Purpose
The purpose of this study was to analyze the effects of systemic and ocular profiles on subfoveal choroidal thickness (SFChT) in treatment-naïve eyes with diabetic retinopathy (DR).
Methods
This study included patients with treatment-naïve DR. They underwent routine laboratory evaluations, including complete blood cell count, liver function tests, kidney function tests, and urinalysis for macroalbuminuria. The systemic and ocular factors associated with the change in SFChT in DR were analyzed.
Results
A total of 136 eyes from 136 patients with diabetes and 30 eyes from 30 age-matched healthy controls were recruited. Generalized linear model analyses showed that the SFChT in treatment-naïve eyes with DR was positively associated with the DR grade and estimated glomerular filtration rate (eGFR;
P
= 0.001) and negatively associated with age (
P
< 0.001) and serum phosphorus levels (
P
= 0.001). Treatment-naïve eyes with proliferative DR (PDR; 313.4 ± 9.0 µm) or severe nonproliferative DR (NPDR; 299.7 ± 9.7 µm) had thicker choroid than eyes with mild to moderate NPDR (251.7 ± 11.1 µm) or no DR (231.2 ± 14.5 µm) after adjusting for age, eGFR, and phosphorus levels.
Conclusions
Choroid is affected by renal function and the grade of DR in patients with diabetes. Advanced retinopathy is associated with choroidal thickening, and the severity of concomitant renal disease is associated with choroidal thinning.
The purpose of this study was to analyze the correlation between renal function and subfoveal choroidal thickness (SFChT) in treatment-naïve proliferative diabetic retinopathy (PDR) patients. This study included 85 eyes of 52 treatment-naïve PDR patients who underwent kidney function testing and urinalysis and 42 eyes of 33 age-matched controls. Treatment-naïve eyes with PDR were categorized into pachychoroid and leptochoroid groups based on the SFChT of the control group. Kidney function profiles were compared between pachychoroid and leptochoroid groups; the relationship between kidney function profile and SFChT was evaluated using regression analysis. Compared with the pachychoroid group, the leptochoroid group had significantly higher serum creatinine (p = 0.026), cystatin C (p = 0.004), and phosphorus (p < 0.001) levels and a lower estimated glomerular filtration rate (eGFR) (p < 0.001). Multivariate linear regression analyses showed that SFChT was positively correlated with eGFR (Cystatin C) (p = 0.007) and negatively correlated with serum phosphorus (p = 0.001). SFChT of patients with eGFR < 30 mL/min/1.73 m2 and serum phosphorus level ≥4.0 mg/dL was less than that of patients with higher eGFR and lower serum phosphorus level. The choroidal thickness of treatment-naïve PDR patients is closely affected by renal function. Kidney function test should be considered if SFChT of patients with treatment-naïve PDR is reduced.
A 69-year-old male presented with a week of worsening headache, mild dizziness and left side weakness, and the radiological work-up of his brain displayed an enhancing mass on the right frontal lobe. The tumor was totally resected. The patient was initially diagnosed with glioblastoma multiforme. His neurologic symptoms recovered after surgery. He underwent adjuvant radiotherapy with concurrent temozolomide. Approximately 7 months after surgery, the patient complained of epigastric pains. Abdominal CT scan showed multiple hepatic metastasis and multiple lymphadenopathy. Chest CT and Torso positron emission tomography-CT scans for additional metastasis study revealed multiple metastatic lesions in the right lung, left pleura, liver, lymph nodes, bones, and muscles. Percutaneous liver biopsy was performed, and associated pathology was consistent with sarcomatous component. After liver biopsy, brain tumor pathology was reviewed, which revealed typical gliomatous and sarcomatous components. The patient was therefore diagnosed with metastatic gliosarcoma. The patient was in a septic condition with aggravated pleural effusion. The patient died 9 months after the diagnosis of primary gliosarcoma.
Purpose:
To use morphological measurements to analyze changes in the position and shape of the lower eyelid after inferior orbital wall reconstruction.
Methods: This study included 47 eyes from 47 patients with blowout fractures. Digital photographs were taken in primary gaze immediately before and after surgery; the degree of enophthalmos was recorded. Several eyelid parameters were measured, including marginal reflex distance 1 (MRD1), MRD2, lower eyelid length (LEL), lower medial palpebral fissure area, lower central palpebral fissure area (LCA), and lower lateral palpebral fissure area.
Results:
The exophthalmometry values (P < 0.001), MRD2 (P < 0.001), LEL (P < 0.001), LCA (P = 0.022), and lower lateral palpebral fissure area (P = 0.038) on the injured side before surgery were significantly smaller than those on the contralateral, uninjured side. Following surgery, the MRD2 increased from 5.01 ± 0.65 mm to 5.60 ± 0.78 mm (P < 0.001), LEL from 25.62 ± 2.11 mm to 26.64 ± 2.29 mm (P < 0.001), lower medial palpebral fissure area from 7.10 ± 3.97 mm2 to 10.37 ± 3.40 mm2 (P < 0.001), and LCA from 20.28 ± 4.79 mm2 to 21.25 ± 5.14 mm2 (P = 0.008). Multivariate linear regression analysis revealed that changes in the MRD2 (P = 0.019) and LCA (P = 0.048) were associated with enophthalmos improvement.
Conclusion:
The central and medial portions of the lower eyelid are retracted after inferior orbital reconstruction in patients with blowout fractures. The amount of central retraction on the lower eyelid is associated with the amount of enophthalmos improvement.
Purpose:To evaluate the effect of cauterization on extraocular muscle (EOM) fibrosis in rats, and to develop a novel EOM fibrosis model. Methods: Twenty-four eyes of 12 Sprague Dawley rats were assigned randomly to two groups. We exposed the superior rectus muscle (SRM) and performed thermal injury 2 mm behind the insertion site of the SRM using a cautery device in the experimental group. The thermal injuries were performed twice for 1 second, for a total of 2 seconds. In the control group, the same procedures except the thermal injury were performed. Two weeks after surgery, all eyes were enucleated and stained with hematoxylin and eosin (H&E) and Masson's trichrome (MT). Results: Staining with H&E and MT showed that thermal injury significantly increased inflammation and fibrosis in the experimental group (p = 0.002, p < 0.001, respectively). Conclusions: Thermal injury using cauterization effectively induced fibrosis of EOM in the rat model. This simple model was effective in inducing fibrosis of SRM and will be useful for studying postoperative fibrosis after strabismus surgery. J Korean Ophthalmol Soc 2018;59(5): [478][479][480][481][482][483]
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