PurposeThe aim of the study reported here was to assess choroidal thickness (CT) and central macular thickness (CMT) in patients with diabetic retinopathy.Materials and methodsA total of 151 eyes from 80 patients from the retina department of Istanbul Training and Research Hospital who had type 2 diabetes mellitus with diabetic retinopathy were studied retrospectively in this cross-sectional research. Patients were divided into three groups: mild–moderate nonproliferative diabetic retinopathy without macular edema (NPDR), mild–moderate nonproliferative diabetic retinopathy with macular edema (DME), and proliferative diabetic retinopathy (PDR). In addition, 40 eyes of 20 healthy individuals comprised a control group. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500-μm intervals up to 1,500 μm temporal and nasal to the fovea. The CMT measurement was obtained for each eye. Serum hemoglobin A1c (HbA1c) levels were measured.ResultsThe study included 191 eyes, comprising 151 eyes of 80 patients and 40 eyes of 20 healthy individuals. Of the 151 patient eyes, 61 had NPDR, 62 had PDR, and 28 eyes had DME. There was no statistically significant difference in age between the groups (P>0.05). In both the PDR and DME groups, the CT was statistically significantly decreased compared with the control group (P<0.001, P<0.001 for the PDR and DME groups, respectively). The mean CMT in the DME group was increased significantly compared with both the NPDR and PDR groups (P<0.001, P<0.001, respectively). In all three groups, serum HbA1c levels were found to be increased significantly compared with the control group (P=0.000). We found a statistically weak–moderate negative correlation between central macular and foveal CT (r=−289, P=0.000). There was a statistically strong correlation between CMT and HbA1c levels (r=0.577, P=0.483) and a statistically weak–moderate negative correlation between the central CT and HbA1c levels (r=−0.331, P<0.001).ConclusionDiabetes changes the CT. CT was found to be significantly decreased in the DME and PDR groups.

Reports of complications associated with local anesthesia in ophthalmic surgery have increased conspicuously in recent years. Sub-Tenon's capsule anesthesia for anterior segment surgery avoids the risks of retrobulbar and peribulbar injections. This study compared sub-Tenon's and retrobulbar anesthesia. Patients undergoing various anterior segment surgery were randomly assigned to sub-Tenon's or retrobulbar anesthesia; 300 were operated with 1-quadrant sub-Tenon's anesthesia (1-QST) and the results were compared with 270 patients operated with retrobulbar anesthesia. Retrobulbar anesthesia consisted of a 2.5 ml injection of a 1:1 mixture of 2% lidocaine without epinephrine and 0.5% bupivacaine. Sub-Tenon's anesthesia involved direct transconjunctival infiltration of the same local anesthetic directly into the sub-Tenon's space, in the inferior-nasal quadrant, using a blunt 23-gauge cannula. Patients undergoing various anterior segment surgery procedures were randomly assigned to 1-QST or retrobulbar anesthesia; 300 patients were operated with 1-QST and the results were compared with 270 patients operated with retrobulbar anesthesia. Preinjection mean (+/- SD) IOP wer 12.9 +/- 3.7 mmHg in the retrobulbar and 13.4 +/- 3.2 mmHg in the 1-QST patients. Preoperative intraocular pressures were 8.7 +/- 3.0 mmHg in the retrobulbar and 9.2 +/- 3.2 mmHg in 1-QST patients. Pre- and postinjection IOP for retrobulbar and 1-QST patients were similar. Pain scores for delivery of the anesthetic, using a numerical rating scale, produced a median score of 1 for 1-QST and 2 for the retrobulbar technique. For the subsequent operative procedure, the median score was 1 for 1-QST and 2 for the retrobulbar patients. Complete akinesia was achieved in 41% with 1-QST and in 69% of retrobulbar patients. 1-QST patients with incomplete akinesia most often had lateral muscle function which did not interfere with the operation. We found the use of a blunt cannula to deliver anesthetic into the sub-Tenon's space as a simple, safe and effective alternative approach to traditional retrobulbar anesthesia in anterior segment surgery.

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ÖzetAmaç: Oküler toksoplazmozis tan›s› alm›fl olan hastalar›n klinik özelliklerini, takip ve tedavi sonuçlar›n› incelemek. Gereç ve Yöntem: 1996 -2007 y›llar› aras›nda S.B. ‹stanbul E¤itim ve Araflt›rma Hastanesi Göz Klini¤i Uvea Birimi'nde aktif oküler toksoplazmozis tan›s› alm›fl olan 57 hasta (ilk atak ve/veya rekürrens) retrospektif olarak de¤erlendirildi. Hastalar›n ortalama takip süresi 5,2 y›ld›. Hastalar›n görme dereceleri, göz içi bas›nçlar› (G‹B) kaydedildi. Biomikroskobik muayeneleri yap›larak ön ve arka segment bulgular› de¤erlendirildi. Klinik görünümü oküler toksoplazmozis ile uyumlu hastalarda toksoplazma spesifik IgG ve IgM antikor testleri birer hafta arayla 2 kez tekrarland›. Sonuçlar: Hastalar›n yafl ortalamalar› 29,7 (16-50) yafl, K/E oran› 33/24 idi. K›rk üç hasta primer (%75,86), 14 hasta rekürren aktivasyon (%24,14) olarak de¤erlendirildi. On iki hastada makula tutulumu (%20,7), 14 hastada periferik tutulum (%24,14) mevcuttu. Sekiz hastada atipik oküler toksoplazmozis (%15,5) bulgular› vard›. Klinik görünümü oküler toksoplazmozis ile uyumlu ve serolojik testleri pozitif olan olgulara primetamin + sulfadiazin + kortikosteroid (makula ve arka kutup yerleflimli görmeyi tehdit eden olgularda) üçlü tedavisi 4-6 hafta süreyle uyguland›. Results: The average age of the patients was 29.7 (range: 16-50) years and the female/male ratio was 33/24. 43 patients (75.86%) had first attack, while 14 patients (24.14%) had recurrence of ocular toxoplasmosis. In 12 patients (20.7%), the macular retina and in 14 patients (24.14%), the peripheral retina was involved. 9 patients (15.5%) had atypical signs of ocular toxoplasmosis. Patients with clinical appearance compatible with ocular toxoplasmosis and positive serological tests have been given triple therapy consisting of pyrimethamine + sulfadiazine + corticosteroid (only for cases with vision-threatening macular and posterior pole involvement) for 4-6 weeks. Discussion: Ocular toxoplasmosis is the most common form of posterior uveitis that can lead to vision loss. The establishment of diagnosis is often based on clinical view and serological tests are helpful in the diagnostic process. The disease is self-limiting in immunocompetent people. The purpose of the treatment is to prevent complications and recurrence. (TJO 2010; 40: 289-94)

61'di (44-78). Onüç gözde santral retinal ven tıkanıklığı (SRVT), 65 gözde retinal ven dal tıkanıklığı (VDT) mevcuttu. Otuzdört (%44) hastada hipertansiyon, 26 (%33) hastada diabetes mellitus saptandı. Ortalama takip süresi 10.5 aydı (1-24 ay). Başlangıç en iyi görme keskinliği SRVT grubunda ortalama 1.12 LogMAR iken, VDT grubunda ortalama 1.08 LogMAR idi. Son muayenede ortalama en iyi görme keskinlikleri SRVT grubunda 0.58 LogMAR, VDT grubunda 0.52 LogMAR olarak saptandı. Üç tedavi grubunda da görme keskinliğinde istatiksel olarak anlamlı artma saptandı (p=0.0). SRVT grubunda grid lazer fotokoagülasyon uygulananlarda ortalama 0.54 LogMAR, intravitreal triamsinolon asetonid enjeksiyonu yapılanlarda ortalama 0.56 LogMAR, intravitreal bevacizumab enjeksiyonu yapılanlarda ortalama 0.57 LogMAR gör-me artışı saptandı. VDT grubunda ise grid lazer fotokoagülasyon uygulananlarda ortalama 0.52 LogMAR, intravitreal triamsinolon asetonid enjeksiyonu yapılanlarda ortalama 0.58 LogMAR, intravitreal bevacizumab enjeksiyonu yapılanlarda ortalama 0.63 LogMAR görme artışı sağlandı. Bevacizumab uygulananlar ile grid lazer fotokoagülasyon uygulananlar arasında istatiksel olarak anlamlı fark saptanmıştır (p=0.0). Triamsinolon asetonid ile diğer tedaviler arasında ise anlamlı fark saptanmamıştır.Sonuç: Retinal ven tıkanıklığı tedavisinde, grid lazer fotokoagülasyon, intravitreal triamsinolon asetonid ve intravitreal bevacizumab uygulamaları etkilidir. İntravitreal bevacizumab enjeksiyonu, grid lazer fotokoagülasyona göre görme keskinliğini daha çok arttırmıştır. İntravitreal bevacizumab enjeksiyonu ile intravitreal triamsinolon enjeksiyonu arasında ise istatiksel olarak anlamlı fark saptanmamıştır. (JAREM 2012; 2: 6-9) Anahtar Sözcükler: Retina ven tıkanıklığı, triamsinolon asetonid, bevacizumab, lazer fotokoagülasyon, intravitreal, grid lazer ABSTRACT Objective: To assess the efficacy of grid laser photocoagulation, intravitreal triamcinolone acetonide injection and intravitreal bevacizumab injection in patients with central retinal vein occlusion or branch retinal vein occlusion.Methods: In a retrospective assessment, 78 eyes of 78 patients (in May 2008-May 2010) with central retinal vein occlusion or retinal vein occlusion were reviewed according to initial and final best-corrected visual acuity. Retinal vein occlusion was diagnosed with fundus examination and fundus fluorescein angiography. Cases who have additional ocular pathologies and neovascularization were excluded from the study. Grid laser photocoagulation was performed in 50 eyes, 4 mg intravitreal triamcinolone acetonide injection was performed in 8 eyes and 1.25 intravitreal bevacizumab injection was performed in 20 eyes. The best visual acuity was assessed before and after treatment. Best corrected visual acuity values obtained with Snellen were translated into logMAR units. At least one logMAR unit improvement in the visual acuity was considered a success.Results: Thirty three patients (40%) were male and 47 (60%) were female. The average age of the patients was...