Echocardiographic evaluation of diastolic functions in patients with polycystic ovary syndrome: A comperative study of diastolic functions in sub-phenotypes of polycystic ovary syndrome

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder among reproductive-aged women. It is known to be associated with cardiovascular diseases. The aim of this study was to determine and compare the echocardiographic data of patients according to the phenotypes of PCOS. Methods: This study included 113 patients with PCOS and 52 controls. Patients were classified into four potential PCOS phenotypes. Laboratory analyses and echocardiographic measurements were performed. Left ventricular mass was calculated by using Devereux formula and was indexed to body surface area. Results: Phenotype-1 PCOS patients had significantly higher homeostasis model assessment — insu­lin resistance (HOMA-IR) (p = 0.023), free testosterone (p < 0.001), LDL cholesterol levels (p < 0.001) and free androgen index (p < 0.001) compared with the control group. There were significant differences between groups regarding the septal thickness, posterior wall thickness, Left ventricular ejection frac­tion, E/A ratio and left ventricular mass index (for all, p < 0.05). PCOS patients with phenotype 1 and 2 had significantly higher left ventricular mass index than the control group (p < 0.001). In univariate and multivariate analyses, PCOS phenotype, modified Ferriman-Gallwey Score and estradiol were found as variables, which independently could affect the left ventricular mass index. Conclusions: This study showed that women in their twenties who specifically fulfilled criteria for PCOS phenotype-1 according to the Rotterdam criteria, had higher left ventricular mass index and decreased E/A ratio, which might be suggestive of early stage diastolic dysfunction. (Cariol J 2017; 24, 4: 364–373

Effect of intravitreal ranibizumab on serous retinal detachment in branch retinal vein occlusion

Purpose: The aim of this study was to evaluate the effect of initial intravitreal ranibizumab injection on visual acuity (VA) and central macular thickness (CMT) for the treatment of macular edema (ME) with and without serous retinal detachment (SRD) secondary to branch retinal vein occlusion (BRVO). Materials and methods: Fifty-two BRVO eyes, treated with intravitreal ranibizumab injection for ME with and without SRD, were retrospectively reviewed. Patients were divided into two groups according to spectral domain optical coherence tomography (SD-OCT). The efficacy of intravitreal ranibizumab injection at first month was assessed by analyzing the change in best-corrected VA and reduction in CMT with SD-OCT. Results: There were 21 patients with SRD and 31 patients with only CME (no-SRD). CMT was significantly greater in the SRD group than in the CME group (451 +/- 62.2 mu m vs 383.5 +/- 37.2 mu m, respectively, P<0.05). After initial intravitreal ranibizumab injection, mean VA improved from 0.87 +/- 0.26 logarithm of the minimum angle of resolution (LogMAR) to 0.54 +/- 0.27 LogMAR (P<0.01) and CMT decreased from 451 +/- 62.2 mu m to 379.3 +/- 58.6 mu m (P<0.001) in the SRD group. In the no-SRD group, mean VA improved from 0.69 +/- 0.25 LogMAR to 0.44 +/- 0.25 LogMAR (P<0.001) and the CMT decreased from 383.5 +/- 37.2 mu m to 337.7 +/- 39.4 mu m (P<0.001) at the first month visit. Eyes with SRD revealed better anatomic results and greater reduction of CMT after intravitreal ranibizumab injection (P<0.01). Conclusion: VA and CMT can be improved by intravitreal ranibizumab injection in BRVO patients with and without SRD. However, more marked improvement in macular morphology was achieved in patients with SRD than those without SRD

Effects of topical antiglaucomatous medications on central corneal epithelial thickness by anterior segment optical coherence tomography

Purpose: To evaluate the effect of topical antiglaucomatous medications on central corneal epithelial thickness measured by anterior segment optical coherence tomography. Materials and methods: A total of 153 eyes of 153 patients using topical antiglaucomatous medications and 110 eyes of 110 control subjects were enrolled. Glaucoma type, duration of therapy, the number of drugs, and drops/day were noted in the patient group. Patients and control subjects underwent ocular examinations including Schirmer test, slit lamp examination for tear film break-up time, and anterior segment optical coherence tomography for central corneal thickness and central corneal epithelial thickness. Central corneal epithelial thickness and other data were evaluated separately with regard to glaucoma type, duration of therapy, the number of drops, and drugs in the patient group. Results: The mean ages of the patients and controls were 60.1 +/- 10.8 and 58.7 +/- 11.2 years, respectively. The groups were similar with regard to mean age and gender (p = 0.058, p = 0.734, respectively). The median (interquartile range) central corneal thickness was 536 (54) mu m in patients and 552 (53) mu m in controls (p = 0.011). The median (interquartile range) central corneal epithelial thickness of patients and controls were 56 (4) mu m and 60 (8) mu m, respectively (p < 0.001). The median (interquartile range) tear film break-up time and Schirmer were 12 (6) s and 10 (8) mm in patients and 16 (2) s and 18 (4) mm in controls, respectively (p < 0.001, p < 0.001). In patient group, there was no significant difference in the median central corneal thickness, central corneal epithelial thickness, and tear film break-up time in terms of glaucoma type, duration of therapy, the number of drugs, and the number of daily drops. Only the median Schirmer test was found to be statistically lower in terms of number of daily eye drops (p = 0.039). Conclusion: Using topical antiglaucomatous medications seems to affect the central corneal epithelial thickness in glaucoma patients. Central corneal epithelial thickness was thinner in glaucoma patients than controls. Anterior segment optical coherence tomography might be helpful to evaluate the effect of antiglaucomatous medications on central corneal epithelial thickness during treatment

A case of reversible cardiomyopathy associated with acute toluene exposure

Inhalation of toluene-based products is popular among young adults. It has been shown to have a variety of adverse effects on several organs and systems. Although the heart seems to be a sensitive target organ to toluene, cardiotoxicity has often been ignored, especially in cases of acute toluene abuse, with relatively low concentrations. Thereby, routine cardiac examination and echocardiography for cardiotoxicity should be performed in cases of acute toluene exposure, even though there is no cardiovascular sign or symptoms. Keywords: Toluene, Acute cardiac toxicity, Cardiomyopath