Purpose The aim of this study was to evaluate macular blood flow in patients with thyroid-associated orbitopathy (TAO) as compared to healthy subjects. The inflammatory nature of the disease, as well as the vascular congestion caused by the increase in the volume of orbital soft tissue and extraocular muscles, rationalize the assessment of retinal blood flow changes in these patients. Methods This is a cross-sectional study with the convenience sampling method. Macular flow density was assessed using optical coherence tomography angiography (OCTA) and compared between patients with TAO and healthy individuals. We also compared macular flow density in two subgroups of patients based on clinical activity score (CAS). Results Eighty–five cases, including 30 healthy individuals and 55 patients with TAO, participated. The foveal avascular zone (FAZ) area was significantly larger in the patient group than in the control. Patients with active TAO with CAS 3 or more had significantly larger FAZ areas than those with CAS less than 3 (p = 0.04). Conclusion We showed that the FAZ area is larger in active TAO patients and can be considered a possible candidate feature for monitoring disease activity and thyroid-associated vasculopathy.
Introduction: Blepharoplasty, which is performed for either functional or cosmetic purposes, is one of the most common surgeries around the world. This procedure can be performed under either local or general anesthesia. It depends on the surgical indication, patient’s demand, surgeon’s plan, and need for auxiliary operations. It has been proved that both local and general anesthesia have different complications. Hypnosis is a skill by which hypnotherapists can make changes in perceptual experience and can be used instead of anesthetic drugs on some occasions. The present study was conducted to survey the effectiveness of hypnosis used as an alternative to anesthesia procedures. Case Presentation: A 54-year-old woman was scheduled for bilateral upper lid cosmetic blepharoplasty. Hypnotic anesthesia was conducted owing to her fear of anesthesia and drug-related side effects. Hypnotic anesthesia was accomplished by a hypnotherapist who was an anesthesiologist, and the operation was done without any surgical complications. Conclusions: Hypnosis may be a good alternative to local anesthesia and lead to a reduction in analgesics consumption.
Purpose: The aim of this study was to evaluate macular blood flow in patients with thyroid-associated orbitopathy (TAO) compare to healthy subjects. Methods: This is a cross-sectional study with the convenience sampling method. Macular flow density was assessed using optical coherence tomography angiography (OCTA) and compared between patients with TAO and healthy individuals. We also compared macular flow density in two subgroups of patients based on clinical activity score (CAS). Results: Eighty–five cases, including 30 healthy individuals and 55 patients with TAO, participated. The foveal avascular zone (FAZ) area was significantly higher in the patient group than in the control. A comparison of flow data between the two subgroups of patients showed a significant difference in the FAZ area (p=0.041). Conclusion: We showed that the FAZ area has an increasing trend from healthy individuals to active TAO patients and can be considered a possible candidate for monitoring the disease activity and thyroid-associated vasculopathy.
Purpose: To evaluate the dimensions of lower punctum in a sample of Iranian normal population using spectral domain anterior segment optical coherence tomography (OCT). Methods: In this cross-sectional study, 102 eyes of 102 healthy volunteers were enrolled. All participants underwent a detailed history and complete ophthalmic examination. Lower punctum metrics were measured using OCT (Spectralis, Heidelberg) with the anterior segment module. External punctal diameter was defined as the largest diameter at the surface of the punctum. Internal punctal diameter was measured at two different depths of 100 μm and 500 μm from the external surface. Measurements were repeated for 30% of data by another grader. The agreement was measured using intraclass correlation coefficient (ICC). Results: The mean age of the participants was 61.5 ± 7.9 years. The mean external punctal diameter was 425.6 ± 124.3 μm. The mean internal punctal diameter at 100 μm and 500 μm was 183 ± 97.5 μm and 77.7 ± 51.4 μm, respectively. The agreement between the graders was high in assessing all punctal characteristics (ICC >0.9 for all measurements). Conclusion: The spectral domain OCT can be used for measuring lower punctum diameter with acceptable reproducibility.
Background To evaluate changes in the vessel density (VD) of the optic nerve head (ONH) microvasculature in thyroid eye disease (TED) using optical coherence tomography angiography (OCTA). This study aimed to applicate the OCTA as a noninvasive modality in screening TED patients to assess sub-clinical changes. Methods In a cross-sectional study, the control group patients were healthy individuals with no ocular abnormalities and were euthyroid. All patients with TED had clinical features of the disease. We divided them into two groups using the clinical activity score (CAS). Patients with CAS scores 0–2 were categorized as group A, and scores three or more as group B. All vessels (AV) and small vessels (SV) VD inside disc and radial peripapillary capillary network were measured using the ONH-OCTA. Results We evaluated 29 patients with TED and 28 healthy controls. The mean whole image AV VD (mean ± SD: 56.33 ± 2.56, p-value = 0.17) and the mean whole image SV VD (mean ± SD: 49.94 ± 2.56, p-value = 0.16) in the TED group had no statically significant difference compared with the control group (AV mean ± SD: 57.20 ± 20.22, SV mean ± SD: 50.84 ± 2.23). We found a non-significant decrease in AV and SV radial peripapillary capillary VD in the TED group. There was a significant decrease in the mean whole image AV VD (mean ± SD: 54.83 ± 3.07, p-value = 0.005) and the mean whole image SV VD (mean ± SD: 48.60 ± 3.18, p-value = 0.013) in CAS group B compared to group A (AV mean ± SD: 57.45 ± 1.33, SV mean ± SD: 50.95 ± 1.37). Conclusion Our study showed non-significant ONH vascular alterations in patients with TED, including reduced VD of ONH in the radial peripapillary capillary. Patients with higher CAS scores had a more noticeable decrease in ONH microvasculature.
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