Role of OCTA in the prognosis of dry-type AMD

OBJECTIVE

This study aimed to determine the prognostic value of Optical Coherence Tomography Angiography (OCTA) in dry-type age-related macular degeneration (AMD).

PATIENTS AND METHODS

Thirty-five eyes of 25 patients with dry-type AMD were included in the study. All patients underwent a complete ophthalmological examination. First and last foveal avascular zone (FAZ), foveal density (FD), FAZ perimeter, non-flow area (NFA), foveal (F)-parafoveal-perifoveal superficial and deep capillary plexus (SCP-DCP) vessel density (VD) OCTA measurements were recorded. Foveal thickness (FT), macular volume (MV), and choroidal thickness (CT) measurements with enhanced depth imaging (EDI) mode were made with Optical Coherence Tomography (OCT). The relationship of all parameters with the best corrected visual acuity (BCVA-logmar) was evaluated. A p-value <0.05 was considered statistically significant.

RESULTS

The mean age of the patients was 73.3±11.8 (45-91) years. There was a statistically significant difference between the first and last BCVA, FT, and FD. While FD and BCVA increased, FT was found to decrease statistically significant (p=0.002, p=0.001, p=0.045, respectively). The correlation of BCVA with other variables at the first and last visit was examined. There was a statistically positive correlation between BCVA and FAZ, FAZ perimeter, and NFA in the first and last measurements. In the second measurement, a statistically negative correlation was found between BCVA and MV, FT, superficial FVD, superficial FT, deep FT, superficial parafoveal VD, superficial parafoveal FT, deep parafoveal FT, deep parafoveal VD, and FD variables.

CONCLUSIONS

There are positive and negative correlations between OCTA parameters and BCVA in the SCP-DCP in dry-type AMD. OCTA has prognostic significance in dry AMD.

The effect of crossword puzzle activity used in distance education on nursing students' problem-solving and clinical decision-making skills: A comparative study

AIM

The study was planned to determine the effect of crossword puzzle activity in distance education on nursing students' problem-solving and clinical decision-making skills.

BACKGROUND

In online education, increasing nursing students' learning skills, motivations and participation is important.

DESIGN

The study is a randomized-controlled trial.

METHOD

The study sample consisted of 132 nursing students registered to the Pediatric Nursing distance course in the 2020-2021 academic year. 20 students who were assigned to the control group did not agree to participate in the study and did not fill in the data form. Accordingly, the study was completed with the participation of 112 students, with 66 students in the experimental group and 46 students in the control group. In the 14-week distance education, 20-question crossword puzzle activity per unit was applied to the students in the experimental group. The standards for reporting consort guidelines for reporting parallel group randomized trials were used to report this research. The students in the control group were taught in the form of presentation. At the beginning and end of the study, CDMNS and PSI were applied to the students. Ethics committee approval (Number: 2021/79) was obtained from the relevant university to conduct the research.

RESULTS

A statistically significant difference was found between pretest and posttest scores of the experimental group in PSI and CDMNS scales (p < 0.001).

CONCLUSION

Crossword puzzle activity used in distance education developed the students' problem-solving and clinical decision-making skills.

Fear of COVID-19 and related factors affecting mothers' breastfeeding self-efficacy during the pandemic

OBJECTIVE

This study aimed to determine the breastfeeding self-efficacy levels of mothers during the pandemic period, to compare them according to various characteristics, and to examine the relationship between the fear of COVID-19 and breastfeeding self-efficacy.

METHOD

The data of this descriptive and cross-sectional were collected through a web-based survey of 392 mothers between June and August 2021. The data collection tools were the Introductory Data Form, the Breast-feeding Self-Efficacy Scale-Short Form, and the Fear of COVID-19 Scale.

RESULTS

The mean score for breastfeeding self-efficacy was found to be 56.18 ± 8.24, while the mean score for the Fear of COVID-19 scale was 21.77 ± 6.14. Having a high fear of COVID-19, breastfeeding more frequently in this period, and suspecting that they had COVID-19 affected the breastfeeding self-efficacy scores positively, whereas graduating from primary school had a negative effect on self-efficacy.

CONCLUSION

The breastfeeding self-efficacy of mothers who were fearful of COVID-19, who breastfed more frequently during the pandemic, and who had a higher education level were positively affected.

The Effect of Perceived Social Support on Psychological Well-Being in COVID-19 Patients

Aim: This study aims to determine the effect of perceived social support experienced by COVID-19 patients on their psychological well-being. Methods: This study is a cross-sectional descriptive study. In the research, the data were collected through online platforms (such as Facebook and WhatsApp) via Google form between March-April 2021 to reduce the risk of transmission. Results: This cross-sectional study was performed on 403 COVID-19 patients. There were statistically significant positive correlations between the mean Psychological Well-Being Scale total score and the Multidimensional Scale of Perceived Social Support total score (r=0.772; p<0.001). Conclusion: It is extremely important to increase social support resources to maintain psychological well-being during and after quarantine practice in patients diagnosed with COVID-19. Keywords: COVID-19, patient, social, support, quarantine

Investigation of the Relationship Between Postpartum-Specific Anxiety and Maternal Attachment and Affecting Factors in a Turkish Sample

Aim: Postpartum-specific anxiety is associated with impaired mother-infant attachment, postpartum depression, reduced probability of breastfeeding, increased risk of infant abuse, and increased probability of anxiety in children and may lead to psychological, cognitive, and psycho-motor disorders in child development. This descriptive and cross-sectional study aims to determine the effect of anxiety level in the postpartum period in women on maternal attachment. Methods: The participants were 384 postpartum women who have a 1-3-month old baby. Data were collected using a personal information form, Postpartum Specific Anxiety Scale, and Maternal Attachment Inventory. Results: It was found that the Postpartum Specific Anxiety Scale in women was at a medium level, while maternal attachment was at a high level. While the Postpartum Specific Anxiety Scale was at higher levels in those who were younger, unemployed, and had no other children, the younger age of the partner increased the Postpartum Specific Anxiety Scale score. No statistically significant relationship was found between Postpartum Specific Anxiety Scale and maternal attachment. Conclusion: It is seen that to evaluate women in terms of anxiety in the postpartum period and to provide the necessary psychosocial support is necessary. The fact that maternal attachment in women was high may have had a positive effect on her relationship with postpartum anxiety. Keywords: postpartum, anxiety, children, bonding

The relationship between breastfeeding attitudes and perceived stress levels of Turkish mothers

AIMS

In the present study, it was aimed to investigate the relationships between breastfeeding attitude and perceived stress levels of Turkish mothers.

METHODS

In this descriptive study, the Personal Information Form prepared by the researchers, Perceived Stress Scale (PSS) and Iowa Infant Feeding Attitude Scale (IIFAS) were used to collect the study data. The present study included 788 mothers having 0-6 month-old infants. The data obtained were with the independent t-test, one-way ANOVA and Pearson correlation analyses.

FINDINGS

The mean scores of the participants obtained from the PSS and IIFAS were 25.60 ± 7.3 and 61 ± 6.6, respectively. At the end of the correlation analysis, it was observed that breastfeeding attitude decreased as the perceived stress level increased in mothers.

CONCLUSIONS

The results of the research indicated that as the perceived stress levels of mothers in the postpartum period increased, their breastfeeding attitudes decreased. It is suggested that nurses should support women by providing education and counselling during pregnancy and postpartum period.

The Magnitude and Determinants of Emotional-Behavioral Problems in Working Adolescents in Turkey

OBJECTIVE

Working adolescents are at a greater risk of mental disorders than are non-working adolescents. The present study was aimed at determining the magnitude and determinants of emotional and behavioral problems in working adolescents.

METHODS

This cross-sectional study was conducted with 343 adolescents attending two vocational training centers in the province of Balikesir between January 2016 and March 2016. The data were collected with the Personal Information Form, and the Strengths and Difficulties Questionnaire. In the analysis, descriptive statistics, the t-test, Mann Whitney U test and one way ANOVA were used.

RESULTS

In the study of the adolescents, 16.9% were determined to have abnormal emotional and behavioral problems. Of the participating adolescents, girls, those with physical illnesses, living in fragmented families, perceiving their economic status as good, having fathers with primary school education and/or having mothers with high school or higher education had significantly higher emotional and behavioral problem scores (p<0.05).

CONCLUSION

In this study, approximately one-fifth working Turkish adolescents had abnormal mental status. Based on the aforementioned results, it can be suggested to develop intervention programs for the prevention, early diagnosis and treatment of emotional and behavioral problems in working adolescents.

Multicenter study of pars plana vitrectomy for optic disc pit maculopathy: MACPIT study

PurposeTo evaluate surgical intervention with pars plana vitrectomy (PPV) for correction of optic disc pit maculopathy (ODP-M).Patients and methodsRetrospective chart review from 13 centres of 51 eyes of 50 patients with ODP-M who underwent PPV between 2002-2014. Anatomic and final best-corrected visual acuity (BCVA) outcomes were evaluated for all cases with different adjuvant techniques.ResultsThere were 23 males and 27 females with median age 25.5 (6-68) years. Preoperative median foveal thickness was 694.5 (331-1384) μm and improved to 252.5 (153-1405) μm. Median BCVA improved from 20/200 (20/20000 to 20/40) to 20/40 (20/2000 to 20/20) with 20/40 or better in 31 eyes. Complete retinal reattachment was achieved in 44 eyes (86.3%) at 7.1 (5.9) months. The good surgical outcomes were achieved in different adjuvant groups. Median follow-up was 24 (6 to 120) months.ConclusionsThese results confirm the long-term effectiveness of PPV for ODP-M. Prospective studies are needed to determine the effectiveness of any adjuvant technique in improving the success of PPV for ODP-M.

Evaluation of the intraocular pressure in obese adolescents

AIM

The aim of this study was to evaluate the intraocular pressure (IOP) levels of children with normal and high Body Mass Index (BMI) and to find out the potential correlation between glaucoma and obesity.

METHODS

Thirty obese and thirty healty children were enrolled in this study. Physical examinations and anthropometric measurements of all patients and controls were performed. Obesity was defined as a BMI exceeding the 95th percentile for the patients according to age and sex. All participants were underwent a complete eye examination. The results of these measurements were considered for statistical analysis.

RESULTS

Mean age was 13.5±2.1 years in obese group and 13.3±2.0 years in control group. Mean BMIs were 28.1±3.9 kg/m2 and 19.7±1.2 kg/m2 in obese and control groups, respectively. No significant difference was found in mean IOP levels of both right and left eyes between two groups (P=0.837 and P=0.755, respectively). There was no significant difference in cup/disc ratios of each eyes and mean central corneal thickness of both right and left eyes between obese patients and controls. In visual field analysis, no statistically significant difference in mean false negativeness and mean false positiveness were found between two groups. There were not also any significant correlations in both mean deviation of each eyes (P=0.78 and P=0.94, respectively) and pattern standart deviation of right and left eyes (P=0.89 and P=0.90, respectively) between obese cases and controls.

CONCLUSION

In this study, there were no significant difference in IOP measurements, central corneal thicknesses, cup/disc ratios and visual field parameters between obese and normal children. No significant correlation was found between obesity and glaucoma or elevated IOP in children.

[Tuberculosis outbreak in 13 people in Saxony-Anhalt: indications of an infection chain by spoligotyping]

BACKGROUND

In Germany the number of new tuberculosis incidents continues to decline slightly. Cases of illnesses are often diagnosed late, due to the uncharacteristic course of tuberculosis. The success in environment investigations by health authorities in finding incidents within one infection chain depends on the compliance of patients among other factors. Tuberculosis occurs especially in groups with social disadvantages. In this population segment the identification of contact persons of a patient with infectious tuberculosis presents difficulties. Moreover, identifying the source of infection is frequently not successful. For these reasons, additional infections and sicknesses are caused. The cultural pathogen proof, including type differentiation and resistance testing, continues to be the "gold standard" in tuberculosis diagnostics and is required for the examination of outbreaks. Molecular methods for fine typification of isolated bacterial strains and their subsequent comparison constitute an important tool in the infection epidemiology investigation of incident clustering.

OBJECTIVE AND METHOD

The objective of this work is the description of a tuberculosis infection chain in Saxony-Anhalt, which was discovered by means of a molecular biological method. The conservative method represents the environment investigations for the expedient selection of contact persons. The investigations always take 2 directions in the process. On the one hand, it is searched for the still unknown source of infection. On the other hand, persons are to be identified, who have been infected before the diagnosis became known. The diagnostics for contact persons includes besides the lung X-ray checkup exam, the Mendel Mantoux tuberculin skin test (THT), sputum tests and the Interferon Gamma (INF-γ) tests (IGRA). In described case, the molecular biological method of spoliogotyping was employed as additional instrument. Therein, fingerprint maps of the patients' tuberculosis strings were created and compared. Infection chains resulting from the environment investigations were thereby secured.

RESULTS

We report on a tuberculosis outbreak in a district of the state of Saxony-Anhalt, which occurred in the time from June 2007 to May 2010. As result of the environment investigations, an infection chain of 13 ill patients (77% ♂, 23% ♀) was identified. In 11 cases the correlation of the infection chain was proven by spoligotyping (9 ♂, 2 ♀). 2 cases (1 ♂, 1 ♀) without verification of the pathogen cannot be attributed on basis of the epidemiological correlations.

Meningokokken-Trägerstatus von Gymnasiasten und mögliche Risikofaktoren

From August 2004 to January 2005 a cluster of 7 cases of serogroup B meningococcal disease occurred in the state of Saxony-Anhalt in the town of Sangerhausen and the surrounding area. This led to an investigation of meningococcal carriage in 816 high school students (grades 9 to 13). The students were also asked to fill out a questionnaire regarding possible risk factors for carriage. The goal of the study was the evaluation of a possibly persistently increased risk for further cases in the region. Results of the study were to be used for a comprehensive and targeted education of the public. The percentage of students found harbouring N. meningitidis in the nasopharynx in Sangerhausen (9.0 %) was not elevated compared to that found in the two control regions of Kelbra, County of Sangerhausen (8.2 %) and Jessen, County of Wittenberg (9.9 %). The serogroup B fine type responsible for the cluster (P1.7-2,16:F3-3:PorB3-24) was found only in one student each in Sangerhausen and Kelbra. Thus, there was no evidence of an increased risk for further cases at the time of the study at the end of January, 2005. This may have been due to intensive contact tracing and provision of chemoprophylaxis in Sangerhausen. Visiting a disco or bar and smoking were identified as risk factors for meningococcal carriage. However, these factors were associated with carriage only in boys but not in girls. This may be explained by sex-specific differences in physical interaction with others. Efforts to prevent further cases during clusters of meningococcal disease should consider sex-specific risk behaviour.

Unilateral Purtscher-like retinopathy after weight-lifting

PURPOSE

To report a case of Purtscher-like retinopathy after weightlifting.

METHODS

A 17-year-old man presented with a sudden visual loss in his left eye after weightlifting two weeks ago. Fundus examination of the left eye showed cotton-wool spots and scattered retinal hemorrhages in the posterior pole. Fluorescein angiography and indocyanine green angiography with a scanning laser ophthalmoscope were performed.

RESULTS

Angiography showed hypofluorescent areas adjacent to the optic disc and in the posterior pole and partial filling insufficiency in the inferior and inferotemporal branch retinal veins. Complete venous filling was noted in late phases of angiography.

CONCLUSIONS

The pathogenesis of weightlifting suggests the Purtscher-like changes as a result of Valsalva maneuver in our case. To our knowledge, this is the first reported case of Purtscher-like retinopathy associated with weightlifting.

Management of free floating iris cysts in the anterior chamber: a case report

PURPOSE

To present a case with free iris cysts in the anterior chamber and its management with YAG laser.

CASE REPORT

A 14-year-old boy presenting with the complaint of seeing a small ball-like moving mass in his left eye.

RESULTS

Slit-lamp examination revealed a pair of free-floating iris cysts located inferiorly in the anterior chamber. After YAG laser application both the cysts collapsed.

CONCLUSIONS

This is the first report of a case with multiple free iris cysts in the anterior chamber. Considering the possibility of endothelial damage in the long-term, it is worth noting the favorable response to YAG laser treatment.

Colour Doppler assessment of blood flow in eyes with central retinal vein occlusion

PURPOSE

To assess the blood flow changes in eyes with central retinal vein occlusion (CRVO) and compare these values with values of fellow eyes and eyes of normal subjects.

METHODS

25 eyes of 25 consecutive newly diagnosed patients with CRVO comprised the study group. Their fellow eyes and those of 25 healthy subjects were the control group. All patients underwent a complete ophthalmological examination. Eyes with CRVO were classified into two groups as non-ischaemic and ischaemic by fundus fluorescein angiography. Colour Doppler imaging was performed with a Toshiba Sonolayer SSH-140A and 7.5-MHz linear array probe. Maximum systolic velocity (V(max)), end-diastolic velocity (V(min)) and resistive index (R(i)) values were noted for each of the central retinal artery (CRA), central retinal vein (CRV) and ophthalmic artery (OA). These parameters were compared with those of the fellow eyes and both eyes of the control group.

RESULTS

Mean ages were 63.55 and 61.45 years in the CRVO and control groups, respectively. Age and sex distributions were statistically identical in both groups. When we compared the eyes with CRVO to the control group, no statistically significant difference existed between the two groups with regard to the V(min) and R(i )values of the CRA and CRV. However, V(max ) values of the CRA and CRV were significantly lower in CRVO eyes when compared to the control group. The CRVO group and control group had similar V(max), V(min ) and R(i) values for the OA. Only the V(max) was significantly lower in the CRV in eyes with CRVO when compared to the unaffected fellow eyes. No statistically significant difference could be detected between any of the parameters of CRA, CRV and OA of the ischaemic and non-ischaemic CRVO groups.

CONCLUSIONS

More data on broader series need to be obtained in order to decide on the practical use of colour Doppler imaging in the differentiation of ischaemic eyes from non-ischaemic eyes in CRVO.

Preserved human amniotic membrane transplantation in the treatment of primary pterygium

BACKGROUND AND OBJECTIVE

To assess the outcome of simple excision with preserved human amniotic membrane transplantation in the treatment of primary pterygium.

PATIENTS AND METHODS

A total of 59 eyes with primary pterygium underwent surgical excision. In Group 1, 28 eyes were treated with simple excision and preserved human amniotic membrane transplantation. In Group 2, 31 eyes were treated with bare sclera excision. These two groups were compared in recurrence, final appearance of the operation site, and complications. Patients were followed for at least 10 months.

RESULTS

During a mean follow up of 14.9 months, we observed 3 (10.7%) recurrences in Group 1 and 20 (38.7%) recurrences in Group 2 (P:0.03). In Group 1, 20 (71.4%) eyes and 14 (45.2%) eyes in Group 2 had a satisfactory final operation site appearance (P:0.041). No serious complication was observed in both groups.

CONCLUSION

Simple excision and preserved human amniotic membrane transplantation appears to be a safe and effective way of treating primary pterygium because of the lack of serious complications and a relatively low rate of recurrence.

Prevention of posterior capsule opacification by retinoic acid and mitomycin

BACKGROUND

Our aim was to evaluate the effect of an intraoperative single dose of retinoic acid (RA) or mitomycin C (MMC) in preventing posterior capsule opacification (PCO).

METHODS

Twenty-seven rabbits were divided randomly into three groups. RA (250 microg/ml) and MMC (0.04 mg/ml) were given 0.1 ml by hydrosection and 0.9 ml into the capsular bag after phacoemulsification. The third group served as a control group. Three months after intervention PCO was graded clinically. Furthermore, proliferation of lens epithelial cells was evaluated histologically.

RESULTS

Two eyes developed corneal edema in the MMC group. On clinical assessment, RA and MMC were significantly effective in preventing PCO compared with controls (P<0.005). On histological analysis, there was significantly reduced proliferative activity on posterior capsules in the treatment groups, in contrast to multilayer cells in the control group.

CONCLUSION

Intraoperative single-dose administration of RA and MMC significantly prevented the development of PCO in rabbit eyes. The optimal biocompatible dosage must be carefully determined by further investigation.

Prevention of posterior capsule opacification by intraoperative single-dose pharmacologic agents

PURPOSE

To determine whether an intraoperative single dose of dexamethasone, diclofenac, ethylenediaminetetraacetic acid (EDTA), a combination of EDTA and RGD peptide (arginine-glycin-aspartic acid sequence), or mitomycin-C (MMC) is a pharmacological means of preventing or reducing the development of posterior capsule opacification (PCO).

SETTING

Department of Ophthalmology, Celal Bayar University, School of Medicine, Manisa, and Department of Pathology, Dokur Eylül University, School of Medicine, Izmir, Turkey.

METHODS

Fifty-four rabbits were randomly divided into 6 groups. Dexamethasone (4 mg/cc), diclofenac (2.5 mg/cc), EDTA (8 mg/cc), a combination of EDTA and RGD peptide (2.5 mg/cc), or MMC (0.04 mg/cc) was given, 0.1 cc by hydrodissection and 0.9 cc into the capsular bag after phacoemulsification. The sixth group served as a control group. After 3 months, the PCO was graded clinically and the proliferation of lens epithelial cells (LECs) was evaluated histologically.

RESULTS

The drugs were significantly effective in preventing PCO compared with the control (P <.005). Dexamethasone had a weaker effect than the other drugs. In histological analysis, although monolayer LECs in the dexamethasone and diclofenac groups were observed, there was no proliferative activity on the posterior capsules in the EDTA, EDTA+RGD, and MMC groups in contrast to the multilayer cells in the control.

CONCLUSIONS

Intraoperative single-dose application of EDTA, EDTA+RGD peptide combination, and MMC significantly prevented the development of PCO in rabbit eyes. Diclofenac was less effective but also reduced PCO. Although dexamethasone did not prevent the proliferation of LECs, it decreased PCO clinically.

Pseudoexfoliation and glaucoma in eyes with retinal vein occlusion

PURPOSE

To evaluate pseudoexfoliation (PE) and pre-existent glaucoma in eyes with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO).

METHODS

Consecutive eyes with a diagnosis of BRVO (73 eyes of 70 patients) and CRVO (53 eyes of 49 patients) examined between July and December 1998 comprised the study eyes. Age-matched control group consisted of 384 eyes of 192 outpatients. The prevalence of PE and glaucoma were determined and appropriate statistical tests were performed.

RESULTS

PE was present in six of 73 eyes with BRVO (8.2%), 11 of 53 eyes with CRVO (20.8%) and 20 of 384 control eyes (5.2%). Two of 73 eyes with BRVO (2.7%) and 10 of 53 eyes with CRVO (18.9%) had glaucoma. Compared with the control eyes, PE was significantly more common in eyes with CRVO and coexistent glaucoma was significantly more common both in eyes with CRVO and in eyes with BRVO.

CONCLUSION

While glaucoma seems to be a risk factor both for BRVO and CRVO, PE is a likely risk factor for CRVO.

Tilt and decentration after primary and secondary transsclerally sutured posterior chamber intraocular lens implantation

PURPOSE

To evaluate tilt and decentration after primary and secondary implantation of transsclerally sutured posterior chamber intraocular lenses (PC IOLs).

SETTING

Dokuz Eylül University Medical School, Department of Ophthalmology, Izmir, Turkey.

METHODS

Fifty-six consecutive eyes of 53 patients who had implantation of transsclerally sutured PC IOLs were prospectively included in the study. Intraocular lens tilt and decentration after primary (14 eyes) and secondary (42 eyes) implantation were compared quantitatively using Purkinje images.

RESULTS

The mean IOL tilt was 6.09 degrees +/- 3.80 (SD) in all eyes, 5.71 +/- 3.41 degrees in the primary implantation group, and 6.22 +/- 3.94 degrees in the secondary implantation group. The mean IOL decentration was 0.67 +/- 0.43 mm (range 0 to 2.5 mm), 0.59 +/- 0.38 mm, and 0.69 +/- 0.45 mm, respectively. There were no statistically significant differences between the primary and secondary implantation groups in decentration or tilt. Decentration greater than 1.0 mm was present in 7 eyes (16.7%) after secondary implantation and in 1 eye (7.1%) after primary implantation. Tilting of more than 10 degrees was present in 7 eyes (16.7%) and 2 eyes (14.2%), respectively. There were no statistically significant differences between the 2 groups in decentration greater than 1.0 mm (chi square = 0.194, P =.834) or in tilting greater than 10 degrees (chi square = 0.834, P =.659).

CONCLUSIONS

Clinically significant IOL tilt or decentration was rare after transscleral implantation. There were no differences in tilt or decentration between primary and secondary implantation.

Retinal breaks and rhegmatogenous retinal detachment in association with branch retinal vein occlusion

BACKGROUND AND OBJECTIVE

To report the incidence and clinical characteristics of retinal breaks and/or rhegmatogenous retinal detachment (RRD) in patients with branch retinal vein occlusion (BRVO).

PATIENTS AND METHODS

We reviewed the clinical records of 230 eyes of 214 patients with BRVO and identified eyes with retinal breaks and/or RRD. Patients had at least 6 months of follow-up.

RESULTS

Seven of 230 eyes (3%) had retinal breaks and 3 eyes (1.3%) had RRD. One of the eyes with RRD had subclinical retinal detachment. All 7 eyes had ischemic disease documented by fluorescein angiography. Two of 7 eyes had concurrent retinal neovascularization. Four eyes with breaks, but without RRD, and the eye with subclinical RRD were managed by argon green laser. Two eyes with RRD were managed successfully with scleral buckling surgery and postoperative supplemental argon green laser. The mean follow-up period was 14.8 +/- 8.3 months.

CONCLUSIONS

Patients with BRVO should be monitored closely for possible retinal break formation and RRD development.

Pars plana vitrectomy with pars plana tube implantation in eyes with intractable glaucoma

AIMS

Intractable glaucoma is glaucoma resistant to medical therapy and conventional surgical procedures. In this study, a planned surgical technique is discussed for controlling the increased intraocular pressure in selected cases with intractable glaucoma.

METHODS

Total pars plana vitrectomy with pars plana tube implantation was performed in 17 eyes of 17 cases with intractable glaucoma. Patients with neovascular glaucoma were not included in this study. The mean age of these patients (seven men, 10 women) was 44.6 (SD 22.1) years and mean follow up period was 30.3 (15.5) months (range 4-71). Drainage implants with a disc were used in 16 cases, whereas, a tube with scleral buckle (Schocket surgery) was preferred in one case. An intraocular pressure below or equal to 20 mm Hg without any adjunctive medication or with only one type of antiglaucomatous drop was considered as an adequate operative outcome.

RESULTS

16 out of 17 eyes maintained adequate pressure control. Only three out of these 16 eyes required prophylactic antiglaucomatous medications. One patient underwent reoperation for pressure control. The most severe complications observed postoperatively were intravitreal haemorrhage (one case), choroidal detachment (one case), implant failure (one case), total retinal detachment (two cases), and corneal endothelial decompensation (five cases).

CONCLUSION

Pars plana placement of drainage tube following pars plana vitrectomy should be considered as an alternative method for controlling increased intraocular pressures in selected patients with intractable glaucoma.

Axial length and hyperopia in eyes with retinal vein occlusions

We performed a prospective study in order to elucidate the predisposing role of axial length and hyperopia in retinal vein occlusions. The study group comprised 39 patients with unilateral central retinal vein occlusion (CRVO), 50 patients with unilateral branch retinal vein occlusion (BRVO), 13 patients with unilateral hemispheric retinal vein occlusion (HRVO) and 45 control eyes. The axial length of affected eyes was compared to fellow eyes and control eyes in each subgroup of patients with retinal vein occlusion. No statistical difference was noted for any of the subgroups (p > 0.05). Hyperopia was detected in 12 of 39 eyes (31%) with CRVO, 14 of 50 eyes (28%) with BRVO, 4 of 13 eyes (31%) with HRVO and 15 of 45 eyes (33%) in the control group. No statistically significant difference was discovered (p > 0.05). In the light of our study, we believe that axial length and hyperopia may not be risk factors in retinal vein occlusions, in contrast to common belief.

Magnetic resonance imaging in the evaluation of eyes treated with silicone oil

BACKGROUND AND OBJECTIVE

To evaluate the sensitivity of magnetic resonance imaging (MRI) in detecting retinal detachment (RD) in eyes filled with silicone oil, and to determine the MRI characteristics of silicone oil in vivo.

PATIENTS AND METHODS

Seven eyes of seven patients with RD and eight eyes of eight patients without RD after silicone oil surgery were included in the study. All of the patients had clear media. MRI was performed in these patients. The results of ophthalmic examinations were compared with MRI findings.

RESULTS

MRI detected six of the seven detached retinas. The multiplanar imaging capability of MRI helped in showing the RDs in various locations. The chemical shift artifact exaggerated the retinal thickness and made the detached retina visible. Fat suppressed images showed the silicone oil-corneal contact clearly.

CONCLUSION

MRI is an effective technique for demonstrating RD in eyes filled with silicone oil and can be used successfully in eyes with opaque media.

Calcification at the posterior pole in scleritis. A case report

We report a case with unilateral recurrent anterior scleritis which developed sclerochoroidal calcification at the posterior pole without any overt sign of posterior scleritis during the follow-up period of nine years. We believe that subtle posterior scleral inflammation might lead to sclerochoroidal calcification which might be dystrophic in nature.

Bilateral duplication of the optic canals

During an autopsy survey of 369 human skulls, one with bilateral (0.27%) and one with unilateral (0.27%) duplication of the optic canal were reported. The anatomical findings in case of this rare anomaly are presented.

Thallium-201 uptake in the orbits

Thallium-201 uptake patterns in the orbits are not widely known. Diffuse, bilateral orbital localization of TI-201 chloride may be an incidental finding because of orbital muscle or other soft tissue uptake. Differences in orbital blood flow and soft tissue mass may be the cause of the varying uptake intensities in most cases. Focal uptakes, even when bilateral, may indicate specific pathology and should be investigated. Sample cases are presented.

Somatostatin receptors in the orbits

In-111 pentetreotide has been recommended for the detection of somatostatin receptor (SSR) positive tumors. Sites with increased numbers of activated lymphocytes may also show In-111 pentetreotide with Graves' ophthalmopathy (GO) compared to various other orbital disorders. Five patients with GO, three patients with necrotizing scleritis, and two patients with orbital pseudotumor were imaged at 4 hours, 24 hours, and 48 hours after injection of In-111 pentetreotide. Although planar images did not show considerable uptake, SPECT slices showed marked and persistent uptake in the orbits unilaterally in one patient, and bilaterally in three patients with GO. There was no significant correlation between the In-111 pentetreotide activity and the degree of opthalmopathy determined by Werner's classification. Pseudotumors also showed positive uptake. Early uptake was present in one patient with necrotizing scleritis because of Wegener's granulomatosis, and was completely diminished at 24 hours. Octreotide treatment in three patients with GO did not cause any clinical improvement. Although the presence of SSR, either on the infiltrated lymphocytes or on fibroblasts, implies that octreotide treatment for GO can be considered, the results are not encouraging. Nonspecific binding might be present when uptake patterns of orbits and persistence of activity during octreotide treatment are considered.

Nd:YAG laser posterior hyaloidotomy in subhyaloid hemorrhage

Subhyaloid hemorrhage is usually a benign condition that generally improves spontaneously and rarely causes visual loss. However, because subhyaloid hemorrhage may be associated with permanent macular changes before it spontaneously resolves, posterior Nd:YAG hyaloidotomy may be indicated in selected patients. We performed Q-switched Nd:YAG laser posterior hyaloidotomy via the transcorneal route in two cases of subhyaloid hemorrhage. The hemorrhage instantaneously drained into the vitreous cavity, resulting in a dramatic increase in visual acuity.

Restrictive myopic myopathy: computed tomography, magnetic resonance imaging, echography, and histological findings

Images

Improving estimation of corneal refractive power by measuring the posterior curvature of the cornea

We developed a formula to measure the posterior curvature of the cornea. In our study, real corneal power in 51 eyes was calculated by using anterior and posterior curvatures and corneal thickness. The corneal refractive index was found to be a variable value between 1.3243 and 1.3339 (mean 1.3304 +/- 0.0003).

Magnetic resonance imaging and computed tomography in the detection and localization of intraocular foreign bodies

In this experimental study, various foreign bodies were inserted into fresh bovine eyes, in different localizations. Twenty-one magnetic and non-magnetic foreign bodies, dimensions of which varied from 1.5 x 1.5 x 2 mm to 3.5 x 6 x 7 mm, were tried to detect by computed tomography (CT) and magnetic resonance imaging (MRI) scanning. In addition, further dissections were applied to check the ocular damage attributable to movement of the foreign bodies. Ferromagnetic foreign bodies have been shown to move in the eye and the risk of torsional forces being applied to the ferromagnetic foreign body seemed to cause intraocular complications during MRI scanning. All of the foreign bodies that were implanted in bovine eyes were recognized on CT scanning, except intraocular lenses. As a general rule, metallic foreign bodies produced beam-hardening artifacts, but these artifacts did not cause any problem in detecting the localizations of foreign bodies.