Insights in Ophthalmology

Insulin treatment in the dark

Joint Event on 23^rd Edition of Advancements in Ophthalmology: Clinical & Surgical Practices & 24^th Edition of International Conference on Ophthalmology Case Reports
July 30-August 01, 2018 Barcelona, Spain

Koyluoglu Nilufer, Yasa Dilek, Arslantas Recai, Altan Tugrul, Salman Salman, Akdemir Asena and Koc Cetin Kaya

stinye University, School of Medicine Beyoglu Eye Research and Education Hospital Second Sight Medical Products Istinye University, School of Engineering

ScientificTracks Abstracts: Insights in Ophthalmology

Abstract

Sight loss has a significant impact on a person’s daily life related to maintaining their independence, social isolation, activities of daily living and issues around financial support. We would like to focus on the difficulties of insülin therapy in a completely blind patient during his postoperative period of Argus II retinal prosthesis surgery. He is 62 years old male with end stage retinitis pigmentosa and he was identified to be eligible for Argus II that can restore vision artificially for RP patients whom there are no other treatment options. He also has type II diabetes and his HbA1c was 6,8 with oral antidiabetic therapy. After cardiology, endocrinology and psychiatry consultations, his surgery performed under general anesthesia without any ocular and systemic complication. Post-operative medication protocol after initial implantation of Argus II includes 14 days of oral prednisolone (60 mg daily) followed by 1 week of tapering dose. In our case, hyperglycemia caused by systemic steroid was regulated by insulin therapy during the recovery period. Fitting was applied at the end of the first week, the bionic vision was initiated and the patient was scheduled for termination of hospitalization. But the patient lived alone in a village far from the city center and had visually impaired friends who died because of the wrong insulin dose in his past. This experience was creating anxiety and resulted in the patient’s need to stay in the hospital until steroid therapy was stopped and insulin support was not needed. In accordance with his desire, he began his new life by providing good metabolic control with OAD alone at the end of two weeks. However, the difficulty of treating diabetes mellitus which is itself also the leading cause of blindness, in blind patients is an important problem that should be studied as multidisciplinary at the state level.

Biography

Dr Nilufer Koyluoglu graduated from Istanbul University, Istanbul School of Medicine. She has completed her residency in Istanbul Universtiy, Cerrahpasa School of Medicine, Department of Ophthalmology in 2002. She has started to work as retina specialist in Turkish Diabetes Society Hospital. She has held the position of Deputy Chief Physician in Dünyagöz Hospital Group in 2005. She initiated the Orbis partnership, Vodafone teleophthalmology program, Argus II Retinal Implant treatment in Turkey, ‘Dunyadiyabet’ and ‘See the Eye’ projects. She is working with the Turkish Paralympic Committee and Turkish Football Federation in order to add the retina awareness to concussion and neuroscience in sports medicine. She is Substantive Consultant Ophthalmologist at Liv Hospital International and Assistant Profesor at Istinye Universty, School of Medicine in Istanbul. She is working at Research and Development Center in Machine Intelligence and Medicine and aims that the eye would be the global symbol for the preventive medicine.

E-mail: niluferkoyluogluunal@gmail.com