surgical procedures for nasal cavity and paranasal sinus malignancies. Surgical margins should be measured before fixation or evaluated if possible before fixation and shrinkage.

Audio-Vestibular Findings in Increased Intracranial Hypertension Syndrome.

OBJECTIVE: Idiopathic intracranial hypertension (IIH) can be manifested by audiological and vestibular complaints. The aim of the present study is to determine the audio-vestibular pathologies and their pathophysiologies in this syndrome by performing current audio-vestibular tests. MATERIALS AND METHODS: The study was performed prospectively on 40 individuals (20 IIH patients, 20 healthy volunteers). Pure tone audiometry, tympanometry, vestibular evoked myogenic potentials, and electronystagmography tests were performed in both groups and the results were compared. RESULTS: The mean age of both groups was found to be 30.2±18.7. There were 11 females and 9 males in each group. The study group patients had significantly worse hearing levels. Pure tone averages were significantly higher in both ears of the study group (p<0.05). Ten patients (50%) in the study group and one healthy volunteer (5%) had pathologic ENG, possibly related to central pathologies (p=0.008). Eight patients (40%) and one (5%) control had variable abnormal VEMP records (p=0008). CONCLUSION: Many IIH patients initially visit otolaryngology clinics since cochlear and vestibular systems are frequently affected in this condition. Our test results suggest inner ear pathologies in these patients. Higher incidence of inferior vestibular nerve and/or saccule dysfunction is detected as a novelty. Increased intracranial pressure may affect the inner ear with similar mechanisms as in hydrops.

Choroidal and central foveal thickness in patients with scleroderma and its systemic associations.

BACKGROUND: The aim was to investigate the morphological changes in the fovea and choroid in patients with scleroderma and its systemic associations. METHODS: Thirty-four scleroderma patients and 31 healthy controls were enrolled. Choroidal thickness (CT) at five defined points (subfoveal [sfCT] and 1.0 [N1.0] and 3.0 µm nasal [N3.0] and 1.0 [T1.0] and 3.0 µm temporal [T3.0] from the centre of the fovea) and central foveal thickness were measured. RESULTS: The mean central foveal thickness (right eye 229.3 ± 28.6 versus 232.6 ± 29.7 and left eye 219.8 ± 21.4 versus 223.3 ± 21.9 µm) and sfCT (right eye 326.4 ± 56.5 versus 327.3 ± 62.1 and left eye 316.7 ± 53.4 versus 317.6 ± 51.6 µm) values were not different in patients with scleroderma compared with the controls (p > 0.05). The mean CT at N1.0, N3.0, T1.0 and T3.0 did not differ among these groups in both eyes (p > 0.05). There was no difference in the mean central foveal thickness and CT of both eyes in diffuse and limited scleroderma (p > 0.05). A negative correlation was found between anti-nuclear antibody positivity and CT at T3 and N3 (respectively, r = -0.439 and r = -0.383, p < 0.05). CONCLUSION: Choroidal thickness at five points and central foveal thickness in both eyes did not significantly differ in scleroderma patients compared with healthy controls. Choroidal thickness at the T3 and N3 points showed a negative correlation with anti-nuclear antibody positivity.