Evaluation of Retinal Vessel Density and Foveal Avascular Zone in Unilateral Exudative Choroidal Neovascularization by Optical Coherence Tomography Angiography.

Objectives: To evaluate treatment-naïve patients with neovascular-exudative age-related macular degeneration (eARMD) in one eye and early-/intermediate-stage nonexudative ARMD (neARMD) in the fellow eye by optical coherence tomography-angiography (OCTA). Methods: A total of 70 eyes of 35 patients (17 females) with first diagnosis of eARMD in one eye and early/intermediate-stage neARMD in the fellow eye were included in this study. The eARMD diagnosis was confirmed by fluorescein angiography. Each subject underwent OCTA imaging by RTVue XR Avanti OCT device. Capillary vessel density (VD) of superficial (SCP) and deep (DCP) retinal capillary plexuses and foveal avascular zone (FAZ) parameters were measured. Results: The mean age was 72.0±8.9 years (range 59-87). The mean visual acuity was 0.7±0.5 logMar for the eARMD eyes and 0.4±0.3 logMar for the fellow eyes (p=0.012). Nineteen patients (54.3%) had occult choroidal neovascularization (CNV), and 16 patients (45.7%) had classical CNV. The mean FAZ area was measured 0.30 ± 0.11 mm2 in the eARMD eyes and 0.27±0.11 mm2 in the fellow eyes (p=0.387). The FAZ circularity index measurement was 1.15±0.03 in eARMD eyes and 1.11±0.05 in the fellow eyes (p=0.014). There was no statistically significant difference in any measure of the macular SCP and DCP's VD between eARMD eyes and their fellow eyes. Conclusion: Potential retinal vascular alterations will be important in ARMD pathogenesis.

Choroidal Thickness in Childhood Obesity.

BACKGROUND AND OBJECTIVE: To evaluate the effects of obesity on choroidal thickness (CT) in childhood. PATIENTS AND METHODS: Forty-four patients with obesity (study group) and 42 healthy children (control group) were enrolled in the study. Subjects underwent a complete ocular examination. The mean CT was measured by enhanced depth imaging optical coherence tomography (EDI-OCT). Body mass index (BMI) was calculated. RESULTS: Mean BMI value was 31.8 ± 1.9 in the study group and 19.8 ± 4.4 in the control group. The mean subfoveal CT value 385.77 µm ± 6.09 µm in the study group and 348.43 µm ± 73.21 µm in the control group. There was a significant difference between the study and control groups with regard to subfoveal CT (P = .017). Subfoveal CT and BMI were positively correlated (r = 0.288; P = .004). CONCLUSIONS: CT increases in childhood obesity. Findings revealed that adiposity causes a significant increase in CT, and it may be related to ocular complications. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:10-17.].

Outcomes of corneal collagen crosslinking using a customized epithelial debridement technique in keratoconic eyes with thin corneas.

The purpose of the study was to evaluate the outcomes and possible complications of CXL performed with customized epithelial debridement technique to keratoconic corneas with the thinnest pachymetry values less than 400 µm. Nineteen eyes of 19 patients were included. The uncorrected (UCVA) and best corrected visual acuity (BCVA), flattest and steepest keratometric (K) readings, central corneal thickness at the thinnest point (t-CCT), endothelial cell density (ECD) were assessed before and 12 months after CXL. The mean UCVA was increased (p = 0.001), while the mean BCVA did not show any difference (p > 0.05). The mean flattest and steepest K readings were decreased (p = 0.001). No change was observed in the mean t-CCT (p > 0.05). The mean ECD was decreased (p = 0.001). The mean pre-CXL and post-CXL percentages of polymegathism and pleomorphism did not show any significant difference (p > 0.05). CXL performed with customized epithelial debridement technique is successful in halting the progression of keratoconus in corneas thinner than 400 µm after 12 months of treatment. However, significant endothelial cell loss can occur after this procedure.

Corneal Biomechanical Properties in Rheumatoid Arthritis.

PURPOSE: To investigate the variations in biomechanical properties of the cornea in rheumatoid arthritis (RA) patients. METHODS: A total of 53 RA patients, and 25 healthy individuals (control group) were enrolled. Rheumatoid arthritis patients were classified as in active phase (group 1; n=24) or in remission phase (group 2; n=29). Corneal biomechanical parameters including corneal hysteresis (CH), corneal resistance factor (CRF), corneal compensated intraocular pressure (IOPcc), and Goldmann-correlated IOP (IOPg) were measured with the Reichert Ocular Response Analyzer. Topographical measurements, including central corneal thickness (CCT), anterior chamber depth, iridocorneal angle, and corneal volume were measured using a Sirius corneal topographer. RESULTS: The mean CH was 9.43±1.17 mm Hg in group 1, 9.42±1.84 mm Hg in group 2, and 10.47±1.68 mm Hg in the control group (P=0.03). The mean IOPcc was 17.85±3.2 mm Hg in group 1, 17.95±3.49 mm Hg in group 2, and 15.36±3.11 mm Hg in the control group (P=0.008). The CH showed a significant positive correlation with CRF (P=0.000, r=0.809) and CCT (P=0.000, r=0.461), and a significant negative correlation with IOPcc (P=0.000, r=-0.469). CONCLUSIONS: Decrease in the mean CH measurements indicates that ultrastructural changes in the cornea may occur in the active phase, and these changes persist in the remission period. In addition, IOPcc is significantly affected by the corneal biomechanical properties. In RA patients, it is important to control the corneal parameters and IOP measurements against the irreversible changes on the optic nerve.

The effect of antihypertensive therapy on dry eye disease.

CONTEXT: There is a generalization that "antihypertensive (antiHT) therapy causes Dry Eye Syndrome", which has been claimed for years however most of the publications are epidemiological studies. We performed a clinical study to investigate the effects of antiHT agents on tear function. OBJECTIVE: The aim of this article is to evaluate the effects of different classes of antiHT medications on tear osmolarity, ocular surface problems and dry eye symptoms. MATERIALS AND METHODS: Prospective, non-randomized a clinical study. A total of 71 patients who would be initiated antiHT medication due to elevated systemic blood pressure were included in the study. Thirty of these patients were given antiHT drugs containing diuretic (diuretic +), and 41 of them were given diuretic-free drugs (diuretic -). While the number of the patients medicated in the group that received Angiotensin Converting Enzyme inhibitors (ACE inh)/Angiotensin receptor blockers (ARB) (ACE/ARB +) was 29, the number of those medicated in the ACE/ARB-free group (ACE/ARB -) was 42. Ocular surface disease index scores, tear osmolarity, Schirmer I test, tear film break-up time (TBUT), fluorescein (FL) and rose bengal corneal staining patterns of the patients were analyzed. The patients were examined through the repetition of all the tests in the 1st and the 3rd month. RESULTS: The participants (n = 71) comprised 38 males and 33 females with a mean age of 51.8 ± 10.4. When the first (0-1st month) and the third month (0-3rd months) control measurements between diuretics (+) and diuretics (-) groups before and after antiHT therapies were compared, a statistically significant difference was not found in any of the tests applied. When the 0-1st month measurements of ACE/ARB (+) and ACE/ARB (-) groups were compared, it was observed that staining with FL in ACE/ARB (+) group decreased in a statistically significant manner (p = 0.035) and there was a significant increase in TBUT values (p = 0.022). DISCUSSION AND CONCLUSION: The use of antiHT drugs containing diuretic had no adverse effect on the tear function tests, but using drugs that contain ACE/ARB could have a positive impact.