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Objective: We aimed to investigate whether there is a seasonal relationship between the emergence of acute dacryocystitis. Methods: The files of patients who applied to the ophthalmology outpatient clinic with complaints of tearing and discharge for five years and were diagnosed with acute dacryocystitis were retrospectively analyzed. Age, gender, date of occurrence of the complaints, and date of diagnosis of acute dacryocystitis were recorded. To determine the seasonal relationship, the data regarding the number of cases who applied every month of the year were analyzed statistically by Rayleigh test. Results: The mean age of 60 patients (45 females, 15 males) included in the study was 54.70±16.80 years. It was found that all patients were not equally likely to be admitted to the hospital and the onset of their complaints throughout the months of the year (p<0.05). The frequency of applications was higher between May and August. Conclusion: There appears to be a seasonal relationship with the timing of acute dacryocystitis. In our series, more acute dacryocystitis cases were encountered during the first spring-summer months. The reason for the increase in acute dacryocystitis cases in the hot seasons of the year may be the increase in infectious agents in these seasons. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of long-term antiglaucomatous therapy on the meibomian glands by meibograpy. Materials and Methods: A total of 31 patients with unilateral ocular hypertension or glaucoma receiving antiglaucomatous medical treatment for at least 1 year were included in this study. The contralateral eyes were used as the control group. Invasive tear film break-up time (TF-BUT), fluorescein staining of the ocular surface, and Schirmer II test were performed in all subjects. Total eyelid score and meibomian gland secretion score were evaluated. Non-contact meibography were performed with the Sirius corneal topographic device. Results: There were 15 (48,4%) males and 16 (51,6%) females and the mean age was 57.9±9.8 years. While the TF-BUT (p<0.001) and Schirmer test (p<0.001) values were significantly lower in the glaucoma group compared to the control group, the ocular surface staining score (p=0.001), eyelid (p<0.001) and meibomian gland secretion (p<0.001) score were significantly higher. Meibomian gland loss area (p<0.001 for the both upper and lower eyelid) and meiboscore (p<0.001 for the upper and lower eyelid) were significantly higher in the glaucoma group. In correlation analysis number of antiglaucoma eye drops, daily benzalkonium chloride exposure was associated with ocular surface parameters and meiboscore. Disease duration was correlated with any of ocular surface parameters. Conclusion: Long-term topical anti-glaucoma treatment adversely affects the ocular surface and meibomian glands. We found that long-term use of topical antiglaucomatous drugs caused significant loss of meibomian glands by meibographic evaluation, as well as decreased ocular surface scores. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To identify long-term changes in individual retinal layer thickness using automated retinal layer segmentation analysis on high-resolution spectral-domain optical coherence tomography (SD-OCT) scans of eyes with macula-off rhegmatogenous retinal detachment (RRD) treated with vitreoretinal surgery (VRS) and gas or silicone oil tamponade and having single-operation success. Methods: A total of 58 patients operated on by VRS for RRD and followed up for 12 months were imaged by SD-OCT. The patients with retinal diseases such as an epiretinal membrane or cystic macular edema in the operated and fellow eyes were excluded. The thicknesses of the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), photoreceptor layer, and retinal pigment epithelium were compared to those of the fellow eyes after the 12-month follow-up. Thickness changes in individual layers were quantitatively analyzed in the operated and fellow eyes and correlated with the type of tamponade used in the surgery. Results: Spectralis OCT automated segmentation software was used for the retinal layer analysis. There were 22 females and 36 males. Their mean age was 60.7 ± 11.2 years. The mean central macular thickness was 214.3 ± 29.5 µm in the operated and 229.7 ± 21.7 µm in the fellow eyes (p = 0.008). There was a statistically significant difference between the operated and the healthy fellow eyes in the following layers: the RNFL (p = 0.017), GCL (p = 0.02), INL (p = 0.005), and ONL (p = 0.008) in the central foveal area; the RNFL (p < 0.001), INL (p = 0.017), and ONL (p = 0.022) in the perifoveal ring; and the RNFL (p < 0.001), IPL (p = 0.042), INL (p = 0.001), and OPL (p = 0.001) in the peripheral ring. The logMAR best corrected visual acuities were 2.51 ± 0.68 and 2.69 ± 0.62 at baseline and 0.60 ± 0.38 and 0.50 ± 0.38 at month 12 in the silicone oil tamponade (n = 28) and the gas tamponade (n = 30) group (p = 0.52 and p = 0.21, respectively). The foveal GCL, OPL, and ONL and the perifoveal GCL and IPL were statistically significantly thinner in the silicone oil tamponade group (p = 0.01, p = 0.046, p = 0.024, p = 0.006, and p = 0.011, respectively). Conclusions: Significant changes were observed in the retinal layers after VRS for RRD. Individual retinal layers seem to be affected 1 year after VRS for RRD. The type of tamponade can influence the thickness of the retinal layers. The thickness of the retinal layers was significantly preserved in eyes treated with gas tamponade when compared to those treated with silicone oil tamponade in the long term. Further studies are needed to validate our results. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the relationships between macular choroidal thickness (mCT) and ocular parameters, such as optic nerve head (ONH) and multifocal electroretinogram (mf-ERG) parameters, in cases with primary open-angle glaucoma (POAG). Methods: This controlled and prospective clinical trial included 49 patients with POAG diagnosed for the fırst time and 47 healthy participants. Macular CTs, ONH and mf-ERG parameters were measured, and the examination findings were recorded at baseline and follow-ups. Results: In the POAG group, the mean mCT was 254.92±37.65 µm at baseline, and it was 235.6±38.48 µm at 3-month and was 237.55±37.27 µm at 6-month. In the glaucoma group, there was a significant decrease in the first three months despite the treatment, but no significant change was observed in the next three months. In the healthy group, the mean mCTs were 287.78±26.77 µm, 285.48±25.58 µm and 285.02±27.44 µm at baseline, at 3-month and at 6-month, respectively. No significant change was observed in the control group throughout the process. However, the mean mCT values in the glaucoma group were significantly thinner in all controls compared to the healthy group (p<0.05). Furthermore, significant correlations were found between CT and some ONH, as well as mf-ERG parameters. Conclusion: The choroid can play an important role in the pathogenesis of glaucoma. Significant correlations in parameters support this relationship. We have observed that the glaucomatous effect initiated first in the inferior quadrant of ONH. [ABSTRACT FROM AUTHOR]

Purpose: To study (i) the long-term effects of intravitreal ranibizumab treatment on changes in submacular choroidal thickness and (ii) the relationship between any resulting changes in choroidal thickness and visual outcomes following such treatment in patients with neovascular age-related macular degeneration (n-AMD). Methods: Reviewed were medical records of 30 consecutive, treatment-naïve, patients with unilateral n-AMD (n = 30 eyes) and unaffected fellow eyes (n = 26 eyes) (controls). Monthly injections of 0.5 mg ranibizumab were administered until stabilization of n-AMD, with additional injections as needed over the following 14-mo. Choroidal thickness was determined using enhanced-depth imaging–optical coherence tomography (EDI–OCT) before and after initiation of ranibizumab therapy. Choroidal thickness measurements were generated via manual segmentation. Results: The mean age of patients was 71.9 ± 7.4 (56–83) years; the mean best-corrected visual acuity (BCVA) of affected eyes improved from 51.1 to 59.4 letters (p < 0.001); and the mean number of injections was 9.16 ± 1.75. Subfoveal choroidal thickness decreased from 208.3 ± 73.7 μm at baseline to 185.3 ± 70.1 μm at mo-14 (p < 0.001), with significant (p < 0.001) decreases at all measured time points. Choroidal thickness also tended to decline in fellow eyes but was only statistically significant nasally 1,000 μm (p =0.04). Mean changes in choroidal thickness did not correlate with BCVA at mo-14 (p = 0.76). Disciform scars and geographic atrophy (p = 0.017), and BCVA (p < 001) at baseline were predictive of visual outcome. Age (p = 0.001), reticular drusen (p = 0.004), and size of choroidal neovascularized area (p = 0.042) were predictive of decreases in choroidal thickness. Conclusions: Submacular choroidal thickness appeared to decrease significantly in eyes with n-AMD over a 14-mo period of ranibizumab treatment. No corresponding decrease in choroidal thickness occurred in fellow eyes. [ABSTRACT FROM AUTHOR]

It is aimed to present a case to demonstrate that the incidental symptomatic retinal macroaneurysm is closed by the effect of intravitreal afribercept. Seventy-six-year-old male patient which was under follow-up for age-related macular degeneration in the retina department presented with retinal edema covering all macular area due to a macroaneurysm in the superior temporal branch of the retinal artery. The patient was treated with 3 consecutive monthly injections of intravitreal aflibercept. Macular edema was observed to gradually decreased with complete closure of the RAM after the treatment. The best corrected visual acuity improved from 3/10 at baseline to 7/10 after the treatment. Ocular or systemic side effect was not observed. Intravitreal aflibercept can provide closure of RAM, disappearance of macular edema by gradual resolution and hence improvement of visual acuity. Intravitreal aflibercept may be an alternative and effective treatment for symptomatic RAM [ABSTRACT FROM AUTHOR]

Copyright of Turk Psikiyatri Dergisi is the property of Turk Psikiyatri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The aim of this study was to evaluate the disease history, treatment adherence, and the criminal history of individuals who committed a homicide offence, with no criminal responsibility due to their psychiatric illness. Materials and Methods: Of 197 who had been released from our forensic psychiatric clinic after one-year-mandatory inpatient treatment, we evaluated 160 patients whom we were able to contact. To determine the severity of the crimes, criminal violence rating scale was used. The sociodemographic characterictics and certain variables associated with the disease and the criminal acts of the individuals were documented. Results: Out of 160 patients, 48 had committed serious homicidal crime while 112 had committed milder or moderate crimes. All homicidal offenders were male. Most were single or divorced, living in metropolitan areas. 29.2% were unemployed. Of the homicidal offenders, 89.6% had a legal guardian, 93.8% had social insurance, 83.3% had psychiatric disorder with psychotic features. 29.2% of homicide offenders had criminal history even prior to the mandatory treatment, most of which were severe violent criminal offenses targeting directly a victim's life. Conclusions: Among homicidal offenders, diagnosis of schizophrenia and other psychotic disorders were more and psychiatric comorbidities were less prevalent. The correlation of homicide and unemployment points to the importance of occupational rehabilitation. Identifying preventive factors and determining the risk of the homicidal behavior in individuals with mental disorders are important for the protection of both the patient and the public. [ABSTRACT FROM AUTHOR]

Objectives: To determine factors influencing compliance in patients with neovascular age-related macular degeneration (n-AMD) undergoing intravitreal anti-vascular endothelial growth factor (VEGF) therapy. Materials and Methods: The files of n-AMD patients recommended treatment with ranibizumab were reviewed retrospectively. The treatment regimen was 3 consecutive monthly injections followed by monthly follow-up with intravitreal injections as needed (pro re nata, PRN). Demographic and ocular characteristics were recorded. The patients were categorized into 2 groups: full compliance to treatment, or incomplete loading schedule and/or irregular maintenance treatment. All patients were interviewed by phone about factors affecting continuation of treatment. Results: Mean age of the 314 patients (160 female, 154 male) included in the study was 71.6±91 years. A total of 246 patients (78.3%) could complete 3 consecutive injections at 1-month intervals after the start of treatment; 57 patients (18.2%) did not attend monthly follow-up during the 1-year follow-up period following the 3 consecutive monthly injections. Overall, 39.8% of the patients were not able to fully comply with the ranibizumab treatment by PRN regimen for 1 year. Better visual acuity at baseline, smaller lesion size, living closer to the hospital, higher education and sociocultural level, and better financial status were determined as factors affecting patient compliance. The most frequent reasons to discontinue treatment were fear of injection, disbelief in the benefit of the treatment, financial limitations, continuation of treatment at another center, and comorbid systemic diseases. Conclusion: Patient compliance and success rates of anti-VEGF therapy may be increased by determining the factors affecting patient compliance and raising awareness about n-AMD among patients and their relatives. [ABSTRACT FROM AUTHOR]

A 55-year-old male presented with a complaint of a painless and sudden loss of vision in the right eye. Fundus photography revealed loss of transparency and edema in the central macular region. Optical coherence tomography showed increased reflectivity and diffused swelling in the inner retinal layers. Fluorescein angiography revealed a large area of capillary non-perfusion with a pronounced hypofluorescent area with distinct borders. To our knowledge, this is the first report of a hemorrhagic macular infarction associated with marijuana and pregabalin misuse. [ABSTRACT FROM PUBLISHER]

Objectives: To assess the agreement of anterior segment parameter measurements derived from Aladdin optical biometer using optical low coherence interferometer and Sirius corneal topography using combined Scheimpflug-Placido disk. Materials and Methods: Data obtained using the Aladdin and Sirius systems from 110 eyes of 59 subjects who had no health problems other than refractive errors were retrospectively evaluated. Anterior chamber depth (ACD), flat (K1) and steep (K2) keratometry readings, and white-to-white distance (WTW) measurements taken with both devices were noted. Results: The mean age of the patients was 47.31±18.57 years (range, 25 to 79 years). Mean ACD was 3.35±0.4 mm using Aladdin and 3.42±0.44 mm using Sirius. Mean difference in ACD was 0.075 mm greater with Sirius than Aladdin (p<0.001). K1 measurement obtained by Aladdin was an average of 0.409 D higher (p<0.001). No statistically significant differences were detected between the two devices in respect to K2 and WTW measurements (p = 0.18, p = 0.85 respectively). Pearson correlation analysis showed high correlation between the two devices for all measurements (r = 0.985, 0.895, 0.961 and 0.766 for ACD, K1, K2 and WTW respectively; p<0.001). Conclusion: Anterior segment parameters obtained by Aladdin optical biometer and Sirius anterior segment analysis system correlated well with each other and measurement differences between the devices were clinically negligible except for K1 values. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Non-arteritic anterior ischemic optic neuropathy (NAION) is the most common acute optic neuropathy in patients over the age of 50 and is the second most common cause of permanent optic nerve-related visual loss in adults after glaucoma. Although the precise cause of NAION remains elusive, the etiology of NAION is believed to be multifactorial. Aims: To evaluate the utility of neutrophil-to-lymphocyte ratio (NLR) as a simple and readily available prognostic factor for clinical disease activity in patients with NAION. Study Design: Case-control study. Methods: Forty-five patients with the diagnosis of NAION and 50 age- and sex-matched controls with/ without any systemic or ocular diseases except cataract were retrospectively enrolled in the study. Demographic characteristics and laboratory findings including complete blood count of all patients and control subjects were obtained from the electronic medical record. The neutrophil and lymphocyte counts were recorded and the NLR was calculated. Results: White blood cell, neutrophil, NLR and platelet values of the NAION patients were significantly higher than those of the controls (p<0.001, p<0.001, p=0.004, p=0.037, respectively). Initial NLR values were negatively correlated with initial and the third month best corrected visual acuity levels in the study group. The optimum NLR cut-off point for NAION was 1.94. Conclusion: NLR could be considered as a new inflammatory marker for assessment of the severity of inflammation in NAION patients with its quick, cheap, easily measurable property with routine complete blood count analysis. [ABSTRACT FROM AUTHOR]

Objective: It was aimed to explore the relationship of clinical psychopathology and treatment response with "duration of untreated psychosis" (DUP) and "duration of untreated illness" (DUI) in 15-20 years old (mean age: 17,34 ± 1.69) inpatients in Turkey. Method: Mood disorders with psyhotic features were grouped as affective psychoses (18 patients, mean age: 17,28 ± 1,75); schizophrenia, schizophreniform disorder and other psychotic disorders were grouped as non-affective psychoses (25 patients, mean age: 17,38 ± 1,68). 43 patiens (11 females, 32 males) were evaluated for acute treatment response with Positive and Negative Sydrome Scale -- PANSS and Clinical Global Impressions Scale --CGI. Results: Mean DUP was determined as 6,5 ± 12,4 weeks, mean DUI was determined as 37,8 ± 49,8 weeks. For the affective psychosis (AP) group; mean DUP was 1,9 ± 1,2 weeks, mean DUI was 24,6 ± 37,1 weeks, for the non-affective psychosis (NAP) group; mean DUP was 9,8 ± 15,5 weeks, mean DUI was 47,3 ± 55,9 weeks. Treatment response was better for the non-affective psychosis group and for the patients who had earlier access to treatment. Shorter DUP and DUI was related with better PANSS negative symptom severity at the time of the discharge. Conclusion: Better treatment response related with shorter DUP and DUI reveals the significance of early treatment for the disease prognosis. [ABSTRACT FROM AUTHOR]

Enhanced depth imaging spectral-domain optical coherence tomography (EDI-SD OCT) has made it possible to visualize and measure quantitively the choroid. In some studies, automated segmentation of choroid-sclera interface was used, but we think that many scans would necessitate manual correction of the automated segmentation because the choroid-sclera interface has not regular contour in most eyes. Our study was longitudinal, and we investigated changes in CT at different time points in a small group of wet age-related macular degeneration (AMD) treated with ranibizumab over 14 months of strict follow-up with regular visits. [Extracted from the article]

This report represents a rare complication of retinal hole aftrer Nd:YAG laser hyaloidotomy in a case of Valsalva retinopathy secondary to vaginal strain from labor. The retinal hole spontaneously closed during follow-up. [ABSTRACT FROM AUTHOR]

Crisponi syndrome (CS)/cold-induced sweating syndrome type 1 (CISS1) is a very rare autosomal-recessive disorder characterized by a complex phenotype with high neonatal lethality, associated with the following main clinical features: hyperthermia and feeding difficulties in the neonatal period, scoliosis, and paradoxical sweating induced by cold since early childhood. CS/CISS1 can be caused by mutations in cytokine receptor-like factor 1 ( CRLF1 ). However, the physiopathological role of CRLF1 is still poorly understood. A subset of CS/CISS1 cases remain yet genetically unexplained after CRLF1 sequencing. In five of them, exome sequencing and targeted Sanger sequencing identified four homozygous disease-causing mutations in kelch-like family member 7 ( KLHL7 ), affecting the Kelch domains of the protein. KLHL7 encodes a BTB-Kelch-related protein involved in the ubiquitination of target proteins for proteasome-mediated degradation. Mono-allelic substitutions in other domains of KLHL7 have been reported in three families affected by a late-onset form of autosomal-dominant retinitis pigmentosa. Retinitis pigmentosa was also present in two surviving children reported here carrying bi-allelic KLHL7 mutations. KLHL7 mutations are thus associated with a more severe phenotype in recessive than in dominant cases. Although these data further support the pathogenic role of KLHL7 mutations in a CS/CISS1-like phenotype, they do not explain all their clinical manifestations and highlight the high phenotypic heterogeneity associated with mutations in KLHL7 . [ABSTRACT FROM AUTHOR]

Objective. To evaluate the correlation between visual outcomes and fluid configuration observed on spectral-domain optical coherence tomography (SD-OCT) in patients with wet age-related macular degeneration (AMD). Methods. Sixty-five eyes of 53 patients with AMD who were administered intravitreal ranibizumab treatment with 12 months of follow-up were included in this retrospective study. Presence of intraretinal cystoid fluid (IRC) and pigment epithelial detachment (PED), thickness of subretinal fluid (SRF), central macular thickness (CMT), and central macular volume (CMV) were assessed. Results. Subretinal fluid was observed in 29 eyes (45%), IRC in 36 eyes (55%), and PED in 39 eyes (60%). Baseline and final best-corrected visual acuity (BCVA) were 0.69±0.4 and 0.60±0.4 logMAR in the IRC negative group and 1.17±0.5 and 0.97±0.5 logMAR in the IRC positive group. BCVA was lower in IRC positive group (baseline p=0.001 and final=0.003); however, marked improvement was detected in both groups. Anatomic improvement and increased visual acuity were observed in groups with and without PED, IRC, and SRF. An inverse correlation was detected between pre-treatment CMT, IRC and post-treatment IRC, and final BCVA. Conclusion. Significant visual and anatomic improvement was observed after one-year of ranibizumab treatment regardless of fluid configuration. However, the presence of IRC was observed to be associated with worse visual acuity. Baseline retinal fluid configuration may have prognostic effects on functional success in patients treated with ranibizumab for wet AMD. Abbreviations. AMD = Age-related macular degeneration, VEGF = Vascular endothelial growth factor, IRC = intraretinal cystoid fluid, PED = pigment epithelial detachment, SRF = subretinal fluid, SD-OCT = spectral-domain ocular coherence tomography, IVR = intravitreal ranibizumab, BCVA = best-corrected visual acuity, FFA = fundus fluorescein angiography, CMT = central macular thickness, CMV = central macular volume., (©Romanian Society of Ophthalmology.)

Purpose: To compare the pain responses of patients with proliferative diabetic retinopathy (PDR) undergoing panretinal photocoagulation (PRP) using either pattern scan laser (PASCAL) or navigated laser photocoagulation (NAVILAS)., Methods: Patients diagnosed with PDR were randomly assigned to undergo either PASCAL or NAVILAS photocoagulation treatment. PRP was performed using the multi-shot mode with a spot size of 200-400 µm and a pulse duration of 30 ms to obtain a white-grayish spot on the retina. Parameters were identical in both procedures. After 30 min of PRP application, patients were asked to verbally describe their pain perception as either "none," "mild," "moderate," "severe," or "very severe" using a verbal rating scale (VRS) and visual analog scale (VAS) by indicating a score from "0" to "10," representing the severity of pain from "no pain" to "severe pain.", Results: A total of 60 eyes of 60 patients (20 females and 40 males) diagnosed with PDR were treated. The mean age of patients was 62.22 ± 9.19 years, and the mean diabetes duration was 195.47 ± 94.54 months. The mean number of laser spots delivered during PRP was 389.47 ± 71.52 in the NAVILAS group and 392.70 ± 54.33 in the PASCAL group (p=0.57). The difference in pain responses between patients in the NAVILAS and PASCAL groups was significant with regard to the mean VRS (1.10 ± 0.67 and 1.47 ± 0.69, respectively; p=0.042) and mean VAS (2.13 ± 1.17 and 2.97 ± 1.35, respectively; p=0.034) scores., Conclusions: Pain responses in patients undergoing PRP with a 30-ms pulse duration were significantly milder in the NAVILAS group than in the PASCAL group.