BackgroundThe aim of this study was to evaluate the prevalence of diabetic macular edema (DME) utilizing optical coherence tomography (OCT), and to clarify the effects of the systemic findings and risk factors on the development of DME.MethodsThis cross-sectional study was conducted in the departments of ophthalmology and endocrinology at the Dokuz Eylul University School of Medicine in Izmir, Turkey. The demographics, type and duration of diabetes mellitus, treatment modality, smoking and alcohol consumption habits, as well as the systemic blood pressure, renal functional tests, hemoglobulin A1c level, serum lipid profile, and 24-h urine albumin level were noted and statistically analyzed. The relationships between the systemic findings and DME were studied.ResultsFour-hundred and thirteen eyes of 413 diabetic patients who were examined between January 2011 and July 2012 were enrolled in this study. The prevalence of DME was 15.3% among the patients. The males exhibited DME significantly more frequently than the females (p = 0.031), and the duration of diabetes was significantly longer in those patients with DME (p < 0.001). Those patients without DME frequently used antihyperlipidemic drugs and had a higher level of high density lipoprotein cholesterol (p = 0.040 and p = 0.046, respectively). The patient’s alcohol consumption, nephropathy, neuropathy, previous cataract surgery, severity of diabetic retinopathy, and insulin usage were statistically significant factors with regard to the DME prevalence.ConclusionsThis study demonstrated the prevalence of DME in Turkey by utilizing OCT. The development of DME can be avoided or limited and the response to treatment may be improved by the regulation of the DME risk factors.

The prevalence of CVI was found to be relatively increased due to the significant reduction in the frequency of preventable causes of SVI. Furthermore our clinical practice for visual rehabilitation in aphakia has resulted in a considerable decrease in SVI in the last decade.

Registration number of clinical trials registry: 2013/43-16. ABSTRACTPurpose: To evaluate the association between macular hole volume (MHV) and postoperative central macular thickness (CMT) using spectral-domain optical coherence tomography (SD-OCT). Methods: Thirty-three eyes of 30 patients with a large full-thickness idiopathic macular hole with or without vitreomacular traction who underwent surgical intervention were included in this cross-sectional study. Complete ophthalmological examination, including SD-OCT, was performed for all participants during the pre-and postoperative visits. MHV was preoperatively measured using SD-OCT, which captured the widest cross-sectional image of the hole. For normal distribution analysis of the data, the Kolmogorov-Smirnov test was performed, and for statistical analyses, chi-square, Student's t-test, Mann-Whitney U test, and Pearson's correlation coefficient test were performed. Results: Mean preoperative best-corrected visual acuity (BCVA) and MHV were found to be 0.99 ± 0.36 (range, 0.3-2.0) logMAR and 0.139 ± 0.076 (range, 0.004-0.318) mm 3 , respectively. Mean follow-up was 16.3 ± 14.3 (range, 3-50) months. No statistical correlations were found between MHV and postoperative BCVA (p=0.588) and between MHV and disease recurrence (p=0.544). A weak negative correlation existed between MHV and final CMT scores (p=0.04, r=-0.383). Conclusions: Greater MHV was found to be weakly associated with lower postoperative CMT scores. Keywords:Retinal perforations/surgery; Tomography, optical coherence; Vitrectomy; Macula lutea; Postoperative period (variação de 0,004-0,318). O seguimento médio foi de 16,3 ± 14,3 meses (variação de 3-50). Não foram encontradas correlações estatísticas entre 588), bem como MHV e recorrência da doença (p=0,544). Uma fraca correlação negativa estava presente entre MHV e pontuações finais CMT (p=0,04,383 RESUMO Objetivo: Avaliar a relação entre o volume do buraco macular (MHV) e a espessura macular central pós-operatória (CMT) por meio da tomografia de coerência óptica de domínio espectral (SD-OCT

Peripapillary choroidal thickness was thinner in glaucomatous eyes compared with normal eyes. Correlation of PCT and RNFL thickness found in patients with glaucoma did not exist in normal subjects.

Unrecognized retinal tears in patients with acute posterior vitreous detachment can cause subsequent retinal detachment. It is therefore important to consider multiple retinal tears, especially in patients with retinal or vitreous hemorrhage.

Objectives:To evaluate the safety and efficacy of active silicone oil removal with a 23-gauge (G) transconjunctival sutureless system.Materials and Methods:One hundred sixteen eyes of 113 patients who had previous retinal detachment surgery with pars plana vitrectomy and silicone oil injection surgery, and underwent silicone oil removal surgery with 23-G transconjonctival sutureless technique in our clinic between January 2009 and April 2014 were reviewed retrospectively. The patients were evaluated with regard to postoperative changes in best corrected visual acuity and intraocular pressure (IOP), and complications that occurred during and after surgery.Results:Of the 113 patients with mean age of 61.1±9.7 years (29-88 years), 62 (54.8%) were males and 51 (45.2%) were females. Silicone oil removal was performed 8.43±5.24 months after the initial surgery. Mean follow-up was 13.38±4.35 months. Visual acuity improved in 69 eyes (59.48%). Anatomic success was achieved in 113 eyes (97.41%). Mean IOP was 16.2±7.2 mmHg at baseline and 14.4±2.6 mmHg at postoperative day 1 (p=0.643). Eight eyes needed suturation of at least one sclerotomy. Retinal redetachment occurred in 3 eyes (2.5%) resulting in a decrease in vision. There were no cases of choroidal detachment, endophthalmitis, clinically significant corneal endothelial decompensation, or macular edema.Conclusion:Active removal of 1,300-centistoke silicone oil with a 23-G transconjunctival sutureless system is a simple, sutureless technique causing minor surgical trauma. Active removal of silicone oil with the 23-G transconjunctival sutureless technique was found to be effective and safe in both phakic and pseudophakic eyes.

Objectives: The effects of silicone endotamponade duration on the macula were evaluated in patients with rhegmatogenous retinal detachment. Materials and Methods: Sixty-five eyes of 65 cases with rhegmatogenous retinal detachment that underwent pars plana vitrectomy and silicone endotamponade were included in the study. All cases were classified in three groups according to duration of silicone tamponade: ≤3 months, 3-6 months, and ≥6 months. All cases were evaluated at 1 week, 1 month, and 3 months after silicone injection, just before and at 1 month after silicone removal in terms of intraretinal pathologies in the macula by using spectral-domain optical coherence tomography (SD-OCT). Results: Sixteen (26.6%) of the patients were female and 49 (75.4%) were male. The mean age of the patients was 58.1±12.1 years (18-82); the mean follow-up time was 12.4±4 months (6-20). The mean duration of silicone tamponade was 6.7±2.3 months (2-12). In 26.6% of patients with ellipsoid zone/outer limiting membrane defect, a statistically significant improvement in reflectivity was detected after silicone oil removal (p=0.016). There was a significant increase in central foveal thickness after silicone removal in eyes with duration of silicone more than 3 months (p=0.003 for 3-6 months, p=0.006 for ≥6 months). The prevalence of cystoid macular edema before and after silicone removal was also significantly higher in the eyes with silicone duration of 6 months or longer (p<0.001). Conclusion: In eyes with silicone endotamponade, structural changes in the macula may differ according to the duration of silicone oil in the eye.

BackgroundPreincisional local anesthetic infiltration at the surgical site is a therapeutic option for postoperative pain relief for pediatric inguinal hernia. Additionally, tramadol has been used as an analgesic for postoperative pain in children. Recently, the local anesthetic effects of tramadol have been reported. The aim of this study was to determine both the systemic analgesic and the local anesthetic effects of tramadol and to determine how it differs from bupivacaine when administered preincisionally.MethodsFifty-two healthy children, aged 2–7 years, who were scheduled for elective herniorrhaphy were randomly allocated to receive either preincisional infiltration at the surgical site with 2 mg/kg tramadol (Group T, n=26) or 0.25 mL/kg 0.5% bupivacaine (Group B, n=26). At the time of anesthetic administration, perioperative hemodynamic parameters were recorded. The pain assessments were performed 10 minutes after the end of anesthesia and during the first 6-hour period, using pain scores. The time of first dose of analgesia and need for additional analgesia were recorded.ResultsBetween T and B groups, the anesthesia time, perioperative hemodynamic changes, and pain scores were not statistically different. However, in group B, the postoperative analgesic requirement was higher than in group T.ConclusionTramadol shows equal analgesic effect to bupivacaine and decreases additional analgesic requirement, when used for preincisional infiltration anesthesia in children undergoing inguinal herniorrhaphy.