Extracellular matrix collagen biomarker levels in patients who underwent pulmonary endarterectomy.

OBJECTIVES: The role of extracellular matrix collagen biomarkers in chronic thromboembolic pulmonary hypertension (CTEPH) is not well known. Our goal was to investigate the matrix metalloproteinase (MMP)-2 and -9 protein levels in patients with CTETH. METHODS: This is a prospective, cross-sectional study. Patients with CTETH who underwent pulmonary endarterectomy comprise group 1, and the control group included patients who underwent lung surgery without pulmonary hypertension (group 2) between March 2020 and March 2021. In addition to serum levels of MMP-9, the pulmonary endarterectomy and control pulmonary artery tissue samples were measured by the enzyme-linked immunosorbent assay  4pl, cubic, quadratic and Western blot techniques. Levels of MMP-2, which consist of pro MMP-2/ß-actin and active MMP-2/ß-actin and MMP-9/ß-actin, were measured only in the tissue samples. RESULTS: Forty-eight patients were enrolled consecutively in group 1 (n: 24) and group 2 (n: 24). The serum concentrations of MMP-9 were similar in both groups. Similarly, a comparison of tissue sample levels of pro MMP-2/ß-actin (P = 0.496) and active MMP-2/ß-actin (P = 0.216) showed no significant difference between the groups. The tissue samples from patients with CTETH had significantly lower amounts of MMP-9/ß-actin compared to the control group (P = 0.001). CONCLUSIONS: This study indicates that serum levels of extracellular matrix collagen biomarkers were similar in patients with CTETH who were candidates for surgery and in patients who had non-pulmonary hypertension who underwent lung surgery. Differences in levels of MMP-9/ß-actin in tissue samples may play a role in pulmonary vascular remodelling in operable patients.

Prevalence, etiology, and biopsychosocial risk factors of cervicogenic dizziness in patients with neck pain: A multi-center, cross-sectional study.

OBJECTIVES: This study aims to investigate the prevalence, etiology, and risk factors of cervicogenic dizziness in patients with neck pain. PATIENTS AND METHODS: Between June 2016 and April 2018, a total of 2,361 patients (526 males, 1,835 females; mean age: 45.0±13.3 years; range, 18 to 75 years) who presented with the complaint of neck pain lasting for at least one month were included in this prospective, cross-sectional study. Data including concomitant dizziness, severity, and quality of life (QoL) impact of vertigo (via Numeric Dizziness Scale [NDS]), QoL (via Dizziness Handicap Inventory [DHI]), mobility (via Timed Up-and-Go [TUG] test), balance performance [via Berg Balance Scale [BBS]), and emotional status (via Hospital Anxiety- Depression Scale [HADS]) were recorded. RESULTS: Dizziness was evident in 40.1% of the patients. Myofascial pain syndrome (MPS) was the most common etiology for neck pain (58.5%) and accompanied with cervicogenic dizziness in 59.7% of the patients. Female versus male sex (odds ratio [OR]: 1.641, 95% CI: 1.241 to 2.171, p=0.001), housewifery versus other occupations (OR: 1.285, 95% CI: 1.006 to 1.642, p=0.045), and lower versus higher education (OR: 1.649-2.564, p<0.001) significantly predicted the increased risk of dizziness in neck pain patients. Patient with dizziness due to MPS had lower dizziness severity scores (p=0.034) and milder impact of dizziness on QoL (p=0.005), lower DHI scores (p=0.004), shorter time to complete the TUG test (p=0.001) and higher BBS scores (p=0.001). CONCLUSION: Our findings suggest a significant impact of biopsychosocial factors on the likelihood and severity of dizziness and association of dizziness due to MPS with better clinical status.

The comparison of the intraocular lens power calculation formulas in long eyes.

OBJECTIVE: To investigate the accurate intraocular lens power formula in eyes with axial length over 26mm by using optical biometry. METHODS: The retrospective case series was conducted at Medicana International Avcilar Hospital, Istanbul, Turkey from 2016 to 2018, and comprised data related to years between 2014 and 2018. Optical low-coherence reflectometry had been used in measurements. The calculation methods were included Hill-radial basis function, Sanders-Retzlaff-Kraff-Theoretical, Hoffer Q, Barrett Universal II, Olsen, Haigis and Holladay-2. The spherical equivalent values that were obtained with automated refractometer at the first postoperative month were recorded. Mean absolute error for each formula was estimated. SPSS 16 was used for data analysis. RESULTS: There were 56 eyes of as many patients with a mean axial length of 26.70±0.88mm. The postoperative numerical error was within ±0.50 diopters in 46(82%) patients, and between the -0.50 and -1.00 diopters in 10(18%). The mean absolute error values were significantly lower in Haigis, Sanders-Retzlaff-Kraff-Theoretical, HofferQ and Holladay-2 formulas compared to the Barrett, Hill, and Olsen formulas (p<0.05). There was no statistically significant intra-group difference for Haigis, Sanders-Retzlaff-Kraff-Theoretical, Hoffer Q, and Holladay-2 formulas (p>0.05). CONCLUSIONS: In long eyes with an axial length over 26mm, Haigis, Sanders-Retzlaff-Kraff-Theoretical, Hoffer Q and Holladay-2 formulas yielded better postoperative refractive outcomes compared to Hill-radial basis function, Barrett Universal IIand Olsen formulas. The Haigis formula had the lowest refractive numerical error.

Ozone treatment for high-dose systemic Steroid-Induced retinal injury.

OBJECTIVE: To investigate the effect of high-dose systemic steroids on retinal tissues and the effectiveness of ozone (O3) therapy. METHODS: Twenty-four New Zealand white rabbits were divided into three groups of eight. Group 1 was accepted as the control group, Group 2 received intramuscular 20 mg/kg methylprednisolone acetate and Group 3 received 14 sessions of ozone treatment in addition to methylprednisolone acetate. The subjects were sacrificed on the 30th day. Retinal tissues were removed. Superoxide dismutase (SOD), catalase (CAT), malondialdehyde (MDA), total antioxidant status (TAS) and total oxidant status (TOS) levels were evaluated for tissue biochemistry and serum ischaemic modified albumin (IMA), interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) levels were evaluated with the ELISA method. Haematoxylin-eosin staining and TUNEL evaluation for apoptosis were evaluated as histopathological methods. RESULTS: In the treatment group, antioxidant parameters of TAS, SOD and CAT were higher, oxidative and ischaemic parameters of MDA, TOS and IMA were lower, inflammatory parameters of IL-6 and TNF-α were lower, retinal thickness was better and apoptosis amount was lower. CONCLUSION: Apoptosis increases in retinal tissues due to high dose systemic steroid administration and the retina becomes thinner. With biochemical examination, oxidation parameters increased while antioxidant parameters decreased. Both histopathological and biochemical parameters improved significantly with ozone treatment.

Silicone perforated punctal plugs for the treatment of punctal stenosis / Tampões perfurados de silicone no tratamento da estenose do ponto lacrimal

ABSTRACT Purpose: Punctal stenosis can result in symptoms such as epiphora and can significantly reduce the quality of life of patients. Perforated punctal plug insertion is an easy procedure that is commonly used as the first step of treatment for punctal stenosis. Methods: Clinical, demographic, and outcome data were retrospectively collected for 54 eyes of 21 males and 11 females who consecutively presented to our Oculoplastic Clinic and underwent silicone Micro Flow perforated punctal plug insertion. All patients had epiphora with punctal stenosis. Results: Of the 54 plugs, 26 plugs (48.1%) were lost and 28 (51.8%) stayed in place. Of the latter, eight were explanted because of the occlusion of the plug with secretions and recurrent conjunctivitis; moreover, two plugs migrated deep into the vertical canaliculus. Of the 54 plugs, only 18 (33.3%) were well-tolerated with significant symptomatic improvement. Conclusion: Plug loss is a prominent problem in patients implanted with perforated punctal plugs. Silicone punctal plugs failed in 66.7% of our patients over a mean follow-up of 14.2 months.

RESUMO Objetivo: A estenose punctal pode resultar em sintomas como a epífora e diminuir significativamente a qua­lidade de vida dos pacientes. A inserção de um tampão perfurado é um procedimento fácil que é comumente usado como o primeiro passo do tratamento para a estenose punctal. Métodos: Dados clínicos, demográficos e de resultado foram coletados retrospectivamente de 54 olhos de 21 homens e 11 mulheres que consecutivamente se apresentaram em nossa Clínica de Oculoplástica e foram submetidos a inserção de um tampão de silicone perfurado Micro Flow. Todos os pacientes tinham epífora com estenose punctal. Resultados: Dos 54 tampões, 26 (48,1%) foram perdidos e 28 (51,8%) permaneceram no local. Destes últimos, 8 foram removidos devido a oclusão do tampão com secreção e conjuntivite recorrente, além disso, 2 migraram profundamente no canalículo vertical. Dos 54 tampões, apenas 18 (33,3%) foram bem tolerados com significativa melhora dos sintomas. Conclusão: A perda de tampões é um problema de destaque em pacientes implantados com tampões perfurados. Tampões de silicone falharam em 66,7% dos pacientes durante um seguimento médio de 14,2 meses.

Silicone perforated punctal plugs for the treatment of punctal stenosis.

PURPOSE: Punctal stenosis can result in symptoms such as epiphora and can significantly reduce the quality of life of patients. Perforated punctal plug insertion is an easy procedure that is commonly used as the first step of treatment for punctal stenosis. METHODS: Clinical, demographic, and outcome data were retrospectively collected for 54 eyes of 21 males and 11 females who consecutively presented to our Oculoplastic Clinic and underwent silicone Micro Flow perforated punctal plug insertion. All patients had epiphora with punctal stenosis. RESULTS: Of the 54 plugs, 26 plugs (48.1%) were lost and 28 (51.8%) stayed in place. Of the latter, eight were explanted because of the occlusion of the plug with secretions and recurrent conjunctivitis; moreover, two plugs migrated deep into the vertical canaliculus. Of the 54 plugs, only 18 (33.3%) were well-tolerated with significant symptomatic improvement. CONCLUSION: Plug loss is a prominent problem in patients implanted with perforated punctal plugs. Silicone punctal plugs failed in 66.7% of our patients over a mean follow-up of 14.2 months.

Comparison of Goldmann applanation, non-contact, dynamic contour and tonopen tonometry measurements in healthy and glaucomatous eyes, and effect of central corneal thickness on the measurement results.

Aim To compare the correlation of intraocular pressure (IOP) measurements obtained using Goldmann applanation tonometry (GAT), non-contact tonometry (NCT), dynamic contour tonometer (DCT) and tono-pen (TP) in glaucomatous and healthy eyes, and to investigate the effect of central corneal thickness (CCT) on the measurements. Methods One hundred eyes of 100 glaucoma patients and 50 eyes of 50 healthy individuals were compared. In all of the eyes, CCT was evaluated using ultrasonic pachymeter. IOP was measured using NCT, TP, DCT and GAT, respectively. IOP measurements and correlation of these measurements with CCT were calculated using Pearson and intra-group correlation analysis. Results In the glaucoma group, the mean IOP was 16.42 ± 2.80 mmHg with NCT, 17.12 ± 2.49 mmHg with TP, 18.27 ± 2.62 mmHg with DCT and 16.08 ± 3.00 mmHg with GAT. The mean CCT was 532.15 ± 39.08 µm. In normal individuals, mean IOP was 14.64 ± 2.20 mmHg with NCT, 15.32 ± 1.85 mmHg with TP, 16.72 ± 2.31 mmHg with DCT and 14.16 ± 2.80 mmHg with GAT. The mean CCT was 538.40 ± 31.64 µm. Conclusion A strong compliance between NCT and GAT has been observed. NCT can be used instead of GAT.

Congenital nasolacrimal duct obstruction: caesarean section vs. vaginal delivery.

Aim To investigate the association between the incidence of congenital nasolacrimal duct obstruction (CNDO) and delivery by caesarean section or spontaneous vaginal labour. Methods A total of 40 patients who were diagnosed as CNDO and treated with lacrimal probing between January 2011 and February 2013 were reviewed retrospectively. The patients were divided into two groups: group 1 (caesarean section delivery) and group 2 (spontaneous vaginal delivery). Results A total of 22 patients delivered by caesarean section (group 1) were compared with 18 patients delivered by spontaneous vaginal labour. There were 10 male (45%), 12 female (55%) patients in group 1 and nine (50 %) males, nine females (50 %) patients in group 2. The mean age of group 1 was 14.85 months (12-22 month) and group 2 was 15.20 months (12-23 month). Mean birth time was 38.1 week (36-40 week) in group 1 and 39.4 week (38-41 week) in group 2. There was no statistically significant difference between the age, gender and birth time between the groups (p>0.05). There was no statistically significant difference between the way of delivery (caesarean section or spontaneous vaginal delivery) and the incidence of CNDO (p>0.05). Conclusion Congenital nasolacrimal duct obstruction was found less frequently among the patients delivered by vaginal delivery comparing to the patients with caesarean delivery, however this difference was not statistically significant. It is considered that, with the studies which include more patients, the difference may become significant.