Multicenter study of pars plana vitrectomy for optic disc pit maculopathy: MACPIT study

Purpose To evaluate surgical intervention with pars plana vitrectomy (PPV) for correction of optic disc pit maculopathy (ODP-M). Patients and methods Retrospective chart review from 13 centres of 51 eyes of 50 patients with ODP-M who underwent PPV between 2002-2014. Anatomic and final best-corrected visual acuity (BCVA) outcomes were evaluated for all cases with different adjuvant techniques. Results There were 23 males and 27 females with median age 25.5 (6-68) years. Preoperative median foveal thickness was 694.5 (331-1384) mu m and improved to 252.5 (153-1405) mu m. Median BCVA improved from 20/200 (20/20000 to 20/40) to 20/40 (20/2000 to 20/20) with 20/40 or better in 31 eyes. Complete retinal reattachment was achieved in 44 eyes (86.3%) at 7.1 (5.9) months. The good surgical outcomes were achieved in different adjuvant groups. Median follow-up was 24 (6 to 120) months. Conclusions These results confirm the long-term effectiveness of PPV for ODP-M. Prospective studies are needed to determine the effectiveness of any adjuvant technique in improving the success of PPV for ODP-M

Nocturia in sleep-disordered breathing

Background and purpose: Nocturia is a common complaint in sleep-disordered breathing (SDB), but there is no study demonstrating the prevalence and frequency of nocturnal urination in a large number of SDB patients. To determine the prevalence and frequency of nocturnal urination among patients with SDB of different severities and to discover the factors related to nocturia

Nocturnal groaning associated with REM sleep phenomenon

Bilimsel zemin: Nokturnal inleme, uyku sırasında respiratuvar disritminin eşlik ettiği ekspiryumda monoton ses çıkışının olduğu bir sendromdur. Günümüze kadar çok az nokturnal inlemeli olgu bildirilmiştir. Nokturnal inleme epizodlarının prevalansı özellikle REM uykusunda çok yüksektir. Bu nedenle REM uykusuyla ilişkili bir fenomen olduğu kabul edilmektedir. Bazı çalışmalarda, hastaların birkaçında bruksizm ve uykuda yürüme de vardır denmesine rağmen, REM uykusuyla ilişkili uyku fenomenleriyle birlikteliği açısından herhangi bir bilgi bulunmamaktadır. Amaç: 20 yaşında gündüz aşırı uykululuğu olan kadın hastada nokturnal inleme ve REM uyku fenomenlerinden uyku paralizisi ve hipnagojik halüsi-nasyonların birlikteliğini bildirmek ve bu birlikteliğin nedenlerini tartışmak. Gereç ve yöntemler: Nörolojik muayenesi ve kulak-burun-boğaz muayenesi, Epworth uykululuk skalası, tüm-gece polisomnografi tetkiki, multipl uyku latansı testi yapıldı. Sonuçlar: Nokturnal inlemeli olgularda diğer REM uykusuyla ilişkili fenomenlerin birlikte bulunabileceği akla gelmeli ve her nokturnal inlemeli olguda sorgulanmalıdır. Ancak bu sayede, bu birlikteliğin rastlantısal mı yoksa benzer patofizyolojiye mi bağlı geliştiği aydınlatabilecektir.Nocturnal Groaning Associated with REM Sleep Phenomenon Scientific background: Nocturnal groaning is described as a syndrome with expiratory monotonous vocalization associated with a respiratory dysrhythmia during sleep. To date, few cases have been reported. Nocturnal groaning is a predominantly REM sleep-related phenomenon, because a great prevalence for REM sleep-related episodes had been observed. Although in some literature it was told that nocturnal groan­ing was associated with some cases of bruxism and/or sleepwalking, there is no report of nocturnal groaning associated with any other REM related sleep phenomenon. Objective: To report the association of REM related sleep phenome-nons, such as sleep paralysis and hypnagogic hallucinations with noctur­nal groaning in a-twenty-year-old girl with excessive daytime sleepiness and to discuss the causes of this association. Material and methods: Neurological and ear-nose-throat examina­tions, Epworth sleepiness scale, full-night polysomnography and multi­ple latency test were done. Results: The association of nocturnal groaning with the other REM sleep related phenemenons had to be kept in mind and investigated in every patient with nocturnal groaning. By this means, whether the occurence of this association is due to a coincidence or same patho-physiological background could be enlightened

Polysomnographic Findings in A Late Onset Wilson’s Disease Patient

Scientific BACKGROUND: Wilson’s disease (WD) is an autosomal recessive degenerative disorder of copper metabolism. As a degenerative disease affecting many parts of CNS, WD has the potential to disrupt sleep regulatory mechanisms and to cause sleep disturbances like other neurodegenerative diseases. Sleep in WD has not been extensively studied before. OBJECTIVES: A late onset WD patient who applied to our out-patient clinic for sleep related problems has been extensively evaluated with clinical and laboratory measures. MATERIALS-METHODS: We performed three polysomnographic evaluations, one followed by continuous daytime recording. RESULTS: We diagnosed various abnormalities including breathing, circadian rhythm and movement disorders related to sleep. CONCLUSIONS: Sleep disorders in WD might be a major contributor to morbidity and mortalit

Sleep and sleepiness in patients with Parkinson's disease before and after dopaminergic treatment

Sleep disturbances and daytime sleepiness are well-known phenomena in Parkinson's disease (PD). Fifteen previously untreated PD patients underwent clinical evaluation, subjective sleep evaluation and polysomnographic evaluation (PSG) before and after a treatment period of mean 8 +/- 3.1 months with dopaminergic drugs. Both mean Unified Parkinson's Disease Rating Scale (UPDRS) total score and mean subset III of the UPDRS were significantly improved with dopaminergic treatment. PSG revealed that administration of dopaminergic drugs resulted in significant increase in mean percentage of stages 1 and 2. The mean Epworth Sleepiness Scale (ESS) score was significantly increased and mean Multiple Sleep Latency Test (MSLT) score was significantly decreased after dopaminergic treatment indicating subjective and objective daytime sleepiness. The differences in MSLT scores were best explained by a higher dose of L-dopa, whereas other variables such as disease duration, treatment duration, Hoehn and Yahr stage, sleep efficiency index or dopamine agonists did not increase the significance. In contrast, any of the variables appeared to explain ESS score variability. This study demonstrates that daytime sleepiness is not present in untreated patients but emerges later during dopaminergic treatment. Total daily L-dopa dose is predictive of objective daytime sleepiness. Furthermore, subjective assessment of sleepiness may cause underestimation of the severity of daytime sleepiness

A Polysomnographic and Clinical Study of Sleep Disorders in Patients with Behcet and Neuro-Behcet Syndrome

Brainstenn is the most common site of involvement in neuro-Behcet syndrome (NBS). On the other hand, the critical importance of this anatomical region in the regulation of sleep has been disregarded in the literature. We aimed to investigate the microstructure of sleep in patients with Behcet syndrome (BS) and NBS. Patients were allocated to 2 groups: (1) BS without any neurological involvement and (2) NBS with brainstem lesions only. A control group was also enrolled in this study. The comparison of polysomnographic parameters between all patients (BS and NBS) with the control group showed that sleep onset was longer (p = 0.006), the duration of superficial NREM sleep stage (N2) was significantly longer (p = 0.018), and the respiratory disturbance index was significantly higher (p = 0.034) in patients. Sleep apnea and restless legs syndrome are more commonly observed in BS and NBS. Our findings emphasize the importance of questioning the quality of sleep and its disorders in patients with BS in order to better handle the common somatic complaints in these patients, such as fatigue or daytime sleepiness. (C) 2014 S. Karger AG, Base