A comparative study of kojic acid cream and hydroquinone in treatment of melasma

چکیده: زمینه و هدف: ملاسما به هیپرپیگمانتاسیون اکتسابی صـورت اطلاق می شـود که به طور عمده در خانم های 55-30 سال دیده می شود که در صورت عدم درمان به موقع، می تواند سبب بروز مشکلات زیبایی در آنان شود. هـدف از این مطالعه، تاثـیر مقایسه ای کرم کوژیک اسید و هیـدروکینون در درمـان ملاسما بود. روش بررسی: این پژوهش به صورت یک کار آزمایی بالینی بر روی 100 نفراز زنان مبتلا به عارضه ملاسمای اپیدرمی، مراجعه کننده به درمانگاه پوست بیمارستان 22 بهمن مشهد انجام شد. تمام واحدهای مورد پژوهش، حداقل دارای دو ضایعه ملاسمایی به صورت قرینه بوده که شدت و وسعت ضایعات دو طرف نیز نسبتاً یکسان بود. برای هر بیمار در طول مطالعه، کرم کوژیک اسید 4 موضعی جهت ضایعه ملاسمایی یک طرف صورت و کرم هیدروکینون 2 برای ضایعه ملاسمایی سمت دیگر صورت، به طور همزمان تجویز شد. در طول 3 ماه مصرف دارو، میزان بهبودی توسط محققین مورد بررسی قرار گرفت و داده ها با استفاده از آزمون آماری غیر پارامتری ویلکاکسون تجزیه و تحلیل گردید. یافته ها: یک ماه پس از مطالعه، 7 به کرم کوژیک اسید و10 به داروی هیدروکینون و دو ماه پس از درمان 24 به کرم کوژیک اسید و 22 به هیدروکینون پاسخ خوب دادند (05/0

Retinal blood flow in patients with primary open angle glaucoma and optic disc hemorrhage

Purpose:To investigate total retinal blood flow (TRBF) and retinal blood flow (RBF) in the superior (S) and the inferior (I) retinal hemifields in patients with primary open angle glaucoma (POAG) both with and without disc hemorrhage (DH). Methods:RBF measurements were obtained from 10 POAG with DH (mean age 71.7, SD=7.39; 9 females)and 10 age matched POAG without DH (mean age 70, SD = 5.27; 6 females) using Doppler SD-OCT (RTVue; Optovue Inc, Fremont, CA, USA) as well as bi-directional laser Doppler flowmetry with densitometry (CLBF-100, Canon, Tokyo, Japan). TRBF measurements were compared between groups, within group for SRBF and IRBF, and for inter-ocular asymmetry (ANOVA; p<0.05). Correlation between TRBF and age, and TRBF and Mean Deviation of Humphrey automated perimetry were also analyzed. Results:Venous TRBF in the POAG with DH group (n=10, 27.1 μl/min, SD 7) was significantly lower than in the age-matched POAG without DH group (n=10, 38.83 μl/min, SD 10.66, p=0.009). RBF was not significantly different between the superior and inferior hemifields for either POAG with DH (p=0.763) or POAG without DH (p=0.481). In the POAG with DH group, venous TRBF was significantly lower in the DH eye (n=8, 28.73 μl/min, SD 6.87) compared to the contralateral eye without DH (n=8, 38.44 μl/min, SD 7.11, p=0.015). There was no significant difference between IOP, MD, BP, HR and MOPP between the POAG with and without DH groups. Also, there was no significant relationship between age or MD index of automated static perimetry with venous TRBF for the POAG with, and without DH group. Conclusions:Venous TRBF was significantly lower in the POAG with DH group compared to both the POAG without DH group and the contralateral eye of the POAG with DH group. There was no within eye asymmetry when comparing SRBF and IRBF either with or without DH, or when comparing the hemifield with DH to that without

Evaluation of the retinal hemodynamics in patients with primary open angle glaucoma and differing nocturnal blood pressure profiles

Purpose: To evaluate the retinal hemodynamic response to normoxic hypercapnia among patients with primary open angle glaucoma (POAG) and differing nocturnal blood pressure (NBP) profiles, using Doppler spectral-domain optical coherence tomography (SD-OCT). Methods: Doppler SD-OCT retinal blood flow (RBF) measurement was acquired using the circum-papillary double circular scan protocol of the RTVue system (Optovue Inc., Freemont, CA). The sample consisted of 17 healthy controls (group mean age 62±7 years; group mean NBP dip 14±8%); 17 POAG with normal NBP dip (age 66±9 years; NBP dip 11±5%), termed “dippers”; and 16 POAG with high NBP dip (age 64±7 years; NBP dip 24±5%), “over-dippers”. The NBP dip magnitude was calculated by taking the difference between mean arterial pressure (MAP) during the day and night while awake and asleep, respectively. Automated gas blender (RespiractTM, Thornhill Research Inc., Toronto) was used to stably provoke normoxic hypercapnia (15% increase in the end-tidal carbon dioxide partial pressure relative to homeostatic baseline). Six Doppler SDOCT RBF scans were acquired, during baseline and also during normoxic hypercapnia. RBF parameters were calculated and ANOVA was used to compare values between groups (p<0.05). Results: Total RBF at baseline was significantly different between the groups with controls being the highest (37.1±4.4mL/min), and over-dippers the lowest (29.6±9.0mL/min). Venous area showed significant differences at baseline between the groups with the lowest value in the over-dipper group, and the highest in the control group (39.9±7.0(x10-3)mm, and 46.6±6.6x(10-3)mm, respectively). Velocity was not significantly different between groups (p=0.27) at baseline. Breathing normoxic hypercapnia provoked an increase in flow that was significantly lower in the over-dipper group (1.0±8.6mL/min) and highest in the controls (8.2±10.8mL/min). Change in velocity was significantly different (p=0.02) between the groups, being highest in the control group (2.4±3.3mm/s) and lowest in the over-dipper group (-0.6±3.1mm/s). Venous area change was not significantly different between groups. Conclusions: Patients with POAG who exhibited an exaggerated nocturnal reduction in MAP also demonstrated lower baseline RBF values and an impeded retinal vascular response to normoxic hypercapnia, indicating greater vascular dysregulation in this group

The relationship between retinal nerve fiber layer thickness and total retinal blood flow in primary open angle glaucoma.

Purpose: To investigate the relationship between Doppler SD-OCT derived retinal blood flow (RBF) and the retinal nerve fiber layer (RNFL) thickness in patients with primary open angle glaucoma (POAG) and healthy age-matched controls. Methods: Thirty three POAG patients (age, 65±8 years; Humphrey Field Analyzer, HFA, mean deviation, MD, -2.28±3.85) and 33 healthy controls (age, 63±5 years; HFA MD -0.48±1.56) were recruited. The Doppler SD-OCT retinal blood flow measurement was taken using the circum-papillary double circular scan protocol in the RTVue system (Optovue Inc., Freemont, CA, USA). A minimum of six RBF scans were acquired. Flow parameters were calculated only from the valid scans. Peri-papillary RNFL thickness was measured using RTVue’s RNFL scan protocol. Results: The total RBF in the POAG group was significantly lower than in the control group (group mean POAG RBF = 30.61±9.29mL/min; group mean control RBF = 40.68±11.32mL/min; p=<0.01). Superior and inferior RBF were also significantly lower in the POAG group (p=<0.01 for both superior & inferior RBF). The average RNFL thickness, superior and inferior RNFL thickness were significantly lower in the POAG group (p=<0.01). Linear regression analysis showed a significant positive correlation between the total RBF and average RNFL thickness (r=0.38, p=0.03), and the superior RBF and superior RNFL thickness (r=0.37, p=0.01). There was no correlation between the inferior RBF and RNFL thickness (r=0.30,p=0.09). Conclusions: There was an association between thinning of the RNFL and reduced inner retinal perfusion in the eyes of patients with POAG

Retinal Blood Flow in Patients with Primary Open Angle Glaucoma and Optic Disc Hemorrhage

Purpose: To investigate venous total retinal blood flow (TRBF) and retinal blood flow (RBF) in the superior and the inferior retinal hemifields in primary open angle glaucoma (POAG) patients with, and without, disc hemorrhage (DH). Methods: RBF measurements were obtained from 10 POAG with DH and 19 POAG without DH using Doppler SD-OCT (RTVue) as well as bi-directional laser Doppler flowmetry (CLBF). Results: RBF was not different between the superior and inferior hemifields for either of the two groups. Venous TRBF in the POAG with DH group was significantly lower than in the age-matched stable POAG without DH group (p=0.009). In the POAG with DH group, venous TRBF was significantly lower in the DH eye compared to contralateral eye without DH (p=0.015). Conclusions: Venous TRBF was significantly lower in the POAG with DH group compared to both the POAG without DH group and the contralateral eye of the POAG with DH group.MAS

The relationship between retinal nerve fibre layer thickness and total retinal blood flow in primary open angle claucoma

Purpose: To investigate the relationship between Doppler SD-OCT derived retinal blood flow (RBF) and the retinal nerve fiber layer (RNFL) thickness in patients with primary open angle glaucoma (POAG) and healthy age-matched controls. Methods: Thirty three POAG patients (age, 65±8 years; Humphrey Field Analyzer, HFA, mean deviation, MD, -2.28±3.85) and 33 healthy controls (age, 63±5 years; HFA MD -0.48±1.56) were recruited. The Doppler SD-OCT retinal blood flow measurement was taken using the circum-papillary double circular scan protocol in the RTVue system (Optovue Inc., Freemont, CA, USA). A minimum of six RBF scans were acquired. Flow parameters were calculated only from the valid scans. Peri-papillary RNFL thickness was measured using RTVue’s RNFL scan protocol. Results: The total RBF in the POAG group was significantly lower than in the control group (group mean POAG RBF = 30.61±9.29µL/min; group mean control RBF = 40.68±11.32µL/min; p=<0.01). Superior and inferior RBF were also significantly lower in the POAG group (p=<0.01 for both superior & inferior RBF). The average RNFL thickness, superior and inferior RNFL thickness were significantly lower in the POAG group (p=<0.01). Linear regression analysis showed a significant positive correlation between the total RBF and average RNFL thickness (r=0.38, p=0.03), and the superior RBF and superior RNFL thickness (r=0.37, p=0.01). There was no correlation between the inferior RBF and RNFL thickness (r=0.30, p=0.09). Conclusions: There was an association between thinning of the RNFL and reduced inner retinal perfusion in the eyes of patients with POAG

Retinal blood flow in patients with primary open angle glaucoma and optic disc hemorrhage.

Purpose: To investigate total retinal blood flow (TRBF) and retinal blood flow (RBF) in the superior (S) and the inferior (I) retinal hemifields in patients with primary open angle glaucoma (POAG) both with and without disc hemorrhage (DH). Methods: RBF measurements were obtained from 10 POAG with DH (mean age 71.7, SD=7.39; 9 females) and 10 age matched POAG without DH (mean age 70, SD = 5.27; 6 females) using Doppler SD-OCT (RTVue; Optovue Inc, Fremont, CA, USA) as well as bi-directional laser Doppler flowmetry with densitometry (CLBF-100, Canon, Tokyo, Japan). TRBF measurements were compared between groups, within group for SRBF and IRBF, and for inter-ocular asymmetry (ANOVA; p<0.05). Correlation between TRBF and age, and TRBF and Mean Deviation of Humphrey automated perimetry were also analyzed. Results: Venous TRBF in the POAG with DH group (n=10, 27.1 µl/min, SD 7) was significantly lower than in the age-matched POAG without DH group (n=10, 38.83 µl/min, SD 10.66, p=0.009). RBF was not significantly different between the superior and inferior hemifields for either POAG with DH (p=0.763) or POAG without DH (p=0.481). In the POAG with DH group, venous TRBF was significantly lower in the DH eye (n=8, 28.73 µl/min, SD 6.87) compared to the contralateral eye without DH (n=8, 38.44 µl/min, SD 7.11, p=0.015). There was no significant difference between IOP, MD, BP, HR and MOPP between the POAG with and without DH groups. Also, there was no significant relationship between age or MD index of automated static perimetry with venous TRBF for the POAG with, and without DH group. Conclusions: Venous TRBF was significantly lower in the POAG with DH group compared to both the POAG without DH group and the contralateral eye of the POAG with DH group. There was no within eye asymmetry when comparing SRBF and IRBF either with or without DH, or when comparing the hemifield with DH to that without