No abstract

Retinopathy of prematurity (ROP) remains a painful examination, despite the common application of local anesthetic eye drops. This study aimed at examining the analgesic effects of 25% glucose in a premature infant pain profile (PIPP) in the first eye examination of infants with ROP. This three-group, randomized clinical trial was conducted from March to February 2017. One oral dose of 25% glucose solution (1 cc/kg) was administered one minute before the first examination of ROP. Mydriatic and anesthetic eye drops were locally instilled in the eyes before the examination for each group. Then, comparisons were made with the control group, which did not receive oral glucose (B), as well as the group which received 1 ml/kg of distilled water (C). The main investigator, who was blinded to the groups, evaluated pain using PIPP at one minute before, during, and one and five minutes after the procedure (ethics code: IR.TUMS.MEDICINE.REC.1396.3130). The baseline characteristics were comparable between the groups. During the procedure, the group receiving oral 20% glucose showed significantly lower PIPP scores (13.8±1.39) compared to the other groups (group B: 15.95±1.27 and group C: 15.10±1.19) (P=0.001). The positive effects persisted for five minutes in this group after the procedure (7.6±1.26), compared to the other groups (P=0.034). During and after ROP screening, oral 25% glucose in combination with local anesthetic eye drops can cause a significant reduction in pain.

Background Ocular manifestations are common in systemic lupus erythematosus (SLE). Retinopathy has previously been linked to disease severity and might have a significant impact on the patient’s quality of life and has also been associated with a poor prognosis in SLE. This study aimed to determine the prevalence of retinopathy among patients who are newly diagnosed with SLE. Methods In a cross-sectional study, patients diagnosed with SLE at a tertiary referral clinic were assessed for inclusion between March 2016 and March 2017. Patients who had received treatment for SLE at any time were excluded, as well as patients with hypertension, diabetes mellitus, and coagulopathy. Clinical findings and laboratory test results were recorded, and patients were examined by an ophthalmologist for evidence of retinal pathologies. SLE disease activity index was also calculated for all patients. Results With 114 patients included in the final analysis, we found a prevalence of 15.8% for retinopathy among newly-diagnosed SLE patients. Cotton-wool spots were the most common finding (78%). Patients with retinopathy had significantly lower hemoglobin levels, C3 and C4 concentrations, and higher ANA and Anti-dsDNA levels. Also, patients with retinopathy had a significantly higher SLE DAI score. Conclusions We found a relatively high rate of retinopathy in SLE patients at the time of their initial diagnosis. Our findings suggest that retinopathy is an early manifestation of the disease. Ophthalmologic screening might be considered for SLE patients at the time of diagnosis, especially for those with severe disease. We also encourage researchers to further evaluate the correlation between retinopathy and disease activity, and the prognosis of ocular involvement.