Visual prognosis and risk factors in patients with uveitis associated with ankylosing spondylitis [Ankilozan spondilit ile ilişkili üveit olgularinin görsel prognozu ve risk faktörleri]

Aim: To examine factors affecting visual prognosis and recurrence in patients having uveitis associated with ankylosing spondylitis (AS). Methods: Thirty-five eyes of 26 patients with uveitis associated with ankylosing spondylitis were evaluated, retrospectively. Clinical and laboratory findings of patients at time of diagnosis possibly affecting visual outcome and recurrence were analyzed. Results: The mean follow-up period was 33.1 ± 32.7 (1-116) months, baseline best corrected visual acuity (BCVA) (logMAR) was 0.33 ± 0.45, final BCVA was 0.22 ± 0.39 (p=0.02). The final BCVA (logMAR) in eyes with baseline legal blindness and cataracts was significantly higher than those without them (p0.05). The positive correlation was also detected between final and baseline BCVA (r = 0.73, p<0.001), while there was no correlation between final BCVA and age of first symptoms, time between AS and uveitis, attack duration, C-reactive protein and erythrocyte sedimentation rate, anterior chamber cell and vitreous hazy levels. When all these factors were examined in terms of recurrence; the recurrence was only affected by gender and it was higher in women than in men (70.6%vs. 33.3%, p=0.028). Conclusion: The final BCVA in patients with uveitis associated with AS was just correlated with the baseline BCVA and influenced by baseline legal blindness and cataract. The recurrence was higher in women than in men. © 2017 Gazi Eye Foundation. All rights reserved

The treatment results of 167 patients with idiopathic macular hole [I•diyopatik maküla deligi olan 167 hastanin tedavi sonuçlari]

Purpose: To evaluate postoperative anatomical and visual results of patients with idiopathic macular hole (IMH). Materials and Methods: In this retrospective study, 167 patients aged between 44-79 years underwent 23 gauge transconjunctival pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling. Phacoemulsification and intraocular lens implantation were performed in 72 cases as additional operations. During the follow-up period, anatomical and functional success and complications were evaluated. Age, symptom duration, preoperative visual acuity, hole diameter and stage, lens status, operation type, paint and internal tamponade used in surgery were the factors, which were evaluated for their effects on anatomical and functional success. Results: The average duration of blurred vision and/or metamorphopsia of cases were 10.0±5.2 months. Twenty-seven (16.2%), eighty-six (51.5%) and fifty-four (32.3%) patients had stage 2, -3, and -4 macular hole, respectively. The closure rate following a single operation was 146/167 (87.4%). Postoperatively visual acuity was increased in 116 eyes (69.5%) while remaining the same in 47 (28.1%) and decreasing in 4 (2.4%) patients. As analyzed by multiple logistic regression model, symptom duration, hole diameter, and used paint were found to be associated with anatomical failure (odds ratios were: 1238, 1014 and 5.079, respectively; all p values, <0.05), symptom duration was detected to be the only factor causing functional failure (odds ratio: 1.082, p=0.15). Conclusion: Pars plana vitrectomy, ILM peeling and the use of intravitreal gas tamponade are standard and successful treatment in IMH surgery and provide satisfactory anatomical and functional results

Bacteriological profile in conjunctival, lacrimal sac, and nasal specimens and conjunctival normalization time following external, endoscopic, and transcanalicular multidiode laser dacryocystorhinostomy

ABSTRACT Purpose: To compare the conjunctival, lacrimal sac, and nasal flora cultures and conjunctival normalization time following external (EX-), endoscopic (EN-), and transcanalicular multidiode laser (TC-) dacryocystorhinostomy (DCR) and to evaluate the relationship between culture positivity and surgical success. We further performed antibiotic sensitivity analyses for lacrimal sac culture samples. Methods: A total of 90 patients with primary acquired nasolacrimal duct obstruction were recruited and divided into EX-DCR (n=32), EN-DCR (n=28), and TC-DCR (n=30) groups. Conjunctival, nasal, and lacrimal sac cultures and antibiograms were analyzed. Results: In all three groups, coagulase-negative Staphylococcus (CNS) was predominantly isolated preoperatively from the conjunctiva, nose, and lacrimal sac and postoperatively from the conjunctiva. Preoperative and postoperative conjunctival culture positivity rates were similar between all the groups (p>0.05). A statistically significant difference in the growth rate of culture in the lacrimal sac was observed between the three groups (p=0.001). CNS and Staphylococcus aureus cultures were predominantly sensitive to linezolid, teicoplanin, tigecycline, vancomycin, and mupirocin. Conjunctival normalization times were similar between the three groups (p>0.05). Anatomical and functional success rates were not found to be significantly correlated with preoperative conjunctival and lacrimal sac culture positivity (p>0.05). Conclusions: Similar rates of preoperative and 1-week postoperative conjunctival culture positivity were observed in all the groups; a significantly lower bacterial growth rate was observed in postoperative conjunctival cultures. CNS was the most commonly isolated organism. Bacterial growth rates in the lacrimal sac samples were significantly higher in the EN-DCR group. Bacterial growth rates obtained preoperatively from the conjunctival and lacrimal sac culture samples were not correlated with DCR success

Assessment of optic nerve head parameters using optical coherence tomography angiography in Behçet Uveitis patients with healthy controls

Purpose: To compare the optical coherence tomography angiography (OCTA) findings of Behçet uveitis (BU) patients with healthy controls and to evaluate their correlation with the best corrected visual acuity (BCVA). Methods: We conducted a thorough ophthalmic examination and OCTA on 20 BU patients and 26 control subjects. Optic nerve head (ONH) flow and non-flow areas, capillary vessel density (CVD) at the optic disc, superficial capillary plexus (SCP) flow and non-flow areas (FAZ), outer retina and choriocapillaris (CC) flow areas, and SCP thickness at the parafoveal region were measured using OCTA. Results: We found significantly lower ONH flow area (1.57±0.17 vs. 1.68±0.08 mm2) and CVD at the optic disc (OD)-centered 4.5x4.5 mm2 area (53.99±4.94 vs. 58.13±1.77%) (p&lt;0.05) but higher ONH non-flow area (0.44±0.23 vs. 0.27±0.10 mm2, p=0.040) in BU patients compared to the controls. There was no significant difference in SCP flow and non-flow areas (FAZ), outer retina and CC flow areas and parafoveal SCP thickness between the two groups (p&gt;0.05). There was a negative correlation between BCVA (logMAR) and the ONH flow area (r= -0.363, p=0.049), SCP flow area (r= -0.703, p&lt;0.001), parafoveal SCP thickness (r= -0.348, p=0.035) and CVD in the OD-centered area (r= -0.644, p=0.002) in BU patients. Conclusion: While there were no micro-vascular changes at the parafoveal region. The CC, ONH-related parameters such as decreased ONH flow area and CVD at the optic disc and increased ONH non-flow area were observed regardless of disease duration and visual acuity in BU patients. © 2020 Gazi Eye Foundation. All rights reserved