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BACKGROUND: To identify thickness variations in the retinal nerve fiber layer around the optic disc and macula in patients with cerebral vein thrombosis (CVT) without papilledema. METHODS: This study included 28 patients with CVT diagnosis and appropriate treatment. Detailed ophthalmologic examination found bilateral vision 10/10, vision field test normal and fundus examination found no papilledema images. The patients had macular and optic retinal nerve fiber layer thickness (RNFL) measured with spectral domain-optical coherence tomography (SD-OCT) (Optovue, Fremont, CA). Patients had retinal nerve fiber thickness compared with a control group. RESULTS: When the effect on the macula and RNFL near the optic nerve disk is investigated, there was significant thinning identified in the macula inferior inner, temporal inner, superior inner and temporal outer quadrants (p = 0.009, 0.001, 0.026, 0.014, respectively) and in the inferior temporal quadrant of the optic nerve disk (p = 0.020) in CVT patients compared to normal individuals. CONCLUSIONS: Even after appropriate treatment of CVT patients, axonal loss was identified with OCT. As a result, it may be important to use OCT measurements to monitor CVT treatment.
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Trombosis Intracraneal/patología , Fibras Nerviosas/patología , Enfermedades del Nervio Óptico/patología , Retina/patología , Células Ganglionares de la Retina/patología , Trombosis de la Vena/patología , Adulto , Anciano , Axones/patología , Estudios de Casos y Controles , Femenino , Humanos , Mácula Lútea/patología , Masculino , Persona de Mediana Edad , Disco Óptico/patología , Estudios Prospectivos , Tomografía de Coherencia Óptica/métodosRESUMEN
PURPOSE: To assess the concentrations of lipocalin-2 (LCN2) in the serum and the aqueous humor of patients with central retinal vein occlusion (CRVO). METHODS: The concentrations of LCN2 in the serum and aqueous humor of 16 cataract patients and 16 patients with CRVO with macular edema were compared. Collection of aqueous samples was conducted in the operating theater under sterile conditions and just prior to intravitreal ranibizumab injection or cataract surgery. LCN2 levels in serum and aqueous humor samples were measured using a commercial kit (human lipocalin-2/NGAL PicoKine ELISA Kit, MyBioSource Inc., USA; Catalog No: MBS175829) based on standard sandwich enzyme-linked immunosorbent assay technology. RESULTS: The concentrations of LCN2 in the aqueous humors of the CRVO group were higher than those of the control group (p = 0.021). There was no significant difference in serum LCN2 level between the two groups (p = 0.463). CONCLUSIONS: Concentrations of LCN2 in aqueous humor are increased in CRVO. LCN2 may be part of a pro-catabolic phenotype, and it may play an important role in the dreaded complications of CRVO, such as macular edema, macular ischemia, and neovascularization, which lead to blindness.
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Humor Acuoso/metabolismo , Lipocalina 2/metabolismo , Oclusión de la Vena Retiniana/metabolismo , Anciano , Anciano de 80 o más Años , Biomarcadores/metabolismo , Ensayo de Inmunoadsorción Enzimática , Femenino , Angiografía con Fluoresceína , Fondo de Ojo , Humanos , Masculino , Persona de Mediana Edad , Oclusión de la Vena Retiniana/diagnóstico , Tomografía de Coherencia ÓpticaRESUMEN
OBJECTIVES: The aim of this study was to investigate whether severe preeclampsia (SPE) affects intraocular pressure (IOP) and ocular perfusion pressure (OPP). MATERIAL AND METHODS: This prospective and comparative study included 64 pregnant females, allocated into 2 groups as Group 1 (31 pregnant women with SPE) and Group 2 (33 normotensive pregnant women). IOP, systolic and diastolic blood pressure, OPP of all the subjects were measured after 20 weeks of gestation and prior to labor and medical therapy. RESULTS: The mean IOP values in Group 1 were not significantly different from those of Group 2 (p = 0.528). The mean OPP values in Group 1 were significantly higher than those of Group 2 (p < 0.001). There was no significant correlation between IOP and OPP levels. No significant differences were determined between the groups in respect of age, gestational age body mass index (BMI) (p < 0.269, p < 0.219 and p < 0.556 respectively). The mean systolic and diastolic blood pressure values were statistically significantly higher in Group 1 than in Group 2 (p < 0.001 and p < 0.001). CONCLUSIONS: Although high IOP was expected in SPE patients, it was found to be constant. This could have been due to an increase in aqueous humor outflow because of changes occurring in angiogenic and anti-angiogenic factors in SPE.
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Presión Sanguínea , Presión Intraocular , Preeclampsia/fisiopatología , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Preeclampsia/diagnóstico , Embarazo , Estudios Prospectivos , Índice de Severidad de la Enfermedad , TurquíaRESUMEN
BACKGROUND: The aim of this study was to assess the intraocular pressure and ocular biometric parameters in migraine patients during acute migraine attacks and compare them with painless period and healthy controls using a new optical biometer AL-Scan. METHODS: In this prospective, case-control study, the axial length, corneal curvature radius, anterior chamber depth, central corneal thickness, and pupil size of 40 migraine patients during acute migraine attacks and painless period and 40 age- and sex-matched healthy subjects were measured using a AL-Scan optical biometer (Nidek Co., Gamagori, Japan). All patients underwent a complete ophthalmic examination before the measurements. IOP and biometer measurements were taken at the same time of day (10:00-12:00) in order to minimize the effects of diurnal variation. RESULTS: There was not a statistically significant difference in intraocular pressure between the migraine patients during acute migraine attacks (15.07 mmHg), painless period (14.10 mmHg), and the controls (15,73 ± 0,81). Also, the ocular biometric parameters did not significantly vary during the acute migraine attacks. CONCLUSIONS: Further studies are needed to evaluate the etiopathologic relationship between intraocular pressure and ocular biometric parameters and acute migraine attack.
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Cámara Anterior/patología , Longitud Axial del Ojo/patología , Córnea/patología , Presión Intraocular/fisiología , Cristalino/patología , Trastornos Migrañosos , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Migrañosos/patología , Trastornos Migrañosos/fisiopatología , Estudios Prospectivos , Pupila/fisiologíaRESUMEN
BACKGROUND: To report a case of a 48-year-old man with Buerger's disease who presented with bilateral normal-tension glaucoma (NTG). CASE PRESENTATION: A 48-year-old man who had been diagnosed with Buerger's disease 12 years ago, and received bilateral below-the-knee amputations for ischemic ulcers of the lower limbs, presented at our clinic due to a sudden loss of visual acuity in the left eye. A fundus exam revealed a cup-to-disc ratio of 0.5 for the right eye and 0.8 for the left eye, arteriolar constriction in both eyes, retinal edema in the inferopapillary area, and splinter hemorrhages and soft exudate in the left eye. We diagnosed the patient as having acute nasal branch retinal artery occlusion in the left eye and bilateral NTG, as a result of the ophthalmologic examination and the other findings. CONCLUSION: Although the pathomechanism of NTG is still unknown, previous studies have suggested that patients with NTG show a higher prevalence of vasospastic disorders. We present the second report of NTG associated with Buerger's disease to be described in the literature.
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Glaucoma de Baja Tensión/etiología , Oclusión de la Arteria Retiniana/etiología , Tromboangitis Obliterante/complicaciones , Estenosis Carotídea/diagnóstico , Angiografía con Fluoresceína , Gonioscopía , Humanos , Presión Intraocular , Glaucoma de Baja Tensión/diagnóstico , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Oclusión de la Arteria Retiniana/diagnóstico , Tromboangitis Obliterante/diagnóstico , Ultrasonografía Doppler en Color , Pruebas del Campo Visual , Campos VisualesRESUMEN
BACKGROUND: To evaluate the obstructive sleep apnea syndrome (OSAS) in patients with nonarteritic anterior ischemic optic neuropathy (NAION). METHODS: We recruited 27 patients with NAION and 27 age-matched and sex-matched controls who also were similar for systemic risk factors such as diabetes mellitus, hypertension, and hypercholesterolemia. All patients and controls underwent overnight polysomnography for the diagnosis of OSAS and calculation of apnea-hypopnea index (AHI). RESULTS: Patients and controls were statistically similar in terms of age, sex, gender, smoking, systemic risk factors, neck circumference, and body mass index. The subjects with AHI ≥ 20 were accepted as OSAS. Fifteen of 27 patients (55.6%) with NAION and 6 of 27 controls (22.2%) had OSAS (P < 0.05). CONCLUSION: The prevalence of OSAS was higher in patients with NAION, and the difference between patient and control groups was statistically significant (P < 0.05). This result supports prior series suggesting the association between NAION and OSAS.
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Neuropatía Óptica Isquémica/complicaciones , Apnea Obstructiva del Sueño/complicaciones , Anciano , Índice de Masa Corporal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neuropatía Óptica Isquémica/fisiopatología , Polisomnografía , Estudios Prospectivos , Factores de Riesgo , Índice de Severidad de la Enfermedad , Apnea Obstructiva del Sueño/diagnóstico , Apnea Obstructiva del Sueño/fisiopatologíaRESUMEN
Germline partial chromosomal deletions of the entire RB1 gene (13q deletions), account for 6% of the RB1 mutational spectrum. The authors report the rare case of one patient with suspected bilateral iris heterochromia who actually had iris hypoplasia (often masquerading as heterochromia) and bilateral retinoblastoma, due to 13q deletion syndrome. [J Pediatr Ophthalmol. 2018;55:e10-e13.].
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Trastornos de los Cromosomas/complicaciones , Enfermedades del Iris/patología , Iris/patología , Mutación , Trastornos de la Pigmentación/diagnóstico , Proteínas de Unión a Retinoblastoma/genética , Retinoblastoma/diagnóstico , Ubiquitina-Proteína Ligasas/genética , Deleción Cromosómica , Trastornos de los Cromosomas/diagnóstico , Trastornos de los Cromosomas/genética , Cromosomas Humanos Par 13/genética , Análisis Mutacional de ADN , ADN de Neoplasias/genética , Diagnóstico Diferencial , Femenino , Angiografía con Fluoresceína , Fondo de Ojo , Humanos , Lactante , Enfermedades del Iris/diagnóstico , Enfermedades del Iris/etiología , Imagen por Resonancia Magnética , Proteínas de Unión a Retinoblastoma/metabolismo , Tomografía de Coherencia Óptica , Ubiquitina-Proteína Ligasas/metabolismoRESUMEN
Presently described is case of a 42-year-old woman with eye injury that was result of gunshot fired by a man at a wedding celebration. Bullet penetrated inferior quadrant of nasal sclera of left eye 7-12 mm behind limbus. Choroid and vitreous were prolapsed around bullet. Hemorrhage, vitreous prolapse and lens subluxation were present in anterior chamber. Presenting visual acuity (VA) was hand motion. Bullet 14x5 mm in size was carefully extracted from the eye. Fifteen days later, argon laser photocoagulation was performed on retina in area of bullet entry point. VA was 20/25 (Snellen) at final visit. In this case, although foreign body was large, area of penetration was Zone III, and initial VA was poor, early and appropriate surgical repair achieved integrity of the globe and good vision prognosis.
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Lesiones Oculares Penetrantes , Heridas por Arma de Fuego , Adulto , Lesiones Oculares Penetrantes/diagnóstico , Lesiones Oculares Penetrantes/fisiopatología , Lesiones Oculares Penetrantes/cirugía , Femenino , Humanos , Fotocoagulación , Pronóstico , Agudeza Visual , Heridas por Arma de Fuego/diagnóstico , Heridas por Arma de Fuego/fisiopatología , Heridas por Arma de Fuego/cirugíaRESUMEN
A 72-year-old woman presented with acute onset of double vision, bilateral complete blepharoptosis, and nearly complete ophthalmoplegia. Orbital and brain magnetic resonance imaging were normal. Further investigation revealed bicytopenia with hepatosplenomegaly. Liver biopsy revealed mantle cell lymphoma. Cytology later showed the presence of mantle cells in cerebrospinal fluid analysis. Her ophthalmoplegia improved from her first cycle of systemic and intrathecal chemotherapy. To the best of our knowledge, this is the second case in the literature of mantle cell lymphoma with central nervous system involvement presenting with ophthalmoplegia. This symptom should be considered one of the initial signs of mantle cell lymphoma.
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PURPOSE: To evaluate the effect of a single dose of intravitreal dexamethasone (DEX) implant on retinal nerve fiber layer (RNFL) thickness in patients with branch retinal vein occlusion (BRVO) in a 6-month period. MATERIALS AND METHODS: This retrospective observational study included the patients with BRVO who received intravitreal DEX implant and whose assessment included the baseline RNFL thickness measurements. The data of 26 eyes of 24 patients were retrospectively analyzed. Spectral domain optic coherence tomography was used to measure peripapillary RNFL thickness in six regional subfields. Intraocular pressure (IOP) values at each visit were recorded. The data of single dose DEX implant during 6 months were assessed. RESULTS: The mean preoperative and postoperative 6th month nasal RNFL values were 85.4 ± 23.0 µm and 82.1 ± 17.6 µm, respectively, and the difference between the measurements was not statistically significant (p = 0.372). There was a slight decrease in the mean RNFL values postoperatively compared to the baseline values in all quadrants except supero-temporal quadrant; however, none of them reached statistically significant level (p > 0.05). The mean IOP values before and 6 months after implantation were 15.7 ± 2.9 mmHg and 16.5 ± 4.2 mmHg, respectively. The difference between the 6th month IOP values and baseline IOP values was not statistically significant (p = 0.236). CONCLUSION: Intravitreal DEX implant seems to have no adverse effect on RNFL thickness in BRVO patients in a 6-month period.
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Dexametasona/administración & dosificación , Células Ganglionares de la Retina/patología , Oclusión de la Vena Retiniana/tratamiento farmacológico , Tomografía de Coherencia Óptica/métodos , Anciano , Implantes de Medicamentos , Femenino , Estudios de Seguimiento , Glucocorticoides/administración & dosificación , Humanos , Inyecciones Intravítreas , Masculino , Fibras Nerviosas/efectos de los fármacos , Fibras Nerviosas/patología , Estudios Prospectivos , Células Ganglionares de la Retina/efectos de los fármacos , Oclusión de la Vena Retiniana/diagnóstico , Vasos Retinianos/efectos de los fármacos , Vasos Retinianos/patología , Estudios Retrospectivos , Resultado del Tratamiento , Agudeza VisualRESUMEN
PURPOSE: To evaluate the effects of ascorbic acid (vitamin C), the main antioxidant agent in the cornea on transepithelial corneal cross-linking (CXL) where the main mechanism is oxidation. METHODS: Twenty eyes of 20 rabbits were divided into 3 groups: Group 1 (7 eyes) had transepithelial corneal CXL after being fed with normal diet; Group 2 (7 eyes) had corneal CXL after once-daily subcutaneous injections of 200 mg of ascorbic acid in addition to normal diet; and the control group (6 eyes) was fed with normal diet but did not have corneal CXL performed. Ascorbic acid levels were measured in aqueous humor and plasma, and biomechanical measurements were applied to the cornea. RESULTS: There was a significant difference in ascorbic acid levels of plasma (P = 0.008) and aqueous humor (P = 0.006) between group 1 and 2. The Young's modulus values of group 1 and 2 were similar (P = 0.741) and were significantly higher than the control group (P = 0.02 and P = 0.01). The increase rate in Young's modulus values was 37.3% in group 1 and 43.9% in group 2 compared to control group. The ultimate strain values in group 1 and 2 were similar (P = 0.632) and were significantly higher than control group (P = 0.04, P = 0.03). The ultimate stress values in group 1 and 2 were similar (P = 0.836) and were significantly lower than control group (P = 0.001, P = 0.001). CONCLUSIONS: Systemic vitamin C does not appear to decrease effectiveness of transepithelial corneal CXL. Therefore, there is no reason to stop or reduce vitamin C supplementation before corneal CXL therapy.
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Antioxidantes/farmacología , Ácido Ascórbico/farmacología , Sustancia Propia/efectos de los fármacos , Reactivos de Enlaces Cruzados , Epitelio Corneal/efectos de los fármacos , Fármacos Fotosensibilizantes/uso terapéutico , Riboflavina/uso terapéutico , Animales , Humor Acuoso/metabolismo , Ácido Ascórbico/sangre , Fenómenos Biomecánicos , Colágeno/metabolismo , Sustancia Propia/metabolismo , Elasticidad , Conejos , Rayos UltravioletaRESUMEN
PURPOSE:: To investigate the relationship between biomechanical properties of the cornea and postoperative refractive changes in patients with low-level astigmatism after cataract surgery. METHODS:: This prospective study recruited patients undergoing cataract surgery involving 2.8-mm superior incisions. Biomechanical properties of the cornea were evaluated preoperatively using the Ocular Response Analyzer, and corneal profiles were evaluated using a Scheimpflug system (Pentacam HR). Topographic astigmatism, total corneal aberrations (TCA) and higher-order corneal aberrations (HOCA) analyses were performed preoperatively and during 1- and 3-month postoperative exams. The incidences of surgically-induced astigmatism (SIA) and HOCAs were calculated using vector analyses. Associations of the preoperative biomechanical properties of the cornea with SIA and HOCAs were evaluated. RESULTS:: This study included 28 eyes of 28 patients. The preoperative corneal hysteresis (CH) was 8.68 ± 1.86 mmHg, and the corneal resistance factor (CRF) was 8.66 ± 1.61 mmHg. At the 1-month postoperative evaluation, significant changes were observed in HOCAs (p=0.023), TCAs (p=0.05), astigmatism (p=0.02), and trefoil (p=0.033); in contrast, differences in coma (p=0.386) and spherical aberration (SA) were not significant (p=0.947). At the 3-month visit, significant changes were only observed in TCAs (p=0.02) and HOCAs (p=0.012). No relationships between the preoperative corneal hysteresis and corneal resistance factor and postoperative SIA and HOCA were identified, other than a positive correlation between the 3-month postoperative incidence of corneal hysteresis and spherical aberration. CONCLUSIONS:: Despite the observed lack of relationships of preoperative biomechanical properties of the cornea with SIA and postoperative aberrations (except for SA), further studies involving larger patient groups are needed to explore the unexpected refractive deviations after cataract surgery.
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Astigmatismo/etiología , Extracción de Catarata/efectos adversos , Córnea/cirugía , Aberración de Frente de Onda Corneal/etiología , Implantación de Lentes Intraoculares/efectos adversos , Complicaciones Posoperatorias/etiología , Adulto , Anciano , Fenómenos Biomecánicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodo Posoperatorio , Periodo Preoperatorio , Estudios ProspectivosRESUMEN
PURPOSE: The aim of this study was to evaluate the early term topographic and aberration results of accelerated (9 mW/cm) corneal cross-linking (CXL) treatment in keratoconic thin corneas. METHODS: Forty-nine eyes from 43 patients (mean age of 21.2 ± 7.1) with progressive keratoconic thin corneas (<400 µm without epithelium) who had accelerated corneal CXL with hypoosmolar riboflavin solution throughout the procedure were enrolled. We measured the uncorrected and corrected distance visual acuity, refraction, slit-lamp examination, topographic values, and corneal higher-order aberrations (Pentacam HR, Oculus Optikgeräte GmbH) preoperatively and 1, 3, and 6 months after surgery. RESULTS: Before surgery, the corneal thickness was 404 ± 18 µm, and the thickness was reduced to 360 ± 24 µm after removing the epithelium. After the application of hypoosmolar riboflavin solution, the thickness increased to 432 ± 44 µm. At month 6, there was a significant increase in uncorrected distance visual acuity (P = 0.043) and corrected distance visual acuity (P = 0.024), a decrease in spherical refraction (P = 0.041), maximum keratometry (Kmax, P = 0.003), anterior elevation values (P = 0.008), corneal thickness (P < 0.001), coma (P = 0.022), spherical aberration (P = 0.001), higher-order root mean square (P = 0.004), and total root mean square (P < 0.001), whereas the cylindrical refraction (P = 0.627), anterior (P = 0.665) and posterior astigmatism (P = 0.165) of the cornea, posterior elevation (P = 0.198), and trefoil (P = 0.141) remained unchanged. No patients showed any complications or scar formation during follow-up. CONCLUSIONS: Accelerated corneal CXL with hypoosmolar riboflavin solution throughout the procedure is effective in thin corneas.
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Colágeno/metabolismo , Reactivos de Enlaces Cruzados/uso terapéutico , Soluciones Hipotónicas/uso terapéutico , Queratocono/tratamiento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/uso terapéutico , Riboflavina/uso terapéutico , Adulto , Córnea/metabolismo , Córnea/patología , Topografía de la Córnea , Femenino , Humanos , Queratocono/patología , Masculino , Persona de Mediana Edad , Agudeza Visual , Adulto JovenRESUMEN
PURPOSE: To evaluate the effect of accelerated corneal cross-linking (CXL) according to corneal thickness in keratoconus. METHODS: Patients undergoing corneal CXL (9 mW/cm(2)) with hypo-osmolar riboflavin solution were included in this study. The patients were divided into 2 groups. Group 1 included patients with corneal thickness below 400 µm (50 eyes from 45 patients), and group 2 included patients with corneal thickness above 400 µm (50 eyes from 47 patients). Visual acuity (VA), refraction, topographic values, and higher-order aberrations were evaluated in the preoperative term and postoperatively at months 1, 3, and 6. RESULTS: The improvements in VA were significant and similar in both groups [0.25/0.19 logMAR, P = 0.130]. In group 1, the rate of decrease in spherical refraction [0.85/0.27 diopters (D), P = 0.012] and maximum keratometry (Kmax, 2.49/0.68 D, P < 0.001) was significantly higher than that in group 2. The cylindrical change was similar (0.43/0.29 D P = 0.173). Corneal thinning was higher in group 2 (25/40.4 µm P < 0.001). Anterior elevation values decreased at higher rates in group 1 (3.73/0.24 µm P < 0.001); neither group showed a significant difference in posterior elevation (-0.14/-0.4 µm P > 0.05). In group 1, all aberration values except trefoil significantly decreased, whereas in group 2 none of the aberrations decreased except the total root mean square. All higher-order aberration values decreased at significantly higher rates in group 1 (P < 0.05). CONCLUSIONS: In thin corneas, accelerated corneal CXL provides better anatomical changes; however, the improvement in VA is similar to that in thick corneas.
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Córnea/patología , Reactivos de Enlaces Cruzados , Queratocono/tratamiento farmacológico , Fármacos Fotosensibilizantes/uso terapéutico , Riboflavina/uso terapéutico , Adolescente , Adulto , Niño , Colágeno/metabolismo , Paquimetría Corneal , Sustancia Propia/metabolismo , Topografía de la Córnea , Aberración de Frente de Onda Corneal/fisiopatología , Femenino , Humanos , Queratocono/metabolismo , Queratocono/fisiopatología , Masculino , Concentración Osmolar , Fotoquimioterapia , Fármacos Fotosensibilizantes/química , Refracción Ocular/fisiología , Estudios Retrospectivos , Riboflavina/química , Rayos Ultravioleta , Agudeza Visual/fisiología , Adulto JovenRESUMEN
PURPOSE: To present complications of using fibrin glue in conjunctival-limbal autografting in pterygium surgeries other than recurrences and discuss their prevention and management strategies. MATERIALS AND METHODOLOGY: The charts of all patients who underwent fibrin glue assisted pterygium excision surgery with conjunctival-limbal autograft transplantation from 2010 to 2013 were reviewed. Patients who developed complications except recurrence postoperatively were included in this study. RESULTS: Sixteen (17.39%) of the 92 patients were detected with a complication. Graft dehiscence was diagnosed in 7 (7.6%) patients with 5 of them treated conservatively and 2 patients requiring suturing. Five (5.43%) patients were diagnosed with cyst formation between the graft and conjunctiva or in the graft-removal area; these cysts were primarily excised and no additional problems occurred. Corneal dellen developed in 3 (3.26%) patients and 2 of them regressed after cessation of topical steroids and application of lubricant therapy while one was treated with amniotic membrane transplantation. Residual fibrin glue particles had stiffened on the ocular surface, which resulted in intensive pain and irritation in one (1.08%) patient on the same day of the surgery. The patient's complaints were reduced by removing these particles from the ocular surface under topical anesthesia. CONCLUSION: Complications in fibrin glue assisted pterygium surgery are relatively different from other techniques. To avoid potential complications of fibrin glue in pterygium surgery, peroperatively ophthalmologists should ensure the conjunctival autograft and conjunctiva are properly adhered, fibrin glue remnants are completely removed from the ocular surface, and no Tenon's capsule remains between the graft and the conjunctiva.
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BACKGROUND: To investigate the effects of selective laser trabeculoplasty (SLT) on macular thickness change. METHODS: Forty eyes of 40 consecutive patients with uncontrolled primary open-angle glaucoma with medical treatment were included in this prospective study. SLT was performed to the inferior 180°, and macular thickness was measured. Data were collected before SLT, and 1 week and 1 month after SLT. Macular thickness evaluation was performed in five quadrants, the central 1 mm quadrant (fovea = F), the nasal 3 mm quadrant surrounding F (NQ), temporal quadrant, superior quadrant (SQ), and inferior quadrant (IQ). The preoperative and postoperative thicknesses were compared. RESULTS: There was an increase in macular thickness in the NQ, IQ, and SQ on the first week after SLT compared to preoperative measurements. On the other hand, there was no significant increase in the F and temporal quadrant. On the first month after SLT, thickness in the NQ, IQ, and SQ was back to preoperative measurements, and there was no significant change between the preoperative measurements in any quadrant. CONCLUSION: There was no significant increase in macular thickness shortly after SLT in our study.
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Oculogyric crisis is an acute dystonic reaction of the ocular muscles characterized by bilateral dystonic elevation of visual gaze lasting from seconds to hours. This reaction is most commonly explained as an adverse reaction to drugs such as antiemetics, antipsychotics, antidepressants, antiepileptics, and antimalarials. Although the incidence of metoclopramide-induced acute dystonic reactions has been reported as 25% in children, there have been few published cases on oculogyric crisis in general. It is important to be able to recognize this ocular side effect because, without a thorough patient history, symptoms can be confused with other diseases such as versive seizures, paroxysmal tonic upward gaze, and encephalopathy. In this paper, we report a case of oculogyric crisis induced by metoclopramide.
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Objective. To report a case of toxic anterior segment syndrome (TASS) that was caused by inadvertent anterior chamber and cornea stromal injection with high dose gentamicin following cataract surgery. Methods. Case report. Results. We report a 72-year-old female patient who developed TASS that was caused by high dose gentamicin (20 mg/0.5 mL), which was inadvertently used during the formation of the anterior chamber and hydration of the corneal incision. Unlike previous cases, hyphema and hemorrhagic fibrinous reaction were seen in the anterior chamber. Despite treatment, bullous keratopathy developed and penetrating keratoplasty was performed. The excised corneal button was sent for histopathological examination. Conclusions. Subconjunctival gentamicin is highly toxic to the corneal endothelium and anterior chamber structures. Including it on the surgical table carries a potentially serious risk for contamination of the anterior chamber.
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PURPOSE: Pterygium is a common clinical entity that usually causes visual impairment, astigmatism and cosmetic problems. Although many surgical techniques to treat pterygium have been proposed, no single method, with minimal patient complications, has yet been accepted and established. Excision combined with conjunctival autograft is the most often used procedure for the treatment of primary pterygium, and the technique is associated with minimized recurrence rates in patients. The purpose of our study was to compare visual and refractive outcomes, complications, and recurrence rates with the use of fibrin glue versus 8.0 vicryl suture in pterygium surgery performed with conjunctival autograft. MATERIALS AND METHODS: Our retrospective, comparative study included 106 eyes of 106 patients operated on for primary pterygium, between the years 2011 and 2012, and followed for ≥ 12 months. Patients were divided into 2 treatment groups: Group 1, vicryl suture use (n = 53), and Group 2, fibrin tissue glue (n = 53). Patient follow-up periods were 21.15 ± 5.3 months for Group 1 and 22.06 ± 5.2 months for Group 2. RESULTS: Demographics and preoperative/follow-up clinical characteristics of patients revealed no significant differences between the 2 patient groups. Additionally, no significant differences were found between the patient groups in visual acuity level changes and refractive values. Although the rates of recurrence (7.5% in Group 1 and 1.9% in Group 2; P = 0.36) and graft dehiscence (Group 1, 7.5% compared with Group 2, 3.8%; P = 0.67) were slightly higher for patients in the suture group, differences did not reach significance. CONCLUSIONS: Our study results suggest that conjunctival autografting with fibrin glue has favorable visual and refractive results for patients, and is associated with lower complication rates, compared with use of the traditional 8.0 vicryl suturing technique. We suggest that fibrin tissue glue provides adequate adhesion and that graft loss will not be a problem if protective shields are used in patients postoperatively. The appropriate surgery technique should be selected by considering the advantages and disadvantages of each procedure.
Asunto(s)
Adhesivo de Tejido de Fibrina/uso terapéutico , Poliglactina 910/uso terapéutico , Pterigion/cirugía , Técnicas de Sutura , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Complicaciones Posoperatorias , Recurrencia , Refractometría , Estudios Retrospectivos , Factores Socioeconómicos , Factores de Tiempo , Agudeza VisualRESUMEN
PURPOSE: To evaluate the toxic effects of chronic lead (Pb) exposure on retinal nerve fiber layer thickness (RNFLT), macular thickness (MT) and choroidal thickness (CT) in battery industry workers. MATERIALS AND METHODS: Male factory workers (n = 50) and healthy non-employees (n = 20) participated in the study. Group 1 (n = 22) comprised lead workers; Group 2 (n = 16), box makers; Group 3 (n = 12), assistant personnel; and Group 4 (n = 20), healthy non-employees. All participants were given Best-Corrected Visual Acuity (BCVA) tests, full ophthalmologic examinations, and Spectral Domain Optical Coherence Tomography (SD-OCT) of the optic nerve head, RNFL, macula, and choroid. Blood lead levels (BLL) in venous blood samples were determined. The duration of exposure to lead varied, and is expressed in months. RESULTS: Average (mean ± SD) ages of participants were 27.55 ± 4.00, 28.69 ± 3.48, 32.00 ± 3.38, and 29.85 ± 5.48 yrs (Groups 1-4, respectively). BLL were 46.2 ± 2.32, 29.31 ± 3.30, 16.9 ± 1.9, and 2.85 ± 0.98 µg/dL (Groups 1-4, respectively). Durations of exposure to lead were 43.86 ± 10.81, 42.81 ± 4.86, and 49.42 ± 6.14 mo (Groups 1-3, respectively). OCT averages for RNFL were 101.68 ± 5.32, 119.50 ± 13.47, 127.67 ± 8.92, and 130.9 ± 6.63 µm (Groups 1-4, respectively). Although RNFLTs of Group 1 were significantly less than those of for Groups 2-4, and, RNFLTs of Groups 2 and 3 were significantly less than that of Group 4, there were no significant differences between Group 2 and 3. MTs were 94.50 ± 6.78, 105.63 ± 5.43, 111.50 ± 6.74 and 147.95 ± 6.67 µm, (Groups 1-4, respectively). CTs were 176.41 ± 15.39, 222.19 ± 17.79, 239.17 ± 15.64, and 251.50 ± 10.98 µm (Groups 1-4, respectively). Both MTs and CTs displayed significant differences among the four groups. CONCLUSIONS: Ocular changes in individuals who are chronically exposed to lead include decrease in RNFT, MT, and CT, and thus these parameters should be evaluated during ophthalmologic examination of individuals working in lead-based industries.