Choroidal thickness in patients with fibromyalgia and correlation with disease severity

Purpose: To evaluate and compare choroidal thickness in patients with fibromyalgia (FM) and healthy controls. Methods: In this prospective, cross-sectional study, forty eyes of 40 patients with FM and 40 eyes of 40 age- and sex-matched healthy subjects were enrolled. FM was diagnosed according to the American College of Rheumatology criteria. The choroidal thickness measurements of the subjects were obtained using spectral-domain optical coherence tomography (RTVue-100, Optovue). Widespread pain index (WPI), symptom severity scale (SSS), and fibromyalgia impact questionnaire (FIQ) scores were recorded. The choroidal thickness measurements of the groups were compared, and correlations among the WPI, SSS, and FIQ scores and these measurements were calculated. Results: Choroidal thicknesses at 1500 μm nasally were 198.5 ± 46.7 μm and 306.3 ± 85.4 μm; at 1000 μm nasally were 211.7 ± 50.2 μm and 310.05 ± 87.26 μm; at 500 μm nasally were 216 ± 55.05 μm and 311.5 ± 83.4 μm; at subfoveal region were 230.9 ± 58.4 μm and 332.4 ± 91.3 μm; at 500 μm temporally 227.5 ± 58.1 μm and 318.15 ± 92.3 μm; at 1000 μm temporally 224.5 ± 57.07 μm and 315.1 ± 84.2 μm; at 1500 μm temporally 212.5 ± 56.08 μm and 312.9 ± 87.8 μm in the FM and control groups, respectively (P < 0.001). Choroidal thicknesses were thinner at all measurement location, except temporal 1000 and 1500 in patients with FIQ score ≥50 than in FIQ score <50. Conclusion: The results of this study demonstrated that choroidal thickness decreases in patients with FM and correlated with disease activity. This choroidal changes might be related with the alterations in autonomic nervous system functioning. Further studies are needed to evaluate the etiopathologic relationship between choroidal thickness and FM

Prevalence and associated factors of external punctal stenosis among elderly patients in Turkey

Purpose: To estimate the prevalence of external punctal stenosis (EPS) in the elderly population and investigate associated factors. Methods: A total of 278 patients >= 65 years of age were evaluated for evidence of EPS from January to July 2016. Associated systemic, ocular, demographic, and lifestyle factors were investigated. Multiple logistic regression analyses were applied to evaluate the factors related to having EPS. P values <0.05 were considered statistically significant. Results: The prevalence of EPS in this study population was 63.3%, with a mean age of 70.67 +/- 7.85 (65-92 years). The ocular factor that was most commonly related to EPS was chronic blepharitis (48.9%). EPS was also associated with taking glaucoma medications (95% CI, 0.08-0.96, p=0.043), smoking history (95% CI, 0.13-0.84, p=0.021), ectropion (95% CI, 0.004-0.26, p=0.001), complaints of tearing (95% CI, 1.11-3.52, p=0.02), and outdoor occupational activity (95% CI, 3.42-9.97, p<0.05). Conclusions: EPS is more common in elderly patients than in the general population. Outdoor occupational activity, taking antiglaucomatous medications, ectropion, and smoking are significantly associated with EPS. In addition, surgical treatment decisions should be made after complete evaluation and interviewing the patients

Evaluation of the acute effect of haemodialysis on retina and optic nerve with optical coherence tomography

Purpose: The primary objective of haemodialysis (HD) was to correct the composition and volume of body fluids. The aim of this study was to evaluate the acute effect of HD on mean arterial pressure changes and on retina and optic nerve with optical coherence tomography (OCT). Methods: Fifty-three eyes of 28 patients were enrolled in this study. The patients' retinal and RNFL thicknesses were measured by OCT and mean arterial pressure alterations were recorded before and immediately after HD session. Results: The results show that while there was a reduction at central foveal thickness and ganglion cell layer thickness, central sub-field and RNFL thickness were increased with HD session. But none of them were statistically significant (p = 0.320, p = 0.792, p = 0.744, p = 0.390). The mean arterial pressure of the patients decreased significantly (p < 0.05) but it was not correlated with retinal and RNFL values. Conclusion: The changes in retinal and RNFL findings were not significant. But these alterations may effect the long term follow-up of the patients with retinal and optic nerve disease. Therefore it is important to pay attention HD session time for these patients' measurements

Anatomical determination of a safe entry point for occipital condyle screw using three-dimensional landmarks

WOS: 000294706700014PubMed ID: 21416278The occipital condyle (OC) is an important area in craniovertebral surgery, but neither its anatomical features nor the procedures concerning the OC have been detailed yet. The morphological analysis of the structures were made in totally 704 sides of the occipital bones of adult skulls by 3D-Doctor Demo version. The length and width of the OC were found to be 23.9 +/- A 3.4 (right), 24 +/- A 3.3 (left) and 11.9 +/- A 2.3 (right), 10.7 +/- A 2.3 mm (left), respectively. The mean anterior intercondylar distance and the posterior intercondylar distance were measured as 20.9 +/- A 3.6 and 43.1 +/- A 4 mm, respectively. The sagittal intercondylar angle was observed as 68.7 +/- A 10.6A(0). The sagittal condylar angle was observed to be 32.9 +/- A 7.6A(0) and 38.2 +/- A 7.3A(0) in the right and left, respectively. The head circumference was observed to be 65.6 +/- A 7.8 and 64.4 +/- A 7.2 mm in the right and left, respectively. The head area was measured as 231.9 +/- A 53.3 and 214.9 +/- A 45.1 mmA(2) in the right and left, respectively. The most common type was oval-like (59.67%), whereas the most unusual one was two-portioned condyle (0.32%). In Pearson correlation analysis, it was significant that a statistically strong relation was noticed between the length and area, and the circumference and area. The findings suggest that the oval type was more successful to work with, while the triangular, circular and two-portioned types were highly risky for the fixation resonance as the surface got quite smaller. As a result, we suggest that by resecting nearly half of the OC, the border of the hypoglossal canal can be involved

How Important Is the Etiology in the Treatment of Epiphora?

Purpose. There are several etiological factors that cause epiphora, and treatment differs according to the cause. We aimed to evaluate the etiology of epiphora and the treatment modalities of the affected patients. Materials and Methods. Data of patients who were referred to ophthalmology clinics for epiphora were retrospectively analyzed. All patients were evaluated for epiphora etiology, treatment modalities, and duration of complaints, after complete ophthalmologic examination. Results. This study consisted of 163 patients with a mean age of 64.61 +/- 16.52 years (range 1-92 years). Lacrimal system disease (48.4% [79/163]) was the most common cause, followed by ocular surface disease (dry eye/blepharitis) (38.7% [ 63/163]). Among the patients included in this study, 69% (113/163) did not receive any treatment, whereas only 1.8% (3/163) were treated surgically. About 4.3% of the patients (7/163) had a complaint for more than 5 years (p = 0.012) and six of these had chronic dacryocystitis and one had ectropion. Conclusion. Epiphora not only has a negative impact on patients' comfort, but also puts them at risk for probable intraocular operations in the future. Therefore, the wide range of its etiology must be taken into consideration and adequate etiology-specific treatment options must be applied