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Purpose: To investigate the clinical benefits of the co-application of bevacizumab and tissue plasminogen activator as adjuncts in the surgical treatment of proliferative diabetic retinopathy. Methods: Patients who underwent vitrectomy for proliferative diabetic retinopathy complications were preoperatively given intravitreal injection with either bevacizumab and tissue plasminogen activator (Group 1) or bevacizumab alone (Group 2). Primary outcomes were surgery time and number of intraoperative iatrogenic retinal breaks. Secondary outcomes included changes in the best-corrected visual acuity and postoperative complications at 3 months postoperatively. Results: The mean surgery time in Group 1 (52.95 ± 5.90 min) was significantly shorter than that in Group 2 (79.61 ± 12.63 min) (p<0.001). The mean number of iatrogenic retinal breaks was 0.50 ± 0.59 (0-2) in Group 1 and 2.00 ± 0.83 (0-3) in Group 2 (p<0.001). The best-corrected visual acuity significantly improved in both groups (p<0.001). One eye in each group developed retinal detachment. Conclusion: Preoperative co-application of bevacizumab and tissue plasminogen activator as adjuncts in the surgical treatment of proliferative diabetic retinopathy shortens the surgery time and reduces the number of intraoperative iatrogenic retinal breaks. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to examine the efficacy and the shortfalls of the Birmingham Eye Trauma Terminology classification system for ocular trauma in predicting the visual outcome. Methods: The records of 256 eyes of 246 patients with a diagnosis of mechanical ocular trauma admitted to the Osman Gazi University Hospital ophthalmology department between 1995 and 2000 were retrospectively reviewed. The zone, type, grade, and pupil status of the injuries were determined according to the Birmingham classification system. Injuries with a good prognosis were defined as injuries that resulted in vision of equal to or better than counting fingers at 1 meter. Fischer's exact test was used to determine the statistical significance of relationships between the final visual acuity and the initial clinical findings. Results: Open eye injuries restricted to zone I, those with no afferent pupillary defect, and those graded as 3 or better or classed as type B were significantly associated with a better visual outcome (p<0.05). Open eye injuries that extended to zone III, had an afferent pupillary defect, or were graded as 4 or worse were significantly associated with a poorer visual outcome (p<0.05). Closed eye injuries classified as type B or grade 4 were significantly associated with a poor visual outcome (p<0.05). Conclusion: The Birmingham classification system for mechanical ocular trauma offers a standardized method for both open and closed eye injuries, however, adding subclasses to type C (injuries with foreign body involvement) could enhance the classification method and help to understand the influence of foreign body properties and sizes on the outcome. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented discussing a mini case series of spectral domain optical coherence tomography (OCT) findings in bilateral diffuse uveal melanocytic proliferation (BDUMP), a rare paraneoplastic disorder.

Purpose: Previous studies have highlighted the effectiveness of slit lamp shields in reducing aerosol spread. Our study investigated the optimal size and design for such shields., Methods: Two sets of shields were made; each set included five cardboards of the following dimensions: 1 (44 × 52 cm), 2 (44 × 44 cm), 3 (22 × 52 cm), 4 (22 × 33.5 cm), and 5 (44 × 22.5 cm). Cardboards in set 1 were kept flat whereas those in set 2 were curved using plastic frames. Aerosol was generated at the patient's position using a water spray bottle, and aerosol levels were measured at the face position of the examiner and on the slit lamp table using two GP2Y1014AU0F sensors. The measurements were recorded in particles/0.01f3 and analyzed using a Mann Whitney U test., Results: Mean background indoor aerosol was 559. After aerosol generation, the level increased to a mean of 571 in the absence of any kind of shield but to a mean of 567 when shields were in place (P < 0.05). Flat shield 1 provided the best protection against inhaled aerosol. Flat shield 2, despite its shorter height compared to shield 1, provided the best protection against precipitated aerosol on the table. Curving shield 5 significantly improved its protective properties against both inhaled and precipitated aerosol while keeping the short height that allowed better access during examinations., Conclusions: Shields reduced aerosol spread with curved shields being more effective while creating fewer physical restrictions. GP2Y1014AU0F particle sensors are effective tools for quantifying aerosol spread., Translational Relevance: An understanding of optimal slit lamp shield design will provide protection for examiners while facilitating effective examination.