Background:The aim was to evaluate the effects of the Valsalva manoeuvre on Ocular Response Analyzer (ORA) measurements. Methods: A total of 152 eyes of 76 healthy individuals were included. The biomechanical properties of cornea, including corneal hysteresis (CH), corneal resistance factor (CRF) and intraocular pressure (IOP) parameters, namely, cornea compensated IOP (IOPcc) and Goldmann correlated IOP (IOPg) as measured with ORA were obtained before and during the Valsalva manoeuvre. Wilcoxon test for group analysis, Mann-Whitney test for intergroup analysis, Generalized Estimating Equation, and Spearman's test for correlation analysis were used. Results: The mean age of the 76 subjects (52 female) was 34.18 ± 10.20 years (range, 21 to 58 years). The mean IOPcc was 14.50 ± 0.30 mmHg before and 19.80 ± 0.60 mmHg during the Valsalva manoeuvre (p < 0.001). The mean IOPg before the Valsalva manoeuvre was 15.02 ± 0.33 mmHg and during was 20.18 ± 0.63 mmHg (p < 0.001). The mean corneal hysteresis was 11.40 ± 0.15 mmHg before Valsalva manoeuvre, and 10.60 ± 0.16 mmHg during Valsalva manoeuvre (p < 0.001). Pre-Valsalva manoeuvre mean corneal resistance factor was 11.97 ± 0.16 mmHg, whereas during the Valsalva manoeuvre, the mean corneal resistance factor was 12.06 ± 0.20 mmHg (p < 0.001). There was no correlation between age and either pre-or during-Valsalva manoeuvre measurements. The change in IOPcc and corneal hysteresis before and during Valsalva manoeuvre showed no intersexual difference; however, IOPg and corneal resistance factor change before and during Valsalva manoeuvre were significantly higher in male subjects. A negative correlation between pre-Valsalva manoeuvre corneal hysteresis and pre-and during-corneal resistance factor difference (r = -0.167) was detected. Conclusions: Valsalva manoeuvre causes a statistically significant increment in IOPcc, IOPg and corneal resistance factor and statistically significant decrement in corneal hysteresis. For this reason, to obtain reliable results, ORA measurements should be performed in suitable positions and with clothes that do not increase thoracic or abdominal pressure.Key words: cornea, corneal hysteresis, corneal resistance factor, intraocular pressure, Ocular Response Analyzer, Valsalva manoeuvreThe Valsalva manoeuvre (VM) is performed frequently in daily life, when moderately forceful attempted exhalation is made against a closed airway. The manoeuvre will elicit various physiologic responses, such as increased intra-thoracic pressure, reduced venous return, increased peripheral venous pressure and a rise in blood pressure.1 Some studies have found that Valsalva manoeuvre also might lead to a rise in intraocular pressure (IOP). 2-5Hysteresis is a measurement of viscous properties, whereas the corneal resistance factor (CRF) is dominated by elastic properties of cornea and is an overall indicator of the corneal resistance.5 Corneal hysteresis (CH) and CRF are closely related to each other but they do not represent the same physical/biomechanical properties...
Purpose: To evaluate the efficacy of the IOL-Vip Revolution telescopic intraocular lens in age-related macular degeneration patients. Methods: A total of 13 eyes of 12 age-related macular degeneration patients with senile cataract were enrolled. Selection of the patients was done by means of a low vision diagnostic and rehabilitative program (IOL-Vip software) that evaluates residual visual function. After standard phacoemulsification surgery, the incision site was enlarged and the IOL-Vip Revolution system was implanted in the capsular bag. The outcome measures were best corrected visual acuity, contrast sensitivity, anterior chamber depth, endothelial cell density, central corneal thickness, and quality-of-life questionnaire. Results: The mean age of the subjects was 72.3 ± 8.5 years. The mean positive power of the intraocular lens was 59 ± 2 D and the negative intraocular lens power was standard (–46 D). Pre- and postoperative best corrected visual acuity were 1.08 ± 0.14 and 0.81 ± 0.16 logMAR in the operated eye and 1.13 ± 0.36 and 1.01 ± 0.40 logMAR in the unoperated eye, respectively. The best corrected visual acuity was increased significantly in both operated and unoperated eyes (p = 0.005 and 0.021, respectively). Quality of life and anterior chamber depth increased significantly (p = 0.018 and 0.008, respectively), while endothelial cell density decreased (p = 0.002). No significant differences were detected in central corneal thickness or contrast sensitivity (p = 0.133 and 0.684, respectively). Conclusion: The results showed that IOL-Vip Revolution telescopic intraocular lens is a promising treatment option in age-related macular degeneration patients. The rehabilitation program may have an important role in the restored clinical results, which also provided visual improvement in the unoperated eyes.
Objectives: To examine the fellow eyes in unilateral non-arteritic ischemic optic neuropathy (NAION) and to compare their optic disc parameters and peripapillary retinal nerve fiber layer (RNFL) thickness with age-and refraction-matched normal controll subjects, using Heidelberg Retinal Tomograph 2 (HRT II). Ma te ri als and Met hods: The fellow eyes of 40 patients with typical unilateral NAION (study group) and one randomly chosen eye of 42 age-, sex-, and refraction-matched normal control subjects were enrolled in the study. Optic disc morphologic features (average disc area, cup area, rim area, disc volume, rim volume, cup/disc area ratio, cup depth) and peripapillary RNFL thickness were evaluated using HRT II, a confoal scanning ophtalmoscopy. Re sults: In the study group, there were 26 (65%) men and 14 (35%) women, whereas there were 27 (64%) men and 15 (36%) women in the control group (Chi square test, p=0.89). Mean age of the patients in the study and control groups was 59.4±10.3 and 57.7±9.1 years, respectively (T test, p=0.72). There was not any statistically significant difference regarding mean spheric equivalent between the two groups (Mann-Whitney U-test, p=0.203). The NAION unaffected fellow eyes had significantly smaller disc areas, cup areas, cup volumes, cup-disc area ratios (vertical and lineer), and cup depths than the control eyes (Mann-Whitney U-test; p<0.05), whereas there was no significant difference in the RNFL thickness between the two. Conclusion: A comparison of the fellow eyes in patients with unilateral NAION and the control eyes showed a significant difference in optic disc parameters and the morphology of RNFL. These differences could be important in the pathogenesis of NAION and needs to have further investigated.
Bu çalışmanın amacı Kan Basıncı Farkındalığı ve İçgörü Ölçeği (KFİÖ)'nin Türkçeye uyarlanması ile geçerlik ve güvenirlik çalışmalarının yapılmasıdır. Gereç-Yöntem: Metodolojik ve tanımlayıcı tipte yapılan çalışmanın örneklemi 188 bireyden oluşmuştur. Görüşme formu ve KFİÖ veri toplama aracı olarak kullanılmıştır. İstatistiksel analizler Jamovi programında yapılmıştır. Bulgular: Geçerlik analizleri sonucu ölçek maddelerinin hedeflenen kavramsal yapıyı ölçtüğü (KGİ=1,00, KMO=0,74, Barlett testi Sig.<0,05), açıklayıcı faktör analizi sonrası ölçeğin orijinalinde olduğu gibi tek boyuttan oluştuğu belirlenmiştir. Güvenirlik analizlerinde değişmezlik yeterli, iç tutarlılık (Cronbach's Alfa=0,75) oldukça güvenilir bulunmuştur. Sistolik kan basıncı ortalaması 129,63±17,80; diastolik kan basıncı ortalaması ise 78,36±11,17 mmHg'dır. Ölçek puan ortalaması 4,52±2,37'dir. Sonuç: KFİÖ'nin Türk toplumunda kan basıncı farkındalığı ve içgörüsünü ölçmek için kullanılabileceği belirlenmiştir.
Amaç: İlişki arayıcı tasarımdaki araştırmanın amacı 18-64 yaş arası Tip 2 Diyabetes Mellitus (T2DM) tanısı olan bireylerin beslenme okuryazarlığı ile öz etkililik ve diyabet öz bakım aktiviteleri arasındaki ilişkinin incelenmesidir. Gereç ve Yöntem: Araştırma büyükşehir il merkezinde yer alan bir aile sağlığı merkezine kayıtlı T2DM tanısı olan 200 yetişkin ile Aralık 2018-Mayıs 2019 tarihleri arasında yürütülmüştür. Veri toplamada sosyodemografik ve sağlık özelliklerini içeren Bilgi Formu, Beslenme Okuryazarlığı Ölçeği, Öz Bakım Ölçeği ve Diyabet Öz Etkililik Ölçeği kullanılmıştır. İstatistiksel analizlerde t-testi, Tek Yönlü Varyans Analizi, Pearson Korelasyon Analizi, Ki-kare ve Fisher Exact ki-kare testleri uygulanmıştır. İstatistiksel olarak %95 güven aralığında p<0.05 anlamlı kabul edilmiştir. Bulgular: Araştırmaya katılanların %65’i kadın, yaş ortalaması 52.9±9.34’dür. Bireylerin beslenme okuryazarlığı %74.5’inde yeterli, %24.9’unda sınırda, %2’sinde yetersizdir. Lise ve üniversite mezunlarında beslenme okuryazarlığı yeterli, ilkokul/ortaokul mezunlarında sınırlıdır (p<0.000). Bireylerin Özbakım ölçek puan ortalamaları 88.03±14.77, Öz-etkililik toplam ölçek puan ortalamaları 69.87±16.60’dır. Beslenme okuryazarlığı toplam ölçek puanları ile özbakım (p=0.001) ve özetkililik puanları (p=0.000) arasında ilişki saptanmıştır. Sonuç: Araştırma sonuçları beslenme okuryazarlığı ile öz-etkililik ve öz bakım davranışları arasında ilişki olduğunu göstermiştir. Birinci basamaktan başlayarak sağlık ekibi üyelerinin bireylerin beslenme okuryazarlığı düzeylerini belirleyerek bireysel eğitimleri planlanmaları, beslenme okuryazarlığı düzeylerine göre eğitim materyallerini hazırlamaları ve eğitimlerde kullanmaları diyabetin etkin yönetimi için önemli uygulamalar olacaktır.
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