Evaluation of the Optic Nerve Head Using Optical Coherence Tomography Angiography in Systemic Sclerosis Patients.

PURPOSE: To quantify microvascular vessel density in the optic disc using optical coherence tomography angiography (OCTA) in patients with systemic sclerosis (SS); to determine whether there is a difference in values between patients and controls; and to correlate the OCTA measurements with disease activity, damage risk, and drug usage. METHODS: Patients aged 20 - 76 years who were followed up after a diagnosis of SS and age- and gender-matched controls. The patients underwent RTVue-XR AngioVue OCTA imaging in this cross-sectional observational study. RESULTS: A total of 61 eyes of 61 consecutive SS patients and 60 eyes of 60 controls were investigated. There was no statistically significant difference between the patients and control groups regarding the average RNFL (retinal fiber layer) and radial peripapillary capillary (RPC) vessel density (VD) measurements (p = 0.35, p = 0.25, respectively). As the antinuclear antibody (ANA) titer increased, RNFLsuperior (p = 0.01, r = - 0.327), RPCwhole (p = 0.029, r = 0.279), RPCperipapillary (p = 0.037, r = - 0.267), RPCsuperior (p = 0.003, r = - 0.371), and RPCinferior (p = 0.02, r = 0.297) values decreased with statistical significance. The RPCinside values were lower in anti-Scl-70-positive patients compared to patients negative for anti-Scl-70 (topoisomerase I) (p = 0.021). The RNFLnasal (p = 0.03, r = - 0.278) value decreased as the years of disease increased. The RPCinside value was higher in patients using hydroxychloroquine and calcium channel blockers than those who did not use them (p = 0.021 and p = 0.027, respectively). The RPCwhole, RPCperipapillary, and RPCnasal values were higher, with statistical significance in corticosteroid users than in those patients who did not use corticosteroids (p = 0.043, 0.030, and 0.033, respectively). CONCLUSION: There was no significant difference between the patients and control groups regarding the average RPC VD measurements. However, since this is the first study to analyze optic disc vessel density in SS patients, optic nerve blood flow changes in scleroderma with OCTA could be studied.

Evaluation of the optic nerve head and macular vessel density in keratoconus patients using optical coherence tomography angiography- a cross-sectional study.

PURPOSE: Our study evaluated macular and optic disc vascular density (VD) changes in patients diagnosed with keratoconus, as compared with gender and age-matched healthy controls, in relation to the keratoconus stage. METHODS: This comparative cross-sectional study included adult patients who received a diagnosis of keratoconus at the Cornea Clinic. All scans consisted of two 4.5 mm × 4.5 mm images of the optic disc area and 6 × 6 mm images of the macular area using optical coherence tomography angiography. RESULTS: The study included 67 patients (26 women (38.8%) and 41 men (61.2%)) and 74 controls (31 women (41.9%) and 43 men (58.1%)). The mean ages of the keratoconus group and the control group were 30.0 ± 8.0 and 31.1 ± 7.5, respectively. Macular VD (whole, superficial, and deep) and peripapillary VD (whole) values were decreased statistically significant compared with the control group (p < 0.01 and p = 0.015, respectively). The keratoconus stage was negatively correlated with both the macular VD (p = 0.048, r = -0.314) and whole-peripapillary VD values (p = 0.03, r = -0.34). CONCLUSION: Keratoconus might affect the posterior and anterior segments due to similar etiologies, including diminished collagen quality. Therefore, examination of the posterior segment should be performed thoroughly in keratoconus patients.

Anterior Segment Optic Coherence Tomography Changes Before and After Phacoemulsification in Primary Open-Angle Glaucoma.

OBJECTIVES: The goal of this study was to compare measurements of values such as the anterior chamber angle (ACA), thickness of the iris, thickness of the cornea, and the angle-opening distance (AOD) of eyes with primary open-angle glaucoma before and after undergoing phacoemulsification with intraocular lens implantation using anterior segment optical coherence tomography (AS-OCT). METHODS: The data of 49 eyes of 39 glaucoma patients who presented at the Cataract and Refractive Surgery Unit of the Ophthalmology Clinic of , University of Health Sciences, Istanbul Traning and Research Hospital between December 2014 and May 2016 were included in the study. All of the patients were examined with AS-OCT. All of the preoperative and postoperative data were evaluated statistically using a paired t-test and the Wilcoxon test. A statistical significance level of alpha was accepted as p<0.05. RESULTS: The AS-OCT measurements of 39 patients (22 women and 17 men) with primary open-angle glaucoma were included in the study. The median age of the total population was 67±8years. No statistically significant difference was found between preoperative and postoperative measurements of the corneal thickness (p=0.480). However, there was a statistically significant difference between measurements of the ACA, AOD (500µm and 750µm), thickness of the iris curvature, anterior chamber depth, and trabecular-iris space area before and after the operation (p<0.001). Intraocular pressure (IOP) levels decreased significantly in the first and third months after surgery (p=0.019; p=0.003, respectively). CONCLUSION: This study with AS-OCT imaging has confirmed after phacoemulsification and intraocular lens implantation in patients with glaucoma, the angle of the anterior chamber grows wider. As a result, IOP decreases and becomes easier to control.