Evaluation of optical coherence tomography parameters before and after parenteral iron treatment of patients with iron deficiency anemia.

PURPOSE: The aim of our study is to evaluate the relationship between iron deficiency anemia (IDA), which is a common and often chronic condition in young women, and the optical coherence tomography (OCT) findings, which have become an indispensable part of ophthalmology practice. We aim to identify a new biomarker for anemia evaluation by demonstrating the morphological changes in the eye before and after iron replacement treatment through OCT findings. METHODS: 70 eyes of 35 patients diagnosed with IDA and planned to have parenteral iron replacement were included in the study. Patients were evaluated before treatment and between 4-6 weeks and 12-16 weeks after treatment. During visits, peripapillary and macular choroidal thicknesses and retinal nerve fiber layer (RNFL) thicknesses were evaluated with OCT along with serum hemoglobin(Hb) values. RESULTS: The mean age of the patients was 36.80 ± 7.25. All 35 patients (100%) were female. The mean baseline Hb values of the patients increased statistically significantly both after 4-6 weeks and after 12-16 weeks (p < 0.05). A statistically significant difference was found between baseline and third visit in OCT findings in subfoveal, temporal, nasal, peripapillary temporal and peripapillary nasal choroidal thicknesses and total, inferior, nasal and temporal RNFL thicknes (p < 0.05). There was no statistically significant difference between the baseline and the third visit in the central macular thickness and superior RNFL thickness. CONCLUSION: Significant increases in choroidal and RNFL thickness were detected after parenteral iron replacement in patients diagnosed with IDA. Our results demonstrate that the changes induced by IDA on the retina can be reversed with treatment.

Retinal vascular caliber in patients with newly diagnosed iron deficiency anemia.

BACKGROUND: To evaluate the retinal vascular caliber using fundus photography in patients with newly diagnosed iron deficiency anemia (IDA). METHODS: This study included 56 eyes of 28 female patients with IDA and the 56 eyes of 28 age- and sex-matched healthy participants. Retinal vascular calibers were measured using image analysis software from fundus photographs. The central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE) and arteriole-to-venule ratio (AVR) were compared between groups. Linear regression analysis was used to quantify the relative impact of hemoglobin level on CRAE, CRVE, and AVR. RESULTS: The CRAE was significantly narrower in patients with IDA. However, no such difference appeared between groups in CRVE. AVR was significantly lower among patients with IDA than in the control group. Linear regression analysis revealed that in patients with IDA, hemoglobin level was associated with CRAE and CRVE but not with AVR. Among non-anemic individuals, there was also no association between hemoglobin level and CRAE, CRVE, or AVR. CONCLUSIONS: Our results showing that the CRAE is significantly narrower in patients with IDA than in healthy non-anemic individuals suggests that vascular caliber may reflect early microvascular alterations resulting from IDA. Added to that, hemoglobin level was associated with CRAE and CRVE in our linear regression analysis of patients with IDA. Certain changes in retinal vascular caliber are also clearly associated with high blood pressure, cardiovascular risk, and mortality. It may be critical to identify all alterations in retinal vascular caliber in order to prevent potential ocular and systemic disorders in patients with IDA.

Subthreshold micropulse laser versus intravitreal anti-VEGF for diabetic macular edema patients with relatively better visual acuity.

AIM: To compare the effects of yellow (577 nm) subthreshold micropulse laser (SML) and intravitreal (IV) anti-vascular endothelial growth factor (VEGF) treatment in patients with diabetic macular edema (DME) with relatively better visual acuity [best corrected visual acuity (BCVA) ≤0.15 logMAR]. METHODS: The medical records of 76 eyes of 47 patients underwent IV (0.5 mg) anti-VEGF injection or SML for the DME with relatively better BCVA were reviewed. The IV group received three consecutive monthly IV anti-VEGF injections, then were retreated as needed. The laser treatment group was treated at baseline and 3mo, and then retreated at 6 and 9mo if needed. All participants were followed up for one year. The mean BCVA and mean central macular thickness (CMT) values changes over the follow-up were evaluated. RESULTS: Twenty-four and 23 patients were assigned to the SML and IV subgroups, respectively. The mean number of treatments was 3.64±0.76 in SML group and 5.85±1.38 in IV group (P<0.05). The subgroups were similar with regard to the mean BCVA score at baseline and at the 1st and 3rd months, but the score of SML group was better than that of IV group at the 6th, 9th, and 12th months (P<0.05). The decrease in the mean CMT values from baseline values was higher in SML group at the 6th, 9th, and 12th months (P<0.05). CONCLUSION: Yellow SML treatment is superior to IV anti-VEGF injection in DME patients with relatively better BCVA for increasing visual acuity and decreasing CMT at 6, 9, and 12mo. SML can be a good alternative first-line therapy for DME with BCVA ≤0.15 logMAR.

Persistence of 137Cs in the litter layers of forest soil horizons of Mount IDA/Kazdagi, Turkey.

In 2010-2012, an extensive study was performed in forest sites of Mount IDA (Kazdagi)/Edremit 26 years after the Chernobyl accident. The (137)Cs activity concentrations were determined by gamma-ray spectrometry in the forest soil layers (OL, OF + OH and A horizons) separately. Based on 341 surface soil samples and 118 soil profiles, activity concentrations of (137)Cs in OL horizons varied between 0.25 ± 0.14 and 70 ± 1 Bq kg(-1), while the ranges of (137)Cs activity concentrations in OF + OH and A horizons were 13 ± 1-555 ± 3 Bq kg(-1) and 2 ± 1-253 ± 2 Bq kg(-1), respectively. Cesium-137 deposition in the study area was estimated to be in the range of 1-39 kBq m(-2) and a linear relationship between the deposition of (137)Cs and the altitude was observed. The distributions of (137)Cs activities in OL, OF + OH and A horizons throughout the region were mapped in detail. The highest (137)Cs activities were found in OF + OH horizons, with markedly lower (137)Cs activity in mineral horizons of soil profiles. It is observed that (137)Cs content of humus layer increases with the thickness of the humus layer for coniferous forest sites. The (137)Cs activity concentrations were higher than the recommended screening limits (150 Bq kg(-1)) at some of the investigated areas. The current activity concentration of top soil layers indicates that over many years since the initial deposition, (137)Cs activity is keeping still high in the organic horizons.