Evaluation of peripapillary choroidal vascularity index in young smokers

Purpose: This retrospective study aimed to compare the peripapillary choroidal vascularity index (CVI) between young smokers who smoked less than 5 packs/year and non-smokers.Methods: The study included 52 smokers and 67 non-smokers, and comprehensive eye examinations were performed on all participants. Axial lengths (AL) were measured, and peripapillary enhanced depth imaging optical coherence tomography (EDI-OCT) images were obtained and evaluated using the Open Source ImageJ software. The CVI, total choroidal area (TCA), luminal area (LA), stromal area (SA), and retinal nerve fibre layer (RNFL) quadrants were compared between the two groups.Results: The mean age of the smokers was 23.76 ± 1.84 years, and for non-smokers, it was 23.98 ± 2.18 years. The mean peripapillary CVI for smokers was 0.65 ± 0.08, and for non-smokers, it was 0.67 ± 0.03. No statistically significant difference in CVI was observed between the two groups. However, statistically significant differences were found in the temporal inferior (TI), temporal superior (TS), nasal inferior (NI), and nasal superior (NS) quadrants of the RNFL between the two groups (p < 0.05). There was no correlation between the number of packs/year and CVI values in the smoking group (r = 0.031, p = 0.826).Conclusion: The study revealed no significant difference in CVI among young smokers who smoked less than 5 packs/year compared to non-smokers. However, there was a statistically significant decrease in the TI, TS, NI, and NS quadrants of the RNFL in early-age smokers.

Visual evoked potential changes following Botox administration in patients with blepharospasm

PURPOSE

To examine visual evoked potential (VEP) changes following botulinum toxin type A (BTA) administration in patients with blepharospasm.

METHODS

Patients diagnosed with blepharospasm receiving BTA administration were included in the study. Three groups, a control group and two study groups (patients examined 14 days after BTA administration-Study Group 1, and patients examined 28 days after BTA administration-Study Group 2) were evaluated. Dilated fundus examinations were performed following detailed ophthalmological examinations and VEP tests. Keypoint (Dantec, Denmark) and ISCEV criteria were adopted for pattern VEP (PVEP) recording. BTA was applied in the form of local injections at a total 15-30 units, at 2.5-5 units per injection.

RESULTS

A mean 19.4 ± 3.2 units of BTA was used for each eye. N70 (ms), P100 (ms), and P100 (uV) values were statistically significantly lower in both study groups following drug administrations compared to the control group (p < 0.001 for all). Significant positive correlation was observed between increased P100 amplitudes and age in the control group (p = 0.008, r = 0.200). Significant negative correlation was observed between the BTA units used and decreased P100 amplitudes in both study groups 1 and 2 following drug administrations (p = 0.017, r = - 0.180 and p = 0.043, r = - 0.153, respectively).

CONCLUSION

VEP may be an important method in the diagnosis and follow-up of blepharospasm and in determining the success of drug administration and additional therapeutic requirements.

Pattern of oculomotor and visual function in children with hydrocephalus

PURPOSE

To investigate the ocular motility disturbances, optic nerve changes, and refractive errors in children with or without surgically treated hydrocephalus.

METHODS

This retrospective study included 63 subjects diagnosed with hydrocephalus between 2007 and 2019 at the Baskent University Hospital. Full orthoptic and ophthalmic examination and brain magnetic resonance imaging were performed in all subjects.

RESULTS

The mean age of patients was 68.4±27.6 months, and the mean follow-up time was 21.3±5.2 months. Twenty-one (51.2%) patients had esotropia (ET), and 14 (34.1%) had exotropia (XT). Of the patients with ET, 9 (14.2%) had a sixth nerve palsy. Four patients (6.3%) had a fourth nerve palsy, and 1 had a superior rectus palsy. Eleven patients had manifest, and 2 latent, nystagmus. Thirteen (20.6%) patients had optic disc abnormalities. The mean BCVA was 0.4±0.2 (0.05-1.0) in the right eye and 0.5±0.2 (0.1-1.0) in the left eye. Of the 19 (30.1%) patients who had a significant refractive error, 9 (47.3%) had hyperopia. Thirty-six (57.1%) patients had ventriculoperitoneal shunt surgery, and 11 (30.5%) of them had shunt revision due to occlusion. Ocular motility disorders were found to be significantly more common in patients who underwent single shunt surgery and shunt revision than those who had no surgical procedure (P=0.041and P=0.032, respectively).

CONCLUSION

The evaluation of ocular motility disorders and visual dysfunction in hydrocephalic children can be a source of valuable information when diagnosing and following the disease.

Oxidant-Antioxidant Balance in the Aqueous Humor of Patients with Retinal Vein Occlusion

PURPOSE

To analyze oxidative stress parameters in the aqueous humor with retinal vein occlusion.

MATERIALS AND METHODS

A total of 56 patients who underwent cataract surgery were enrolled in this study. The eyes with retinal vein occlusion were included in the study group. Aqueous humor was sampled from all patients and analyzed by an automated measurement method. Total oxidant status (TOS), total antioxidant status (TAS), and oxidative stres index (OSI) were calculated.

RESULTS

OSI was significantly higher in the study group (p = 0.04). TAS was significantly lower (p = 0.01) and OSI was significantly higher (p = 0.01) in cases with both central retinal vein occlusion and macular edema. Previous laser photocoalugation to the retina and the duration of disease had no significant effect on the levels of oxidative stress parameters.

CONCLUSION

OSI was found higher in patients with retinal vein occlusion. This increase is more significant in patients with macular edema and central retinal vein occlusion; in which TAS was also found to decrease.

Angioid streaks in a case of Camurati-Engelmann disease

Camurati-Engelmann disease (CED) is a rare autosomal dominant disease with various phenotypic expressions. The hallmark of the disease is bilateral symmetric diaphyseal hyperostosis of the long bones with progressive involvement of the metaphysis. Ocular manifestations occur rarely and mainly result from bony overgrowth of the orbit and optic canal stenosis. We report a case of CED showing angioid streaks (ASs) in both fundi with no macular involvement and discuss the possible theories of the pathogenesis of AS in this disease.

A novel tool reflecting the role of oxidative stress in the cataracts: thiol/disulfide homeostasis

We investigated serum and aqueous humor thiol/disulfide (T-D) homeostasis in patients with cataracts versus healthy controls. In total, 56 patients with cataracts and 49 healthy controls were enrolled in this case-control study. Serum total thiol (TT), native thiol (NT), and disulfide (DS) concentrations were determined using a novel automated measurement method. Additionally, DS/TT, DS/NT and NT/TT percentage ratios were compared between the groups. In comparison with the control group, serum NT levels and aqueous humor TT and NT levels were significantly lower (p < .05, p < .05 and p < .001, respectively), whereas serum and aqueous humor DS levels were significantly higher in cataract patients (p < .01 and p < .001). DS/TT and DS/NT ratios were significantly higher and the NT/TT ratio was lower in cataract patients in serum (p < .005) and aqueous humor samples (p < .001). In conclusion, serum T-D homeostasis may be useful as biochemical markers, indicating the role of oxidative stress in the development of cataracts. Further studies are needed to confirm the pathophysiological role of T-D homeostasis in cataractogenesis.

Unenhanced respiratory-navigated NATIVE® TrueFISP magnetic resonance angiography in the evaluation of renal arteries: Comparison with contrast-enhanced magnetic resonance angiography

PURPOSE

To compare unenhanced three-dimensional (3D) NATIVE^® true fast imaging with steady-state precession (TrueFISP) magnetic resonance (MR) angiography with the more conventional MR angiography technique obtained after intravenous administration of a gadolinium chelate in the evaluation of renal arteries and their branches in patients with suspected renal artery stenosis.

MATERIALS AND METHODS

A total of 39 patients (25 men, 14 women) with a mean age of 51.4±17.5years (SD) (range: 10-82years) were included in the study. All patients with suspected renal artery stenosis underwent unenhanced 3D NATIVE^® TrueFISP MR angiography and contrast-enhanced MR angiography. The two MR angiography methods were compared by two independent readers for image quality using a four-point scale, diagnostic performance and grading of renal artery stenosis on a total of 78 renal arteries.

RESULTS

For both readers image quality of unenhanced 3D NATIVE^® TrueFISP MR angiography (3.12 to 3.63) was greater than that of contrast-enhanced MR angiography (1.94 to 2.71) for renal artery ostium-trunk and the left renal artery segmental branches. The sensitivity of 3D NATIVE^® TrueFISP MR angiography for the diagnosis of renal artery stenosis was 100% for both readers for the right renal artery and 66% and 80% for the left renal artery for reader 1 and reader 2, respectively. Agreement between 3D NATIVE^® TrueFISP MR angiography and CE-MR angiography was 95% (74/78) for reader 1 and 92% (72/78) for reader 2.

CONCLUSION

Unenhanced NATIVE^® TrueFISP magnetic resonance angiography can play an additional role in the evaluation of renal arteries in patients with hypertension, especially in subjects at risk of nephrogenic systemic fibrosis.

The Choroid and Optical Coherence Tomography

The choroid is the most vascular tissue in the eye and it plays an important role in the pathophysiology of various common chorioretinal diseases such as central serous retinopathy, age-related macular degeneration and degenerative myopia. Quantitative assessment of the choroid has been quite challenging with traditional imaging modalities such as indocyanine green angiography and ultrasonography due to limited resolution and repeatability. With the advent of optical coherence tomography (OCT) technology, detailed visualization of the choroid in vivo is now possible. Measurements of choroidal thickness have also enabled new directions in research to study normal and pathological processes within the choroid. The aim of the present study is to review the current literature on choroidal imaging using OCT.

Chemical peritonitis associated with high dialysate acetaldehyde concentrations

BACKGROUND

During the standard heat sterilization process of lactate-buffered peritoneal dialysis (PD) solutions, glucose degrades to form compounds called glucose degradation products such as acetaldehyde, formaldehyde, or glyoxal. Despite evidence that these products may be responsible for some in vitro cytotoxic effects induced by commercially available PD fluids, data on their acute or chronic effects on the human peritoneum is scarce.

SUBJECTS AND METHODS

This case presentation is based on an observation of 21 aseptic peritonitis cases of unknown aetiology. All cases appeared within one month in a university hospital PD unit that had a peritonitis rate of 1 episode/26 patient months and 55 active patients on CAPD. Acetaldehyde level in the bags was assayed by gas chromatography.

RESULTS

Twenty-one patients presented with signs of peritonitis including cloudy dialysate and abdominal tenderness with additional abdominal pain in 11 patients and vomiting in one. In all cases, cultures and Gram stains were negative for micro-organisms. Fever was not observed in any patient. Average dialysate white blood cell count was 1795/mm(3). All patients were free of intraperitoneal medication when symptoms appeared. Patients were using PD solutions from a newly established domestic production plant. Apparently all patients with symptoms of peritonitis used bags with the same lot number and the solution in the bags appeared to be darker in colour than that in bags with other lot numbers. Chemical analysis of the unused PD solution samples revealed acetaldehyde levels of 17-20 p.p. m. in bags containing darker solution, which is very high compared with the usual acetaldehyde level of 6 p.p.m. in heat-sterilized PD solutions.

CONCLUSIONS

Based on the above findings, we hypothesize that higher levels of acetaldehyde and possibly other glucose degradation products may have been an aetiological factor in these 21 cases of chemical peritonitis. Our observation suggests that acetaldehyde, in concentrations 3-4 times higher than the usual level in commercially available PD solutions, may induce acute sterile peritonitis in CAPD patients.

Effect of cefodizime on peritoneal mononuclear- and polymorphonuclear-cell chemotaxis

In this study, a third-generation cephalosporin with proposed immunomodulatory properties, cefodizime, was investigated to see if it has any effect on the chemotactic activity of human peritoneal monocyte and polymorphonuclear cell populations ex vivo. Ten continuous ambulatory peritoneal dialysis patients with peritonitis were entered in the study. Monocytes and polymorphonuclear cells were isolated from the patients' peritoneal effluent prior to initiation of any antibiotic therapy. Chemotaxis was measured by the Boyden chamber method before and after 2-hour incubation with cefodizime (200 mg/2L). Following 2-hour incubation with 200 mg/2L cefodizime, monocyte chemotaxis was increased from 36.8 +/- 5.6 microns to 50.2 +/- 6.6 microns (P = 0.0005). A similar increase was observed in polymorphonuclear cells from 42.0 +/- 8.8 microns to 48.7 +/- 10.3 microns (P = 0.02). We conclude that cefodizime acts as a priming agent on peritoneal polymorphonuclear cells, particularly on monocytes, and increases their chemotactic movements.