Evaluation of arteriovenous crossing sheathotomy for decompression of branch retinal vein occlusion

Bu çalışma, Eylül 2005 tarihleri arasında Turkey[Antalya]’da düzenlenen Meeting of the Turkish-Ophthalmological-Soceity’da bildiri olarak sunulmuştur.Purpose To report the effects of arteriovenous adventitial sheathotomy on anatomical and functional improvements in patients with macular oedema due to branch retinal vein occlusion (BRVO). Methods Pars plana vitrectomy and arteriovenous sheathotomy was performed on 11 patients with BRVO who had vision loss due to macular oedema. Ten patients with macular oedema due to BRVO and who have been treated with grid laser photocoagulation were included in the control group. The measurement of visual acuity with ETDRS chart was taken preoperatively and at 1, 3, 6, and 9 months follow-up in the study group and at 1, 3, 6, and 9 months after grid laser in the control group. Results The mean preoperative logMAR visual acuity was 0.84 +/- 0.3 in the surgical group and 1.06 +/- 0.4 in the control group. The postoperative mean logMAR visual acuity was 0.41 +/- 0.2, 0.40 +/- 0.2, 0.40 +/- 0.3, and 0.36 +/- 0.3 at 1, 3, 6, and 9 months follow-up, respectively. In the control group the postlaser mean logMAR visual acuity was 0.92 +/- 0.3, 0.87 +/- 0.4, 0.85 +/- 0.3, and 0.82 +/- 0.3 at 1, 3, 6, and 9 months follow-up, respectively. The improvements of visual acuity in both groups were statistically significant when compared to pretreatment (P=0.003 and P=0.007 at 9 months in the study and control group, respectively). Conclusion Arteriovenous sheathotomy for decompression of BRVO in patients who have vision loss due to macular oedema was safe and effective for anatomical and functional improvement and resulted in significantly better visual outcomes than a matched control group of laser-treated eyes.Türk Oftalmoloji Derneğ

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Can fracture healing be accelerated by serum transfer in head trauma cases? An experimental head trauma model in rats

Objectives: In this study, we aimed to investigate whether the positive union effect caused by head trauma could be transferred between individuals.& nbsp; Materials and methods: Seventy-two male rats with an average weight of 375 g were used in this study and divided into four groups including 18 in each group. Group 1 consisted of serum donor rats that were exposed to head trauma, while Group 2 consisted of study rats with long bone fractures that were given the serum obtained from the rats in Group 1, Group 3 included control rats with isolated long bone fractures, and Group 4 included control rats with both head trauma and long bone fractures. For radiological evaluation, the ratio of the width of the callus to the width of the neighboring diaphysis was considered as the callus-todiaphyseal ratio in the study and control groups. Histopathological and radiological evaluations was made on Days 10, 20, and 30.& nbsp; Results: In evaluation of the radiological data regarding the callusto-diaphyseal ratio, Group 3 was found to have significantly lower radiological values than Group 4 on Day 10 (p=0.006). Group 2 had significantly higher values than Group 3 (p=0.02). On Day 20, Group 2 exhibited significantly higher radiological values than Group 3 (p=0.004), but lower than Group 4 (p=0.032). As for Day 30, Group 2 exhibited significantly higher radiological values than Group 3, but lower than Group 4 (p=0.001). In the evaluation of the Huo scores obtained for histopathological evaluation, there was no significant difference among the groups on Days 10, 20, and 30 (p=0.295, p=0.569, and p=0.729, respectively).& nbsp; Conclusion: Our study results suggest that the osteoinductive effect after head trauma can be transmitted between individuals by means of serum transfer

A life-threatening problem occurring in the canalis inguinalis in children: Incarcerated hernia

Amaç: Çocuklarda görülen en sık cerrahi hastalık kasık fıtıklarıdır ve %5-18 oranında boğulma riski taşır. Bu çalışmada bebek ve çocuklarda görülen boğulmuş kasık fıtığının klinik özellikleri incelendi. Hastalar ve Yöntemler: Ocak 1994-Haziran 2006 döneminde boğulmuş kasık fıtığı nedeniyle takip ve tedavi edilen 33 çocuk olgunun (30 erkek, 3 kız; ort. yaş 2; dağılım 20 gün-6 yaş) kayıtları geriye dönük olarak incelendi. Bulgular: Kasıkta şişlik (n=33), kusma (n=19) ve skrotumda krepitasyon (n=10) en sık görülen semptomlardı. Olgulardan 26'sında elle geri itme girişimi başarılı oldu ancak yedi olguda acil cerrahi girişim yapılması gerekti. Fıtık kesesinde en çok sıkışan organ ince bağırsaklardı (n=22). Olgulardan üçünde testis iskemisi, ikisinde ince bağırsak, birinde ise kalın bağırsak iskemisi gelişmişti. Boğulmuş kasık fıtığı nedeniyle iki hasta (%6.0) kaybedildi. Sonuç: Bölgemizde boğulmuş kasık fıtığı olgularının hastaneye getirilmesinin geciktirildiği düşüncesindeyiz. Çocuklarda kasık fıtığı görüldüğünde mümkün olan en kısa zamanda ameliyat edilmelidir. Böylece boğulmuş kasık fıtığının yol açtığı yaşamsal sorunlar ortadan kaldırılmış olacaktır.Objectives: Inguinal hernia is the most common surgical disorder in childhood and is associated with 5-18 % incarceration risk. The clinical features of incarcerated inguinal hernia in infants and children were assessed. Patients and Methods: The medical records of 33 pediatric cases (30 males, 3 females; mean age 2 years; range 20 days-6 years) treated and followed up in our hospital for incarcerated inguinal hernia in the period of January 1994 and June 2006 were retrospectivelye evaluated. Results: The most frequent symptoms were inguinal lump (n=33), vomiting (n=19) and crepitation of the scrotum (n=10). Manual reduction of hernia was successful in 26 cases and 7 of them underwent emergency hernia repair. Small bowel was the most frequent incarcerated organ (n=22). Testicular ischemia developed in 3 patients, partial small bowel ischemia in 2, and colon ischemia in one patient. Two patients (6%) died due to incarcerated inguinal hernia. Conclusion: We think that in our region, cases of incarcerated inguinal hernia are admitted to the hospital with delay. The children with inguinal hernia should be operated as soon as possible. Life-threatening complications of incarcerated inguinal hernia may thus be prevented

Comparative evaluation of apoptotic activity in photoreceptor cells after intravitreal injection of bevacizumab and pegaptanib sodium in rabbits

To evaluate quantitatively the apoptotic activity after intravitreal injections of pegaptanib sodium and bevacizumab in the rabbit retina. METHODS. Different doses of bevacizumab (0.25, 0.625, 1.25, and 2.5 mg) and pegaptanib sodium (0.15, 0.3, and 0.6 mg) were injected intravitreally in 48 rabbits. The eyes were enucleated at different times for early studies at day 14 and for late studies at 3 months after a single injection or at 3 months, with 1 injection in each of the 3 months (day 90). The time course and dose-response of photoreceptor cells in the rabbit retina after intravitreal injection of bevacizumab or pegaptanib sodium were examined by histologic analysis with hematoxylin and eosin (H&E) staining, caspase-3 and -9 immunostaining, and in situ terminal-deoxynucleotidyl transferase-mediated biotin-deoxyuridine triphosphate nick-end labeling (TUNEL) of DNA fragments of paraffin-embedded sections. RESULTS. No sign of retinal toxicity was seen in H&E stained histologic sections of eyes that had received bevacizumab or pegaptanib sodium. Nuclear DNA fragmentation in the outer retinal layers shown by the TUNEL method was evident in the high-dose groups (55.3% with 1.25 mg and 64.5% with 2.5 mg bevacizumab, and 48.5% with 0.6 mg pegaptanib sodium) at 14 days and also in the clinical dose groups (49.8% with three injections [1 each month] of 0.625 mg bevacizumab and 44.3% with 0.15 mg pegaptanib sodium) at 90 days. The ratios of TUNEL-positive cells in physiologic saline and the sham-control groups were 32.3% and 21%, respectively. CONCLUSIONS. Intravitreal injection of bevacizumab and pegaptanib sodium caused a significant increase in apoptotic activity in rabbit photoreceptor cells. However, although bevacizumab caused increasing apoptotic activity at higher doses, similar dose-dependent adverse effects were not evident for pegaptanib sodium.Pfize

Neutrophil-to-Lymphocyte Ratio as a Marker in Patients with Non-arteritic Anterior Ischemic Optic Neuropathy

Background: Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common acute optic neuropathy in patients over the age of 50 and is the second most common cause of permanent optic nerve-related visual loss in adults after glaucoma. Although the precise cause of NAION remains elusive, the etiology of NAION is believed to be multifactorial. Aims: To evaluate the utility of neutrophil-to-lymphocyte ratio (NLR) as a simple and readily available prognostic factor for clinical disease activity in patients with NAION. Study Design: Case-control study. Methods: Forty-five patients with the diagnosis of NAION and 50 age- and sex-matched controls with/without any systemic or ocular diseases except cataract were retrospectively enrolled in the study. Demographic characteristics and laboratory findings including complete blood count of all patients and control subjects were obtained from the electronic medical record. The neutrophil and lymphocyte counts were recorded and the NLR was calculated. Results: White blood cell, neutrophil, NLR and platelet values of the NAION patients were significantly higher than those of the controls (p<0.001, p<0.001, p=0.004, p=0.037, respectively). Initial NLR values were negatively correlated with initial and the third month best corrected visual acuity levels in the study group. The optimum NLR cut-off point for NAION was 1.94. Conclusion: NLR could be considered as a new inflammatory marker for assessment of the severity of inflammation in NAION patients with its quick, cheap, easily measurable property with routine complete blood count analysis

Comparison of Anterior Segment Measurements Obtained by Aladdin Optical Biometer and Sirius Corneal Topography

Objectives: To assess the agreement of anterior segment parameter measurements derived from Aladdin optical biometer using optical low coherence interferometer and Sirius corneal topography using combined Scheimpflug-Placido disk. Materials and Methods: Data obtained using the Aladdin and Sirius systems from 110 eyes of 59 subjects who had no health problems other than refractive errors were retrospectively evaluated. Anterior chamber depth (ACD), flat (K1) and steep (K2) keratometry readings, and white-to-white distance (WTW) measurements taken with both devices were noted. Results: The mean age of the patients was 47.31±18.57 years (range, 25 to 79 years). Mean ACD was 3.35±0.4 mm using Aladdin and 3.42±0.44 mm using Sirius. Mean difference in ACD was 0.075 mm greater with Sirius than Aladdin (p<0.001). K1 measurement obtained by Aladdin was an average of 0.409 D higher (p<0.001). No statistically significant differences were detected between the two devices in respect to K2 and WTW measurements (p=0.18, p=0.85 respectively). Pearson correlation analysis showed high correlation between the two devices for all measurements (r=0.985, 0.895, 0.961 and 0.766 for ACD, K1, K2 and WTW respectively; p<0.001). Conclusion: Anterior segment parameters obtained by Aladdin optical biometer and Sirius anterior segment analysis system correlated well with each other and measurement differences between the devices were clinically negligible except for K1 values

Assessment of Macular Sensitivity and Fixation Stability by MP-1 Microperimetry in Diabetic Macular Edema

Pur po se: To evaluate macular light sensitivity and fixation stability in subjects with clinically significant macular edema (CSME) related to diabetes mellitus. Ma te ri al and Met hod: Thirty eyes of 22 patients with CSME, as defined by Early Treatment Diabetic Retinopathy Study, and 32 eyes of 32 healthy subjects were enrolled in this study. Microperimetry was performed with the Micro Perimeter MP-1 in both groups. The mean retinal sensitivities at central 4°, at central 12° and at central 20° were measured. The mean extent of preferred retinal locus (PRL), fixation stability and fixation location were calculated using fixation test in MP-1 microperimeter. Statistical analysis was performed using student t-test and chisquare test. Re sults: The mean best-corrected visual acuity (BCVA) was significantly lower in the CSME group than the control group (p<0.001). The mean retinal sensitivities at central 4°, 12° and 20° areas were significantly lower in the CSME group compared to the control group (p<0.001, for each central degrees). In subjects with CSME, fixation stability was detected as stable in 8 (26.7%) eyes, relatively unstable in 21 (70%) eyes and unstable in 1 (3.3%) eye. Significant decrease was found in fixation stability and fixation location scores in eyes with CSME compared to control subjects (p<0.001). The difference of mean extent in PRL between the groups was statistically significant (p<0.001). Dis cus si on: The macular light sensitivity and fixation stability are affected in patients with CSME. MP-1 micropeimetry might be helpful to evaluate the extent of PRL and useful for evaluation of severity and progression of diabetic macular edema. (Turk J Ophthalmol 2012; 42: 310-5