Association between septoplasty, Lund-Mackay score and Lund-Kennedy score with endoscopic dacryocystorhinostomy results.

PURPOSE: To compare endoscopic dacryocystorhinostomy (endo-DCR) + septoplasty with endo-DCR alone and determine the relationship between sinusitis and endo-DCR surgery results. METHODS: Our study included 55 patients with nasolacrimal duct obstruction (NLDO) between June 2017 and June 2019. Patients were divided into two groups as endo-DCR alone and endo-DCR + septoplasty. Patients' symptoms were thoroughly evaluated and scored using the Lund-Mackay (LM) score and the Lund-Kennedy (LK) system. According to LK endoscopy scoring; those with a score of 0 were determined as group 1 (40 (58.8%) cases); and those with a score greater than 0 were determined as group 2 (28(41.2%) cases). According to LM CT scoring system, cases whose score was 0 were determined as group 1 (44(%66.2) cases); those greater than 0 were determined as group 2 (23(33.8%) cases). RESULTS: A total of 68 endo-DCR surgeries, 42 unilateral and 13 bilateral, were performed. Forty one cases (60.3%) were managed with endo-DCR alone, and septoplasty surgery was performed in 27 (39.7%) cases in addition to endo-DCR due to septum deviation. There was no statistically significant difference in functional and anatomical success between the two groups in terms of surgery type (anatomical success p = .353, functional success p = .528); LK endoscopy scoring (anatomical success p = .956, functional success p = .925) and LM CT scoring system (anatomical success p = .202, functional success p = .172). CONCLUSION: LK endoscopy and LM CT scores did not show any influence on functional and anatomic outcomes in endo-DCR cases.

The prevalence of papilledema in patients with migraine: a crucial cooccurrence of migraine and idiopathic intracranial hypertension.

OBJECTIVE: We aimed to investigate the prevalence of idiopathic intracranial hypertension (IIH) in patients with migraine by screening for papilledema. MATERIALS AND METHODS: We have included all the patients with migraine who applied to our neurology clinic during December 2019 and accepted to participate in the study. The demographic and clinical characteristics including migraine subtype (episodic/chronic), headache frequency per month, and headache characteristics of all patients were interrogated. Besides, the presence of fibromyalgia (FM) and chronic fatigue syndrome (CFS) was noted. Fundus examination was performed in all of the patients and the presence of papilledema was noted. RESULTS: Overall, 158 consecutive migraineurs were included in this study. The mean age of the group was 35.9 ± 9.9 and the female/male ratio was 134/24. Papilledema was determined in 10 (6%) patients. There was a past medical history of having IIH in one of these patients. In four of the patients, the diagnosis of IIH was newly established. Comparative analyses between episodic migraineurs and chronic migraineurs revealed that female gender was more prevalent in chronic migraineurs (p = 0.00) and the comorbidities of FM and CFS were more common in chronic migraineurs. Remarkably, papilledema was found to be more common in chronic migraineurs. The results of the logistic regression analyses revealed that obesity was the only predictor for the presence of papilledema (p = 0.014). CONCLUSION: Our results may suggest that IIH should be kept in mind as a notable comorbidity in migraineurs, particularly in the subgroup of obese patients with chronic migraine.

Effects of Topical Thymoquinone in an Experimental Dry Eye Model

Objectives: To comparatively evaluate the effects of thymoquinone (TQ), the biologically active main component of volatile oil derived from Nigella sativa seeds, in an experimental dry eye model. Materials and Methods: A total of 36 BALB/c mice 10 weeks of age were used in the study. The mice were divided into 6 groups of 6 mice. Two groups were negative and positive controls, and the other 4 groups were treated with balanced salt solution, fluorometholone (FML), TQ, or vehicle (Tween80). After 1 week of treatment, the mice were killed and the eyes removed for histopathologic examination and cytokine analysis. Interleukin (IL)-1α tumor necrosis factor-α, interferon-γ, IL-2, IL-6, IL-10, and lactoferrin levels in the conjunctival tissue were measured by multiplex immunobead assay. The presence of inflammatory cells in ocular tissue samples were investigated by hematoxylin-eosin and periodic acid-Schiff staining. Inflammatory T cells containing CXT receptor in the conjunctiva were determined by flow cytometry. Results: FLML and TQ groups had less inflammatory cell density and more goblet cells compared to the other groups. High levels of IL-1α and IL-2 were found in the TQ group. Conclusion: TQ treatment was associated with reduced inflammation in pathological examination, but did not significant lower cytokine levels.

The influence of monocular vision on the plantar pressure distribution.

BACKGROUND: Although the influence of monocular vision to upper limb biomechanics has been well documented, data about lower extremity biomechanics are limited. The objective of the present study was to demonstrate pedobarographic differences between both feet of the individuals with monocular vision in static and dynamic conditions. METHODS: Pedobarographic analysis of twenty-four participants with monocular vision was performed. Relative static pressure load (%) and dynamic peak plantar pressure (N/cm(2)), force (N) distributions and contact area percentages (%) were recorded under both low vision and normal vision side foot. FINDINGS: The results showed that relative static pressure loads did not differ between low vision and normal vision foot. Under midfoot of low vision side, a significant increment was found in peak plantar pressures (2.42 (SD 1.09) N/cm(2)) and forces (136.77 (SD 64.96) N) compared to normal vision side foot (1.87 (SD 0.96) N/cm(2); 106.94 (SD 65.03) N). No difference in contact area percentages was detected. INTERPRETATION: These results indicate that there are differences in plantar pressure measurements between feet of individuals with monocular vision. These pedobarographic differences reported here appear to support the assumption that individuals with monocular vision have adaptive gait strategies such as, decreased walking speed, limited ankle motion and postural compensations.

Surgically Induced Corneal Astigmatism Following Intravitreal Ranibizumab Injection.

PURPOSE: To evaluate surgically induced astigmatism (SIA) after an intravitreal ranibizumab (IVR) injection. METHODS: Fifty eight eyes of 58 patients who underwent IVR injection due to age-related macular degeneration (wet form) or macular edema were included in this study. Patients' pre- and postoperative detailed ophthalmologic examinations were done and topographic keratometric values (K1, K2) were noted. Pre- and postoperative measurements were compared. RESULTS: The mean preoperative astigmatism of 0.87 Diopters (D) was found to be 0.95 D, 0.75 D, 0.82 D and 0.78 D on the 1st day, 3rd day, 1st week and 1st month, respectively. After injection, absolute change in astigmatism was found to be 0.08 D, 0.12 D, 0.05 D and 0.09 D on the 1st day, 3rd day, 1st week and 1st month, respectively. The absolute change in astigmatism seemed to be insignificant in terms of refractive analysis, however; when we performed a vectorial analysis, which takes into account changes in the axis of astigmatism, the mean value of induced astigmatism were found to be 0.33±0.22 D, 0.32±0.29 D, 0.41±0.37 D, 0.46±0.32 D on the 1st day, 3rd day, 1st week and on 1st month, respectively. CONCLUSION: Intravitreal injection is a minimally invasive ophthalmologic procedure, however; it may still cause statistically significant induced astigmatism when evaluated from a vectorial point of view.

The effects of diazepam on blood pressure levels in cataract surgery.

OBJECTIVE: To evaluate the effects of oral diazepam on blood pressure (BP) alterations in patients that underwent cataract surgery under topical anesthesia. METHODS: A total of 147 patients that underwent phacoemulsification surgery under topical anesthesia, were reviewed retrospectively. The study took place in the Department of Ophthalmology, Adnan Menderes University Medical Faculty, Aydin, Turkey, between January 2011 and July 2013. Patients were divided into 2 groups: Group 1: received 5 mg diazepam per oral one hour prior to surgery, and Group 2 (control group): none administered preoperatively. The BP readings of all patients were scanned through their files. Five readings were chosen for statistical analysis. The first reading was taken in the ophthalmology ward on the morning of the operation, the second was taken in the premedication room just before the surgery, 2 readings were taken intraoperatively and recorded as third and fourth values, and the fifth reading was recorded from those taken in the ophthalmology ward after surgery. RESULTS: Group 1 had a mean age of 62.17 +/- 10.01 years, while the Group 2 had a mean age of 64.31 +/- 10.88 years. There were no differences between the 2 groups by means of systolic and diastolic BP levels measured preoperatively in the ophthalmology ward. Intraoperative systolic and diastolic BP levels were significantly higher in Group 2 (p<0.001). CONCLUSION: Elevated BP can undermine surgical outcomes; and may lead to unforeseen complications. To prevent the elevation of BP to risky levels in the intraoperative period, diazepam administration may be beneficial, even in normotensive patients.