Comparison of the effectiveness and ocular tolerability of the medicine therapies of topical fixed combinations in the primary open-angle glaucoma

Primer açık açılı glokom (PAAG) kronik, bilateral, sıklıkla asimetrik bir optik nöropatidir. PAAG, açık ön kamara açısı ve yüksek (>21 mmHg) göz içi basıncı (GİB) ile seyreden, optik sinir liflerinde edinsel kayba ve görme alanında anormalliklere neden olan bir hastalıktır. Çalışmamızın amacı; şu an ülkemizde glokom tedavisinde kullanılmakta olan sabit kombine göz damlalarının GİB üzerine etkilerinin ve oküler tolerabilitelerinin kıyaslanmasıydı. Çalışmamıza 58 hasta (106 göz) dahil edildi. Hastalar uygulanan sabit kombine göz damlalarına göre gruplandırıldı [grup 1 (brimonide tartrate 0,2% / timolol maleate 0,5%), grup 2 (dorzolamid hidroklorür 0,2% / timolol maleat 0,5%), grup 3 (latanoprost 0,005% / timolol maleat 0,5%)]. Yaş ortalaması, cinsiyet, hasta sayısı ve MKK ölçümleri bakımından üç grup arasında anlamlı fark saptanmadı (p>0,05). Her üç grupta, hastaların çalışmaya dahil edilmeden önceki (saat 10:30' da elde edilen iki GİB ölçümünün ortalaması) GİB ortalamaları arasında istatistiki olarak fark saptanmadı (p>0,05). Başlangıçta ve 2. ayda elde edilen gün içi tüm GİB ortalamaları, 2. ayda elde edilen GİB düşüş miktarları üç grup arasında istatistiki anlamda benzer bulundu (p>0,05). Her üç grupta da 2. ayda elde edilen GİB ortalamaları, başlangıçta elde edilen GİB ortalamalarına göre istatistiksel olarak ileri düzeyde anlamlı düşüş gösterdi (p0,05). Her üç grup için hesaplanan yan etki skor ortalamaları istatistiksel açıdan benzer bulundu (p>0,05). Sonuç olarak çalışmamızda GİB düzeyinin her üç ilaç ile de istenilen seviyelere gerilediği görüldü. Her üç ilacın GİB üzerine etkileri benzer olarak değerlendirildi. Her üç tedavi grubunda da yan etkiler tolere edilebilir düzeydeydi.Primary Open-Angle Glaucoma (POAG) is an optical neuropathy which is chronic, bilateral and frequently asymmetric. POAG is a disease that causes to acquired loss in the optical nerve fibers and abnormalities in the field of vision with open angle of anteior chamber and high (>21 mmHg) intraocular pressure (IOP). Aim of our study was to compare the effects of fixed combined eye drops, which are currently in use for glaucoma therapy in our country, on IOP and their ocular tolerabilities. Fifty eight patients (106 eyes) were included into our study. Patients were grouped according to their applied fixed combined eye drops [group 1 (brimonide tartrate 0,2% / timolol maleate 0,5%), group 2 (dorzolamid hydrochloride 0,2% / timolol maleate 0,5%), group 3 (latanoprost 0,005% / timolol maleate 0,5%)]. No significant difference was found among the three groups in terms of average age, sex, number of patients and central corneal thickness measures (p>0,05). There is no statistical difference found among the IOP averages of the three groups of patients before they were involved into the study (average of the two IOP measures which were taken at 10:30) (p>0,05). All IOP averages which were obtained at all hours at the beginning and in the second month and IOP decrease amounts which were obtained in the second month, were all found to be similar in statistical terms (p>0,05). Decrease in the IOP which was obtained in the second month was regarded to be significant in statistical terms for each of the three groups (p0,05). Averages of the side effect scores which were calculated for each of the three groups were found to be similar in statistical terms (p>0,05). As a conclusion, it was seen in our study that IOP level regressed to the desired levels with any of these three medicines. Effects of the each three medicines on IOP were evaluated to be similar. In each of the three treatment groups, side effects were within a tolerable range

Vitamin B12 deficiency evaluation and treatment in severe dry eye disease with neuropathic ocular pain

OZER, MURAT ATABEY/0000-0003-1807-6911WOS: 000401437600016PubMed: 28299439This study aims to understand the effect of vitamin B12 deficiency on neuropathic ocular pain (NOP) and symptoms in patients with dry eye disease (DED). Patients with severe DED (without receiving topical artificial tears treatment) and ocular pain were enrolled (n = 90). Patients with severe DED and vitamin B12 deficiency (group 1, n = 45) received parenteral vitamin B12 supplement + topical treatment (artificial tears treatment + cyclosporine), and patients with severe DED and normal serum vitamin B12 level (group 2, n = 45) received only topical treatment (artificial tears treatment + cyclosporine). Patients were evaluated by the ocular surface disease index (OSDI) questionnaire, 3rd question (have you experienced painful or sore eyes during last week?) score of OSDI as a pain determiner and pain frequency measure), tear break up time (TBUT), and Schirmer's type 1 test. We compared the groups' OSDI, TBUT, and Schirmer's test recordings at the first visit and after 12 weeks retrospectively. The OSDI score, 3rd OSDI question score, TBUT, and Schirmer's test results improved after 12 weeks (p < 0.001 for each group). The mean vitamin B12 level at enrollment was 144.24 +/- 43.36 pg/ml in group 1 and 417.53 +/- 87.22 pg/ml in group 2. The mean vitamin B12 level in group 1 reached to 450 +/- 60.563 pg/ml after 12 weeks of treatment. The mean score changes between the groups were not statistically significant; however, the decrease in the OSDI questionnaire score (-30.80 +/- 5.24) and 3rd OSDI question score (-2.82 +/- 0.53) were remarkable in group 1 (Table 2). The mean TBUT increase was +7.98 +/- 2.90 s and Schirmer's test result increase was +12.16 +/- 2.01 mm in group 1. The mean TBUT increase was +6.18 +/- 1.49 s and Schirmer's test result increase was +6.71 +/- 1.47 mm in group 2. These findings indicate that vitamin B12 deficiency is related with NOP. It may be important to consider measuring the serum vitamin B12 level in patients with severe DED presenting with resistant ocular pain despite taking topical treatment

The effects of intravitreal H2S application on apoptosis in the retina and cornea in experimental glaucoma model

Erisgin, Zuleyha/0000-0003-3523-6542; ozen, serkan/0000-0002-5166-6801WOS: 000498850600001PubMed: 31777145One of the most important causes of visual loss (blindness) is glaucoma, which occurs due to the degeneration of the ganglion cells in retina. It has been shown that hydrogen sulphide (H2S) acts an antioxidant, neuroprotective and neuromodulator and provides protection against oxidative stress and apoptosis. This study aims to examine through which apoptotic pathway H2S acts in experimental glaucoma model. Twenty-two male wistar albino rats were used in this study. Group 1 (n = 6, control group): Intravitreal saline was given in the third week without inducing ocular hypertension (OHT) with laser photocoagulation. Group 2 (n = 8): After the induction of OHT with laser photocoagulation, intravitreal saline was given in the third week. Group 3 (n = 8): After the induction of OHT with laser photocoagulation, intravitreal H2S's donor sodium hydrosulphide (NaSH) 100 nmol/L was given in the third week. At the end of the 6th week, the eyes of the rats were sacrified under anaesthesia and extracted and then routine tissue follow-up was undertaken. Besides haematoxylin & eosin (H&E) staining, Bax, Bcl-2, p53 and caspase-3 activation were examined immunohistochemically in the retina and the cornea. This showed that ocular hypertension caused apoptosis through the intrinsic pathway, due to Bax and caspase-3 activation, in both retina and cornea, and that this led to DNA damage due to p53 activation. Also, we found that H2S exposure in glaucoma distinctly suppressed Bax, caspase-3 and p53 activations in retina but that it has a limited effect on the cornea. According to these results, glaucoma caused apoptosis in the retina through intrinsic pathway, and the damage to the retina could be compensated partially by H2S but would have limited on the cornea

Results of dexamethasone implant in the treatment of retinal vein occlussion related macular edema

Amaç: Retina ven oklüzyonu ile ilişkili maküler ödem tedavisinde deksametazon implantın 1 yıllık sonuçlarını değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu retrospektif gözlemsel çalışmada santral retina ven oklüzyonu ve retina ven dal oklüzyonu ile ilişkili maküler ödemde hastanemize başvurmuş ve deksametazon implant tedavisi uygulanmış 47 hastanın (47 göz) dosyaları tarandı. Dosyalardan en iyi düzeltilmiş görme keskinliği, optik koherans tomografi ve göz içi basıncı ölçümü kayıtları retrospektif olarak başlangıç, 4,8,12,24,36 ve 48. haftalardaki vizitlerden temin edildi. Bulgular: Ortalama görme keskinliği (logMAR) 0,230,11 seviyesinden 0,640,18 seviyesine artış göstermiş ve 48. haftada bu değer 0,55 0,17 olarak kaydedilmiştir (p0,001). Ortalama santral maküler kalınlık değeri ilk ve 48. hafta vizitinde sırası ile 507,724,9 µm, 251,8 25,5 µm olarak tespit edilmiştir (p0,001). Başlangıçtaki ortalama göz içi basıncı 14,9 2,7, 24. haftada 15,3 3,3 ve 48. haftada 15,6 3,1mmHg olarak bulunuştur. İlk vizit ile diğer vizitler arası göz içi basıncı ölçüm değerleri arasında istatistiksel anlamlı fark bulunamamıştır(p0,05) Fakik olan ve olmayan hastalar ayrı ayrı değerlendirildiğinde görme keskinliği ortalamalarında 12. haftadan sonra fakik olmayangrup lehine fark saptanmıştır (p0,001).Sonuç: Klinik pratikte deksametazon implant uygulaması santral retina ven oklüzyonu ve retina ven dal oklüzyonu ile ilişkili maküler ödemde hem görme keskinliği hem de santral maküler kalınlıkta etkili bir düzelme sağlamıştır. Ayrıca deksametazon implant tolere edilebilir ve kabul edilebilir bir güvenlik profiline sahiptir.Objective: To evaluate one year results of dexamethasone implants in the treatment of macular edema related to retinal vein occlusion. Material and Method: This retrospective, observational study conducted in our hospital enrolled 47 patiens (47 eyes) diagnosed with macular edema following branch retinal vein occlusion or central retinal vein occlusion who were given dexamethasone implant. Patients were evaluated by the best corrected visual acuity, optical cohorens tomograph and intraocular pressure recordings at the first, 4,8,12,24,36 and 48th week visits retrospectively. Results: The mean best corrected visual acuity (logMAR) level increased from 0.23±0.11 to 0.64±0.18 in the 8th week and was enrolled 0.55±0.17 in the 48th week (p 0.05). When the phakic and nonphakic patients were evaluated separately, there was a difference in favor of the nonphakic group on the mean of best corrected visual acuity after the 12th week (p <0.001). Conclusion: Dexamethasone implant was effective in improving best corrected visual acuity and central macular thickness in patients with branch retinal vein occlusion and central retinal vein occlusion in clinical practice. dexamethasone implant was well tolerated and had an acceptable safety profile

Evaluation of the optic nerve and scleral-choroidal-retinal layer with ultrasound elastography in glaucoma and physiological optic nerve head cupping

WOS: 000436419100013PubMed: 29400372Aim: To evaluate the strain ratio of the optic nerve and retina-choroid-sclera (RCS) layers in individuals with physiological optic disc cupping (PC) and glaucoma patients using strain elastography. Material and methods: We evaluated 56 eyes of 56 subjects (20 eyes with glaucoma, 19 eyes with PC, and 17 normal eyes). The strain ratio of orbital fat to optic nerve (SROFON) was calculated as the ratio of the optic nerve to intraconal fat tissue and the strain ratio of orbital fat to retina-choroid-sclera (SROFRCS) was calculated as the ratio of RCS layers to intraconal fat tissue. Results: SROFON was 0.92 in the control group, 1.07 in the PC group and 1.6 in the glaucoma group and a statistically significant difference was present between the three groups (p<0.05). SROFRCS had no statistically significant difference between the three groups. Conclusions: SROFON values could contribute to the differentiation of the patients with glaucoma and PC

Evaluation of the effects of selective laser trabeculoplasty on anterior segment parameters by anterior segment optical coherence tomography

WOS: 000495711900001PubMed: 31713002To prospectively examine the effects of selective laser trabeculoplasty (SLT) on the anterior chamber angle (ACA) and its related parameters using anterior segment-optic coherence tomography (AS-OCT). Fifty eyes of 50 patients with primary open angle glaucoma (POAG) and ocular hypertension were included in the study. AS-OCT was performed before SLT application, immediately after and at 1 day and 1 month. Intraocular pressure (IOP), central corneal thickness (CCT) and anterior chamber depth (ACD) were also recorded and evaluated. No statistically significant difference was determined in ACA and other AS-OCT parameters (AOD, angle opening distance at 500 and 750 mm; TISA, trabecular-iris space area at 500 and 750 mm) before and 1 day after SLT application (p > 0.05). However, a statistically significant increase was determined in both the temporal and nasal ACA, AOD and TISA values between the baseline and day 30 (p 0.05). SLT resulted in an increase in ACA, AOD and TISA when evaluated using AS-OCT. We think that this study provides a different perspective concerning the effects of SLT in the angle region and the involved mechanism

Evaluation of the effects of selective laser trabeculoplasty on anterior segment parameters by anterior segment optical coherence tomography

WOS: 000495711900001PubMed: 31713002To prospectively examine the effects of selective laser trabeculoplasty (SLT) on the anterior chamber angle (ACA) and its related parameters using anterior segment-optic coherence tomography (AS-OCT). Fifty eyes of 50 patients with primary open angle glaucoma (POAG) and ocular hypertension were included in the study. AS-OCT was performed before SLT application, immediately after and at 1 day and 1 month. Intraocular pressure (IOP), central corneal thickness (CCT) and anterior chamber depth (ACD) were also recorded and evaluated. No statistically significant difference was determined in ACA and other AS-OCT parameters (AOD, angle opening distance at 500 and 750 mm; TISA, trabecular-iris space area at 500 and 750 mm) before and 1 day after SLT application (p > 0.05). However, a statistically significant increase was determined in both the temporal and nasal ACA, AOD and TISA values between the baseline and day 30 (p 0.05). SLT resulted in an increase in ACA, AOD and TISA when evaluated using AS-OCT. We think that this study provides a different perspective concerning the effects of SLT in the angle region and the involved mechanism

The evaluation of retinal and choroidal structural changes by optical coherence tomography in patients with chronic obstructive pulmonary disease

gok, mustafa/0000-0002-7660-6557; yildirim, berna botan/0000-0001-7730-1379WOS: 000427324100016PubMed: 28956644Purpose: To evaluate the retinal nerve fiber layer (RNFL) thickness, ganglion cell-inner plexiform layer (GCL+) thickness, and macular choroidal thickness (mCT) in patients with chronic obstructive pulmonary disease (COPD) using spectral domain optical coherence tomography (SD-OCT). Methods: A total of 79 COPD patients and 71 age-and sex-matched healthy individuals were enrolled in this prospective cross-sectional study. The patients were divided into two subgroups (with mild-to-moderate COPD and severe COPD) using spirometric data suggested by the Global Initiative for Chronic Obstructive Lung Disease guideline. The RNFL, GCL+, and mCT were compared between groups. Results: The average and nasal RNFL thicknesses in the COPD group were significantly lower than those in control group (p = 0.023 and 0.027 respectively). Statistically significant reductions in average thickness and in those of all six wedge-shaped GCL+ sectors were evident in the COPD group compared with control group and were more marked in patients with severe COPD. The other RNFL data did not differ significantly between COPD and control groups. The mCT was somewhat thinner at all the measured locations in COPD group compared with control group, but statistically significance was not attained. Conclusions: The study results revealed significant average, nasal RNFL, global GCL+ loss, and a nonsignificant choroidal thinning in patients with COPD compared to healthy subjects. The eye seems to be one of the affected tissues during the natural course of the COPD

İndapamid Kullanımına Bağlı Geçici Miyopi, Koroid Kalınlaşması ve Açı Kapanması: Bir Olgu Sunumu

Sulphonamide-derived drugs may cause morphological changes in the ciliary body and uveal tract. Ciliary body swelling and cilio-cho-roidal effusion associated with indapamide (a sulfa-derivative diuretic, antihypertensive agent) intake have been demonstrated throughultrasound biomicroscopy (UBM) and classic ultrasonography previously. A 52-year-old male patient suffering from acute blurredvision and a dull eye pain referred to the ophthalmology clinic. The indapamide (1.5 mg tablet once a day) was prescribed to the patienttwo weeks before for essential hypertension. Bilateral signifi cant myopic shift and intraocular pressure (IOP) elevation were determinedat the initial examination. Anterior segment and enhanced depth imaging optical coherence tomography (EDI-OCT) scans revealedshallow anterior chamber, angle closure and choroidal thickening. This case is the third presentation with bilateral angle closure andincrease in intraocular pressure (IOP) due to indapamide use and fi rst one demonstrating choroidal thickening via EDI-OCT as a novelfollow-up instrument.Sülfonamid türevi ilaçlar siliyer cisim ve uveada yapısal değişikliklere neden olabilmektedir. İndapamid (sülfonamid türevi bir diüretik,antihipertansif ajan) alımıyla ilişkili siliyer cisim ödemi ve siliokoroidal efüzyon, daha önce ultrasonik biyomikroskopi (UBM) ve kla-sik ultrasonografi ile gösterilmiştir. Bu olgu sunumunda; 52 yaşında erkek hasta akut bulanık görme ve künt göz ağrısı şikâyetiyle kli-niğimize başvurdu. Hastanın ayrıntılı anemnezinde esansiyel hipertansiyon nedeniyle 2 haftadır günde bir kez 1,5 mg tablet İndapamidkullanıyor olduğu öğrenildi. İlk oküler değerlendirme neticesinde hastada her iki gözde belirgin miyopik refraktif kayma ve göz içibasıncında (GİB) artış saptandı. Ön segment ve EDI optik koherens tomografi (OKT) görüntülemeleri sonucunda belirgin sığ ön ka-mara, irido-korneal açı kapanması ve koroidal kalınlaşma tespit edildi. Bu olgu literatürdeki, indapamid kullanımına bağlı bilateralirido-korneal açı kapanması ve göz içi basıncı artışı ile seyreden üçüncü olgu sunumu olmakla beraber, koroidal kalınlaşmanın EDI-OKT yardımıyla gösterildiği ilk olgudur

Effects of intravitreous sodium hydrosulfide on intraocular pressure and retinopathy in ocular hypertensive rats

Erisgin, Zuleyha/0000-0003-3523-6542WOS: 000432534800002PubMed: 29215307We investigated the possible neuroprotectant and intraocular pressure (TOP) lowering effects of intravitreous injection of sodium hydrosulfide (NaSH) in a rodent model of experimental glaucoma. Glaucoma currently is treated by controlling TOP using medications and/or surgery. These methods are not entirely adequate for all patients. We divided 24 rats into three groups. For the control group, the right eye was treated with intravitreous saline. For the glaucoma group, ocular hypertension was induced by photocoagulating three episcleral veins and the limbal plexus of the right eye using an argon laser, then saline was injected into the vitreous of these eyes during the third week. For the NaSH group, rats were treated with intravenous NaSH 3 weeks after photocoagulation. IOP was measured each week during the 6 week experimental period. Coagulating the episcleral veins rapidly increased the IOP of rat eyes. Intravitreous injection of NaSH significantly reduced IOP. Intravitreous NaSH prevented degeneration of the retina and decreased the number of apoptotic cells. Intravitreous NaSH appeared to reduce IOP and to prevent IOP induced retinopathy in rats