János Hargitai

Normal Value Ranges for Central Retinal Thickness Asymmetry in Healthy Caucasian Adults Measured by SPECTRALIS SD-OCT Posterior Pole Asymmetry Analysis.

PURPOSE To determine the normal variation in central retinal thickness asymmetry in healthy Caucasian adults using the posterior pole asymmetry analysis (PPAA) of a SPECTRALIS spectral-domain optical coherence tomography (SD-OCT) device. METHODS Healthy Caucasian individuals aged between 18 and 45 years with a visual acuity of minimum 20/20 and a spherical equivalent between -1.5 and +1.5 diopters were recruited. Retinal thickness and retinal nerve fiber layer thickness (RNFL) were using measured SPECTRALIS SD-OCT. Inter- and intraocular differences in central retinal thickness were calculated using the PPAA. The association between age, sex, and interocular asymmetry was evaluated by a linear model with Gaussian correlation structure. RESULTS A total of 105 individuals, 30 men and 75 women, were studied. The mean age ± SD was 28.8 ± 7.87 years. The grand mean interocular retinal thickness asymmetry was 5.6 μm (95% confidence interval [CI]: 4.6-6.5) and the grand mean intraocular retinal thickness asymmetry was 8.3 μm (95% CI: 6.8-9.9) in the right eye and 8.4 μm (95% CI: 6.7-10.0) in the left eye. The highest local asymmetries were found in the nasal corners of macula were the posterior pole thickness map overlaps the temporal vascular arches. A slight general age and sex effect on the mean interocular retinal thickness asymmetry was found to be respectively 0.04 μm/year (95% CI: 0.02-0.06 μm) and 0.54 μm (95% CI: 0.19-0.88 μm) for men compared with women. CONCLUSIONS Statistically significant physiological asymmetries in inter- and intraocular central retinal thickness exist. This must be considered when early signs of glaucoma or other pathologies are evaluated based on the retinal thickness asymmetry. (http://www.controlled-trials.com/isrctn/ number, ISRCTN09017572.).

Comparing the efficacy of mydriatic cocktail- soaked sponge and conventional pupil dilation in patients using tamsulosin - a randomized controlled trial

BackgroundA strong association exists between the use of tamsulosin and the occurance of intraoperative floppy iris syndrome. Several methods were advocated to overcome the progressive intraopertive miosis.Our purpose was to investigate the effect of a mydriatic-cocktail soaked cellulose sponge on perioperative pupil diameter in tamsulosin-treated patients undergoing elective cataract surgery.MethodsPatients using tamsulosin were dilated either with mydriatic-cocktail soaked sponge (group 1) or with conventional eyedrop regimen (group 2). Control patients not taking any α1 adrenergic receptor inhibtors were also dilated with mydriatic sponge (group 3).In all groups oxybuprocain 0.4%, cocain 4%, tropicamide 1%, phenylephrine 10%, diclophenac 0.1% along with chloramphenicol 0.5% were used preoperatively.Pupil diameter (mm) was measured preoperatively, after nucleus delivery, and before IOL implantation. Adverse effects associated with the use of sponge, minor and major intraoperative complications, the use of iris retractors and operation time were recorded.Differences in general between groups were analyzed with a one way analysis of variance (ANOVA); differences between groups in proportions were assessed by Fisher’s exact test.ResultsMean pupil diameter (mm) was preopertively: 7.52 ± 1.21, 7.30 ± 1.55 and 7.99 ± 0.96 (ANOVA: p = 0.079); after nucleus delivery: 6 ± 1.20, 6.29 ± 1.12 and 6.52 ± 0.81 (ANOVA: p = 0.123); before IOL implantation: 5.46 ± 1.06, 5.83 ± 1.09 and 6.17 ± 0.89 (ANOVA: p = 0.0291).No adverse effect related to sponge use was detected. Frequency of minor complications, and iris hook use was similar in the two tamsulosin treated group. Operation time did not differ significantly in the three groups.ConclusionWe have found that using a mydriatic cocktail-soaked wick – an alternative way to achieve intraoperative mydriasis for cataract surgery – was as effective and safe as the conventional repeated eyedrops regiment for tamsulosin treated patients.Trial registrationCurrent Controlled Trials ISRCTN37834752

Functional benefits and patient satisfaction with upper blepharoplasty – evaluated by objective and subjective outcome measures

To investigate the functional benefits and patient satisfaction with upper blepharoplasty in patients meeting the Danish visitation guidelines for upper blepharoplasty from the Danish Health and Medicines Authority (Sundhedsstyrelsen).