Mattinglymathews0773
To report a case of optic neuropathy (ON) following botulinum toxin A (BTA) injection into the medial rectus muscle.
We describe a 37-year-old man with unilateral ON after a BTA injection into the left medial rectus for treatment of traumatic sixth nerve palsy. Oral prednisolone was prescribed for 14 days. After two weeks, his visual acuity returned to 20/20.
Botulinum toxin-induced neuropathy is a rare and vision-threatening complication of BTA. In patients with recent injection of BTA who present with visual complaints, botulinum toxin-induced neuropathy should be considered.
Botulinum toxin-induced neuropathy is a rare and vision-threatening complication of BTA. In patients with recent injection of BTA who present with visual complaints, botulinum toxin-induced neuropathy should be considered.
To evaluate the effect of interocular axial length (AL) difference on outcomes of treatment for anisometropic amblyopia in comparison with normal participants.
In this historical cohort study, 83 patients with anisometropic amblyopia were divided into two age groups, 70 children (mean, 7.86
±
1.56 and range, 5-15 years) and 13 adults (mean, 26.46
±
10.87 and range, 16-45 years). The control group consisted of 43 non-amblyopic children and 17 non-amblyopic adults. Treatment outcomes after a period of one year were defined as successful or unsuccessful when posttreatment amblyopic corrected distance visual acuity (CDVA) was reported as
≤
0.9 versus CDVA
≤
0.8, respectively. AL was measured using a Lenstar LS900 (Haag-Streit AG, Switzerland).
Fifty-nine patients showed satisfactory treatment outcomes (55 children and 4 adults), while unsuccessful treatment outcomes were observed in 24 patients (15 children and 9 adults). The mean of amblyopia treatment duration was 1.24
±
0.76 years. The mean of interocular AL difference in all patients, control, successful and unsuccessful treatment outcome groups were 0.49
±
0.70mm (range, 0.00-3.89 mm), 0.12
±
0.07 mm (range, 0.02-0.41), 0.33
±
0.23 mm (range, 0.00-0.99 mm), and 1.81
±
0.80 mm (range, 1.14-3.89 mm), respectively. In both age groups, the mean of interocular AL difference in patients with unsuccessful treatment outcomes was greater than those with successful treatment outcomes and that of the control group (
<
0.001).
The results of this study suggest that the outcome of anisometropic amblyopia treatment may depend on the interocular AL difference.
The results of this study suggest that the outcome of anisometropic amblyopia treatment may depend on the interocular AL difference.
This cross-sectional study aimed to compare changes in scleral thickness between eyes injected with repeated anti-vascular endothelial growth factor (anti-VEGF) drugs and fellow injection naive eyes using optical coherence tomography (OCT).
A total of 79 patients treated with three intravitreal anti-VEGF injections in one eye versus no injections in the fellow eye were included.Anterior segment-OCT measured scleral thickness in the inferotemporal quadrant 4 mm away from the limbus.
Injected eyes had a mean scleral thickness of 588
±
95 μm versus 618
±
85 μm in fellow naïve eyes (
<
0.001). Comparing injected eyes to fellow naïve eyes stratified by injection number showed a mean scleral thickness of 585
±
93 μm versus 615
±
83 μm in eyes with 3-10 injections (
= 32,
= 0.042); 606
±
90 μm versus 636
±
79 μm in eyes with 11-20 injections (
= 24,
= 0.017); and 573
±
104 μm versus 604
±
93 μm in eyes with
>
20 injections (
= 23,
= 0.041). There was no significant correlation between injection number and scleral thickness change (
= -0.07,
= 0.26). When stratified by indication, subjects with retinal vein occlusions showed a statistically significant difference in scleral thickness between injected and fellow naïve eyes (535
±
94 μm and 598
±
101 μm, respectively,
= 0.001).
Compared to injection naive eyes,multiple intravitreal injections at the repeated scleral quadrant results in scleral thinning. Consideration of multiple injection sites should be considered to avoid these changes.
Compared to injection naive eyes,multiple intravitreal injections at the repeated scleral quadrant results in scleral thinning. Consideration of multiple injection sites should be considered to avoid these changes.
To examine the association between the use of topical non-steroidal anti-inflammatory (NSAID) medication, systemic statin therapy, and the incidence rate of two of the most common postsurgical procedures in adult patients undergoing cataract surgery in Finland between January 1, 2010 and December 31, 2016.
This retrospective, nationwide cohort study considered 176,052 cataract operations coded with the International Classification of Disease coding early adult (H25.0), normal (H25.1), other senile (H25.8), pre-senile (H26.02), or other (related to trauma, other eye disease, or medication). Operations were linked to purchased and reimbursed medications using Anatomical Therapeutic Chemical codes. The incidence rate of intravitreal anti-vascular endothelial growth factor (VEGF) injections, and neodymium-doped yttrium aluminum (NdYAG) laser treatments of posterior capsular opacification were evaluated using the Poisson regression model.
In our registry cohort, patients with a prescription of topical NSAID t surgery.[This corrects the article DOI 10.18502/jovr.v16i4.9747.].[This corrects the article DOI 10.18502/jovr.v17i1.10171.].Peripheral ulcerative keratitis (PUK) is a rare but serious ocular condition that is an important clinical entity due to its ophthalmological and systemic implications. It is characterized by progressive peripheral corneal stromal thinning with an associated epithelial defect and can be associated with an underlying local or systemic pro-inflammatory condition, or present in an idiopathic form (Mooren ulcer). Associated conditions include autoimmune diseases, systemic and ocular infections, dermatologic diseases, and ocular surgery. Cell-mediated and auto-antibody-mediated immune responses have been implicated in the pathogenesis of PUK, destroying peripheral corneal tissue via matrix metalloproteinases. Clinically, patients with PUK present with painful vision loss, a peripheral corneal ulcer, and often adjacent scleritis, episcleritis, iritis, or conjunctivitis. Diagnostic evaluation should be focused on identifying the underlying etiology and ruling out conditions that may mimic PUK, including marginal keratitis and Terrien marginal degeneration. Treatment should be focused on reducing local disease burden with topical lubrication, while simultaneously addressing the underlying cause with antimicrobials or anti-inflammatory when appropriate. Existing and emerging biologic immunomodulatory therapies have proven useful in PUK due to autoimmune conditions. Surgical treatment is generally reserved for cases of severe thinning or corneal perforation.
To evaluate varied aspects of binocular function in multiple gaze positions.
In 2018, this cross-sectional study was conducted on 21 participants (male = 11) with an age range of 19-25 years. Having emmetropia and 10/10 visual acuity in both eyes were conditions of the inclusion criteria for the cross-sectional study. The following aspects of binocular function including amplitude of accommodation (AA), near point of convergence, near phoria, and monocular accommodative facility were evaluated in five gazes (primary, upward, downward, left, and right) for all subjects.
Near point of convergence values showed significant differences in all gaze positions (
<
0.001). The lowest near point of convergence value was seen in the primary gaze (2.69 cm) and the downward gaze (3.47 cm) and the highest near point of convergence value was seen in the left gaze (7.5 cm). There was also a significant difference in the amplitude of accommodation among the upward, downward, and the primary gaze (
ve sufficiency evaluation was inconsistent among the multiple gaze positions, the accommodative facility evaluation was consistent in all gazes.
Outcome prediction of intensive care unit (ICU)-admitted patients is one of the important issues for physicians. This study aimed to compare the accuracy of Quick Sequential Organ Failure Assessment (qSOFA), Confusion, Urea, Respiratory Rate, Blood Pressure and Age Above or Below 65 Years (CURB-65), and Systemic Inflammatory Response Syndrome (SIRS) scores in predicting the in-hospital mortality of COVID-19 patients.
This prognostic accuracy study was performed on 225 ICU-admitted patients with a definitive diagnosis of COVID-19 from July to December 2021 in Tehran, Iran. The patients' clinical characteristics were evaluated at the time of ICU admission, and they were followed up until discharge from ICU. The screening performance characteristics of CURB-65, qSOFA, and SIRS in predicting their mortality was compared.
225 patients with the mean age of 63.27±14.89 years were studied (56.89% male). read more The in-hospital mortality rate of this series of patients was 39.10%. The area under the curve (AUC) of SIRS, CURB-65, and qSOFA were 0.62 (95% CI 0.55 - 0.69), 0.66 (95% CI 0.59 - 0.73), and 0.61(95% CI 0.54 - 0.67), respectively (p = 0.508). In cut-off ≥1, the estimated sensitivity values of SIRS, CURB-65, and qSOFA were 85.23%, 96.59%, and 78.41%, respectively. The estimated specificity of scores were 34.31%, 6.57%, and 38.69%, respectively. In cut-off ≥2, the sensitivity values of SIRS, CURB-65, and qSOFA were evaluated as 39.77%, 87.50%, and 15.91%, respectively. Meanwhile, the specificity of scores were 72.99%, 34.31%, and 92.70%.
It seems that the performance of SIRS, CURB-65, and qSOFA is similar in predicting the ICU mortality of COVID-19 patients. However, the sensitivity of CURB-65 is higher than qSOFA and SIRS.
It seems that the performance of SIRS, CURB-65, and qSOFA is similar in predicting the ICU mortality of COVID-19 patients. However, the sensitivity of CURB-65 is higher than qSOFA and SIRS.
The use of point-of-care ultrasonography (POCUS) for identifying medial collateral ligament (MCL) tears has increased in recent years. This study aimed to evaluate the diagnostic accuracy of POCUS in the diagnosis of acute MCL tears of the knee.
This prospective cross-sectional study was performed on patients with suspected MCL tear of the knee in the emergency department (ED). After history taking and primary physical examination, radiographic imaging of the knee was done. If there was no fracture in the knee X-ray, the POCUS examination was done. All of the patients were asked to refer to an orthopedic clinic, 7-10 days after discharge from ED, for Magnetic Resonance Imaging (MRI) evaluation. The second POCUS was done in the orthopedic clinic. Finally, the findings of POCUS and MRI were compared in diagnosing MCL injury.
Two hundred and fifty patients with a mean age of 25.05 ± 9.12 years were analyzed (86.8% male). According to the MRI findings, as the gold standard, 55(22.0%) patients had MCL injury.
