Retinal nerve fiber layer decrease and choroidal layer increase after four weeks of buprenorphine/naloxone maintenance treatment in opioid use disorder

Background and Objectives: Spectral-domain optical coherence tomography (SD-OCT) findings in substance use disorders have been investigated in recent years. In this study, we compared the retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL), the inner plexiform layer (IPL), and the choroid thickness (CT) of OUD and control groups before and after buprenorphine/naloxone maintenance treatment (BN-MT).MethodsThe OUD group consisted of 46 male subjects and the control group consisted of 49 male subjects. Patients with chronic opioid use and opioid positivity in their urine during the initial SD-OCT application were included in the study. At the end of the fourth week of BN-MT, SD-OCT was repeated and BN positivity was detected in the urine of the patients at this time.ResultsThere was a significant difference between OUD and control groups in terms of nasal superior and CT values of both eyes (p<0.05) before BN use. The values of RNFL sectors and CT of both eyes before and after BN-MT differed significantly (p<0.05); CT increased and RNFL sectors decreased. After BN-MT, psychometric scales differed significantly in favor of the patients (p<0.05). The SD-OCT values of the OUD group after BN-MT were compared with the control group: the right IPL (p=0.003), the left IPL (p=0.023), the right N (p=0.001) and the left N (p<0.001) values were significantly lower in the OUD group.ConclusionThis is the first study to show the SD-OCT findings of patients with OUD before and after BN-MT. The findings of this study may indicate possible effects of chronic opioid use in patients and/or possible effects of exogenous opioid or BN present in the body during SD-OCT applications. However, based on our findings, it is not possible to distinguish between the two possible outcomes. The fact that the use of BN acting through opioid receptors has different effects from exogenous opioids may be due to different receptor profiles. (AU)

Successful treatment of olfactory reference syndrome with clomipramine / Tratamiento eficaz del síndrome de referencia olfativo con clomipramina

Subjective halitosis is a chronic disorder, and cannot be easily identified or measured by objective methods. The patients who are complaining with subjective halitosis usually refer to dentists, yet they reject to psychiatric consultations. One of the causes is olfactory reference syndrome (ORS) which is accepted as delusional or obsessive thoughts. ORS patients are usually refer to others’ behaviours; people who are closing their mouth, coughing and touching their nose, opening window, turning faces to another side to protect themselves. These are the signs as to emitting malodour which patients misinterpret. This paper illustrates a 51-old male who suffers from halitosis since 30 years which is diagnosed as ORS and treated with clomipramine

La halitosis subjetiva es un trastorno crónico y no es fácilmente identificable o cuantificable con métodos objetivos. Los pacientes que se quejan de halitosis subjetiva por lo general consultan al dentista, pero evitan la consulta psiquiátrica. Una de las causas es el síndrome de referencia olfativo (SRO), que se reconoce como pensamientos delirantes u obsesivos. Los pacientes con SRO generalmente hacen referencia a los comportamientos de los demás, personas que cierran la boca, tosen y se tocan la nariz, abren la ventana o giran la cara hacia otro lado para protegerse. Estos son los signos del hecho de desprender mal aliento que los pacientes malinterpretan. Este artículo expone el caso de un varón de 51 años que sufre halitosis desde hace 30 años, que se diagnostica como SRO y se trata con clomipramina