Fluorescein Dye Disappearance Test: A Reliable Test in Assessment of Success After Dacryocystorhinostomy Procedure

Purpose: To evaluate the reliability indices of 5-minute fluorescein dye disappearance test (FDDT) for anatomical and subjective successes after dacryocystorhinostomy (DCR) procedure and to propose a paradigm in assessment of patients with tearing after DCR. Methods: In a retrospective study, results of FDDT (176 eyes of 176 patients) were tested against the success rates after both external (135 eyes) and endoscopic endonasal (41 eyes) DCR and bicanalicular silicone intubation. Subjective success was defined as no symptom or intermittent excess tear (without overflow) in cold weather and anatomical success as free passage on irrigation test. Irrigation was performed at the time of tube removal in 58 eyes and at the last follow up in 118 eyes. Fluorescein dye disappearance test and subjective success were assessed either 1 week after tube removal (58 eyes) or at the last follow up (118 eyes). Grades 0 and 1 were considered as negative FDDT, and grades 2 and 3 as positive FDDT. Results: Included patients who had primary acquired (94.9) and traumatic (5.1) nasolacrimal duct obstruction had a mean age of 49.8 years and a mean follow up of 11.7 months. There were 15 cases with previously failed DCR. The mean time of tube removal was 7.2 weeks (SD = 2.2). Final anatomical and subjective success rates were 95.5 (168/176) and 92 (162/176), respectively. Fluorescein dye disappearance test showed a sensitivity of 100 and a specificity of 86.3 for the anatomical success. They were 85.7 and 88.2 for the subjective success, accordingly. Conclusions: All anatomically failed DCR showed a positive FDDT (100 sensitivity) in this series. The proposed paradigm offers a less invasive approach to post-DCR epiphora. Copyright © 2015 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc

Evaluation of the Methanol Extract of Yazd Native Plants on Peripheral Blood Mononuclear Cell Proliferation and IL-4 Secretion

Introduction: Echinops ilicifolius, Echinops jesdianus, Echinops ceratophorus and Echinops lasiolepis are defined as native plants of Yazd that their immunomedulatory effects have not been studied yet. The aim of this study was to determine the effect of different concentrations of these plants on peripheral blood mononuclear cells(PBMCs) proliferation and interleukin(IL)-4 secretions. methods: Root extracts of Echinops ilicifolius, Echinops jesdianus, Echinops ceratophorus and Echinops lasiolepis were prepared by Maceration method. PBMCs were obtained from three healthy volunteer individuals and cultured with the presence of 0.1,1,10,100 and 200 µg/ml with concentrations of 10 µg/ml of phytohemagglutinin. The rate of cell proliferation was determined by BrdU kit. The IL-4 levels in PBMCs. supernatant were measured by enzyme-linked immunosorbent assay(ELISA). P value<0.05 was considered significant. Results: The different concentrations of root extracts of all plants showed inhibitory effect on PBMCs. There was a significant difference among Echinops lasiolepis extracts in different concentrations(p=0.045). The levels of IL-4 were similar in super natant in control group and different concentrations and the control groups. Conclusions: The results showed that root extracts of Echinops species had inhibitory effect on PBMCs proliferation and in some species with decrease in IL-4 secretion might have immunomedulatory effects. The effect of Echinops extract fractions on PBMC is suggested

Color Doppler imaging of orbital vasculature before and after orbital decompression in thyroid eye disease

Purpose: To measure alterations in orbital blood flow parameters using color Doppler imaging (CDI) before and after orbital decompression in patients with moderate to severe thyroid eye disease (TED). Methods: Resistance index (RI) and maximum and minimum velocity of ophthalmic artery (OA), superior ophthalmic vein (SOV), and central retinal artery (CRA) of 24 eyes (14 patients) with TED were measured before and at least 3 months after cosmetic orbital decompression procedure (single or double walls) using CDI. Complete eye examination was performed to define the severity (EUGOGO classification) and activity (clinical activity score) of TED. Results: Median OA (p = 0.003) and CRA (p = 0.001) resistance indices were significantly reduced postoperatively. Significant differences were found in maximum (p = 0.001) and minimum (p = 0.014) velocity of SOV before and after surgery. While a significant decrease in exophthalmometry was observed after the orbital decompression (p = 0.031), intraocular pressure changes were not significant (p = 0.182). Conclusion: Orbital decompression procedure led to a significant reduction of RI in both CRA and OA in patients with TED. © 2018, © 2018 Taylor & Francis