Mini-mental state exam versus Montreal Cognitive Assessment in patients with diabetic retinopathy.

BACKGROUND: Mini-mental state exam (MMSE) was used several times but no study has examined cognition on the Montreal Cognitive Assessment (MoCA) in diabetes and diabetic retinopathy (DR). In this study, we compared MMSE with MoCA in patients with DR and searched for an association between the severity of DR and cognitive impairment (CI). METHODS: This cross-sectional study comprised 120 consecutive patients with diabetes. Patients were divided into four groups as no DR, mild DR, severe nonproliferative DR (PDR) and PDR. Each group consisted 30 inviduals. CI was assessed using the MMSE and MoCA. RESULTS: The number of subjects with a score>21 were significantly lower on the MoCA than on the MMSE between groups (all P<0.05). The mean MoCA score was significantly lower than the MMSE score (P<0.001) There was a linear association between the grade of DR and a score<21 on both tests, CONCLUSION: MoCA provides more insight into the cognitive function in DR.

Retinal nerve fiber layer thickness in the acute phase of sildenafil treatment.

OBJECTIVE: To evaluate the early effect of sildenafil on the retinal nerve fiber layer (RNFL) thickness. PATIENTS AND METHODS: Sixty eyes of 60 patients were enrolled in the study. The patients underwent RNFL analysis by scanning laser polarimetry (Nerve Fiber Analyzer, GDx VCC:5.3.3; Laser Diagnostic Technologies, San Diego, CA, USA) before and after a single 100 mg dose of sildenafil. Sixty eyes of 60 volunteers of similar age and sex distribution were taken as the control group. The RNFL thickness parameters evaluated included temporal, superior, nasal, inferior, temporal (TSNIT) average, superior average (SA), inferior average (IA), TSNIT standard deviation (SD), and nerve fiber index (NFI). RESULTS: The mean age of the patients was 53,52 ± 9,26 years. The mean pre- and post-treatment TSNIT, SA, IA, TSNIT SD, and NFI of the patients were 57.46 ± 4.94 µ versus 56.90 ± 4.59 microns (µ), 68.93 ± 6,12 µ versus 67,79 ± 5,49 µ, 66,71 ± 7.10 µ versus 66.31 ± 6.82 µ, 24 ± 3.86 µ versus 23.40 ± 4.05 µ, and 16.50 ± 6.08 µ versus 14.92 ± 6.76 µ, respectively. There were no statistically significant differences between pre- and post-treatment RNFL thicknesses (p = 0.527, p = 0.281, p = 0.754, p = 0.416, p = 0.185, respectively). CONCLUSIONS: A single 100 mg dose of sildenafil seems to have no unfavorable effect on RNFL thickness in the acute phase of treatment.

Mini mental state exam versus Montreal cognitive assessment in patients with age-related macular degeneration.

OBJECTIVE: To compare the ability of the MMSE and MoCA to identify cognitive dysfunction in patients with age-related macular degeneration (AMD). PATIENTS AND METHODS: The study included 81 (29 female, 52 male) AMD patients who were recruited from the Ophthalmology Department of Kirikkale University during 2012. Participants were screened for cognitive impairment using the MMSE and MoCA. The scores were recorded for all participants. The primary outcome measure was the proportion of patients with a score less than 21 on either test. RESULTS: The percentage of subjects who scored below a cut off of 21/30 was higher on the MoCA (48.1%) than on the MMSE (18.5%) (p = 0.05). The range and standard deviation of scores was larger with the MoCA (7-30, 5.34) than with the MMSE (19-30, 3.26). There was a more pronounced ceiling effect of the MMSE than of the MoCA. The mean MMSE scores of dry-and wet-type AMD patients was significantly higher than the MoCA scores of the same patients (p = 0.000 and p = 0.000). CONCLUSIONS: The MoCA seems to be more sensitive than the MMSE to early cognitive impairment in AMD patients.

Mean platelet volume in retinal vein occlusion.

OBJECTIVE: The exact pathogenic mechanism underlying the thrombotic tendency in retinal vein occlusion (RVO) is still not fully established. We investigated relationship between platelet indices including mean platelet volume (MPV) and platelet count in RVO patients compared to control group. PATIENTS AND METHODS: Forty six patients (19 female, 27 male) diagnosed as RVO were included in the study. Forty-six subjects (26 female, 20 male) served as controls. Patients were evaluated by careful biomicroscopic examination using a fundus contact lens and fluorescein angiography. Blood samples for total blood count with MPV were obtained after overnight fasting from the antecubital vein. RESULTS: The mean platelet volume was 8.11 ± 1.15 fl in RVO group. It was 8.68 ± 0.98 fl in controls. When compared, the mean MPV was significantly lower in RVO patients (p < 0.05). The mean platelet volume was also significantly lower in branch retinal vein occlusion group in comparison to controls (7.92 ± 1.19 fl. versus 8.68 ± 0.98 fl.) (p < 0.05). CONCLUSIONS: MPV was significantly lower in patients with RVO than control group. MPV does not seem to be a potentially useful biomarker for prediction of RVO.

Retinal nerve fiber layer thickness in congenital color vision deficiency.

PURPOSE: To evaluate the thickness of the retinal nerve fiber layer (RNFL) in subjects with congenital red-green color vision deficiency (CVD). METHODS: This study included 20 healthy subjects with congenital red-green CVD and 22 healthy subjects with normal color vision. After Ishihara test and examinations visual field by automated perimetry, all individuals underwent scanning laser polarimetry to measure the thickness of the RNFL. RESULTS: All scanning laser polarimetry parameters related to RNFL thickness were found to be similar in subjects with congenital CVD and normal color vision (p>0.05). CONCLUSIONS: This is the first report suggesting normal thickness of the RNFL in subjects with congenital red-green CVD.

Short-term effect of topical brinzolamide on human central corneal thickness.

PURPOSE: To investigate the effect of short-term brinzolamide application on human central corneal thickness (CCT). METHODS: Seventeen eyes of 16 patients who underwent neodymium:YAG laser posterior capsulotomy were included in the study group. Twenty-two subjects served as controls. Brinzolamide twice daily and fluorometholone four times daily were initiated after the procedure. Corneal thickness was evaluated with an ultrasound pachymetry from the central region. CCT measurements were performed before the procedure, at first day, and at the end of first week. RESULTS: The mean baseline CCT value was 535.1+/-37.8 micronm. In comparison to the control group (546.4+/-22.2 micronm), there was no statistically significant difference (p=0.248). After brinzolamide instillation, the mean CCT values at first day and at first week was measured as 545.1+/-40.1 micronm and 538.8+/-39.4 micronm, respectively. The difference at first day was statistically significant when compared to the baseline values (p=0.00017). When compared to the control group, no statistically significant difference was observed for the mean CCT values of the first day and first week (p=0.906 and p=0.484, respectively). In the fellow eyes, mean CCT values increased following the dorzolamide instillation (529.3+/-42.6 micronm, 534+/-41.7 micronm, and 533+/-41.9 micronm, respectively). No statistically significant difference was observed between the control group and fellow eye group when compared (p=0.162, p=0.247, p=0.270, respectively). CONCLUSIONS: Brinzolamide may cause a short-term increase in the human CCT, particularly on the first day.

Limbal autograft and allograft transplantations in patients with corneal burns.

AIM: To investigate and compare the surgical outcomes of limbal autograft and limbal allograft transplantations in patients with corneal burns. METHODS: In total, 20 patients (n=22 eyes) with chemical burn and two patients (n=2 eyes) with thermal burn were included in this study. Limbal autograft or limbal allograft transplantation surgery was performed in all patients. HLA-typing was tested before allograft surgeries. Limbal allografting was performed in all eyes using donor tissue from live relatives. Systemic cyclosporine A was administered for immunosuppression. RESULTS: The corneal surface was successfully reconstructed in all eyes (100%) after limbal autografting, two eyes required additional amniotic membrane transplantation and one eye required allografting. The mean follow-up period for limbal autografts was 13.9 +/- 7.0 months. Limbal allografting failed to reduce corneal vascularity and opacification in five (55.6%) eyes and was successful only in four (44.4%) eyes (mean follow-up 16.2 +/- 11.2 months) (P=0.002). In all, 15 eyes undergoing limbal autografting completed re-epithelialization of the cornea at a mean of 35.6 +/- 60.2 days. The mean epithelial healing time in nine eyes undergoing limbal allografting was 13.0 +/- 7.3 days (P=0.525). After limbal autografting, functional vision (> or =1/10) was attained in 12 (80%) eyes. Only one eye (11.1%) achieved functional vision after limbal allografting (P=0.036). Penetrating keratoplasty was performed in three patients following limbal allografting. No cyclosporine-associated side effects were observed. CONCLUSIONS: Limbal autograft transplantation is an effective and safe procedure for unilateral corneal burns. It seems that limbal allograft transplantation is better combined with penetrating keratoplasty for a better visual outcome and higher graft survival rate. Systemic immunosuppression seems to be necessary for limbal allografts even in the presence of HLA-matched donor tissues.