Short-term intraocular pressure changes after intravitreal bevacizumab injection

Intravitreal injections of anti-vascular endothelial growth factors [antiVEGFs] have become more popular quickly in recent years. Bevacizumab is an anti- vascular endothelial growth factor agent [anti-VEGF] used to treat choroidal neovascularization and retinal vascular disorders. Rare long lasting ocular adverse events are reported in the intravitreal injection of this drug that include intraocular inflammation, retinal tears, vitreous hemorrhage, endophtalmitis, and lens changes. One important concern about intravitreal injection of anti-VEGF drug is intraocular pressure [IOP] elevation. There are two kinds of IOP elevation. First one is an acute elevation of IOP [after few minutes] and the second is delayed IOP elevation [after few months]. The prevalence of IOP elevation immediately after injection is significantly high and seems to have the potential risk for optic nerve fiber loss results in decreased vision but fortunately this IOP elevation seems to be transient in most of studies

Role of pulse oximetry in detecting mild to moderate hepatopulmonary syndrome in children

Hepatopulmonary syndrome [HPS] refers to arterial hypoxemia caused by pulmonary vasodilation, which is a consequence of portal hypertension. HPS is associated with increased morbidity and mortality; thus, it is important to diagnose this entity as soon as possible for treatment to be administered. In a cross-sectional study, 40 children [6 months to 14 years old] with chronic liver disease were enrolled. In all patients, measurements of Oxygen saturation [SaO[2]] were performed with a pulse oximeter in the supine position [SPO[2]] and then in the upright position [delta SPO[2]]. Children were divided into three groups: i] those with both SPO[2]>96% and deltaSPO[2]>4%; ii] children with either SPO[2]>96% or delta SPO[2] > 4%; and iii] those with neither of these signs. Then, contrast-enhanced echocardiography [CEE] and arterial blood gas [ABG] were performed. Finally, the prevalence of mild to moderate HPS was calculated in the three groups. There were 30 patients who had neither of the two signs, of which 9 had HPS. Ten patients had one of the two signs, in whom 4 had HPS. None of the patients had both signs. The sensitivity of the pulse oximetry was 30%, specificity was 77%, positive predictive value was 38% and negative predictive value was 70%.There is a significant prevalence of HPS in cirrhotic patients which effects prognosis. Based on our study results, we have determined that pulse oximetry could not be a reliable screening procedure in mild to moderate HPS. It is recommended to use gold standard tests [echocardiography and arterial blood gasometry] for the screening and diagnosis of HPS in children.