Purpose: To describe the anterior segment AS- OCT findings of herpetic simplex keratitis. Methods: Forty-two eyes of 42 patients with proven herpetic keratitis of varying severity were included in this prospective, observational, non-comparative case series. All subjects underwent ophthalmologic examination and AS-OCT imaging. Results: Twenty-five of the 42 eyes (59.5%) had subepithelial infiltrates. In 11 of these cases, the overlying epithelium was appeared intact, but in 14 cases, hydropic changes, heaping, and defects were observed. Seventeen eyes (40.5%) showed stromal involvement: 6 case of scarring at presentation and one case associated with uveitis. Stromal infiltrates were also seen, in 10 cases, as a diffuse or local lentiform or spindle-shaped hyper-reflective area in the stroma. Conclusion: Herpetic keratouveitis has characteristic features on AS-OCT images. This study demonstrates that herpetic keratitis also has characteristic AS-OCT features, including subepithelial infiltration and specific stromal hyper-reflective patterns. These features are not unique to herpetic keratitis, but AS-OCT imaging may provide useful supplementary information for diagnosing and monitoring herpetic keratitis.

Purpose: To describe the anterior segment AS- OCT findings of herpetic simplex keratitis. Methods: Forty-two eyes of 42 patients with proven herpetic keratitis of varying severity were included in this prospective, observational, non-comparative case series. All subjects underwent ophthalmologic examination and AS-OCT imaging. Results: Twenty-five of the 42 eyes (59.5%) had subepithelial infiltrates. In 11 of these cases, the overlying epithelium was appeared intact, but in 14 cases, hydropic changes, heaping, and defects were observed. Seventeen eyes (40.5%) showed stromal involvement: 6 case of scarring at presentation and one case associated with uveitis. Stromal infiltrates were also seen, in 10 cases, as a diffuse or local lentiform or spindle-shaped hyper-reflective area in the stroma. Conclusion: Herpetic keratouveitis has characteristic features on AS-OCT images. This study demonstrates that herpetic keratitis also has characteristic AS-OCT features, including subepithelial infiltration and specific stromal hyper-reflective patterns. These features are not unique to herpetic keratitis, but AS-OCT imaging may provide useful supplementary information for diagnosing and monitoring herpetic keratitis.

Purpose: To describe the anterior segment AS- OCT findings of herpetic simplex keratitis. Methods: Forty-two eyes of 42 patients with proven herpetic keratitis of varying severity were included in this prospective, observational, non-comparative case series. All subjects underwent ophthalmologic examination and AS-OCT imaging. Results: Twenty-five of the 42 eyes (59.5%) had subepithelial infiltrates. In 11 of these cases, the overlying epithelium was appeared intact, but in 14 cases, hydropic changes, heaping, and defects were observed. Seventeen eyes (40.5%) showed stromal involvement: 6 case of scarring at presentation and one case associated with uveitis. Stromal infiltrates were also seen, in 10 cases, as a diffuse or local lentiform or spindle-shaped hyper-reflective area in the stroma. Conclusion: Herpetic keratouveitis has characteristic features on AS-OCT images. This study demonstrates that herpetic keratitis also has characteristic AS-OCT features, including subepithelial infiltration and specific stromal hyper-reflective patterns. These features are not unique to herpetic keratitis, but AS-OCT imaging may provide useful supplementary information for diagnosing and monitoring herpetic keratitis.

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The administration of ketamine as nebulized inhalation is relatively new and studies on nebulized ketamine are scarce. We aimed to investigate the analgesic efficacy of nebulized ketamine (1 and 2 mg.kg−1) administered 30 min before general anesthesia in children undergoing elective tonsillectomy in comparison with intravenous ketamine (0.5 mg.kg−1) and saline placebo. Methods: One hundred children aged (7-12) years were randomly allocated in four groups) n = 25) receive; Saline Placebo (Group C), Intravenous Ketamine 0.5 mg.kg−1 (Group K-IV), Nebulized Ketamine 1 mg.kg−1 (Group K-N1) or 2 mg.kg−1 (Group K-N2). The primary endpoint was the total consumption of rescue analgesics in the first 24 h postoperative. Results: The mean time to first request for rescue analgesics was prolonged in K-N1(400.9±60.5 min, 95% CI 375.9-425.87) and K-N2 (455. 5±44.6 min, 95% CI 437.1-473.9) groups compared with Group K-IV (318.5±86.1 min, 95% CI 282.9-354.1) and Group C (68.3±21.9 min, 95% CI 59.5-77.1; p 0.001), with a significant difference between K-N1 and K-N2 Groups(p 0.001). The total consumption of IV paracetamol in the first 24 h postoperative was reduced in Group K-IV (672.6±272.8 mg, 95% CI 559.9---785.2), Group K-N1 (715.6± 103.2 mg, 95% CI 590.4-840.8) and Group K-N2 (696.6±133.3 mg, 95% CI 558.8-834.4) compared with Control Group (1153.8±312.4 mg, 95% CI 1024.8-1282.8; p 0.001). With no difference between intravenous and Nebulized Ketamine Groups (p = 0.312). Patients in intravenous and Nebulized Ketamine Groups showed lower postoperative VRS scores compared with Group C (p 0.001), no differences between K-IV, K-N1 or K-N2 group and without significant adverse effects Conclusion: Preemptive nebulized ketamine was effective for post-tonsillectomy pain relief. It can be considered as an effective alternative route to IV ketamine.

The administration of ketamine as nebulized inhalation is relatively new and studies on nebulized ketamine are scarce. We aimed to investigate the analgesic efficacy of nebulized ketamine (1 and 2 mg.kg−1) administered 30 min before general anesthesia in children undergoing elective tonsillectomy in comparison with intravenous ketamine (0.5 mg.kg−1) and saline placebo. Methods: One hundred children aged (7-12) years were randomly allocated in four groups) n = 25) receive; Saline Placebo (Group C), Intravenous Ketamine 0.5 mg.kg−1 (Group K-IV), Nebulized Ketamine 1 mg.kg−1 (Group K-N1) or 2 mg.kg−1 (Group K-N2). The primary endpoint was the total consumption of rescue analgesics in the first 24 h postoperative. Results: The mean time to first request for rescue analgesics was prolonged in K-N1(400.9±60.5 min, 95% CI 375.9-425.87) and K-N2 (455. 5±44.6 min, 95% CI 437.1-473.9) groups compared with Group K-IV (318.5±86.1 min, 95% CI 282.9-354.1) and Group C (68.3±21.9 min, 95% CI 59.5-77.1; p 0.001), with a significant difference between K-N1 and K-N2 Groups(p 0.001). The total consumption of IV paracetamol in the first 24 h postoperative was reduced in Group K-IV (672.6±272.8 mg, 95% CI 559.9---785.2), Group K-N1 (715.6± 103.2 mg, 95% CI 590.4-840.8) and Group K-N2 (696.6±133.3 mg, 95% CI 558.8-834.4) compared with Control Group (1153.8±312.4 mg, 95% CI 1024.8-1282.8; p 0.001). With no difference between intravenous and Nebulized Ketamine Groups (p = 0.312). Patients in intravenous and Nebulized Ketamine Groups showed lower postoperative VRS scores compared with Group C (p 0.001), no differences between K-IV, K-N1 or K-N2 group and without significant adverse effects Conclusion: Preemptive nebulized ketamine was effective for post-tonsillectomy pain relief. It can be considered as an effective alternative route to IV ketamine.

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