Association between lower extremity venous insufficiency and increased choroidal thickness.

PURPOSE: The goal of this study is to investigate the association between the choroid and lower extremity venous insufficiency (LEVI). METHODS: This prospective cross-sectional study includes 56 patients with LEVI and 50 age/sex-similar control subjects. Choroidal thickness (CT) measurements from 5 different points were captured from all participants by optical coherence tomography. In the group with LEVI on physical examination, reflux at the saphenofemoral junction, and the diameter of the great and small saphenous veins were evaluated via color Doppler ultrasonography. RESULTS: The mean subfoveal CT was higher in the varicose group than in the control group (363.04±99.75µm vs. 320.30±73.46µm, P=0.013). In addition, the CTs at the temporal 3mm, temporal 1mm, nasal 1mm, and nasal 3mm distance from the fovea were higher in the LEVI group compared to the controls (for all, P<0.05). There was no correlation between CT and diameter of the great and small saphenous vein in patients with LEVI (for all, P>0.05). However, the great and small saphenous veins of patients with CT above 400µm were observed to be wider in patients with LEVI (P=0.027 and P=0.007, respectively). CONCLUSION: Varicose veins can be a feature of systemic venous pathology. Another component of systemic venous disease may be increased CT. Patients with high CT should be investigated for susceptibility to LEVI.

Comparison of two sedation protocols on intraocular pressure and hemodynamic responses during colonoscopy.

OBJECTIVE: Colonoscopy is one of the most frequently performed interventional endoscopic procedures for diagnosis and treatment. During the procedure, the increase in intraabdominal pressure can cause undesirable spikes in intraocular pressure. In the literature, there are no studies on agent combinations that cause the least effect on intraocular pressure and hemodynamic response in colonoscopic procedures, which are performed more frequently in the elderly, the patient group at the greatest risk for glaucoma. This study aimed to compare ketamine-propofol and ketamine-midazolam protocols in terms of their effects on hemodynamic parameters and intraocular pressure. MATERIALS AND METHODS: The research was a randomized clinical controlled double-blind study. The study was conducted on 60 healthy adults who underwent elective colonoscopy. Ketamin-midazolam and ketamine-propofol combinations were used. Hemodynamic parameters, intraocular pressures at five different times, and the satisfaction levels of the endoscopist and the patient were recorded. RESULTS: In both groups, there was a statistically significant difference between the pre-procedure intraocular pressure values and the values at the 1st minute of the procedure and at recovery (p<0.05). No statistically significant difference was found between the intraocular pressure values of the study groups at any time point (p>0.05). CONCLUSIONS: Both combinations can be used safely. The combination of ketamine and propofol in subanesthetic doses provides better sedation without disturbing the hemodynamics and is preferable.