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Objectives: The study aimed to evaluate the demographic and clinical characteristics of evisceration cases and to assess the psychosocial effects of prosthesis usage using the newly defined Global Ocular Prosthesis Score (GOPS). Methods: The records of 245 patients who underwent evisceration surgery between January 2010 and May 2021 were retrospectively reviewed. The study included 216 eyes of 216 patients who had regular follow-up of at least 6 months. Their demographic characteristics, indications for surgery, surgical methods, implant size, and complications were recorded. A total of 175 patients with ocular prostheses were evaluated using a 20-item questionnaire called GOPS. Results: About 154 of the 216 patients were male (71.3%), and 62 were female (28.7%), with a mean age of 34.9 years (range: 3-83). The mean follow-up duration was 52.5±34.2 months (range: 6-125). Among the cases, 101 (46.7%) had a penetrating globe injury, 91 (42.1%) had painful absolute eyes, 10 (4.6%) had corneal abscess, 8 (3.7%) had painless blind eyes due to Behçet's disease, 7 (3.2%) had endophthalmitis, 1 (0.04%) had prematurity retinopathy, 1 (0.04%) had corneal melting due to toxic epidermal necrolysis, and phthisis bulbi. Most of the traumas (74.5%) were caused by young (mean age 33.6 years) males. Sphere extrusion was observed in 16 (7.4%) patients at an average of 3 months (15 days to 6 months). Tenon cyst excision was performed in two patients. The mean GOPS was 71.74. Conclusion: It has been observed that the most common reasons for evisceration in a tertiary eye hospital are globe injuries and painful eyes. Although losing an eye can have negative physical and psychological effects on patients and may prevent them from fulfilling their social roles, it has been observed that the use of ocular prostheses positively impacts patient satisfaction. The use of the GOPS questionnaire can be helpful in assessing the quality of life of evisceration patients.
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PURPOSE: To evaluate the prevalence of the obstruction of lacrimal drainage system (LDS) in patients with pseudoexfoliation (PXF) syndrome. MATERIALS AND METHODS: This cross-sectional study included 152 eyes of 76 consecutive patients with bilateral PXF syndrome and 170 eyes of 85 age and gender-matched controls. The LDS evaluation was performed based on dye disappearance test, slit-lamp examination, diagnostic probing, and irrigation test. The presence of punctal stenosis and canalicular obstruction were considered as the obstruction of proximal LDS; and complete or incomplete nasolacrimal duct obstruction was considered as obstruction of distal LDS. Demographic characteristics, ophthalmologic findings, and prevalence and site of obstruction of LDS were compared among the groups. RESULTS: The prevalence of obstruction of LDS was higher in the PXF syndrome group when compared to controls (21.1% vs 12.2%), but the difference was not statistically significant (p = 0.061). The obstruction of proximal LDS was found to be more frequent in the PXF syndrome (17.7%) group when compared to controls (10.0%), and this difference was statistically significant (p = 0.041). There was significantly more punctal stenosis in the PXF syndrome group when compared to controls (15.1% vs 7.6%, p = 0.033). The prevalence of canalicular stenosis and obstruction of distal LDS was similar in the PXF and the control groups (p = 0.596 and p = 0.741, respectively). CONCLUSION: The prevalence of punctal stenosis was statistically significantly higher in the PXF syndrome group when compared to the controls. This association is probably related to increased local ocular surface inflammation which is triggered by the accumulation of PXF material.
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Síndrome de Exfoliación , Enfermedades de los Párpados , Obstrucción del Conducto Lagrimal , Conducto Nasolagrimal , Humanos , Síndrome de Exfoliación/complicaciones , Obstrucción del Conducto Lagrimal/diagnóstico , Estudios Transversales , Constricción PatológicaRESUMEN
SIGNIFICANCE: Digital device usage among children has increased significantly in recent years. Prolonged screen exposure can have adverse effects on the eye, especially on the ocular surface. PURPOSE: We aimed to evaluate the duration of screen exposure and its effect on the ocular surface in healthy children aged 10 to 18 years. METHODS: This cross-sectional observational study included 200 healthy children. Screen exposure times of the children were ascertained, and the effect of screen exposure on the ocular surface was evaluated using tear breakup time, kerato-epitheliopathy (Oxford) score, and Schirmer test. The Ocular Surface Disease Index (OSDI) was used to assess subjective dry eye symptoms. Findings for subjects with a daily screen exposure time of fewer than 2 hours were compared with those reporting more than 2 hours of screen time. Statistical evaluation included the Shapiro-Wilk test, Student t test, and Pearson correlation analysis. RESULTS: The mean ± standard deviation (SD) age was 14 ± 2.6 years, and 88.5% of the participants used mobile phones or computers every day. The mean ± SD tear breakup time was 10.3 ± 4.1 seconds, and the Schirmer test score was 15.6 ± 4.7 mm. The Oxford score was 0.4 ± 1, and no corneal staining was detected in 83.5% of the subjects. The mean ± SD OSDI score was 23.5 ± 17.8, and 67.5% of subjects had a mild-to-severe ocular surface disease. When daily screen exposure times less than and greater than 2 hours were compared, there was no statistically significant difference between the two groups in tear breakup time, Schirmer test, Oxford score, and OSDI score. Whereas there was a statistically significant weak positive correlation (r = 0.307, P = .001) between OSDI score and screen exposure time, there was no correlation between tear breakup time, Schirmer test, and Oxford score and screen exposure time. CONCLUSIONS: Screen exposure in healthy children may cause ocular surface symptoms without causing changes in ocular surface findings.
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Síndromes de Ojo Seco , Niño , Estudios Transversales , Síndromes de Ojo Seco/diagnóstico , Síndromes de Ojo Seco/etiología , Humanos , LágrimasRESUMEN
PURPOSE: The purpose of this study was to evaluate the association between dry eye disease and patients with newly diagnosed obsessive-compulsive disorder (OCD). METHODS: Thirty treatment-naive patients with OCD and 30 healthy controls were included in this prospective study. The Ocular Surface Disease Index, tear breakup time, Schirmer I test, corneal and conjunctival staining grade (Oxford scale), and neutrophil-to-leucocyte ratio values were obtained for all participants. RESULTS: The comparison of the patients with OCD and healthy controls showed significantly higher values in Ocular Surface Disease Index (34.8 vs. 20.8, P = 0.001), corneal Oxford scoring (0.9 vs. 0.6, P = 0.02), and conjunctival Oxford scoring (0.8 vs. 0.5, P = 0.04), with consistently lower values in the Schirmer I test (15.7 vs. 18.8, P = 0.043) and tear breakup time (9.1 vs. 12.9, P = 0.001). The mean neutrophil-to-leucocyte ratio values were significantly higher in the OCD group compared with the controls (2.4 ± 0.9 vs. 1.6 ± 0.4, respectively; P = 0.001). CONCLUSIONS: Our study showed a relation between dry eye disease and patients with newly diagnosed OCD who were not using any psychiatric drug. Our findings suggest that inflammation, which plays an important role in the pathogenesis of both diseases, may be responsible for this relationship.
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Síndromes de Ojo Seco/complicaciones , Trastorno Obsesivo Compulsivo/complicaciones , Adulto , Estudios de Casos y Controles , Síndromes de Ojo Seco/diagnóstico , Femenino , Humanos , Recuento de Leucocitos , Masculino , Neutrófilos/citología , Trastorno Obsesivo Compulsivo/diagnóstico , Estudios Prospectivos , Psicometría , Encuestas y Cuestionarios , Lágrimas/fisiología , Adulto JovenRESUMEN
OBJECTIVES: This was an assessment of one-snip punctoplasty outcomes in patients for whom adjunctive punctal re-dilatation was performed in-office for early postoperative cicatricial changes. METHODS: A retrospective analysis was conducted of patients who underwent one-snip punctoplasty between March 2019 and February 2020 due to acquired punctal stenosis. Patients were followed up on the first, third, and seventh postoperative day, then weekly for the remainder of the first month, every 2 weeks over the next month, and then monthly. Punctal re-dilatation was performed if patients showed early clinical signs of re-stenosis. Demographic details, the number and timing of re-dilatation procedures, the timing of re-stenosis, and anatomical and functional success rates were analyzed. RESULTS: The medical records of 148 eyes of 86 patients were evaluated. A re-dilation procedure was performed in a total of 57 (38.5%) puncta showing signs of early cicatrization. The first punctal re-dilatation was performed at a mean of 17.2±11.3 days (range: 3-57 days). Re-stenosis was observed in 25 puncta (16.9%) at a mean of 5.6±3.1 weeks (range: 2-16 weeks). The anatomical success rate was 83.1% and the functional success rate was 79.1%. There were no significant differences in the anatomical and functional success rates between the patients who did and did not need adjunctive re-dilatation. CONCLUSION: In-office punctal re-dilatation may improve functional and anatomical success rates after one-snip punctoplasty by preventing recurrent punctal cicatrization.
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PURPOSE: To assess the effect of hemodialysis on retinal and choroidal thicknesses using spectral-domain optical coherence tomography (SD-OCT). METHODS: In this prospective interventional study, 25 hemodialysis patients (17 male, 8 female) were enrolled. All participants underwent high-speed, high-resolution SD-OCT (λ=840 mm; 26.000 A-scans/s; 5 µm resolution) before and after hemodialysis. Choroidal thickness was measured perpendicularly from the outer edge of the retinal pigment epithelium to the choroid-sclera boundary at the fovea and at five additional points: 500 µm and 1000 µm nasal to the fovea and 500 µm, 1000 µm, and 1500 µm temporal to the fovea. Two masked physicians performed the measurements. Choroidal and retinal thicknesses before and after hemodialysis were compared. RESULTS: The median choroidal thicknesses before and after hemodialysis were 182 µm (range, 103-374 µm) and 161 µm (range, 90-353 µm), respectively (P<0.001). The median retinal thicknesses were 246 µm (range, 179-296 µm) before and 248 µm (range, 141-299 µm) after hemodialysis (P>0.05). Systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate, and ocular perfusion pressure significantly decreased after hemodialysis (P<0.001). Intraocular pressure did not vary significantly (P=0.540). CONCLUSION: Hemodialysis seems to cause a significant decrease in choroidal thickness, whereas it has no effect on retinal thickness. This significant decrease in choroidal thickness might be due to the extensive fluid absorption in hemodialysis, which could result in decreased ocular blood flow.
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Coroides/anatomía & histología , Coroides/diagnóstico por imagen , Diálisis Renal/efectos adversos , Retina/anatomía & histología , Retina/diagnóstico por imagen , Adulto , Coroides/fisiopatología , Ojo/irrigación sanguínea , Femenino , Hemodinámica , Humanos , Presión Intraocular , Fallo Renal Crónico/fisiopatología , Fallo Renal Crónico/terapia , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Tamaño de los Órganos , Estudios Prospectivos , Valores de Referencia , Retina/fisiopatología , Estadísticas no Paramétricas , Factores de Tiempo , Tomografía de Coherencia Óptica/métodos , Adulto JovenRESUMEN
ABSTRACT Purpose: To assess the effect of hemodialysis on retinal and choroidal thicknesses using spectral-domain optical coherence tomography (SD-OCT). Methods: In this prospective interventional study, 25 hemodialysis patients (17 male, 8 female) were enrolled. All participants underwent high-speed, high-resolution SD-OCT (λ=840 mm; 26.000 A-scans/s; 5 µm resolution) before and after hemodialysis. Choroidal thickness was measured perpendicularly from the outer edge of the retinal pigment epithelium to the choroid-sclera boundary at the fovea and at five additional points: 500 µm and 1000 µm nasal to the fovea and 500 µm, 1000 µm, and 1500 µm temporal to the fovea. Two masked physicians performed the measurements. Choroidal and retinal thicknesses before and after hemodialysis were compared. Results: The median choroidal thicknesses before and after hemodialysis were 182 µm (range, 103-374 µm) and 161 µm (range, 90-353 µm), respectively (P<0.001). The median retinal thicknesses were 246 µm (range, 179-296 µm) before and 248 µm (range, 141-299 µm) after hemodialysis (P>0.05). Systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate, and ocular perfusion pressure significantly decreased after hemodialysis (P<0.001). Intraocular pressure did not vary significantly (P=0.540). Conclusion: Hemodialysis seems to cause a significant decrease in choroidal thickness, whereas it has no effect on retinal thickness. This significant decrease in choroidal thickness might be due to the extensive fluid absorption in hemodialysis, which could result in decreased ocular blood flow.
RESUMO Objetivo: Avaliar o efeito da hemodiálise (HD) na espessura da retina (RT) e na espessura da coroide (CT) usando tomografia de coerência óptica de domínio espectral (SD-OCT). Método: Neste estudo prospectivo intervencionista foram incluídos 25 pacientes em HD (17 homens e 8 mulheres). Todos os participantes foram submetidos a SD-OCT com dispositivo de alta resolução (λ=840 mm; 26.000 A-scans/seg e resolução de 5 µm), antes e após HD. A CT foi medida perpendicularmente a partir da borda externa do epitélio pigmentar da retina até o limite coroide-esclera na fóvea e em mais de 5 pontos localizados 500 µm nasal à fóvea, 1.000 µm nasal à fóvea; 500 µm temporal à fóvea, 1.000 µm temporal à fóvea, e 1.500 µm temporal à fóvea. Dois médicos realizaram as medidas sem o conhecimento do diagnóstico. Os dados da CT e RT, antes e após a HD foram comparados. Resultados: As CTs medianas antes e após a HD foram 182 µm (variação de 103-374 µm) e 161 µm (variação de 90-353 µm), respectivamente (p<0,001). A RT foi 246 µm (variação de 179-296 µm) antes e 248 µm (variação de 141-299 µm) após a HD (p>0,05). A pressão arterial sistólica, pressão arterial diastólica, as médias de pressão arterial média, frequência cardíaca e pressão de perfusão ocular diminuíram significativamente após HD (p<0,001). A pressão intraocular não alterou significativamente (p=0,540). Conclusão: A HD parece causar uma redução significativa da CT, e não ter efeito sobre a RT. Esta redução significativa da CT pode ser devida à grande absorção de fluido durante a HD, o que pode resultar numa diminuição do fluxo sanguíneo ocular.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven , Retina/anatomía & histología , Retina/diagnóstico por imagen , Coroides/anatomía & histología , Coroides/diagnóstico por imagen , Diálisis Renal/efectos adversos , Tamaño de los Órganos , Valores de Referencia , Retina/fisiopatología , Factores de Tiempo , Variaciones Dependientes del Observador , Estudios Prospectivos , Coroides/fisiopatología , Estadísticas no Paramétricas , Tomografía de Coherencia Óptica/métodos , Ojo/irrigación sanguínea , Hemodinámica , Presión Intraocular , Fallo Renal Crónico/fisiopatología , Fallo Renal Crónico/terapiaRESUMEN
AIM: To assess choroidal thickness in patients with severe obstructive sleep apnea syndrome (OSAS) and compare them with healthy controls, using spectral domain optical coherence tomography (OCT). METHODS: In this observational, cross-sectional study, choroidal thicknesses of 23 newly severe OSAS patients and 23 body mass index- age- and sex-matched healthy subjects were measured using a high-speed, high-resolution frequency domain-OCT device (λ=840 nm, 26000 A-scans/s, 5 µm axial resolution). All patients underwent a complete ophthalmic examination before the measurements. OCT measurements were taken at the same time of day (9:00 a.m.), in order to minimize the effects of diurnal variation. RESULTS: There was a statistically significant difference in median choroidal thickness between the OSAS patients (201 µm; range 145-237 µm) and the controls (324 µm; range 296-383 µm; P<0.001). There were significant differences at all measurement points (P<0.001 for all). The apnea-hypopnea index (AHI) values were more than 30 in all OSAS patients and the mean AHI was 48.57±6.54. The interexaminer intraclass correlation coefficient (ICC) for the mean choroidal thickness was 0.938 (95%CI, 0.908-0.985) and ICC was greater than 0.90 for all measurement points. CONCLUSION: The decreased choroidal thickness of patients with severe OSAS might be related to the the autonomic disregulation associated with this disease. Further studies are needed to evaluate the etiopathologic relationship between choroidal thickness and OSAS.