Research Article
BibTex RIS Cite

Subkonjonktival Kanaması olan Hastalarda Refraktif Durum ve Aksiyel Uzunluğun Önemi

Year 2020, Volume: 42 Issue: 6, 682 - 687, 09.11.2020

Erdoğan Yaşar Ugur Gürlevik

https://doi.org/10.20515/otd.678412

Abstract

Subkonjonktival kanama (SKH), konjonktival damarların aniden yırtılması ile kanın subkonjonktival dokuya ve episkleral boşluğa lokalize sızması sonucu ortaya çıkan ağrısız bir hastalıktır. Bu çalışmada amacımız subkonjonktival kanamalı hastalarda refraktif durum, aksiyel uzunluk ve ön segment parametrelerini değerlendirmektir. Bu prospektif çalışmaya subkonjonktival kanaması olan 51 hastanın 51 gözü ve 40 sağlıklı bireyin 40 gözü dahil edildi. Ayrıntılı olarak sistemik hastalıklar, kullanılan ilaçlar ve diğer risk faktörleri sorgulandı. Demografik sorgulamadan sonra risk faktörleri için ayrıntılı biyomikroskopi göz muayenesi yapıldı. Daha sonra kırma kusuru, göz içi basıncı, eksenel uzunluk, lens kalınlığı, santral kornea kalınlığı ve ön kamara derinliği ölçümleri yapılarak sonuçlar kaydedildi. SKH'li hastaların yaş ortalaması 49.4±6.8 (28-59) ve kontrol grubunun yaş ortalaması 50.4±6.8 (32-57) idi. SKH risk faktörleri açısından hastalar yeterli istatistiksel analize sahip 3 gruba ayrıldı (HT, antikoagülan kullanımı ve Valsalva öyküsü). Sonuçlara göre, HT'li hastalar ile kontrol grupları arasında hipermetrop (p <0.001), kısa aksiyel uzunluk (p<0.001) ve dar ön kamara derinliği (p<0.001) açısından anlamlı bir fark saptandı. Ek olarak, aksiyel uzunluk ile SKH tekrar sayısı arasında anlamlı negatif korelasyon(p=0.036, r=-0.544) saptandı. Antikoagülan kullanımı ve Valsalva öyküsü olan hastalar ile kontrol grubu arasında kırma kusuru, ön segment parametreleri ve aksiyel uzunluk açısından anlamlı fark bulunmadı (p> 0.05). SKH'li hastaların muayenesinde hipermetrop, kısa aksiyel uzunluk ve dar ön kamera tespit edilirse, hastalar HT açısından ayrıntılı olarak araştırılmalıdır. Ek olarak SKH etiyolojisinde gözle ilgili parametrelerin de önemli olduğu bulunmuştur.

Keywords

Subkonjonktival kanama

Supporting Institution

yok

Project Number

yok

References

  • 1. Mimura T, Yamagami S, Usui T, Funatsu H, Noma H, Fukuoka S, et al. Location and extent of subconjunctival hemorrhage. Ophthalmologica. 2010; 224: 90–95.
  • 2. Incorvaia C, Costagliola C, Parmeggiani F, Gemmati D, Scapoli GL, Sebastini A. Recurrent episodes of spontaneous subconjunctival hemorrhage in patients with factor XIII Val34Leu mutation. Am J Ophthalmol. 2002; 134: 927–929.
  • 3. Duke-Elder, S. Diseases of the outer eye. System of ophthalmology. 1965;8, 309-314.
  • 4. Fukuyama J, Hayasaka S, Yamada K, Setogawa T. Causes of subconjunctival hemorrhage. Ophthalmologica. 1990;200(2):63–67.
  • 5.Kaimbo, W. A., & Kaimbo, D. Epidemiology of traumatic and spontaneous subconjunctival haemorrhages in Congo. Bull Soc belge Ophthalmol. 2009;311: 31-6.
  • 6. Huynh, Nancy, Jay Wang, and Demetrios Vavvas. Dilated fundus exam and associated findings in spontaneous subconjunctival haemorrhage. Acta ophthalmologica, 2017, 95.5: e432-e433.
  • 7. Mimura T, Usui T, Yamagami S, et al. Recent causes of subconjunctival hemorrhage. Ophthalmologica. 2010;224:133-7.
  • 8. Kumar N, Jivan S, Thomas P, McLure H. Sub-Tenon’s anesthesia with aspirin, warfarin, and clopidogrel. J Cataract Refract Surg. 2006;32:1022–1025
  • 9. Sodhi PK, Jose R. Subconjunctival hemorrhage: the first presenting clinical feature of idiopathic thrombocytopenic purpura. Jpn J Ophthalmol.2003;47:316–318
  • 10. Schmitz J. Conjunctivochalasis and subconjunctival hemorrhage. Ophthalmology. 2010; 117(12):2444
  • 11. Sklar VE, Patriarca PA, Onorato IM, et al. Clinical findings and results of treatment in acute hemorrhagic conjunctivitis in Southern Florida. Am J Ophthalmol. 1983;95(1):45–54.
  • 12. Lee HM, Naor J, DeAngelis D, Rootman DS. Primary localized conjunctival amyloidosis presenting with recurrence of subconjunctival hemorrhage. Am J Ophthalmol. 2010; 129(2):245–247
  • 13. Kiratli H, Uzun S, Tarlan B, Tanas Ö. Recurrent subconjunctival hemorrhage due to cavernous hemangioma of the conjunctiva. Can J Ophthalmol. 2012;47(3):318–320.
  • 14. Pong JC, Lam DK, Lai JS. Spontaneous subconjunctival haemorrhage secondary to carotid-cavernous fistula. Clin Experiment Ophthalmol. 2008;36(1):90–91
  • 15. ÇİLOĞLU, Emine; KÖKER, Ömer Faruk; ÖZCAN, Altan Atakan. Retina Ven Tıkanıklığında Göz içi Basınç ve Aksiyel Uzunluk Değerlendirilmesi. Glokom-Katarakt/Journal of Glaucoma-Cataract, 2013, 8.2.
  • 16. Toricelli A, Castro Reis AS, Abucham JZ, Suzuki R, Malta R.F.S, Monteiro M. L. R. Bilateral Nonarteritic Anterior Ischemic Optic Neuropathy Following Acute Angle Clsoure Glaucoma in a Patient with Iridoschisis: a case report. Arq Bras Oftalmol 2011; 74-1: 61-63
  • 17. Szigeti A, Schneider M, Ecsedy M, Nagy ZZ, Recsan Z. Association Between Retinal Vein Occlusion, Axial Length and Vitreous Chamber Depth Measured by Optical Low Cohorence Reflectometry. BMC Ophthalmology. 2015
  • 18. Christoffersen NL, Larsen M. Pathophysiology and hemo-dynamics of branch retinal vein occlusion. Ophthalmology 1999;106;2054-62
  • 19.Bandello F, Tavola A, Pierro L. Axial length and refraction in retinal vein occlusions. Ophthalmologica 1998;212:133-5.
  • 20.Saxena RC, Saxena S, Rajiv N. Hyperopia in branch retinal vein occlusion. Ann Ophthalmol. 1995;27:15–8.
  • 21. Majjii AS, Janarthanan M, Naduvilath TJ. Significance of refractive status in branch retinal vein occlusion: a case control study. Retina. 1997;17:200–4.

The Importance of Refractive Status and Axial Length in Patients with Subconjunctival Hemorrhage

Year 2020, Volume: 42 Issue: 6, 682 - 687, 09.11.2020

Erdoğan Yaşar Ugur Gürlevik

https://doi.org/10.20515/otd.678412

Abstract

Subconjunctival hemorrhage(SCH) is a painless disease that occurs as a result of the localized extravasation of blood to subconjunctival tissue and episcleral space by suddenly rupturing conjunctival vessels. Our aim is evaluate the refractive status, axial length and anterior segment parameters in patients with subconjunctival hemorrhage in this study. A fifty-one eye of 51 patients with subconjunctival hemorrhage and 40 eyes of 40 healthy individuals were enrolled in this prospective study. In detail, systemic diseases, used drugs, and other risk factors were questioned. After demographic questioning, a detailed biomicroscopy eye examination was performed for risk factors. Then refractive error, intraocular pressure, axial length, lens thickness, central corneal thickness, and anterior chamber depth were measurements performed. The mean age of patients with SCH was 49.4±6.8 (28-59) and the mean age of the control group was 50.4±6.8 (32-57). In terms of risk factors of SCH, the patients were divided into 3 groups that had sufficient statistical analysis (HT, use of anticoagulants and history of Valsalva). According to results, a significant difference was found between patients with HT and control groups in terms of spherical refraction (hyperopia) (p<0.001), short axial length (p<0.001) and narrow anterior chamber depth (p<0.001). In addition a significant negative correlation between axial length and SCH repeat number (p= 0.036, r =-0.544). No significant difference was detected between anticoagulant usage-Valsalva patients and the control group in terms of refractive error, anterior segment parameters and axial length(p>0.05). If the hyperopia, short axial length, and narrow anterior camera are detected in the examination of patients with SCH, the patients should be investigated in detail in terms of HT. In addition, eye related parameters were found to be important in SCH etiology.

Keywords

Subconjunctival hemorrhage hyperopia axial length

Project Number

yok

References

  • 1. Mimura T, Yamagami S, Usui T, Funatsu H, Noma H, Fukuoka S, et al. Location and extent of subconjunctival hemorrhage. Ophthalmologica. 2010; 224: 90–95.
  • 2. Incorvaia C, Costagliola C, Parmeggiani F, Gemmati D, Scapoli GL, Sebastini A. Recurrent episodes of spontaneous subconjunctival hemorrhage in patients with factor XIII Val34Leu mutation. Am J Ophthalmol. 2002; 134: 927–929.
  • 3. Duke-Elder, S. Diseases of the outer eye. System of ophthalmology. 1965;8, 309-314.
  • 4. Fukuyama J, Hayasaka S, Yamada K, Setogawa T. Causes of subconjunctival hemorrhage. Ophthalmologica. 1990;200(2):63–67.
  • 5.Kaimbo, W. A., & Kaimbo, D. Epidemiology of traumatic and spontaneous subconjunctival haemorrhages in Congo. Bull Soc belge Ophthalmol. 2009;311: 31-6.
  • 6. Huynh, Nancy, Jay Wang, and Demetrios Vavvas. Dilated fundus exam and associated findings in spontaneous subconjunctival haemorrhage. Acta ophthalmologica, 2017, 95.5: e432-e433.
  • 7. Mimura T, Usui T, Yamagami S, et al. Recent causes of subconjunctival hemorrhage. Ophthalmologica. 2010;224:133-7.
  • 8. Kumar N, Jivan S, Thomas P, McLure H. Sub-Tenon’s anesthesia with aspirin, warfarin, and clopidogrel. J Cataract Refract Surg. 2006;32:1022–1025
  • 9. Sodhi PK, Jose R. Subconjunctival hemorrhage: the first presenting clinical feature of idiopathic thrombocytopenic purpura. Jpn J Ophthalmol.2003;47:316–318
  • 10. Schmitz J. Conjunctivochalasis and subconjunctival hemorrhage. Ophthalmology. 2010; 117(12):2444
  • 11. Sklar VE, Patriarca PA, Onorato IM, et al. Clinical findings and results of treatment in acute hemorrhagic conjunctivitis in Southern Florida. Am J Ophthalmol. 1983;95(1):45–54.
  • 12. Lee HM, Naor J, DeAngelis D, Rootman DS. Primary localized conjunctival amyloidosis presenting with recurrence of subconjunctival hemorrhage. Am J Ophthalmol. 2010; 129(2):245–247
  • 13. Kiratli H, Uzun S, Tarlan B, Tanas Ö. Recurrent subconjunctival hemorrhage due to cavernous hemangioma of the conjunctiva. Can J Ophthalmol. 2012;47(3):318–320.
  • 14. Pong JC, Lam DK, Lai JS. Spontaneous subconjunctival haemorrhage secondary to carotid-cavernous fistula. Clin Experiment Ophthalmol. 2008;36(1):90–91
  • 15. ÇİLOĞLU, Emine; KÖKER, Ömer Faruk; ÖZCAN, Altan Atakan. Retina Ven Tıkanıklığında Göz içi Basınç ve Aksiyel Uzunluk Değerlendirilmesi. Glokom-Katarakt/Journal of Glaucoma-Cataract, 2013, 8.2.
  • 16. Toricelli A, Castro Reis AS, Abucham JZ, Suzuki R, Malta R.F.S, Monteiro M. L. R. Bilateral Nonarteritic Anterior Ischemic Optic Neuropathy Following Acute Angle Clsoure Glaucoma in a Patient with Iridoschisis: a case report. Arq Bras Oftalmol 2011; 74-1: 61-63
  • 17. Szigeti A, Schneider M, Ecsedy M, Nagy ZZ, Recsan Z. Association Between Retinal Vein Occlusion, Axial Length and Vitreous Chamber Depth Measured by Optical Low Cohorence Reflectometry. BMC Ophthalmology. 2015
  • 18. Christoffersen NL, Larsen M. Pathophysiology and hemo-dynamics of branch retinal vein occlusion. Ophthalmology 1999;106;2054-62
  • 19.Bandello F, Tavola A, Pierro L. Axial length and refraction in retinal vein occlusions. Ophthalmologica 1998;212:133-5.
  • 20.Saxena RC, Saxena S, Rajiv N. Hyperopia in branch retinal vein occlusion. Ann Ophthalmol. 1995;27:15–8.
  • 21. Majjii AS, Janarthanan M, Naduvilath TJ. Significance of refractive status in branch retinal vein occlusion: a case control study. Retina. 1997;17:200–4.
There are 21 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section ORİJİNAL MAKALE
Authors

Erdoğan Yaşar 0000-0001-5129-9397

Ugur Gürlevik 0000-0003-2965-481X

Project Number yok
Publication Date November 9, 2020
Published in Issue Year 2020 Volume: 42 Issue: 6

Cite

Vancouver Yaşar E, Gürlevik U. The Importance of Refractive Status and Axial Length in Patients with Subconjunctival Hemorrhage. Osmangazi Tıp Dergisi. 2020;42(6):682-7.


13299        13308       13306       13305    13307  1330126978