Purpose: To investigate the relationship between the serum and aqueous levels of inflammatory markers and diabetic macular edema (DME). Methods: The study included four patient groups: the healthy control group (n = 23 eyes); the diabetic control group (n = 22 eyes); the groups with and without DME (n = 20 eyes and n = 22 eyes, respectively). The patients were evaluated based on their serum levels of HbA_1c, C-reactive protein (CRP) and serum and aqueous levels of tumor necrosis factor-alpha (TNF-α). Results: Statistically significant differences were present for the serum CRP levels and for the aqueous TNF-α levels between the healthy control group and the group with DME (p = 0.004 and p = 0.03, respectively); for the serum TNF-α levels between the healthy control group and the groups without and with DME (p = 0.009 and p = 0.001, respectively). Conclusions: Increased serum levels of CRP and serum and aqueous levels of TNF-α in DME suggest that inflammation is involved in the pathogenesis of DME.

The purpose of this study was to investigate whether the severity of diabetic disease in the retina is paralleled by changes in the photoreceptor layer. This cross-sectional study included healthy volunteers (30 volunteers, 60 eyes) and patients with diabetes (48 patients, 96 eyes). Each patient underwent a single session of spectral domain optical coherence tomography (OCT) in which each retina was imaged twice. On each OCT image, the thickness of the PROS layer was measured at the foveal center and at points 750 μm temporal to and nasal to the center. For statistical analyses, OCT images were assigned to one of the following groups: healthy, diabetes without retinopathy (DM), diabetic retinopathy (DR), or diabetic retinopathy with macular edema (DME). The mean PROS thickness at the foveal center in the first and second-obtained OCT images was as follows: healthy, 38.5 μm and 38.6 μm; DM, 38.2 μm and 38.2 μm; DR, 35.6 μm and 36.1 μm; DME, 32.6 μm and 32.6 μm. In the first and second-obtained images, significant differences were found between the healthy group and DR and DME (p < 0.05 for all), between the DM group and the DME (p < 0.05 for all), and between the DR group and the DME group (p < 0.05 for all). No significant differences between groups were found at the nasal and temporal locations. The PROS layer at the foveal center was thinner in patients who had diabetic retinopathy or diabetic macular edema than both the healthy volunteers and diabetic patients without retinopathy.

To evaluate the efficacy and complications of transconjunctival Botulinum toxin A injections performed according to an algorithm, for the management of upper eyelid retraction associated with thyro...

Purpose.: To evaluate the outcome of silicone intubation and tube removal in external dacryocystorhinostomy (DCR) patients with distal canalicular or common canalicular obstruction. Methods: Seventy-five eyes of 69 patients with distal or common canalicular obstruction who had undergone external DCR and silicone tube insertion were included in the study. Silicone tube was left in place at least for 3 months. Presence of epiphora was questioned and patency was assessed by irrigation at each control after tube removal. Results.: Mean patient age was 49.8±14.4 years (range 15-78) and mean follow-up after surgery was 13.2±4.2 months (range 6-25). After tube removal, 16 eyes (21.3%) presented with epiphora and occluded canalicular systems. Two eyes (2.7%) presented with epiphora which started just after tube removal and had a patent canalicular system. Fifty-seven eyes (76%) were free of symptoms and had patent canalicular systems and 3 of these eyes (4%) had epiphora while the tube was in place. Conclusions.: Silicone intubation is indicated in patients with distal or common canalicular obstruction. The majority of patients with canalicular problems are relieved of epiphora after silicone tube removal. However, the tube itself may transiently occlude the canalicular system and cause epiphora in some patients, and in some it can aid tear flow even in the presence of a patent system.

To compare predictability of the outcomes of Muller’s muscle conjunctiva resection (MMCR) in patients with severe versus mild/moderate involutional aponeurotic ptosis. This was a retrospective case-control study. All cases were recruited into the groups in terms of preoperative marginal reflex distance of upper eyelid (MRD-1). Group 1 consisted of patients with mild to moderate blepharoptosis was defined as an MRD-1 equal to 1.1 to 3 mm and Group 2 consisted of patients with severe blepharoptosis defined as MRD-1 ⩽ 1 mm. All patients underwent MMCR based on the response to phenylephrine and the amount of ptosis. MRD-1 obtained both manually and with ImageJ analysis program preoperatively and on the postoperative sixth month was compared. Successful surgical outcome criteria were defined as MRD-1 ⩾ 2.5 mm and inter-eyelid symmetry ⩽ 1 mm. A total of 97 eyes of 83 participants met the inclusion criteria for this study (Group 1 n = 50, Group 2 n = 47). In terms of MRD-1 success rates were 88% in Group 1, and 70.2% in Group 2 (p = 0.03). Preoperative MRD-1 which was measured by ImageJ, and the amount of resected tissue in mm were the predictive data of surgical outcome by the logistic regression analysis (OR 6.45, 95% CI 1.82–22.78, p = 0.004, OR 2.47, 95% CI 1.05–5.80, p = 0.037, respectively). The surgical success of MMCR can be predicted via tissue resection length and preoperative MRD-1. Higher surgical success rates were obtained in cases with mild-moderate ptosis and clinically acceptable success rates were obtained in cases with severe ptosis.