The relationship between optic disc-foveal distance with choroidal and retinal nerve fiber thickness.

BACKGROUND: The optic disc-foveal distance is very important as it is an anatomical measure of the fundus. As this distance increases and the fundus tension, there may be variability in retinal and choroidal thickness. The aim of this study was to determine the relationship between optic disc-foveal distance and choroidal and retinal nerve fiber thickness in healthy subjects. MATERIALS AND METHODS: A total of 72 people between the ages of 20-36 participated in the study. Optic disc-foveal distance was measured with a fundus camera and choroidal and retinal nerve fiber thicknesses were measured with an OCT (Optical coherence tomography) device. Littmann's formula (t = p × q × s) as modified by Bennett was applied to correct the magnification at the fundus camera imaging stage. RESULTS: The thickness of the nasal choroid (p=0.005; p=0.006), subfoveal choroid (p=0.004; p < 0.001) and temporal choroid (p=0.001; p=0.001) layers decreased as the DFD (Optic disc-to-foveal distance) increased in both right and left eyes of the individuals participating in the study, which was statistically significant. In addition, it was observed that the RNLF (Retinal nerve fiber layer) increased as the DFD distance increased, but this was not statistically significant. CONCLUSION: This study demonstrated that the optic disc-foveal distance, an anatomical measure of the fundus, does not affect RNLF in young and healthy subjects, but choroidal thickness does.

Analysis of pupillary responses in pediatric patients with vitamin D deficiency.

PURPOSE: To evaluate the effects of vitamin D deficiency on pupillary responses in the pediatric population. METHODS: The study was conducted using data from the right eyes of 52 children with vitamin D deficiency and 52 healthy children. Measurements were taken under static and dynamic conditions with automatic pupillometry. Static measurements were performed at scotopic, mesopic, and photopic light intensities. The mean pupil dilation speed was calculated by observing the changes in pupil dilation over time according to dynamic measurements. Differences between patient and control groups were analyzed for the static and dynamic measurements and the mean pupil dilation speed. RESULTS: While the two groups were similar in terms of scotopic, mesopic, the first dynamic measurements, and the pupil dilation speed data (p > 0.05), a significant difference was found in the photopic conditions (p = 0.001). The mean pupil diameter of the patient group was 4.46 ± 0.928 mm and 3.95 ± 0.556 mm in the control group under photopic conditions. CONCLUSIONS: Pediatric patients with vitamin D deficiency have significantly larger pupil diameters in photopic conditions than healthy children. These results suggest that there is an autonomic dysfunction in vitamin D deficiency in the pediatric population, especially pointing to the parasympathetic system.

Efficacy of automatic pupillometry as a screening technique to detect autonomic dysfunction in bipolar disorder.

CLINICAL RELEVANCE: Autonomic nervous system abnormalities in the pathophysiology of bipolar disorder are controversial. Pupillary features may be affected as a result of autonomic nervous system abnormalities in bipolar disorder. Small changes in pupillary responses may not be noticeable on clinical examination. Automated pupillemetries can be helpful in demonstrating these changes reliably and quantitatively. BACKGROUND: The aim of this study was to compare the static and dynamic pupillary responses of bipolar patients with healthy controls. In addition, pupillary response differences between mania, depression and remission stages were investigated. METHODS: The bipolar patient group consisted of 39 eyes of 39 patients with 13 patients in each of the stages: mania, depression and remission. The control group consisted of 39 eyes of 39 healthy volunteers. After the ophthalmic examination, static and dynamic pupillometry measurements were made. The mean pupil dilatation speed was calculated according to dynamic measurements. Static pupillometry measurements including scotopic, mesopic and photopic pupil diameters; the first dynamic measurements at 0th second and pupillary dilatation speed were used for statistical analysis. RESULTS: There was no difference static and the first dynamic pupillometry measurements between the bipolar and control groups (p > 0.05 for all parameters), but there was a significant difference in mean pupil dilatation speed (p = 0.041). No significant differences were found between the 3 groups for all static and the first dynamic pupillometry measurements and the mean pupil dilatation speed (p > 0.05). CONCLUSION: Static and the first dynamic measurements of bipolar patients were not different from healthy controls. The mean pupil dilatation speed of bipolar patients was significantly lower, but this difference had a low effect size.

Isolated Bilateral Macular Edema due to Le Fort Type 1 and Mandibular Fracture: A Case Report.

We report the diagnosis and follow-up process of a case who had bilateral macular edema after blunt facial trauma. A 36-year-old male patient with Le Fort type 1 and mandibular fracture without direct ocular trauma referred to the ophthalmology clinic. Visual acuity was 0.1 in both eyes according to Snellen chart. Ocular examination was normal except bilateral macular edema. The patient did not have any prior systemic or neurological diseases. The patient did not have cotton-wool spots, retinal hemorrhage, or Purtscher flecken in the fundus examination. He used topical 0.1% nepafenac solution for 1 month. Visual acuity returned to normal after complete resolution of the macular edema at 1 month and did not recur in the follow-up. We think that this case may be an isolated macular edema due to facial trauma or an atypical presentation of Purtscher retinopathy. Although facial fractures and trauma may cause Purtscher retinopathy with involvement of different retinal structures, the findings in this case suggest that isolated involvement of macula can also occur in these injuries.

Can the long term using of pregabalin in fibromyalgia affect the choroid and retinal nerve fiber layer?

BACKGROUND: In this study, the effects of long-term pregabalin use on the choroid and retinal nerve fiber layer were investigated in the fibromyalgia disease. METHODS: The patient group consisted of 41 fibromyalgia patients using pregabalin. The control group consisted of 41 newly diagnosed fibromyalgia patients who had not received any treatment yet. Choroidal and retinal nerve fiber layer thickness measurements were performed with Cirrus HD-OCT (Carl Zeiss Meditec Inc., Dublin, CA, USA) 30 minutes after pupil dilation with 1% tropicamide. RESULTS: There was no difference in subfoveal choroidal thickness, nasal choroidal thickness and temporal choroidal thickness between the patient and control groups (p > 0.05). Increasing the duration of drug use within the patient group was found to thin the retinal nerve fiber layer (p < 0.05). CONCLUSION: We found that pregabalin had no effect on the choroid, while it had a thinning effect for retinal nerve fiber layer. It is recommended not to be preferred pregabalin in fibromyalgia patients with retinal nerve fiber layer damage such as diabetic retinopathy and glaucoma. Patients treated with pregabalin should have regular control in the ophthalmology clinic.

Dry eye in chronic stroke patients with hemiplegia: A cross-sectional study.

Objective: Dry eye is reported to be associated with several neurological diseases. The aim of this study is to evaluate the patients with hemiplegia after stroke for dry eye and compare their results with a control group.Materials and methods: Forty-five patients with hemiplegia and 45 individuals as the control group were included in the study. Tear function tests (Schirmer and tear breakup time) and a dry eye questionnaire for dry eye symptoms (ocular surface disease index) were performed and the results of the two groups were compared.Results: Schirmer test results were significantly lower in the post-stroke hemiplegia group compared to the control group (11.3 ± 8.2 mm and 20.6 ± 11.6 mm, respectively, p < .001). Tear breakup time results were significantly lower in the post-stroke hemiplegia group compared to the control group (7.9 ± 3.1 s and 12.1 ± 4.3 s, respectively, p < .001). Ocular surface disease index scores were not significantly different between hemiplegia and control groups (21.6 ± 20.0 and 19.8 ± 13.9, respectively, p = .635). Schirmer scores lower than 10 mm (60% and 30%, p < .001) and tear breakup time results lower than 10 s (65.6% and 28.9%, p < .001) were also higher in the hemiplegia group compared to control group.Conclusion: We found lower Schirmer test and tear breakup time results and similar OSDI scores in hemiplegia patients compared to controls. Hemiplegia patients may have dry eye without typical symptoms. This should be taken into consideration in the follow-up and rehabilitation of post-stroke hemiplegia patients.