Comparison of topical nepafenac 0.1% with intravitreal dexamethasone implant for the treatment of Irvine-Gass syndrome.

AIM: To compare safety and efficacy of intravitreal dexamethasone (IVD) implant with topical nepafenac (TN) 0.1% in previously untreated Irvine-Gass syndrome (IGS) in clinical practice. METHODS: This was a retrospective study of 62 eyes with IGS after phacoemulsification with posterior chamber intraocular lens (IOL) implantation. None of the patients used treatment before IVD or TN. Best-corrected visual acuity (BCVA) with Early Treatment Diabetic Retinopathy Study chart (ETDRS), slit-lamp, intraocular pressure (IOP) measurement, fundus examination, spectral-domain optical coherence tomography (OCT) and fundus florescein angiography were performed to all subjects at baseline, 1, 3 and 6mo. RESULTS: The mean BCVA of the IVD group was 49.3±6.8, and the mean BCVA of the TN group was 32.9±7.3 ETDRS letters in post-treatment month 6. The mean central macular thickness (CRT) of IVD group was 266.6±53.5 µm and the mean CRT of TN group was 364.9±56.3 µm in post-treatment month 6. Baseline BCVA has correlation with final BCVA in TN group however there was no correlation between baseline BCVA and final BCVA in IVD group. CONCLUSION: IVD is found to be better than TN in controlling pseudophakic macular edema and improving visual acuity. IVD group also has significantly lower CRT however IOP is not significantly different between two groups in post-treatment month 6.

Retinal ganglion cell complex and peripapillary retinal nerve fiber layer thicknesses following carotid endarterectomy.

PURPOSE: To examine changes in retinal ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thicknesses by optical coherence tomography (OCT) in contralateral and ipsilatateral eyes of carotid artery stenosis (CAS) patients before and after carotid endarterectomy (CEA). METHODS: Forty-two consecutive patients diagnosed with CAS (70-99% stenosis rate) who underwent CEA were included in this prospective cross-sectional study. The indication for CEA was based on the Asymptomatic Carotid Atherosclerosis Study. Doppler ultrasonography and computed tomography angiography were performed to calculate CAS. All the subjects underwent an ophthalmological examination, including best corrected visual acuity (BCVA), intraocular pressure (IOP) measurements, biomicroscopy, fundoscopy, and OCT before and after the surgery. RESULTS: The mean preoperative intraocular pressure was 15.2 ± 2.1 mmHg in the ipsilateral eye and 15.8 ± 2.7 in the contralateral eye. The mean postoperative intraocular pressure in the ipsilateral and contralateral eye was 18.6 ± 3.0 and 19.3 ± 3.8, respectively. The intraocular pressure was significantly higher in postoperative eyes (p = 0.0001). There was a statistically significant decrease in peripapillary RNFL thickness in superior quadrants postoperatively in ipsilateral eyes. The retinal GCC layer thickness was not significantly different before and after CEA in ipsilateral and contralateral eyes. CONCLUSIONS: Carotid endarterectomy results in thinning of the superior peripapillary RNFL thickness. To the best of our knowledge, this is the first study to examine peripapillary RNFL and GCC thicknesses before and after CEA.

Comparison of long-term results of trabeculectomy to treat pseudoexfoliative glaucoma and primary open angle glaucoma.

AIM: To compare the long term outcome of trabeculectomy in patients with pseudoexfoliative glaucoma (PEG) and primary open angle glaucoma (POAG) in terms of surgical success. METHODS: The success of the trabeculectomy was evaluated by three criteria. Criterion A: intraocular pressure (IOP) ≤21 mm Hg and decrease in IOP ≥20%; Criterion B: IOP ≤18 mm Hg and decrease in IOP ≥30%; Criterion C: IOP ≤15 mm Hg and decrease in IOP ≥50%. Patients that met these criteria without medical treatment were considered to be completely successful, while those that met these criteria with medical treatment were considered partially successful. Significance levels of differences between the POAG and PEG groups in the Kaplan-Meier survival curves were calculated with the log-rank test. RESULTS: Sixty-four eyes from 64 patients with PEG and 51 eyes from 51 patients with POAG were evaluated. No significant differences were detected between the PEG and POAG groups according to full or partial success relative to each of the three criteria (A: P=0.73, 0.32; B: P=0.73, 0.31; C:P=0.90, 0.27). CONCLUSION: There is no difference in the long-term success of trabeculectomy between PEG and POAG patients whose clinical characteristics are otherwise the same.

Increased Fibrinogen to Albumin Ratio in Ischemic Retinal Vein Occlusions.

PURPOSE: To demonstrate the relationship between ischemia and plasma fibrinogen and serum albumin levels in cases of retinal vein occlusion (RVO). METHODS: This study included 44 patients with central RVO (CRVO), 68 patients with branch RVO (BRVO), and 54 age- and sex-matched controls, for a total of 166 subjects. All of the subjects underwent full ophthalmologic examinations and complete physical examinations, including a detailed medical history and blood count, and biochemical parameters. RESULTS: The mean fibrinogen to albumin ratios were 92.5 ± 36.1 for the patients with CRVO, 84.5 ± 31.5 for the patients with BRVO, and 68.4 ± 12.2 for the control group. Overall, the patients with CRVO and patients with BRVO with ischemia had higher fibrinogen to albumin ratios and higher fibrinogen levels. Moreover, significant positive correlations were found between ischemia and the fibrinogen to albumin ratio (r = 0.732, p = 0.001) and the fibrinogen level (r = 0.669, p = 0.001). CONCLUSIONS: The fibrinogen to albumin ratio is significantly associated with ischemic RVO. Instead of complicated and invasive methods, such as a retinal angiogram, the fibrinogen to albumin ratio could be a useful initial diagnostic test to predict ischemia in RVO.

Elevated Neutrophil Lymphocyte Ratio in Recurrent Optic Neuritis.

Purpose. To demonstrate the relation between optic neuritis (ON) and systemic inflammation markers as neutrophil lymphocyte ratio (N/L ratio), platelet count, mean platelet volume (MPV), and red cell distribution width (RDW) and furthermore to evaluate the utilization of these markers to predict the frequency of the ON episodes. Methods. Forty-two patients with acute ON and forty healthy subjects were enrolled into the study. The medical records were reviewed for age, sex, hemoglobin (Hb), Haematocrit (Htc), RDW, platelet count, MPV, white blood cell count (WBC), neutrophil and lymphocyte count, and neutrophil lymphocyte ratio (N/L ratio). Results. The mean N/L ratio, platelet counts, and RDW were significantly higher in ON group (p = 0.000, p = 0.048, and p = 0.002). There was a significant relation between N/L ratio and number of episodes (r = 0.492, p = 0.001). There was a statistically significant difference for MPV between one episode group and recurrent ON group (p = 0.035). Conclusions. Simple and inexpensive laboratory methods could help us show systemic inflammation and monitor ON patients. Higher N/L ratio can be a useful marker for predicting recurrent attacks.

[The factors affecting visual outcome in open globe injuries]. / Açik göz küresi yaralanmalarinda sonuç görme keskinligi üzerine etkisi olan faktörler.

BACKGROUND: To evaluate the factors affecting visual acuity in cases subjected to surgical repair due to open globe injury. METHODS: The records of the patients who have been subjected to emergency surgical repair due to open globe injury were examined retrospectively. From a total of 195 cases, 119 eyes of 119 cases who fulfilled the inclusion criteria were included into the study. Cases were examined in terms of age, gender, trauma type, localization, preoperative examination findings, the presence of additional surgical interventions and the findings in the last examination. Chi-square test and logistic regression analysis were used in statistical analysis. RESULTS: Original visual acuity (p=0.042), zone (p=0.001), trauma type (p=0.003), preoperative anterior chamber loss (p=0.005), existence of hyphema (p=0.001), vitreous prolapse (p=0.000) and posterior segment pathology development (p=0.000) influenced the visual outcome. In cases with grade 4 or grade 5 resulting visual acuity, statistically significant factors were determined as "existence of pathology in the posterior segment" (p=0.000, Odds ratio=12.397) and "total anterior chamber loss" (p=0.015, Odds ratio=4.661). CONCLUSION: Changes occurring at the posterior segment pathology and anterior chamber loss are determinant in terms of resulting visual acuity. For this reason, ophthalmoscopy and ultrasonography that should not be omitted in the follow-up period for cases with a transparent media and with media opacity, respectively.