GirişP eribulber blok, oftalmik cerrahide anestezi ve akinezi sağlamak için kullanılan rejyonal anestezi tekniklerinden biridir. Kas konusu dışına (ekstrakonal) verilen lokal anestezik ile optik sinir hasarından kaçınılmaktadır. Bundan dolayı daha fazla anestezik ajan gerektirir. Peribulber blok, birden fazla enjeksiyona gereksinim duyulması ve fazla miktarda lokal anestezik ajan verilmesi gibi dezavantajları olmasına rağmen oftalmik cerrahi öncesinde komplikasyonların azlığı nedeniyle sıklıkla tercih edilir (1). Oftalmik cerrahi geçirecek hastalarda peribulber anestezi altında major komplikasyonların oranı %0,006 olarak bildirilmiştir (2). Teorik olarak peribulber bloğun daha güvenli ve kolay olduğu düşünülmesine rağmen literatürde peribulber blok sonrası beyinsapı anestezisi gelişen vakalar bildirilmiştir (3, 4). Olgumuzda katarakt ameliyatı öncesi yapılan peribulber bloğa bağlı muhtemel beyin sapı anestezisi nedeniyle gelişen solunum depresyonu sunulmaktadır.
Olgu SunumuSağ göz için elektif katarakt cerrahisi planlanan 68 yaşındaki bayan hastanın bu raporun yayınlanması için bilgilendirilmiş yazılı onamı alındı. Yaklaşık onbeş yıldır esansiyel hipertansiyonu mevcuttu ve tedavide indapamid ve triamteren kullanmaktaydı. Hipertansiyon dışında herhangi bir sistemik hastalığı olmayan hastanın laboratuar değerlerinde özellik yoktu. Preoperatif risk skoru Amerikan Anesteziyologlar Derneği (ASA: American Society of Anesthesiologists) ASA II'idi. Bir yıl önce diğer gözden peribulber blok ile katarakt cerrahisi geçiren hasta sorunsuz taburcu edilmişti. Hasta monitorize edildi (kalp hızı, elektrokardiyografi, noninvaziv kan basıncı ve oksijen satürasyonu) ve damar yolu açıldı. Katarakt cerrahisi öncesi anestezi sağlamak amacıyla 6 mL %2 lidokain hidroklorid (Jetokain ampul; Adeka İlaç San., Samsun, Türkiye) kullanılarak alt kapakta inferotemporal alt orbital kenardan lateral kantus ve lateral limbusun ortasından 25 gauge ve 25 mm uzunluğun-da iğne ile Göz Hastalıkları uzmanı tarafından peribulber blok yapıldı.Peribulbar block is used to obtain anaesthesia and akinesia of the eye by injecting a local anaesthetic around the musclecone. A patient scheduled for cataract surgery received peribulbar block with 6 mL of 2% lidocaine hydrochloride. Following the injection, confusion, hypotension and dilatation of the contralateral pupil rapidly progressed to loss of consciousness and respiratory arrest. The patient was intubated and mechanically ventilated for 30 min. The patient regained her consciousness, was extubated and transferred to the intensive care unit for further follow-up. Although brainstem anaesthesia because of peribulbar block is very rare, this procedure should be performed with complete monitorisation and resuscitation equipment. Keywords: Peribulbar anaesthesia, brainstem anaesthesia, respiratory arrest, patient monitarisation Peribulber blok ile kas konusu dışına lokal anestezik madde verilerek gözde anestezi ve akinezi sağlanmaktadır. Katarakt cerrahisi planlanan bir hastada peribulber alana 6 mL %2 lidokai...
Unilateral retinal pigment epithelium dysgenesis (URPED) is a very rare clinical condition first described in 2002. Fundus examination and imaging findings are almost pathognomonic and can facilitate diagnosis of this uncommon disease. In this article, we present a 32-year-old patient who developed type II neovascularization (NV) as a complication of URPED. After 6 months of monthly intravitreal bevacizumab injection, visual acuity increased from 20/32 to 20/20 but optic coherence tomography findings were partially improved. The aim of this report is to highlight URPED and secondary type 2 NV, the pathogenesis and prognosis of which are unknown but which cause visual loss especially in the younger population.
The purpose of this study was to evaluate the association between dry eye disease and patients with newly diagnosed obsessive-compulsive disorder (OCD).Methods: Thirty treatment-naive patients with OCD and 30 healthy controls were included in this prospective study. The Ocular Surface Disease Index, tear breakup time, Schirmer I test, corneal and conjunctival staining grade (Oxford scale), and neutrophil-toleucocyte ratio values were obtained for all participants.Results: The comparison of the patients with OCD and healthy controls showed significantly higher values in Ocular Surface Disease Index (34.8 vs. 20.8, P = 0.001), corneal Oxford scoring (0.9 vs. 0.6, P = 0.02), and conjunctival Oxford scoring (0.8 vs. 0.5, P = 0.04), with consistently lower values in the Schirmer I test (15.7 vs. 18.8, P = 0.043) and tear breakup time (9.1 vs. 12.9, P = 0.001). The mean neutrophil-to-leucocyte ratio values were significantly higher in the OCD group compared with the controls (2.4 6 0.9 vs. 1.6 6 0.4, respectively; P = 0.001).
Conclusions:Our study showed a relation between dry eye disease and patients with newly diagnosed OCD who were not using any psychiatric drug. Our findings suggest that inflammation, which plays an important role in the pathogenesis of both diseases, may be responsible for this relationship.
Fovea plana is a congenital condition characterized by anatomic absence of the foveal pit. It may be isolated or associated with congenital ocular anomalies. In this report, we present a case of fovea plana associated with situs inversus of the optic disc, optic disc hypoplasia, tilted optic disc, and prepapillary vascular loop and with best corrected visual acuity of 20/32. The aim of this report is to demonstrate the coexistence of very rare multiple optic disc anomalies and fovea plana, and also to emphasize that the use of multimodal imaging methods facilitates the identification of rare anomalies.
Aims and Scope Eurasian Journal of Medicine (Eurasian J Med) is an international, scientific, open access periodical published by independent, unbiased, and tripleblinded peer-review principles. The journal is the official publication of
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