Prescription Errors In Ophthalmology

PubMe

Arginine-Restricted Therapy Resistant Bilateral Macular Edema Associated with Gyrate Atrophy

Introduction. Gyrate atrophy is a rare genetical metabolic disorder affecting vision. Here, we report a 9-year-old boy with gyrate atrophy associated with bilateral macular edema at the time of diagnosis and the effect of long term metabolic control on macular edema. Case Presentation. A 9-year-old boy presented with a complaint of low visual acuity (best corrected visual acuity: 20/80 in both eyes, refractive error: −12.00 D). Dilated fundus examination revealed multiple bilateral, sharply defined, and scalloped chorioretinal atrophy areas in the midperipheral and peripheral zone. Spectral-domain optical coherence tomography revealed bilateral cystoid macular edema in both eyes. Serum ornithine level was high (622 μmol/L). An arginine-restricted diet reduced serum ornithine level (55 μmol/L). However, visual findings including macular edema remained unchanged in 2 years of follow-up. Conclusion. Arginine-restricted diet did not improve macular edema in our patient with gyrate atrophy. A more comprehensive understanding of the underlying factors for macular edema will lead to the development of effective therapies

Ocular surface changes following oral anticholinergic use for overactive bladder

Objective: To investigate the effect of oral solifenacin succinate on Schirmer I test results, tear break-up time (TBUT) and Ocular Surface Disease Index (OSDI) scores in overactive bladder (OAB) patients and to compare these results with those of healthy control subjects.Materials and methods: The female OAB patients who were prescribed oral solifenacin succinate 5mg/day (Group I, N=80) and age-matched healthy female subjects (Group II, N=40) were recruited for the study and underwent ophthalmological examination prior to oral treatment and after 4 weeks. They completed the OSDI questionnaire and underwent ocular surface tests including Schirmer I test and TBUT.Results: The statistical analysis of the Schirmer I test and TBUT revealed no significant difference between the baseline and 4th week values in both groups (Group I, p=0.506 and p=0.070 consecutively) (Group II, p=0.810 and p=0.823 consecutively). OSDI scores were found to be significantly increased in group I (21.84.2 vs 23.1 +/- 4.6, p=0.020) and remained unchanged in group II (20.5 +/- 7.0 vs 20.7 +/- 7.0, p=0.805).Conclusions: Short-term solifenacin succinate treatment has no effect on the Schirmer I test results and TBUT, but ocular surface symptoms appeared to be exacerbated in respect with increased OSDI scores. However, the clinical significance needs to be further evaluated with larger studies

Effects of early and late feed restriction or feed withdrawal on growth performance, ascites and blood constituents of broiler chickens

A study was conducted with male broilers to determine the effects of early and late feed restriction or feed withdrawal. In the experiment five treatments were represented by three replicate floor pens, each containing 20 broilers. The experimental procedure was a completely randomized design. The treatments were ad libitum (AL), 25% (FR-25) and 50% (FR-50) feed-restricted or 8 h (FW-8) and 16 h (FW-16) feed withdrawal regimes, respectively FW-16 regime significantly reduced weight gain to 21 days of age compared to AL or FR-25 regimes (P <0.05). However, the overall weight gains between 9 days and 42 days of age were not significantly affected by the treatments. FW-8 and FW-16 broilers consumed significantly less feed than either AL or FR broilers between 9 and 21 days (P <0.05), however FW-8 and FW-16 broilers had similar feed intake to AL or FR-25 and FR-50 broilers between 9 and 42 days of age. Feed: gain, abdominal fat pad and heart weights, mortality, death due to ascites, and the incidence of leg disorders were unchanged by feeding regimes, although the incidence of ascites in FW-16 was significantly (P <0.05) lower than AL fed broilers. Blood constituents, such as albumin, total cholesterol, ketone bodies, glucose, chlorine, lactate dehydrogenase, alanine aminotransferase and creatine were also significantly affected by feeding regimes (P <0.05)

An overlooked effect of systemic anticholinergics: alteration on accommodation amplitude

AIM: To investigate the effect of oral solifenacin succinate, tolterodine -L -tartarate and oxybutinin hydrochloride (HCl) on accommodation amplitude

The effect of oral solifenacin succinate treatment on intraocular pressure: glaucoma paradox during overactive bladder treatment

Introduction and hypothesis Anticholinergic medication is the mainstay of pharmacotherapy for overactive bladder (OAB). The aim of the study is to investigate the effect of oral solifenacin succinate on intraocular pressure (IOP) in female OAB patients and to discuss the ocular drawbacks during treatment

Intralenticular Sustained-Release Dexamethasone Implant: Is It Still Effective on Macular Edema

Purpose: To report the therapeutic efficacy of an accidentally injected intralenticular sustained-release dexamethasone implant in a patient with macular edema secondary to branch retinal vein occlusion and shortly discuss the management strategy of this rare complication. Methods: Complete ophthalmological examination and optical coherence tomography imaging were performed at each visit. Results: The implant accidentally caused a posterior capsular tear during the procedure and was injected into the crystalline lens because of an involuntary head movement of the patient. Since the anterior segment was normal, and the resultant cataract and implant itself did not obscure the visual axis, the decision was made to observe the patient with intralenticular implant, preserve the therapeutic effect and avoid reinjection. The macular edema resolved within time, while visual acuity did not show significant improvement due to an increase in lens opacification. The patient underwent phacoemulsification surgery at 7 months after the injection with implantation of posterior chamber IOL into the capsular bag. Conclusion: Inadvertent injection of sustained-release intravitreal dexamethasone implant into the crystalline lens is an uncommon but possible complication that is mostly caused by surgeon inexperience, improper technique and uncontrolled head movement during the procedure. Once this complication occurs, early phacoemulsification and repositioning of the implant into the vitreous is the frequently preferred management strategy. However, remarkable decrease in macular edema and visual acuity improvement can also be achieved without an immediate surgical intervention

An analysis of the relationship between ABCC8 and KCNJ11 gene polymorphisms and diabetic retinopathy in Turkish population

Diabetic retinopathy (DR) occurs due to high blood glucose damage to the retina and leads to blindness if left untreated. KATP and related genes (KCNJ11 and ABCC8) play an important role in insulin secretion by glucose-stimulated pancreatic beta cells and the regulation of insulin secretion. KCNJ11 E23K (rs5219), ABCC8–3 C/T (rs1799854), Thr759Thr (rs1801261) and Arg1273Arg (rs1799859) are among the possible related single nucleotide polymorphisms (SNPs). The aim of this study is to find out how DR and these SNPs are associated with one another in the Turkish population. This study included 176 patients with type 2 diabetes mellitus without retinopathy (T2DM-rp), 177 DR patients, and 204 controls. Genomic DNA was extracted from whole blood, and genotypes were determined by the PCR-RFLP method. In the present study, a significant difference was not found between all the groups in terms of Arg1273Arg polymorphism located in the ABCC8 gene. The T allele and the TT genotype in the −3 C/T polymorphism in this gene may have a protective effect in the development of DR (p = 0.036 for the TT genotype; p = 0.034 for T allele) and PDR (p = 0.042 and 0.025 for the TT genotype). The AA genotype showed a significant increase in the DR group compared to T2DM-rp in the KCNJ11 E23K polymorphism (p = 0.046). Consequently, the T allele and TT genotype in the −3 C/T polymorphism of the ABCC8 gene may have a protective marker on the development of DR and PDR, while the AA genotype in the E23K polymorphism of the KCNJ11 gene may be effective in the development of DR in the Turkish population.</p