Search

Background: To evaluate the efficacy and safety of intravitreal injections of 4 mg (high dose) of aflibercept in treatment-naive patients with neovascular AMD(nAMD) with treat and extend(TREX) dosing regimens, and to determine the frequency of injections. Methods: In this interventional, retrospective study a total of 15 eyes of 14 patients (eight female and 9 male) with nAMD were included. All patients were examined and OCT imaging was performed at the time of initial presentation, on the day of each injection and at subsequent follow-up visits. Each eye received intravitreal injections of 4 mg/0.1 mL aflibercept at the dose of every 4 weeks for three months (loading phase) after that 4 mg high dose of aflibercept was applied as the TREX regime. The eyes with a minimum follow-up time of 12 months are included. Results: The mean age of the patients was 74.9 ± 7.3(61–85) years and the mean follow-up time was 20.33 ± 8.7(12–34) months. Total number of injections were 9.3 ± 3.0 (5–14) during the follow-up period. A statistically significant increase was found in terms of best-corrected visual acuity and central macular thickness between mean baseline values and at 1, 3, 6, 12 months, and the final examination(p < 0.05 for each comparison). No complication was observed during follow-up. Conclusions: High-dose Aflibercept of 4 mg/0.1 mL application with the TREX regimen was found to be efficient and safe. High-dose may also help to reduce the frequency of injections and visits in the follow-up period in eyes with nAMD. Prospective studies with large series are warranted. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to assess the frequency of smoking cessation and to identify the factors affecting smoking cessation success among individuals seeking assistance at a smoking cessation centre. Methods: This cross-sectional study included 1,570 individuals who applied to the smoking cessation centre in Izmir, Turkey, between 2009 and 2018, and completed three follow-ups. Data were obtained from the centre's records. Factors affecting smoking cessation success were analysed using logistic regression in multivariate analysis. Results: The median age to start smoking was 19 (17-22), and the median number of cigarettes consumed per day was 20 (20-30). Among the participants, 59.9% exhibited a high/very high level of nicotine dependence, and 79.6% had attempted to quit smoking previously. The median number of patient follow-ups was 7 (5-10). Of the patients, 34.0% successfully quit smoking for one year. According to the multivariate analysis results, smoking cessation success increased with being married by 2.26 times (95% CI: 1.51-3.38, p < 0.001), the absence of other smokers in the household by 1.38 times (95% CI: 1.01-1.88, p = 0.04), having a low level of nicotine dependence by 1.75 times (95% CI: 1.23-2.48, p = 0.002), and more patient follow-ups by 1.61 times (95% CI: 1.52-1.72, p < 0.001). Conclusions: Smoking cessation success is increased by the support and follow-up provided by healthcare professionals, the absence of other smokers in the household, and a low level of nicotine dependency. [ABSTRACT FROM AUTHOR]

In this study, 419 Turkish middle school students (203 girls, 216 boys) were surveyed on their exposure to and engagement in bullying, and their level of hopelessness. Our findings suggest that girls were victims of indirect (e.g. gossiping) bullying more than boys. Boys reported being victims of physical (e.g. damaging property) and verbal (e.g. teasing) bullying more than girls. While the level of hopelessness among victims of physical and verbal bullying was higher than non-victims, no difference was found between the victims of indirect bullying and non-victims. Students who never talked to their teachers and parents about bullying reported higher levels of hopelessness than others. The implications of the study for intervention and prevention programs are discussed. (Contains 4 tables.)

Copyright of Turkish Journal of Public Health is the property of Turkish Journal of Public Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Proliferative vitreoretinopathy (PVR) is a wound healing process, which is characterized by membrane formation on both surfaces of the retina and in the vitreus as a result of migration and proliferation of cells in these areas. Contraction of formed membranes causes traction retinal detachment (RD) in the first stage, which in time may result in reopening of preexisting breaks; or new breaks form and rhegmatogenous RD component may be added to the scene. PVR is the most frequent cause of failure after RD surgery. Stages in the pathogenesis of PVR in order are, inflammation with activation and proliferation of cells, extracellular matrix formation and remodeling, and contraction. Each stage is a complicated process, in which various molecules and cells play roles. Although, the primary treatment of PVR is a well-performed surgery; multiple phamacological agents can be use to prevent PVR formation or prevent its recurrence as adjuvants to surgery. Antiinflammatory, antiproliferative drugs, and agents that inhibit formation and contraction of extracellular matrix are some of them. As the importance of molecules that play roles in every step of PVR ptahogenesis and genetic predispositions get clear, and as the drugs can be given more efficiently and for longer time, the efficiency of pharmacotherapy of PVR will be more effective. Investigative studies to develop effective drugs for the prophylaxis and treatment PVR without side effects, that will be easily used for long times are currently ongoing. Especially, the prophylaxis of PVR seems to be possible with the current pharmacotherapy options available. It is demonstrated that postoperative inflammation is decreased with the use of antiinflammatory agents. Intraoperative infusion of low molecular weight heparin and 5-fluorouracil is clinically found effective in the prevention of PVR in eyes with high risk for PVR development. The studies that will show the efficacy of isotretinoin in the prophylaxis and treatment of PVR will be announced in the near future, which seem to be hopeful. Because the pathogenesis of PVR is complicated, combined therapies which are effective for its every stage are expected to be more successful for the effective pharmacotherapy of PVR. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the anatomical and functional outcomes of combined 25 gauge and 20 gauge pars plana vitrectomy (PPV) in the treatment of a variety of vitreoretinal diseases. Materials and Methods: In this retrospective interventional case series combined 25 gauge and 20 gauge PPV was performed in 41 eyes. In the combined technique, two 25 g sutureless sclerotomies and one 20 g (for the active hand) sclerotomy were performed. Eyes with a minimum followup of 6 months were evaluated. Main outcome measures were the number of sutures in 25 gauge sclerotomies, changes in visual acuity, intraocular pressure (IOP), and rates of complications. Results: Mean follow-up was 9.34±2.27 months. No suture was necessary for the 25g sclerotomies. Mean visual acuity improved at postoperative month 1 (p=0.002) and at the last visit (p<0.001). A significant decrease in mean IOP was detected after 2 hours (p<0.001) and by day 1 (p=0.001) postoperatively. In one (2.43%) eye transient severe hypotony was observed. In two eyes operated on with a diagnosis of a macular hole, the holes were sealed after a second surgical procedure. Conclusion: Combined 25 g and 20 g PPV for treatment of a variety of vitreoretinal diseases yielded anatomic and functional recovery without significant complications. This technique combines the advantages of both systems, expands the indications of 25 g sutureless vitrectomy, and obviates the need for a variety of 25 g instruments. [ABSTRACT FROM AUTHOR]

Purpose: To compare anatomical and functional outcomes of 25 gauge sutureless pars plana vitrectomy (PPV) and 20 gauge PPV in eyes with diabetic vitreous hemorrhage (VH). Materials and Methods: IIn this interventional case series 15 eyes (Group 1) underwent 20-gauge PPV, and 29 eyes (Group 2) underwent 25 gauge sutureless PPV with oblique sclerotomies due to diabetic VH. Eyes with a minimum follow-up of 6 months were evaluated. The main outcome measures were changes in visual acuity (VA), intraocular pressure (IOP), and rates of complications. Results: In all eyes PPV was performed without complication. The mean follow-up period was 14±9.14 months. Mean VA in Group 1 increased significantly at postoperative week 1 and thereafter, whereas it increased in Group 2 at postoperative month 1 and thereafter (p<0.05). Mean log- MAR change, mean IOP levels, and rates of complications did not differ significantly between the two groups during follow-up (p>0.05). Transient hypotony was detected in 3 eyes in Group 2 only (p>0.05). Revitrectomy was performed in 1 (6.66%) and 3 (10.34%) eyes due to postoperative rehemorrhage in the two groups, respectively (p>0.05). Conclusions: In this study 25 gauge sutureless pars plana vitrectomy with oblique sclerotomies and 20 gauge vitrectomy were similarly effective and safe in the treatment of diabetic VH. Further prospective randomized and controlled studies with larger series and with longer follow-up are warranted. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the clinical features, surgical methods and results of surgery in retinal detachments (RD) developing after refractive lens excange (RLE) and phacic intraocular lens (PIL) implantation in highly myopic eyes. Materials and Methods: Nine eyes of 7 patients who had rhegmatogenous retinal detachment after RLE and PIL implantation for high myopia were included in the study. Best corrected visual acuities (BCVA), duration between the refractive surgery (RS) and retinal detachment (RD), vitreoretinal findings, anatomic and functional success (at least 2 lines increase in visual acuity) were evaluated. Results: Of the patients 4 were female, 3 were male. The mean age of 7 patients was 38.14±9.42. Posterior chamber phacic intraocular lens was implanted in 3 (33.3%) eyes, anterior chamber phacic intraocular lens was implanted in 1 (11.1%) eye and RLE was performed in 5 (55.5%) eyes. Mean interval between RS and RD was 63.66±42.3 months. Preoperative mean BCVA was 20/25000 (0.001) median proliferative vitreoretinopathy grade was B (A-D2). Eight (88.8%) eyes had macular detachment. Scleral buckling was performed in 1 eye, pars plana vitrectomy±scleral buckling was performed in 8 eyes. The mean follow up was 13.77±5.58 months after surgery. Retinal attachment was achieved with single operation in 6 (66.6%) eyes, with two surgeries in 2 (22.2%) eyes, and with three operations 1 (11.1%) eye. Final anatomical success rate was 100%. Functional successs was achieved in 7 (77.7%) eyes. Conclusion: Retinal detachments following refractive surgery represent a complicated group of retinal diseases. However, successful anatomical and functional results can be obtained if appropriate treatment methods are prefered. [ABSTRACT FROM AUTHOR]

A patient who had subfoveal fluid associated with sympathetic ophthalmia following scleral buckling and subretinal fluid drainage surgery is evaluated. The subfoveal fluid was demonstrated with optical coherence tomography. The patient received oral corticosteroid and cyclosporine A combination. He is followed with regular examinations, fluorescein angiography and OCT. Visual acuity increased from 20/25 to 20/20 and the subfoveal fluid resolved in the sympathizing eye with therapy. OCT may be a valuable tool in monitoring the response to the systemic therapy of sympathetic ophthalmia with subfoveal exudation. [ABSTRACT FROM AUTHOR]