RESUMEN
ABSTRACT Purpose: Obesity is associated with eye diseases, but the underlying structural changes and pathogenic mechanisms have not been examined in detail. Here, we assessed the effects of morbid obesity on the morphometric indices of eye disease. Methods: Morbidly obese volunteers (n=101, body mass index [BMI] ³40) and healthy individuals (n=95, BMI: 18.50-24.99) were examined by Goldman applanation tonometry, pachymetry, and spectral domain optical coherence tomography. Intraocular pressure, anterior chamber depth, axial length, central corneal thickness, retinal nerve fiber layer thickness, central foveal thickness, and choroidal thickness were compared between groups. Results: Uncorrected intraocular pressure was significantly greater in the morbidly obese group than in the healthy control group (15.5 ± 2.5 vs. 14.5 ± 2.6 mmHg, p=0.009), whereas axial length, anterior chamber depth, and central corneal thickness did not differ between the groups. The mean retinal nerve fiber layer thickness at the temporal quadrant was reduced in the morbidly obese group (72.7 ± 13.6 vs. 85.05 ± 52.6 mm, p=0.024). Similarly, the mean retinal thicknesses at nasal and temporal 1500-mm locations were lower in the morbidly obese group (346.6 ± 18.2 vs. 353.7 ± 18.8 mm, p=0.008; 323.1 ± 20.3 vs. 330.0 ± 18.9 mm, p=0.001). The mean choroidal thickness was also reduced in almost all measurement locations (fovea, temporal 500 and 1000 mm, and nasal 500, 1000, and 1500 mm) of the obese group (p<0.05). Weight and BMI were negatively correlated with subfoveal choroidal thickness (r=-0.186, p=0.009; r=-0.173, p=0.015). Conclusion: Morbid obesity is associated with elevated uncorrected intraocular pressure and signs of neuropathy and retinopathy. Obesity may thus increase the risks of glaucoma and glaucomatous optic neuropathy.
RESUMO Objetivo: A obesidade está associada a doenças oulares, mas as mudanças estruturais subjacentes e os mecanismos patogênicos não foram examinados detalhadamente. Aqui avaliamos os efeitos da obesidade mórbida nos índices morfométricos da doença ocular. Métodos: Voluntários obesos mórbidos (n=101, índice de massa corporal ³40) e indivíduos saudáveis (n=95, índice de massa corporal 18,50 a 24,99) foram examinados por tonometria de aplanação de Goldman, paquimetria e tomografia de coerência óptica de domício espectral. A pressão intraocular, profundidade da câmara anterior, comprimento axial, espessura central da córnea, espessura da camada de fibras nervosas da retina, espessura foveal central e espessura da coroide foram comparadas entre os grupos. Resultados: A pressão intraocular não corrigida foi significativamente maior no grupo com obesidade mórbida do que no grupo controle saudável (15,5 ± 2,5 vs. 14,5 ± 2,6 mmHg, p=0,009), enquanto que o comprimento axial, profundidade da câmara anterior e espessura central da córnea não diferiram entre os grupos. A espessura média da camada de fibras nervosas da retina no quadrante temporal foi reduzida no grupo com obesidade mórbida (72,7 ± 13,6 vs. 85,05 ± 52,6 mm, p=0,024). Da mesma forma, a média das espesuras da retinianas nas localizações nasal e temporal de 1500 m foi menor no grupo com obesidade mórbida (346,6 ± 18,2 mm vs. 353,7 ± 18,8 mm, p=0,008; 323,1 ± 20,3 mm vs. 330,0 ± 18,9 mm, p=0,001). A espessura média da coroide também foi reduzida em quase todos os locais de mensuração (fóvea, temporal 500 e 1000 mm, nasal 500, 1000 e 1500 mm) do grupo obeso (p<0,05). Peso e índice de massa corporal foram negativamente correlacionados com a espessura da coroide subfoveal (r=-0,186, p=0,009; r=-0,173, p=0,015). Conclusão: A obesidade mórbida está associada à elevada pressão intraocular não corrigida e a sinais de neuropatia e retinopatia. A obesidade pode, assim, aumentar os riscos de glaucoma e neuropatia óptica glaucomatosa.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Enfermedades de la Retina/etiología , Obesidad Mórbida/complicaciones , Enfermedades de la Coroides/etiología , Retina/patología , Enfermedades de la Retina/fisiopatología , Tonometría Ocular/métodos , Obesidad Mórbida/fisiopatología , Índice de Masa Corporal , Estudios de Casos y Controles , Enfermedades de la Coroides/fisiopatología , Glaucoma/etiología , Glaucoma/fisiopatología , Coroides/patología , Estadísticas no Paramétricas , Tomografía de Coherencia Óptica/métodos , Paquimetría Corneal/métodos , Presión IntraocularRESUMEN
ABSTRACT Purpose: To compare effects of 5% topical povidone iodine with prophylactic topical azithromycin and moxifloxacin on bacterial flora in patients undergoing intravitreal injection. Methods: A total of 132 patients were randomly assigned to receive treatment with azithromycin or moxifloxacin, or no treatment (control group). In total, 528 specimens were obtained at the time of admission, 4 days before intravitreal injection, 4 days after intravitreal injection, and 8 days after intravitreal injection. Samples were immediately sent to the microbiology laboratory for incubation. Results: The microorganism observed most frequently was coagulasenegative Staphylococcus (23.8%). When the results of samples obtained on Day 4 before injection were assessed, growth of coagulase-negative Staphylococcus was significantly lower in the moxifloxacin group, compared with controls (p=0.049). Acinetobacter baumannii continued to grow after administration of azithromycin (p=0.033). When the results of four days after intravitreal injection were evaluated, growth of coagulase-ne gative Staphylococcus was higher in controls, compared with patients who received azithromycin or moxifloxacin (p=0.004). Eradication rate was significantly higher in the moxifloxacin group than in the control group (p=0.001). Samples obtained on Day 8 after intravitreal injection showed similar levels of bacterial growth in all groups (p=0.217). Conclusion: Moxifloxacin was more effective than 5% povidone iodine in controlling the growth of conjunctival bacterial flora. Use of moxifloxacin in combination with 5% povidone iodine resulted in a synergistic effect.
RESUMO Objetivo: Comparar os efeitos de iodopovidona tópico a 5% com azitromicina e moxifloxacina profiláticas sobre a flora bacteriana em pacientes submetidos à injeção intravítrea. Métodos: Um total de 132 pacientes foram aleatoriamente designados para receber tratamento com azitromicina ou moxifloxacina ou nenhum tratamento (grupo controle). No total, 528 amostras foram obtidas no momento na admissão, 4 dias antes da injeção intravítrea, 4 dias após a injeção intravítrea e 8 dias após a injeção intravítrea. As amostras foram imediatamente enviadas para o laboratório de microbiologia para incubação. Resultados: O microorganismo mais frequentemente observado foi o Staphylococcus coagulase-negativo (23,8%). Quando os resultados das amostras obtidas no dia 4 antes da injeção foram avaliados, o crescimento do Staphylococcus coagulase-negativo foi significativamente menor no grupo mo xifloxacina, em comparação com os controles (p=0,049). Acinetobacter baumannii continuou a crescer após a administração de azitromicina (p=0,033). Quando os resultados de 4 dias após a injeção intravítrea foram avaliados, o crescimento do Staphylococcus coagulase-negativo foi maior no controle, em comparação com pacientes que receberam azitromicina ou moxifloxacina (p=0,004). A taxa de erradicação também foi significativamente maior no grupo moxifloxacina do que no grupo controle (p=0,001). As amostras obtidas no dia 8 após injeção intravítrea mostraram níveis semelhantes de crescimento bacteriano em todos os grupos (p=0,217). Conclusão: A moxifloxacina foi mais eficaz do que 5% de iodopovidona no controle do crescimento da flora bacteriana conjuntival. O uso de moxifloxacina em combinação com 5% de iodopovidona resultou em um efeito sinérgico.
Asunto(s)
Humanos , Povidona Yodada/administración & dosificación , Azitromicina/administración & dosificación , Conjuntiva/microbiología , Inyecciones Intravítreas/métodos , Moxifloxacino/administración & dosificación , Antiinfecciosos Locales/administración & dosificación , Antibacterianos/administración & dosificación , Factores de Tiempo , Acinetobacter/aislamiento & purificación , Acinetobacter/efectos de los fármacos , Conjuntivitis Bacteriana/microbiología , Conjuntivitis Bacteriana/prevención & control , Endoftalmitis/microbiología , Endoftalmitis/prevención & control , Resultado del Tratamiento , Conjuntiva/efectos de los fármacos , Escherichia coli/aislamiento & purificación , Escherichia coli/efectos de los fármacosRESUMEN
PURPOSE: Obesity is associated with eye diseases, but the underlying structural changes and pathogenic mechanisms have not been examined in detail. Here, we assessed the effects of morbid obesity on the morphometric indices of eye disease. METHODS: Morbidly obese volunteers (n=101, body mass index [BMI] ³40) and healthy individuals (n=95, BMI: 18.50-24.99) were examined by Goldman applanation tonometry, pachymetry, and spectral domain optical coherence tomography. Intraocular pressure, anterior chamber depth, axial length, central corneal thickness, retinal nerve fiber layer thickness, central foveal thickness, and choroidal thickness were compared between groups. RESULTS: Uncorrected intraocular pressure was significantly greater in the morbidly obese group than in the healthy control group (15.5 ± 2.5 vs. 14.5 ± 2.6 mmHg, p=0.009), whereas axial length, anterior chamber depth, and central corneal thickness did not differ between the groups. The mean retinal nerve fiber layer thickness at the temporal quadrant was reduced in the morbidly obese group (72.7 ± 13.6 vs. 85.05 ± 52.6 mm, p=0.024). Similarly, the mean retinal thicknesses at nasal and temporal 1500-mm locations were lower in the morbidly obese group (346.6 ± 18.2 vs. 353.7 ± 18.8 mm, p=0.008; 323.1 ± 20.3 vs. 330.0 ± 18.9 mm, p=0.001). The mean choroidal thickness was also reduced in almost all measurement locations (fovea, temporal 500 and 1000 mm, and nasal 500, 1000, and 1500 mm) of the obese group (p<0.05). Weight and BMI were negatively correlated with subfoveal choroidal thickness (r=-0.186, p=0.009; r=-0.173, p=0.015). CONCLUSION: Morbid obesity is associated with elevated uncorrected intraocular pressure and signs of neuropathy and retinopathy. Obesity may thus increase the risks of glaucoma and glaucomatous optic neuropathy.
Asunto(s)
Enfermedades de la Coroides/etiología , Obesidad Mórbida/complicaciones , Enfermedades de la Retina/etiología , Adolescente , Adulto , Índice de Masa Corporal , Estudios de Casos y Controles , Coroides/patología , Enfermedades de la Coroides/fisiopatología , Paquimetría Corneal/métodos , Femenino , Glaucoma/etiología , Glaucoma/fisiopatología , Humanos , Presión Intraocular , Masculino , Persona de Mediana Edad , Obesidad Mórbida/fisiopatología , Retina/patología , Enfermedades de la Retina/fisiopatología , Estadísticas no Paramétricas , Tomografía de Coherencia Óptica/métodos , Tonometría Ocular/métodos , Adulto JovenRESUMEN
PURPOSE: To compare effects of 5% topical povidone iodine with prophylactic topical azithromycin and moxifloxacin on bacterial flora in patients undergoing intravitreal injection. METHODS: A total of 132 patients were randomly assigned to receive treatment with azithromycin or moxifloxacin, or no treatment (control group). In total, 528 specimens were obtained at the time of admission, 4 days before intravitreal injection, 4 days after intravitreal injection, and 8 days after intravitreal injection. Samples were immediately sent to the microbiology laboratory for incubation. RESULTS: The microorganism observed most frequently was coagulasenegative Staphylococcus (23.8%). When the results of samples obtained on Day 4 before injection were assessed, growth of coagulase-negative Staphylococcus was significantly lower in the moxifloxacin group, compared with controls (p=0.049). Acinetobacter baumannii continued to grow after administration of azithromycin (p=0.033). When the results of four days after intravitreal injection were evaluated, growth of coagulase-ne gative Staphylococcus was higher in controls, compared with patients who received azithromycin or moxifloxacin (p=0.004). Eradication rate was significantly higher in the moxifloxacin group than in the control group (p=0.001). Samples obtained on Day 8 after intravitreal injection showed similar levels of bacterial growth in all groups (p=0.217). CONCLUSION: Moxifloxacin was more effective than 5% povidone iodine in controlling the growth of conjunctival bacterial flora. Use of moxifloxacin in combination with 5% povidone iodine resulted in a synergistic effect.