Synthesis and Photophysical Characterizations of Benzimidazole Functionalized BODIPY Dyes.

Herein, a series of new BODIPY dyes substituted by 2-phenyl benzimidazole units at the meso (C8) position including methyl/ethyl, phenyl, or p-methoxyphenyl moieties at the distal and proximal positions of the BODIPY core have been successfully synthesized and their photophysical characteristics were analyzed. Experimentally investigating absorption and fluorescence profiles in the THF media was followed by density functional theory (DFT) calculations to clarify photophysical features. Theoretical analyses have revealed that upon excitation, both electrons and holes are confined solely within the BODIPY core. The energy levels of the frontier molecular orbitals converge depending on the presence of the phenyl and p-methoxyphenyl substituents. The orbital distributions of both electron and hole were in the -3 and -5 positions, which demonstrates a continuous conjugation with the BODIPY core at these sites. However, the electron density present on the phenyl rings located at the -1, -7, and -8 (meso) positions was found to be negligible. The benzimidazole-BODIPYs exhibited photodynamic activity (Φ∆) ranging from ~ 7% to ~ 11%, determined by a comparative method. Moreover, the compounds have shown to maintain their stability thermally in a non-reactive/inert environment up to temperatures surpassing 300 °C, exhibiting primarily a two-phase decomposition process. These compounds have the potential to function as antibacterial and anti-biofilm agents when used in concentrations ranging from 0.5 to 2.0 mg/mL. The results provide a basis for evaluating heterocyclic benzimidazole units on photophysical processes containing BODIPY chromophores.

Demographic, Etiological, and Clinical Characteristics of Eyelid Lacerations.

Objectives: To evaluate the demographic, etiological, and accompanying clinical factors in eyelid lacerations (EL). Materials and Methods: The records of patients who presented to our clinic between 2018 and 2022 with eyelid trauma were retrospectively reviewed. Age, gender, cause of injury, clinical findings, accompanying ocular findings, and additional complications were analyzed. Results: The study included 135 patients (106 male, 29 female) with a mean age of 37.0±18.6 years. Among the patients, 29 (21.4%) were 18 years old or younger, 93 (68.8%) were between 19 and 64 years old, and 13 (9.6%) were 65 years old or older. EL were most caused by various sharp objects in 44 patients (33%), blunt trauma in 40 patients (30%), falls in 30 patients (22%), and traffic accidents in 21 patients (15%). Fifteen eyes (11.1%) had foreign bodies at the wound site. Thirty patients (22.2%) (20 lower eyelid, 10 upper eyelid) had accompanying canalicular lacerations. Twenty-three (17%) patients had accompanying conjunctival lacerations, 14 (10.3%) had open-globe injury, 10 (7.4%) had corneal epithelial defects, 9 (6.6%) had intravitreal hemorrhage, 6 (4.4%) had hyphema, and 5 (3.7%) had retinal detachment. Four patients had lid notching and 1 patient (0.7%) had ectropion. Five patients (3.7%) required suturing. No additional complications were observed. Conclusion: EL are more commonly seen in young adulthood and in males. The most common mechanism of injury is impact by various objects. Eyelash margin and canalicular lacerations frequently accompany these injuries. Serious ocular pathologies such as hyphema and open-globe injury can accompany eyelid trauma.

Retinal nerve fiber layer and ganglion cell complex thickness in diabetic smokers without diabetic retinopathy.

PURPOSE: To compare the thickness of the retinal nerve fiber layer (RNFL) and macular ganglion cell-inner plexiform layer (GC-IPL) in smoker and nonsmoker diabetics without diabetic retinopathy. MATERIALS AND METHODS: Patients with diabetes were divided into two groups according to their smoking status: Group 1 consisted of 38 smoker diabetics who had chronically smoked more than 20 cigarettes per day for more than five years; Group 2 consisted of 38 nonsmoker diabetics. After a detailed ophthalmologic examination, the mean and regional (superior, supratemporal, inferior, inferotemporal, temporal, nasal, superonasal, and inferonasal) RNFL and GC-IPL thicknesses were measured with spectral-domain optic coherence tomography (SD-OCT) and compared between groups. RESULTS: The mean age was 54.7 ± 10.5 and 51.2 ± 9.7 years in the smoker and nonsmoker groups, respectively (p = 0.14). Gender, duration of diabetes, and the mean axial length were similar between groups (p:0.43, p:0.54, p: 0.52, respectively). Mean RNFL thickness was 89.1 ± 8.0 µm in the smoker group and 93.4 ± 7.0 µm in the nonsmoker group, and it was significantly thinner in the smoker group (p = 0.01). The temporal RNFL thickness in the smoker group was thinner than in the nonsmoker group (p = 0.02). There was no difference in superior, inferior, and nasal RNFL thicknesses between the groups (p = 0.31, p = 0.12, p = 0.39, respectively). The mean macular GC-IPL thickness of the smoker and nonsmoker groups was 78.53 ± 15.74 µm and 83.08 ± 5.85 µm, respectively (p = 0.09). Superior, superonasal, inferonasal, inferior, inferotemporal, and superotemporal quadrant GC-IPL thicknesses were similar between the groups (p = 0.07, p = 0.60, p = 0.55, p = 0.77, p = 0.71, p = 0.08, respectively). The groups showed no difference in minimum GC-IPL thickness (p = 0.43). There was a significant negative correlation between smoking exposure and mean, inferior quadrant RNFL thicknesses in the smoker group (p = 0.04, r= -0.32, and p = 0.01, r= -0.39, respectively). CONCLUSION: Mean RNFL thickness was significantly thinner in smoker diabetics. Although not statistically significant, especially mean, superior, and superotemporal GC-IPL was thinner in smoker diabetics. The results suggest a potential association between the coexistence of diabetes and smoking with alterations in RNFL and GC-IPL thickness.

Characteristics of pediatric traumatic cataract and factors affecting visual outcomes.

PURPOSE: To evaluate the clinical characteristics, surgical approach and visual results in pediatric traumatic cataract. MATERIAL AND METHODS: Data of pediatric and adult traumatic cataract patients were retrospectively analyzed. Age, gender, cause and zone of trauma, additional clinical findings, initial and final visual acuity (VA) were analyzed and compared between groups. RESULTS: The mean age of 18 patients in the pediatric group was 9.4(SD 5.7); 18 patients in the adult group was 47.8(16.2) years. There was a male predominance in both groups (12/16 male, respectively). The most common cause of trauma was sharp metal objects (50%) in the pediatric group and wooden and traffic accidents (33%) in the adult group. The initial mean VA of the patients were 0.03(0.09), 0.09(0.1) in the pediatric and adult groups, respectively, (p: 0.34). The mean ocular trauma score (OTS) was 51.4(16.4) and 59.6(10.5) in the pediatric and adult groups, respectively (p: 0.09). Simultaneous surgery was performed in 5 (28%) eyes in both groups. Subsequent lens extraction and IOL implantation were performed in 10 of pediatric and 13 of adult patients. The final VA was 0.3(0.7), 0.3(0.4) in the pediatric and adult group, respectively (p: 0.94). Final VA was correlated with OTS in both of the groups and the presence of additional surgery in the pediatric group. CONCLUSION: Traumatic cataract is a major cause of visual loss in children. Lower OTS and presence of additional surgery were the prognostic factors for poor final VA in the pediatric cases. Optimal timing and accurate management of traumatic cataract are important in the pediatric population.

Systemic Inflammatory Marker Levels in Serous Macular Detachment Secondary to Retinal Vein Occlusion.

Purpose: To evaluate the association of systemic inflammatory marker levels in macular edema with serous macular detachment (SMD) secondary to retinal vein occlusion (RVO). Methods: Patients diagnosed with RVO were categorized into two groups based on the presence or absence of SMD: Group 1 included 30 eyes with SMD, while Group 2 included 30 eyes without SMD. Levels of neutrophils, monocytes, lymphocytes, thrombocytes, and mean platelet volume (MPV) were analyzed. Systemic inflammatory markers, including neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), were calculated and compared between the two groups. Results: The mean neutrophil levels were significantly higher in Group 1 (P = 0.002). The mean lymphocyte, monocytes, thrombocyte, and MPV levels did not differ significantly between groups. NLR and SII levels were significantly higher in the SMD group (P = 0.004 and P = 0.016, respectively). There was no significant difference between the groups in terms of PLR. The optimal receiver operator characteristic (ROC) cut-off value of NLR for SMD was calculated as 1.55 with 73% sensitivity and 63% specificity (area under the curve [AUC] = 0.714, 95% confidence interval [CI]: 0.584-0.845). The optimal ROC cut-off value of SII for SMD was calculated as 451.75 with 63% sensitivity and 63% specificity (AUC = 0.681, 95% CI: 0.546-0.816). In this study, branch RVO was present in 48 patients, and central RVO was present in 12 patients. Neutrophil, MPV levels, and NLR, PLR, SII ratios were similar between patients with branch and central occlusion. Conclusion: Neutrophil levels, NLR, and SII were found to be significantly higher in eyes with SMD secondary to RVO.

Relationship of Temperament Differences with Diagnosis, Severity and Accompanying Psychiatric Symptoms in Autism Spectrum Disorder.

Introduction: Temperament differences were shown in children with autism spectrum disorder (ASD); however, associations of temperament with ASD severity and accompanying psychiatric symptoms have yet to be studied. Methods: We evaluated 58 ASD-diagnosed children's temperaments through disorder severity and psychiatric symptoms and compared them with 58 typically developed children. We utilized the Children's Behavior Questionnaire-Short Form, The Strengths and Difficulties Questionnaire (SDQ). The Childhood Autism Rating Scale (CARS) was used to evaluate psychiatric symptoms and ASD severity levels of children. Results: Negative affect, effortful control, and perceptual sensitivity were found lower in ASD-diagnosed children and decreased with ASD severity. Effortful control was also found negatively correlated with scores of behavioral problems, hyperactivity, and total difficulties. Besides, anger/frustration was found predictive for conduct and peer problems, and total difficulty scores. Conclusion: Further studies are needed to verify and expand these pioneer findings.

Serum inflammatory marker levels in serous macular detachment secondary to diabetic macular edema.

PURPOSE: To evaluate the serum inflammatory marker levels in serous macular detachment (SMD) secondary to diabetic macular edema (DME). MATERIAL AND METHODS: Patients with DME were divided into two groups according to the presence of SMD. Group 1 consisted of 40 patients with SMD, Group 2 consisted of 40 patients without SMD, and Group 3 consisted of 40 healthy subjects. Neutrophil and mean platelet volume (MPV) were obtained from blood samples. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and the systemic immune inflammation index (SII) were calculated. In Group 1 and 2 sub-group analysis was done according to grade of diabetic retinopathy (DR) and the results were analyzed in these subgroups. RESULTS: The neutrophils, MPV, NLR, and SII levels were significantly higher in Group 1 (p = 0.000, p = 0.004, p = 0.000, p = 0.001, respectively). In subgroup analysis; the neutrophils, NLR, and SII levels were significantly higher in patients with proliferative DR (p = 0.044, p = 0.046, p = 0.046, respectively) and the SII levels were significantly higher in patients with severe nonproliferative DR in Group 1 (p = 0.039). The mean CMT values were 548.8 ± 138.3 µm in Group 1 and 420.1 ± 112.7 µm in Group 2. The CMT values were significantly higher in Group 1 (p: 0.000). However, there was no significant correlation between the CMT values and the systemic inflamatuar markers levels (p>0.05) in both of the groups. CONCLUSIONS: NLR and SII levels were significantly higher in DME with SMD, especially in advanced cases. Elevated serum inflammatory markers might be associated with a higher incidence of SMD.

Assessment of Red Cell Distribution Width, Platelet/lymphocyte Ratio, Systemic Immune-inflammation Index, and Neutrophil/lymphocyte Ratio Values in Patients with Central Retinal Artery Occlusion.

PURPOSE: To evaluate complete blood count (CBC)-derived inflammatory indices in central retinal artery occlusion (CRAO). METHODS: A total of 42 patients with CRAO (CRAO group) and 42 age- and sex-matched subjects without CRAO (Control group) were included. CBC parameters including red cell distribution width (RDW) levels were assayed. Platelet/lymphocyte ratio (PLR), systemic immune-inflammation index (SII) and neutrophil/ lymphocyte ratio (NLR) were calculated. RESULTS: RDW, PLR, SII and NLR values were significantly higher in CRAO group than control group [15.2 ± 1.47% vs 13.96 ± 1.13% (p < .001), 127.94 ± 48.21 vs 101.16 ± 24.84 (p = .008), 667.11 ± 357.84 vs 493.44 ± 207.07 (p = .008), 2.70 ± 1.27 vs 2.13 ± 0.83 (p = .018), respectively]. In multivariate analysis only RDW was independent predictor for CRAO (OR 2.317, p < .001). On ROC analysis, area under curve of RDW, PLR, SII, and NLR for CRAO were 0.761, 0.685, 0.622 and 0.618, respectively. CONCLUSION: RDW seems superior to other inflammatory indices to predict CRAO.

The effect of pterygium surgery on intraocular lens power and ocular biometric parameters.

AIMS: To evaluate the effect of pterygium surgery on intraocular lens (IOL) power and ocular biometric parameters and to evaluate the factors affecting these parameters. METHODS: Twenty-eight eyes of 25 patients diagnosed with pterygium were evaluated. Axial length (AL), mean keratometry (Sim K), K1, K2, anterior chamber depth (ACD), corneal astigmatism, and ocular biometry parameters were obtained with a dual Scheimpflug analyzer. Pterygium sizes (horizontal, vertical) were measured manually, and pterygium height was analyzed with anterior segment optic coherence tomography. IOL power was calculated according to SRK/T, SRK II, Hoffer Q, Haigis, and Holladay formulas. Limbal conjunctival autograft was performed in all patients after excisional pterygium surgery. Preoperative and postoperative 1st month measurements were analyzed and compared. RESULTS: The mean age of the patients was 51.5 ± 13.8 years. Mean horizontal pterygium length, vertical width, height, and percentage extension of the pterygium were 2.4 ± 0.9, 4.7 ± 1.0 mm, 297 ± 93µm, and 20.2 ± 7.2%, respectively. There was a significant increase in Sim K, K1, and K2 values postoperatively. Postoperative IOL power was significantly lower than preoperative values in all formulas. The change in IOL power after surgery was -0.3 ± 0.6D in the SRKT, -0.3 ± 0.5D in SRK II, -0.4 ± 0.7D in Hoffer Q, -0.5±0.7D in Haigis, and -0.3 ± 0.7D in Holladay 2 formulas. The change in IOL power has a moderate positive linear correlation with the horizontal and vertical sizes of the pterygium and a high positive linear correlation with the percentage extension of the pterygium. CONCLUSIONS: Pterygium surgery causes a significant decrease in calculated IOL power obtained with all formulas. It becomes more pronounced with the increase in the size of the pterygium.

Bisphenol S leads to cytotoxicity-induced antioxidant responses and oxidative stress in isolated rainbow trout (Oncorhyncus mykiss) hepatocytes.

BACKGROUND: Bisphenol S (BPS) is a chemical compound that is utilized in the plastic industry as an alternative to bisphenol A (BPA). The toxic effects of BPS in fish is less known and limited. Therefore, in the present study, the influence of BPS on rainbow trout (Oncorhyncus mykiss) hepatocytes in vitro was investigated. METHODS AND RESULTS: For this purpose the fish hepatocytes were isolated, and then the cultured cells were treated with increasing concentrations of BPS (0, 15.63, 31.25, 62.50, 125, 250, and 500 µM) for 24 h. The cytotoxic impact of BPS was determined in the culture media using lactate dehydrogenase assay and then, the antioxidant defence indicators were assayed. The results showed that concentration-dependent increases were observed in the percentage of cytotoxicity. The superoxide dismutase activity was reduced, while the catalase and glutathione peroxidase activity increased with all of the BPS concentrations. The glutathione S-transferase (GST) activity significantly increased after a BPS concentration of 31.25 µM or higher, while GST Theta 1-1 activity was decreased by the same concentrations of BPS. The reduced glutathione content significantly decreased with a BPS concentration of 31.25 µM or higher, and the malondialdehyde content increased after BPS concentrations of 125, 250, and 500 µM. CONCLUSIONS: The findings determined herein suggested that BPS causes cytotoxicity in fish hepatocytes and can lead to oxidative stress, resulting hepatotoxic in fish. Thus, the utilization of BPS instead of BPA as safe alternative in industry should be re-evaluated in the future for environmental health.

Does pterygium morphology affect corneal astigmatism?

PURPOSE: The purpose of this study was to evaluate the correlation between corneal astigmatism and the morphology of pterygium with anterior segment optic coherence tomography (AS-OCT). MATERIAL AND METHODS: The size of pterygium (horizontal length, vertical width) was measured manually; pterygium area and percentage extension of the pterygium onto the cornea were calculated. Anterior and posterior corneal astigmatism, Sim K, K1, K2 were measured using a dual Scheimpflug analyzer. Morphological patterns of the pterygium analyzed with AS-OCT were determined according to the extension of the pterygium apex below the corneal epithelium. Two tomographic patterns were identified: continuous and nodular. Correlation between anterior corneal astigmatism and pterygium size, percentage extension of the pterygium, and morphological pattern of the pterygium was analyzed. RESULTS: The mean ages of the 47 patients were 49.4 ± 16.6 (22-80) years. Mean horizontal pterygium length, vertical width, pterygium area, and percentage extension of the pterygium were 2.8 ± 1.2 mm, 4.8 ± 1.6 mm, 7.42 ± 5.6 mm2 and 24.5 ± 10.4%, respectively. Mean anterior corneal astigmatism was 2.3 ± 2.3 D and simulated keratometry was 43.4 ± 2.02 D. In terms of the morphological pattern of the pterygium, 24 eyes had continuous, 23 eyes had a nodular pattern and the median (interquartile range) anterior corneal astigmatism was 1.87 (1.01-3.80) and 1.22 D (0.58-2.35), respectively (p = 0.102). Other topographic and pterygium size parameters were similar between groups. Analyzing the correlations in groups separately, a positive moderate statistically significant correlation was present between vertical width, percentage extension, pterygium area, and anterior corneal astigmatism in both continuous and nodular groups. CONCLUSIONS: Although not statistically significant, anterior corneal astigmatism was higher in continuous group. Using AS-OCT to standardize the morphology of pterygium could provide additional clinical information.

Histology of some major immune system organs in Lake Van fish Alburnus tarichi (Güldenstädt, 1814) (Cyprinidae).

The teleostean immune system is variable between and within taxa in terms of morphology. Accordingly, in the current study, the histology of some immune organs (thymus, kidney and spleen) of Lake Van fish (Alburnus tarichi) was investigated. For this purpose, the tissues from eight mature fish were fixed and embedded in paraffin wax, and then the sections were stained with haematoxylin and eosin, Mallory's triple, periodic acid-Schiff and Alcian blue (pH of 2.5) for histologic examinations. In the thymus, no clear discrimination of the cortex and medulla was observed. Lymphoid cells within a reticulo-epithelial network were the predominant cell type in the thymus. The other components in the thymus were macrophages and myoid, mast-like, plasma-like, cystic cells, Hassall's corpuscles, and single or multiple epithelial cystic structures. In the kidney, the head kidney, a major haematopoietic site, consisted of lymphoid and non-lymphoid zones within a reticular network. Cells exhibiting mitotic figures were also detected in the haematopoietic tissue of the head kidney. Haematopoietic tissue was also found in the trunk kidney dispersed amongst the excretory components. The spleen was composed of red and white pulp. The red pulp comprised abundant erythrocytes, whilst the white pulp contained leucocytes with a reticular network. Ellipsoids were also determined in the white pulp. Melanomacrophage centres were found in all of the examined lymphoid tissues of the fish. These findings, which were reported, herein, for the first time will provide reference knowledge for future studies of this anadromous fish.

Histology of corpuscles of Stannius in Lake Van fish (Alburnus tarichi Güldenstädt, 1814) (Cyprinidae).

In the present study, the location, histology and number of corpuscles of Stannius (Sc), which are endocrine glands associated with the kidneys of teleost fish, were investigated for the first time in Lake Van fish (Alburnus tarichi), an anadromous and endemic inhabiting Turkey's Lake Van Basin. The Sc, which were ovoid or spheroid and white or cream in colour, were found to vary in number between three and five among the examined fish. The glands were located in the caudal part of the kidney, and either partially or completely embedded, and found to be present on both the ventral and dorsal surface of either side of the caudal part of the kidney. The Sc were surrounded by a connective tissue capsule that penetrated and divided the gland into incomplete lobules. Two types of cells were determined in the parenchyma of the gland. Type-I cells were predominant throughout the parenchyma and larger than the second (type-II). In the type-I cells, the cytoplasm was observed as weakly or moderately eosinophilic with haematoxylin and eosin staining and weakly or moderately acidophilic with Mallory's triple staining. In the type-I cells, the cytoplasm exhibited weak to moderate periodic acid-Schiff staining and slight or uniform staining with aldehyde fuchsin. The type-II cells were round, had a darkly stained spherical nucleus and were dispersed among the type-I cells. They displayed no cytoplasmic staining with the abovementioned stains.

A histological and histochemical study on the gallbladder of the Alburnus tarichi (Güldenstädt, 1814) (Cyprinidae) / Estudio histológico e histoquímico de la vesícula biliar de Alburnus tarichi (Güldenstädt, 1814) (Cyprinidae)

In the current study, the histological structure of the gallbladder of Alburnus tarichi (Güldenstädt, 1814) was investigated. Hematoxylin and eosin were used to stain the histological sections for routine examinations, in addition to using periodic acid Schiff (PAS) for the neutral mucins, aldehyde fuchsin (AF) for the sulphated mucins, and Alcian blue (AB; pH: 2.5) for the acidic mucins. In addition, proliferating cell nuclear antigen (PCNA) immune-staining was performed for the detection of dividing cells among the epithelium. The gallbladder of A. tarichi was composed of mucosa, muscularis, and serosa or adventitia layers. The mucosa covering the wavy pleomorphic folds was made up of tall columnar epithelium and a lamina propria. The apical surface of the epithelial cells was lined by continuous short microvilli. On the epithelium, the luminal surface was remarkably stained with PAS, AF, and AB. Slight to moderate staining was observed on the epithelial cells in the apical zone with PAS. The cytoplasm of epithelial cells were stained in a slight manner with AF. No goblet cells were observed among the epithelium. According to the PCNA immune-staining, some epithelial cells were observed to proliferate. The lamina propria consisted of loose connective tissue that contained fibrocytes, collagen and elastic fibers, capillaries, and small blood vessels. The muscularis layer displayed muscle fibers that were circular, smooth, and surrounded by collagen fibers. The subserosal and serosal or adventitial layers had typical morphology to those of other fish and vertebrates.

En este estudio, se investigó la estructura histológica de la vesícula biliar de Alburnus tarichi (Güldenstädt, 1814). Las secciones histológicas se tiñeron con Hematoxilina-Eosina para los exámenes de rutina, además de usar el ácido periódico de Schiff (PAS) para las mucinas neutras, aldehído fucsina (FA) para las mucinas sulfatadas y azul alcián (AB; pH: 2,5) para las mucinas ácidas. Además, se realizó una tinción inmune de antígeno nuclear de células proliferativas (PCNA) para la detección de células en división entre el epitelio. La vesícula biliar de A. tarichi estaba compuesta de capas, mucosa, muscular y serosa o adventicia. La mucosa que cubría los pliegues pleomórficos ondulados estaba formada por un epitelio columnar alto y una lámina propia. Se observó una superficie apical de las células epiteliales revestida por microvellosidades cortas y continuas. En el epitelio se observó una tinción importante de la superficie luminal teñida con PAS, FA y AB. Se observó una tinción leve a moderada en las células epiteliales en la zona apical con PAS. El citoplasma de las células epiteliales se tiñó ligeramente con FA. No se observaron células caliciformes entre el epitelio. Según la tinción de PCNA, se observó que proliferaban algunas células epiteliales. La lámina propia consistía en tejido conectivo laxo que contenía fibrocitos, colágeno y fibras elásticas, capilares y pequeños vasos sanguíneos. La capa muscular mostraba fibras musculares circulares, lisas y rodeadas de fibras de colágeno. Las capas subserosas y serosas o adventicias tenían una morfología típica a la de otros peces y vertebrados.

Effects of topical antiglaucomatous medications on central corneal epithelial thickness by anterior segment optical coherence tomography.

PURPOSE: To evaluate the effect of topical antiglaucomatous medications on central corneal epithelial thickness measured by anterior segment optical coherence tomography. MATERIALS AND METHODS: A total of 153 eyes of 153 patients using topical antiglaucomatous medications and 110 eyes of 110 control subjects were enrolled. Glaucoma type, duration of therapy, the number of drugs, and drops/day were noted in the patient group. Patients and control subjects underwent ocular examinations including Schirmer test, slit lamp examination for tear film break-up time, and anterior segment optical coherence tomography for central corneal thickness and central corneal epithelial thickness. Central corneal epithelial thickness and other data were evaluated separately with regard to glaucoma type, duration of therapy, the number of drops, and drugs in the patient group. RESULTS: The mean ages of the patients and controls were 60.1 ± 10.8 and 58.7 ± 11.2 years, respectively. The groups were similar with regard to mean age and gender (p = 0.058, p = 0.734, respectively). The median (interquartile range) central corneal thickness was 536 (54) µm in patients and 552 (53) µm in controls (p = 0.011). The median (interquartile range) central corneal epithelial thickness of patients and controls were 56 (4) µm and 60 (8) µm, respectively (p < 0.001). The median (interquartile range) tear film break-up time and Schirmer were 12 (6) s and 10 (8) mm in patients and 16 (2) s and 18 (4) mm in controls, respectively (p < 0.001, p < 0.001). In patient group, there was no significant difference in the median central corneal thickness, central corneal epithelial thickness, and tear film break-up time in terms of glaucoma type, duration of therapy, the number of drugs, and the number of daily drops. Only the median Schirmer test was found to be statistically lower in terms of number of daily eye drops (p = 0.039). CONCLUSION: Using topical antiglaucomatous medications seems to affect the central corneal epithelial thickness in glaucoma patients. Central corneal epithelial thickness was thinner in glaucoma patients than controls. Anterior segment optical coherence tomography might be helpful to evaluate the effect of antiglaucomatous medications on central corneal epithelial thickness during treatment.

Efficacy of intravitreal dexamethasone implant in persistent diabetic macular edema after primary treatment with intravitreal ranibizumab.

PURPOSE: To evaluate the efficiency and possible complications of intravitreal dexamethasone (IVD) implant in diabetic macular edema (DME) resistant to treatment of three consecutive intravitreal ranibizumab (IVR) injections. METHODS: Fifty eyes of 38 patients were considered in this study. The best corrected visual acuity (BCVA), central macular thickness (CMT), and values of intraocular pressure (IOP) were examined preoperatively and postoperatively in the 1st, 2nd, 4th, and 6th months of IVD implantation. RESULTS: Twenty of the patients were women, and 18 of the patients were men. Mean age was 64.63 ± 7.15 (52-83) years. Mean number of IVR injection before IVD implantation was 3.4 ± 0.38. Mean BCVA (logMAR) was 0.874 ± 0.398 before IVD implantation, 0.598 ± 0.306 at the 1st month, 0.602 ± 0.340 at the 2nd month, 0.708 ± 0.359 at 4th month, and 0.800 ± 0.370 at 6th month. Mean of CMT was 519.700 ± 155.802 µm before IVD implantation, 274.000 ± 73.112 µm at the 1st month, 307.98 ± 87.869 µm at the 2nd month, 387.82 ± 110.503 µm at 4th month, and 478.54 ± 163.743 µm at 6th month. Improvements in BCVA and CMT were statistically significant (P < 0.05) at 1st, 2nd, and 4th months; however, these values were not statistically significant at 6 months. At 1st day, 1st and 2nd months, the values of IOP were increased significantly after IVD. Cataract progression was observed in just 1 of the 22 phakic patients. CONCLUSIONS: In DME resistant to treatment of consecutive IVR, IVD implantation has been observed to be effective in increasing BCVA and decreasing CMT in the first 3 months. IVD implantation can be considered an alternative method in the treatment of resistant DME.

CORRELATIONS between Functional and Structural Tests Measured by Spectral Domain Optical Coherence Tomography in Severe Glaucoma.

Purpose: To evaluate the relationship between visual acuity, visual field and spectral domain optical coherence tomography (OCT) parameters, including retinal nerve fiber layer (RNFL), ganglion cell-internal plexiform layer (GC-IPL) thicknesses, and optic nerve head parameters in patients with severe glaucoma. Material and Methods: Patients with the diagnosis of severe glaucoma were recruited from the data gathered at our glaucoma department. A detailed ophthalmic examination was performed using the Standard Automated Perimetry (the 30-2 SITA standard program was used for VF testing). Cirrus EDI-OCT was used for peripapillary RNFL and GC-IPL thickness measurements. Optic nerve head parameters, including mean cup-to-disc (c/d) ratio, rim area, vertical c/d ratio, cup volume, were also measured by spectral domain OCT. Correlations between these structural parameters and functional parameters (visual acuity, VF parameters) were investigated. Results: Forty-one eyes of 34 patients with severe glaucoma were enrolled in this study. Correlations between BCVA and mean GC-IPL thickness (p = .03), superior GC-IPL thickness (p = .03), inferonasal GC-IPL thickness (p = .01), superonasal GC-IPL thickness (p = .01), superotemporal GC-IPL thickness (p = .04), and rim area (p = .00) were found to be positive statistically significant. There was also a positive statistically significant correlation between MD and inferotemporal GC-IPL thickness (p = .03). Negative statistically significant correlations were found between BCVA and mean c/d ratio (p = .00), vertical c/d ratio (p = .02) and cup volume (p = .00). Discussion: Mean, superior, inferonasal, superonasal, and superotemporal GC-IPL thicknesses and mean c/d ratio, vertical c/d ratio and cup volume were found to be correlated with BCVA in patients with severe glaucoma.

Evaluation of fundus autofluorescence imaging of diabetic patients without retinopathy.

PURPOSE: To evaluate the usefulness of fundus autofluorescence imaging of diabetic patients without retinopathy to investigate early retinal damage. METHODS: Fundus autofluorescence images of patients with type 2 diabetes mellitus without retinopathy (diabetic group) and age-sex matched healthy patients (control group) were recorded with a CX-1 digital mydriatic retinal camera after detailed ophthalmologic examinations. MATLAB 2013a software was used to measure the average pixel intensity and average curve width of the macula and fovea. RESULTS: Fifty-six eyes of 28 patients, as the diabetic group, and 54 eyes of 27 healthy patients, as the control group, were included in this study. The mean aggregation index was 168.32 ± 37.18 grayscale units (gsu) in the diabetic group and 152.27 ± 30.39 gsu in the control group (p=0.014). The mean average pixel intensity value of the fovea was 150.87 ± 35.83 gsu the in diabetic group and as 141.51 ± 31.10 gsu in the control group (p=0.060). The average curve width value was statistically higher in the diabetic group than in the control group (71.7 ± 9.2 vs. 59.4 ± 8.6 gsu, respectively, p=0.03). CONCLUSION: Fundus autofluorescence imaging analysis revealed that diabetic patients without retinopathy have significant fluorescence alterations. Therefore, a noninvasive imaging technique, such as fundus autofluorescence, may be valuable for evaluation of the retina of diabetic patients without retinopathy.

Correlation of the aqueous humor total antioxidant capacity, total oxidant status, and levels of IL-6 and VEGF with diabetic retinopathy status.

PURPOSE: We aimed to compare the aqueous humor total oxidant status, total antioxidant capacity, and levels of interleukin-6 and vascular endothelial growth factor between patients with diabetic retinopathy and controls and to correlate these levels with the DR status. METHODS: Patients who underwent cataract surgery were enrolled. The first group (control group) comprised patients without diabetes; the second group comprised diabetic patients without retinopathy; the third group comprised patients with nonproliferative diabetic retinopathy; and the fourth group comprised patients with proliferative diabetic retinopathy. All patients underwent full ophthalmologic examination before cataract surgery. Prior to surgery, samples of aqueous humor sampling were obtained and stored at -80 °C. Total antioxidant capacity, total oxidant status, and levels interleukin-6 and vascular endothelial growth factor were investigated in these samples and correlated with diabetic retinopathy status. RESULTS: This study analyzed 86 pairs of eyes of 86 patients. All groups were statistically similar in age and sex, but the total antioxidant capacity was lowest in patients with proliferative diabetic retinopathy. Moreover, the total oxidant status and levels of vascular endothelial growth factor and interleukin-6 were found to slightly increase according to the retinopathy status. CONCLUSION: Oxidative stress, interleukin-6, and vascular endothelial growth factor in the aqueous humor seem to play important roles in the pathogenesis of diabetic retinopathy, especially in the proliferative type.