Effect of oral citicoline therapy on retinal nerve flber layer and ganglion cell-inner plexiform layer in patients with primary open angle glaucoma

AIM: To evaluate the short-term effects of oral citicoline therapy on the retinal nerve fiber layer(RNFL) and the macular ganglion cell-inner plexiform layer(m GCIPL) in patients with primary open angle glaucoma(POAG).METHODS: Fifty-four eyes of 54 patients with POAG glaucoma included in the study.In addition to a topical hypotensive, 250-mg oral citicoline was administered to 27 patients, while 27 patients were assigned as the control group.RNFL and m GCIPL values were measured using optical coherence tomography(OCT) at 1 d before treatment and 3 mo after the initiation of treatment.At the third month visit, citicoline treatment was discontinued and drug-free control(wash-out) measurements were obtained at the fourth month in citicoline group.RESULTS: The average RNFL thickness was significantly higher at month 3 than the baseline(P=0.038) in citicoline group.However, this improvement partially regressed after a 1-month wash-out period.No statistically significant changes in RNFL were observed in the superior, nasal, temporal and inferior quadrants at months 3 and 4(P>0.05).The change in the average and inferior quadrant RNFL thickness in the citicoline group at 3 mo was significantly greater than the control group(P=0.006 and P=0.014, respectively).There were no significant differences between the groups according to the change in m GCIPL thickness and the superior, nasal and temporal quadrant RNFL thickness(P>0.05).CONCLUSION: With oral citicoline treatment, the loss in the average RNFL is prevented in POAG patients in the short-term.Study data show that citicoline may have a significant impact on slowing glaucoma progression, which could have a potential neuroprotective effect.

Surgical Outcomes of Nontraumatic Pediatric Cataracts

Purpose: To evaluate post-surgical complications in patients who were operated for nontraumatic pediatric cataracts in our clinic. Methods: Medical records of 62 patients (101 eyes) that underwent cataract surgery younger than 15 years of age, without history of ocular trauma and with a minimum follow-up period of 6 months, were reviewed retrospectively. Results: The most common initial complaint was leukocoria. Thirty-nine patients (62.9%) had bilateral cataracts and 23 patients (37.1%) had unilateral cataracts. The most common type was posterior polar cataract (22%) in patients with unilateral cataracts, and total cataract (33%) in patients with bilateral cataracts. The overall prevalence of postoperative complications was 58%, visual axis opacification (VAO) being the most common one (39%). The incidence of VAO was significantly higher in eyes with intact posterior capsules. Secondary glaucoma occurred in 12 (12%) eyes. Thirty-one (50%) patients were orthophoria, 17 (27%) patients had esotropia, and 14 (23%) patients had exotropia. Additional surgery for all of these complications was performed in 53 (53%) eyes. Conclusions: Despite appropriate surgical treatment of nontraumatic pediatric cataracts, post-surgical complications including VAO, glaucoma, or strabismus remain an important cause of morbidity in these patients. Posterior capsulotomy and anterior vitrectomy must be performed in all children below 6 years to reduce the need for additional surgery for VAO.

Detection of H.pylori Antigen in the Stool Samples of Children,in Tekirdag,Turkey

Introduction: Helicobacter pylori (H. pylori) is an important bacterial pathogen, predominantly in undeveloped countries and regions. We conducted this study to investigate the presence of H. pylori antigen in the stool specimens of children, in Tekirdag, Turkey. Material and Methods: Stool specimens of 1441 children aging between 0 month to 15 years, with the complaints of abdominal pain, anemia, gastroenteritis, nausea and vomiting were included in the study. The subjects were divided into three groups based on their ages: Group A (0 month - 5 years), Group B (6 - 10 years) and Group C (11 - 15 years). All specimens were tested for H. pylori antigen with HP Ag (DIA.PRO, Diagnostic Bioprobes, Italy). Results were evaluated statistically. Results: The median age of children with H. pylori positive samples was 6.6 ± 4.1 and 47.9% were girls. Overall positivity of H. pylori stool antigen was 6.6%. Positivity rates due to ages in Groups A, B and C were: 8.9%, 5.8%,? 5.2% respectively (x2 = 9.3, p = 0.01). No difference was observed due to gender (x2 = 0.17, p = 0.68). Conclusion: Higher antigen positivity obtained in 0 - 5 years group, indicates the risk of acquiring the infection in early years of life. Preventive measures for the development of H. pylori infection gain importance, especially in developing countries.