Background: Recent development of cataract surgery has led to the improvement of visual outcomes. However, pseudophakic cystoid macular oedema (CME), which is also known as Irvine–Gass syndrome, remains a usual cause of unexpected visual disturbance after both complicated and uncomplicated cataract surgeries. Optical coherence tomography is an important method in detecting changes prior to clinical presentation.Aim: To assess macular thickness changes after uncomplicated phacoemulsification using spectral domain optical coherence tomography (SD-OCT).Setting: The study assessed healthy patients who had uneventful phacoemulsification and changes in macular thickness in Ibn Al Haitham Teaching Eye Hospital (tertiary eye center), Baghdad, Iraq.Methods: Macular thickness of 86 eyes with uncomplicated phacoemulsification were measured by using four OCT examinations: one preoperatively, which was used as a control, and three in the first week and first and second months. Incidence of macular thickness changes was evaluated in the central and para and perifoveal areas to detect which areas of the macular map will be affected more. Significance was tested by using paired t-test and p 0.05 was considered significant.Results: Significant increase in macular thickness postoperatively during the 2-month period reaching the maximum level in the second month; early significant changes were noticed in paracentral area in the first week whilst significant increase in the central and pericentral area was recorded in the first month. Cystoid macular oedema (CME) was detected in six eyes (7%) in the second month.Conclusion: Significant variation in macular thickness can occur after uneventful phacoemulsification surgery in healthy patients. Cystoid macular oedema was detected in 7% of our patients using SD-OCT. It is rare after uncomplicated phacoemulsification in healthy individuals but should be kept in mind in the follow-up period. A detailed fundus examination with OCT imaging is thus recommended in the first or second month postoperatively for the early detection and treatment of CME.
Objectives: Dickkopf-1 (DKK-1) is WNT/b-catenin pathway antagonist which plays a detrimental role in the development of diabetic retinopathy (DR). This research aimed to assess serum DKK-1 levels in diabetic patients who have and have not developed DR and, compare them with the control subjects finding out whether we can use it as an indicator for DR early diagnosis and to find out which one of the widely used two groups of antidiabetic treatments had the greater effect on this biomarker and hence on the progression of DR. Methods: The study participants were divided into two subgroups: First, 70 patients (36 male, 34 female) with type 2 diabetes mellitus, among them 35 patients diagnosed with DR and 35 with no evidence of DR, and secondly, non-diabetic controls (11 male, 9 female) were selected from the patients attending Ibn AL-Haitham hospital for ophthalmology and a specialized center for endocrinology and diabetes. Venous blood samples of all participants were drawn after an overnight fast, and serum samples were stored at -20ºC until DKK-1 assay. Results: Serum DKK-1 showed significantly lower levels in diabetic patients with (6.1 ± 2 ng/mL) or without DR (14 ± 6.2 ng/mL) when compared to those of controls (34 ± 12.25 ng/mL) (p 0.05). Furthermore, serum DKK-1 levels were lower in the late stage of DR compared to the early stage 5.6 ± 1.7 and 7 ± 1.9 ng/mL, respectively. Furthermore, DPP-4 inhibitors cause a better increment in DKK-1 levels when compared to SU in the NDR group. Conclusions: Reduced serum levels of DKK-1 are related to the existence and worsening of DR and have the prospect to serve as an indicator for this condition.
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