To investigate foveal avascular zone (FAZ) area and retinal vascular density (VD) in patients with psoriasis according to disease severity using optical coherence tomography angiography (OCTA).
...Twenty-seven patients with mild psoriasis (Group 1), 28 with moderate to severe psoriasis (Group 2) and 30 healthy controls (Group 3) were evaluated with OCTA. Foveal and parafoveal VD and FAZ area were measured and compared.
FAZ values were significantly higher in Group 2 (0.20 ± 0.1, 0.31 ± 0.07, 0.20 ± 0.09; P < .001, respectively.). The mean VD value were significantly lower in the deep capillary plexus in parafoveal area in Group 2 (35.5 ± 8.7, 28.7 ± 4.6, 35.0 ± 3.5; P < .001, respectively.). These changes showed significant correlation with Psoriasis Area and Severity Index (PASI) scores of patients.
Our results suggest that OCTA may have a future role as alert of potentially more severe disease in cases clinically classified as mild disease.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
To evaluate tear film quality and intraocular pressure (IOP) changes after upper eyelid blepharoplasty.
This retrospective study included 42 eyes of 21 patients who underwent upper eyelid ...blepharoplasty for dermatochalasis between January 2018 and June 2018 in our clinic. Schirmer's and tear break-up time (TBUT) values and IOP were measured preoperatively and postoperatively at first day, 1 month, and 3 months in all patients. The ocular surface staining pattern was evaluated according to Oxford scale. Effects of upper eyelid blepharoplasty on tear film quality and IOP were evaluated.
All patients were female and their mean age was 53.28±7.98. The postoperative Schirmer's test scores at postoperative 3 months were significantly (p<0.01) lower than all previous preoperative measures. Similarly, the postoperative 1-week measurements were significantly (p<0.01) higher than the postoperative 1-month and 3-month measurements. In terms of TBUT, the postoperative 1-week measurement was significantly (p<0.05) higher than the postoperative 1-month measurement and the preoperative value than the postoperative 1-month measurement. There was no significant (p>0.05) difference between the measurements in terms of IOP values. Of the 42 eyes evaluated according to Oxford scale, 28 (66%) had mild symptoms, 10 (23%) had moderate symptoms, and 4 (9%) had marked symptoms. No patient with severe symptoms was detected.
Upper eyelid blepharoplasty may have a negative effect on tear film quality in early postoperative period; however, it does not affect IOP at any period. Understanding the effects of surgery performed specifically on ocular surface through larger case series may necessitate ophthalmologic examination for preoperative evaluation and postoperative follow-up of dermatochalasis cases.
Background
To evaluate the retinal nerve fiber layer (RNFL) and peripapillary vascular density (VD) changes in the pediatric group with optic disk drusen (ODD).
Methods
Sixty eyes of 30 patients with ...buried ODD referred by the pediatric or neurology physicians to ophthalmology clinic with a preliminary diagnosis of papillary edema were included in this retrospective study. Sixty eyes of 30 healthy children were included as the control group. Thickness of RNFL (micrometer) and VD percentages (%) of the superior, inferior, nasal, and temporal quadrants of the peripapillary region of all cases were evaluated with optical coherence tomography angiography (OCT-A) device.
Results
The study and control groups were homogeneous in terms of age and gender. VD values were significantly lower in the study group for all four quadrants, when compared to controls (
p
< 0.001,
p
< 0.001,
p
= 0.003, and
p
< 0.001, for inferior, superior, nasal, and temporal quadrants, respectively. For RFNL thickness measurements, a significant difference between groups was only evident for the nasal quadrant, where the study group had significantly higher nasal RFNL thickness (
p
= 0.001).
Conclusion
This study detected decreases in peripapillary VD values in all quadrants and peripapillary RNFL thickening in nasal quadrant in pediatric cases with buried drusen compared to healthy controls. Further studies are necessary to reveal the effects of drusen pathogenesis on optic nerve head perfusion and to understand the underlying mechanisms of related complications.
Optical coherence tomography angiography (OCTA) is a useful method for determining choroidal neovascular membranes (CNVM) in different subtypes of pattern dystrophy.
We aimed to evaluate the optical ...coherence tomography (OCT) findings in different subtypes of pattern dystrophy and to detect CNVM not detectable by conventional method using OCTA.
Of 55 eyes included in this retrospective, cross-sectional study, adult onset vitelliform macular dystrophy was present in 42 eyes (32 eyes vitelliform stage-10 eyes vitelliruptive stage), butterfly-shaped pattern dystrophy in 8 eyes, and multifocal pattern dystrophy simulating fundus flavimaculatus in 5 eyes. Fluorescein angiography (FA), fundus autofluorescence, OCT and OCTA imaging were performed in all cases.
The study included 55 eyes of 29 patients, of which 21 were female and 8 were male. On OCT, 25 eyes had hyperreflective dots, 14 eyes had a disruption in the ellipsoid zone (EZ), and 6 eyes had atrophy in the outer retinal layers, and these findings were detected in all subtypes. Findings consistent with CNVM were detected in 1 eye using FA, 3 eyes using OCT and 5 eyes in OCTA.
In this study, we demonstrated that in different subtypes of pattern dystrophies OCT findings such as hyperreflective dots, disruption in the EZ, atrophy in the outer retinal layers and CNVM can be seen, and that a quiescent CNVM lesion, which cannot be detected by conventional methods, can be detected by OCTA, a new imaging method.
Metaplastic breast carcinoma (MpBC) is a rare disease entity, accounting for less than 1% of all breast carcinomas. Furthermore, it is a heterogenous disease with different subgroups, including ...malignant epithelial (carcinoma) and stromal (sarcoma) features. Here we evaluated, retrospectively, 14 female MpBC patients admitted to Ankara Oncology Training and Research Hospital between 2005 and 2011. Median age was 45.5 (range:16.0-76.0) and tumor size 57.5 mm (range: 20.0-80.0 mm). Histopathological subtypes were as follows: 5 carcinosarcoma, 5 squamous and 4 adenosquamous carcinoma. All but one with upfront lung metastasis, had their primary breast tumor operated. Axillary lymph nodes were involved in 64.3%. The most common sites of metastasis were lungs and brain. Chemotherapy including antracycline, taxane and even platinium was planned for adjuvant, neoadjuvant and palliative purposes in 9, 3 and 1 patient, respectively. Median cycles of chemotherapy was 6 (range:4-8). Median follow-up of the patients was 52 months (95%CI 10.4-93.6 month). Median 3 year progression free survival (PFS) and overall survival (OS) in this patients cohort were 33% and 56%, respectively. In conclusion, MpBC is a rare and orphan disease without standardized treatment approaches and the prognosis is poor so that larger studies to investigate different treatment schedules are urgently needed.
Abstract Central nervous system (CNS) metastases are detected in up to one third of patients with advanced breast cancer, but their incidence and outcomes by breast cancer subtypes are not precisely ...documented. Herein, we retrospectively analyzed clinicopathologic data of 259 breast cancer patients with CNS metastases to evaluate the association between breast cancer subtypes and CNS metastasis. The patient groups were classified according to their hormone receptor status and HER-2 expression. Median follow-up time among the patients was 42 months and median survival after CNS metastasis detection was 7.8 months. In HER-2 overexpressing group, median time period between the diagnosis of breast cancer and the detection of CNS metastasis (15.9 months) was significantly shorter compared to the other groups ( p = 0.01). The triple negative group had the shortest median survival time after CNS metastasis (6.6 months), although statistically not significant ( p = 0.3). In multivariate Cox regression analyses, having solitary CNS metastasis (HR 0.4, 95% CI; 0.2–0.7, p = 0.004), and receiving chemotherapy after CNS metastasis (HR 0.4, 95% CI; 0.287–0.772, p = 0.003) were independent prognostic factors for increasing survival after CNS metastasis. In conclusion, new and effective treatment strategies are required for breast carcinoma patients with brain metastasis considering the positive effect of the treatment on survival.
To evaluate the thicknesses of retinal nerve fiber layer (RNFL) and macula by fourier-domain (FD) optical coherence tomography (OCT) in non-diabetic patients with end-stage-renal-failure (ESRF) ...undergoing hemodialysis (HD).
This is a prospective and observational study. Both eyes of 20 patients receiving HD (group 1) and 34 control patients (group 2) were evaluated by FD-OCT. Macular and RNFL thicknesses were compared between groups and their correlation with age, duration of HD, and gender were examined. In group 1, macular and RNFL thicknesses were evaluated before and shortly after HD in the first day, first and sixth months.
In group 1, pre-HD temporal, inferior, average RNFL thicknesses were thinner than group 2. This thinning did not correlate with duration of HD, age and gender. Pre-HD macular thicknesses were thinner than group 2. These thinnings did not correlate with age, but the thinnings at superior, nasal and average thickness correlated negatively with duration of HD. Nasal, temporal, and average macular thicknesses were thinner in female patients. The thickenings of RNFL and macula that were observed in the after HD first day and first month did not showed consistency in the sixth month except superior quadrant RNFL.
Macular and RNFL thicknesses of patients receiving HD were less than the normal population. Age has no effect on these thinnings. The duration of HD affects more than gender. Hemodialysis session causes a consistent increase in superior quadrant RNFL.
To examine the changes in choriocapillaris and retina caused by coronavirus disease 2019 (COVID-19) by comparing optical coherence tomography angiography (OCTA) findings of COVID-19 patients and ...healthy controls.
The study and control groups consisted of 54 eyes of 27 participants, each. Patients and controls underwent OCTA examination. Foveal zone vessel density and parafoveal zone vessel density (for 4 quadrants: nasal, temporal, superior, inferior) were calculated for both superficial and deep capillary plexuses. Additionally, choriocapillaris flow and foveal avascular zone areas were calculated.
For the parafoveal area in the study group, vessel density was significantly lower in the superior and nasal quadrants of the superficial capillary plexus and in all quadrants of the deep capillary plexus compared with controls (p < 0.05 for all). The study group had significantly higher choriocapillaris flow area values compared with controls (p = 0.042).
Reduced vessel density of the retinal capillary plexus was detected in COVID-19 patients who may be at risk for retinal vascular complications.
Cette étude examinait les effets de la COVID-19 sur la choriocapillaire et la rétine en comparant les images obtenues à l'angiographie-tomographie par cohérence optique (OCTA, pour optical coherence tomography angiography) chez des sujets ayant été infectés par la COVID-19 à celles de sujets sains.
L’étude comptait 2 groupes de 27 participants chacun (54 yeux). Les patients et les sujets témoins ont subi un examen à l'OCTA. La densité vasculaire de la zone fovéale et la densité vasculaire de la zone parafovéale (dans les 4 quadrants: nasal, temporal, supérieur et inférieur) ont été calculées, tant dans le plexus capillaire superficiel que dans le plexus capillaire profond. On a également calculé l'aire du débit de la choriocapillaire de même que l'aire de la zone fovéale avasculaire.
La densité vasculaire de la zone parafovéale chez les patients était significativement moindre dans les quadrants supérieur et nasal du plexus capillaire superficiel et dans tous les quadrants du plexus capillaire profond, comparativement aux sujets témoins (p < 0,05 pour l'ensemble des mesures). De même, l'aire du débit de la choriocapillaire était significativement plus élevée chez les patients, comparativement aux sujets témoins (p = 0,042).
On a observé une baisse de la densité vasculaire du plexus capillaire rétinien chez des patients qui ont été infectés par la COVID-19, ce qui les expose peut-être à un risque de complications vasculaires rétiniennes.
This study aims to evaluate the treatment modalities applied for retinopathy of prematurity (ROP) and to determine the efficacy and results of treatment modalities.
Premature babies, who needed ...treatment for ROP and followed-up in the Neonatal Intensive Care Unit (NICU) of our hospital or external centers, were retrospectively evaluated between January 2012 and January 2017. According to the criteria determined by the International ROP committee, the zones and stages of the cases were recorded. In this study, patients were evaluated in three groups. Group 1: plus disease with any stage in zone 1, group 2: plus disease in zone 2, together with stage 2 or 3, group 3: classified as aggressive posterior retinopathy (APROP). The birth weight, gestational age, treatment weeks and treatments that were administered were recorded. Regression in plus disease, macular dragging and retinal detachment did not develop were evaluated as successful treatment.
1746 preterm babies were examined. 65 (3.7%) preterm babies were included in this study, 31 female and 34 male. 126 eyes of preterm babies were intervened. The mean birth weight was 1159 (535-2200) grams, and the mean gestational age was 28.4±2.5 (24-34) weeks. Group 1 had 33 eyes (26.1%), group 2 had 71 eyes (56.3%), and group 3 had 22 eyes (17.4%). 94 eyes (74.6%) were treated once, 26 eyes (20.6%) were treated twice, 6 eyes (4.8%) received treatment three times. The first treatment was applied at 36±2.4 (32-41) weeks. The first treatment was performed with intravitreal bevacizumab (IVB) in 75.8% of group 1 and 95.5% of group 3, and with diode laser photocoagulation (LPC) in 78.9% of group 2. There was a significant correlation between birth week and birth weight and first treatment week. Re-treatment was applied to 32,8% in LPC group and 19.2% in the IVB group due to recurrence. 5 eyes which were applied LPC+IVB did not need any re-treatment. Stage 4a retinal detachment developed in both eyes of 1 patient from group 1. Macular traction was developed in 2 eyes of 1 patient in group 2. After the treatments, success in 122 eyes (96.8%) was obtained.
ROP can be controlled by convenient and effective treatment. Although conventional LPC is still the first treatment option for ROP, IVB alone or combination with LPC is a highly effective treatment option for zone 1 disease and APROP. IVB reduces the number of ROP treatments.
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