The correlation of clinical findings and macular changes detected by optical coherence tomography in patients with uveitis [Üveitlerde optik koherens tomografide tespit edilen maküler degişikliklerin klinik bulgular ile i·lişkisi]

Purpose: To evaluate the optical coherence tomography (OCT) changes in uveitis patients with macular involvement and to investigate the correlation between clinical activation and tomographic features. Material and Method: Patients who have been followed for uveitis in Uvea-Behçet department were enrolled in the study. Patients having any kind of media opacity (cataract, condensation of vitreous, corneal opacity) were excluded. Main outcome measures were visual acuity, macular thickness, and the integrity of the photoreceptor inner and outer segment junction during active and inactive period of the disease. Results: Twenty-six eyes of 19 (7 females, 12 males) patients were included. The patients were classified as having anterior uveitis (2 patients), posterior uveitis (10 patients) and panuveitis (7 patients). The mean macular thickness was 335.38±113.88 µm in active stage and 235.96±48.38 µm in remission phase. This difference was statistically significant (p=0.025). The integrity of photoreceptor inner and outer segment junction was disturbed in 65% of patients with active disease, while in 30.8%, the integrity of this layer was regained during remission. Discussion: OCT provides clinically important information about the changes induced by acute inflammatory episodes. These findings were observed to correlate with clinical features. OCT is a non-invasive technique which may be used for follow-up and for evaluation of the response to treatment of patients with uveitis

The effectiveness of probing for the treatment of congenital nasolacrimal duct obstruction [Dogumsal nazolakrimal kanal tıkanıklıgı tedavisinde sondalama yönteminin etkinligi]

Purpose: To investigate the outcome of probing in patients with congenital nasolacrimal duct obstruction and to evaluate the success rate among age groups. Material and Method: The charts of patients who underwent probing for congenital nasolacrimal duct obstruction between 2008 and 2011 were reviewed. Patients' ages at the time of probing, the presence of watering complaints and epiphora, and fluorescein dye disappearance test results after the procedure were recorded. Findings were evaluated according to age groups. Results: Forty-six patients (24 girls (52.2%), 22 boys (47.8%)) diagnosed as congenital nasolacrimal duct obstruction were included in the study. Probing was performed to the right eye in 13 (28.3%), left eye in 13 (28.3%) and both eyes in 20 (43.4%) patients, i.e. to 66 eyes in total. Age at time of probing was between 18 days and 6 years (average: 23.5 months). Six patients were under 12 months, 26 patients were between 12 and 24 months, and 14 patients were over 24 months. Mean follow-up period was 4.32 (1-24) months. By probing, success was achieved in 48 of 66 eyes (72.72%). According to the age group, success rate of probing was 100% (6 of 6 eyes) in patients under 12 months, while it was 80.95% (34 of 42 eyes) in patients between 12-24 months and 44.44% (8 eyes of 18) in those over 24 months. Discussion: In the first year of life, probing is an effective treatment for congenital nasolacrimal duct obstruction in cases not improving with conservative treatment. As the age increases, the chance of success decreases, thus the application should not be delayed. However, in selected cases with advanced age, it can be recommended prior to invasive treatments

Clinical approach in orbital cellulitis cases: Case series [Orbital Selülit Olgularında Klinik Yaklaşım: Olgu Serisi]

Purpose: To evaluate the etiological factors, diagnosis, follow-up and treatment procedures in cases of orbital cellulitis. Material and Method: A retrospective review was performed on medical records of patients with orbital cellulitis treated between 2009 and 2011 in our clinic. The patients were studied for age, ophthalmologic examination features, laboratory and radiology results, treatment modalities and the response to these treatments. Results: Eleven patients (7 male, 4 female) having an average age of 9.7 years (6 months-25 years) participated in the study. All patients had eyelid oedema, hyperemia and ocular pain; with chemosis in 3, gaze restriction in 6, relative afferent pupillary defect and proptosis in 4 cases. Orbital cellulitis was observed to occur secondary to paranasal sinusitis in 10 patients (90.9%) and 1 patient had only history of superior respiratory tract infection. Sinus infection was localized in ethmoid and maxillary sinuses in all except one case. Laboratory tests showed leukocytosis in 8 patients. Surgical drainage was performed in 7 of 8 patients with abscess formation observed with radiological imaging. The remainder of the patients were followed with sole medical treatment. All patients recovered without any vision loss or life-threatening complication. Discussion: Orbital cellulitis cases must be followed with radiologic imaging for any complication that may occur and patients with abscess should be evaluated for surgical drainage besides antimicrobial treatment