Evaluation of the lamina cribrosa after topical latanoprost therapy in primary open-angle glaucoma or ocular hypertension.

PURPOSE: To investigate that the changes of lamina cribrosa (LC) thickness and depth after latanoprost therapy in primary open-angle glaucoma (POAG) and ocular hypertension (OHT) patients. METHODS: In this single-center prospective cross-sectional study, 35 eyes from 35 patients with POAG or OHT (study group) and 26 age- and gender- matched healthy individuals (control group) were included. All participants were examined by spectral domain optical coherence tomography (SD-OCT) with enhanced depth imaging (EDI) mode for LC thickness and depth measurements at the first visit before latanoprost therapy and at visits after 1 (second visit) and 3 (third visit) months of latanoprost therapy. RESULTS: The mean LC thickness in both horizontal and vertical scans of the study group were thinner than the control group (p < 0.001, for both). During latanoprost therapy in the study group, the LC thickness values in horizontal scans significantly differed over the three visits, gradually increased (p < 0.05). There was significantly decrease in LC depth in horizontal scans between the first and third visits, and the second and third visits (p = 0.003 and p = 0.008, respectively). The gradual decrease in LC depth in vertical scans was observed at all visits, but the statistically significant difference was between the first and third visits only (p = 0.048). CONCLUSION: POAG/OHT patients showed more LC thinning compared with healthy individuals. The significant increase in LC thickness and the significant decrease in LC depth were detected after IOP reduction therapy with latanoprost in ocular hypertensive/ glaucomatous eyes.

Comparison of the inhibitory effect of topical cyclosporine A 0.1% and topical anti-VEGF application in an experimental model of corneal neovascularization / Comparação do efeito inibitório da ciclosporina A 0,1% tópica e aplicação de anti-VEGF tópica em um modelo experimental de neovascularização da córnea

ABSTRACT Purpose: The aim of this study was to compare the effects of topical cyclosporine 0.1% and bevacizumab on experimentally induced corneal neovascularization in a rat model. Methods: A total of 30 adult Sprague-Dawley rats were used in this experimental study. The central cornea of the rats was cauterized chemically. The rats were randomly enrolled into three groups as follows: Group 1 received bevacizumab 1%, Group 2 received cyclosporine 0.1%, and Group 3 received isotonic saline twice a day for 28 days. Slit-lamp examination of all rats was performed at the 3rd and 28th day. The rats were then sacrificed, and the corneas were excised. The number of blood vessels, state of inflammation, and collagen formation were evaluated histopathologically in the corneal sections. Results: Corneal opacity and edema grades were significantly lower in Group 2 than in Group 3 (p=0.04 and 0.00, respectively). In the histopathological examination, Group 2 demonstrated significantly lesser number of blood vessels than Group 3 (p=0.001). Regarding collagen formation, Group 2 exhibited more regular collagen formation than Groups 1 and 3 (p=0.03). Inflammation grades were significantly lower in Groups 1 and 2 than in Group 3 (p=0.014 and 0.001, respectively). Conclusion: Topical bevacizumab is effective in inhibiting newly formed corneal neovascularization. The topical cyclosporine 0.1% treatment appears to be more effective than the topical bevacizumab treatment.

RESUMO Objetivo: Comparar os efeitos da ciclosporina tópica 0,1% e do bevacizumabe na neovascularização da córnea produzida experimentalmente em um modelo com ratos. Métodos: Trinta ratos Sprague-Dawley adultos foram usados neste estudo experimental. A córnea central dos ratos foi cauterizada quimicamente. Os ratos foram distribuídos aleatoriamente em três grupos. O grupo 1 recebeu bevacizumabe a 1%, o grupo 2 recebeu ciclosporina tópica a 0,1% e o grupo 3 recebeu solução salina isotônica duas vezes ao dia durante 28 dias. O exame de lâmpada de fenda de todos os ratos foi realizado no terceiro e no vigésimo oitavo dias. Os ratos foram então sacrificados e as córneas excisadas. Nos cortes da córnea, o número de vasos sanguíneos, o estado de inflamação e a formação de colágeno foram avaliados em uma análise anatomopatológica. Resultados: No Grupo 2, os graus de opacidade e de edema da córnea foram significativamente menores que no Grupo 3 (p=0,04 e 0,00, respectivamente). No exame histopatológico, o Grupo 2 apresentou um número significativamente menor de vasos sanguíneos do que o Grupo 3 (p=0,001). Em relação à avaliação da formação de colágeno, esta mostrou-se mais regular no Grupo 2 que no Grupo 1 e no Grupo 3 (p=0,03). Os graus de inflamação foram significativamente menores no Grupo 1 e no Grupo 2 em comparação com o Grupo 3 (p=0,014 e 0,001, respectivamente). Conclusão: O bevacizumabe tópico é eficaz na inibição da neovascularização da córnea recém-formada. O tratamento tópico com ciclosporina a 0,1% parece ser mais eficaz em comparação ao tratamento tópico com bevacizumabe.

Comparison of the inhibitory effect of topical cyclosporine A 0.1% and topical anti-VEGF application in an experimental model of corneal neovascularization.

PURPOSE: The aim of this study was to compare the effects of topical cyclosporine 0.1% and bevacizumab on experimentally induced corneal neovascularization in a rat model. METHODS: A total of 30 adult Sprague-Dawley rats were used in this experimental study. The central cornea of the rats was cauterized chemically. The rats were randomly enrolled into three groups as follows: Group 1 received bevacizumab 1%, Group 2 received cyclosporine 0.1%, and Group 3 received isotonic saline twice a day for 28 days. Slit-lamp examination of all rats was performed at the 3rd and 28th day. The rats were then sacrificed, and the corneas were excised. The number of blood vessels, state of inflammation, and collagen formation were evaluated histopathologically in the corneal sections. RESULTS: Corneal opacity and edema grades were significantly lower in Group 2 than in Group 3 (p=0.04 and 0.00, respectively). In the histopathological examination, Group 2 demonstrated significantly lesser number of blood vessels than Group 3 (p=0.001). Regarding collagen formation, Group 2 exhibited more regular collagen formation than Groups 1 and 3 (p=0.03). Inflammation grades were significantly lower in Groups 1 and 2 than in Group 3 (p=0.014 and 0.001, respectively). CONCLUSION: Topical bevacizumab is effective in inhibiting newly formed corneal neovascularization. The topical cyclosporine 0.1% treatment appears to be more effective than the topical bevacizumab treatment.

Comparison of ganglion cell-inner plexiform layer thickness in exfoliative glaucoma and primary open-angle glaucoma.

PURPOSE: To determine and compare the thickness of the ganglion cell-inner plexiform layer (GCIPL), the thickness of the retina nerve fiber layer (RNFL), and the parameters of the optic nerve head (ONH) in exfoliative glaucoma (XFG), primary open-angle glaucoma (POAG), and control eyes using optical coherence tomography (OCT). METHODS: The study was a retrospective observational cross-sectional study of 43 eyes of patients with XFG, 44 eyes of patients with POAG, and 37 eyes of healthy participants. Visual acuity, intraocular pressure, central corneal thickness, rim-area, disc-area, average cup/disc ratio, vertical cup/disc ratio, cup volume, average RNFL thickness, and GCIPL (average, minimum, superior, superotemporal, superonasal, inferior, inferotemporal, and inferonasal) thicknesses were determined. RESULTS: RNFL thicknesses were similar in the XFG and POAG groups (p = 0.065), and both glaucoma groups had significantly thinner RNFLs than the controls (p = 0.002). The XFG group had significantly thinner average and minimum GCIPLs compared to the POAG and control groups (p = 0.027, p < 0.001 for average thickness and p = 0.038, p < 0.001 for minimum thickness, respectively). No significant difference was found in the ONH parameters among the three groups except for rim-area and cup volume (p > 0.05 for all ONH parameters, p < 0.001 for rim-area, and p = 0.003 for cup volume). Mean visual field mean deviation was -11.6 ± 8.2 dB in the XFG group and -10.4 ± 9.3 dB in the POAG group (p = 0.453). CONCLUSION: Eyes with XFG were found to have a thinner GCIPL (minimum and average) than eyes with POAG or from healthy controls, although the RNFL measurements were similar to those of eyes with POAG. GCIPL thickness may be a more valuable indicator than RNFL thickness in patients with XFG for early detection of glaucoma and/or for glaucoma progression measurement. There is still some debate in the literature about whether decreases in GCIPL thickness and RNFL thickness (and/or ONH parameter change) are the best indicators for early detection and progress measurement of glaucoma.

Determination of Neurodegeneration in Polycystic Ovary Syndrome with Retinal Segmentation Analysis.

Purpose: To compare the thickness of each retinal layer in patients with polycystic ovary syndrome (PCOS) versus healthy, age-matched controls by using retinal segmentation analysis.Methods: In our cross-sectional study, 37 patients with PCOS (i.e., patient group) and 35 healthy individuals (i.e., control group) underwent spectral-domain optical coherence tomography imaging. Using built-in automatic retinal segmentation software to analyze the images collected, we compared the thickness of the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer, outer plexiform layer, outer nuclear layer, photoreceptor layer (PRL), retinal pigment epithelium (RPE), inner retinal layers, and outer retinal layers between the groups. To analyze the measurements, we used a traditional Early Treatment Diabetic Retinopathy Study (ETDRS) grid.Results: In ETDRS subfields, 6-mm nasal RNFL thickness; 3- and 6-mm nasal GCL thickness; 3-mm superior and 6-mm nasal IPL thickness; 1-mm central, 3-mm nasal, superior, and inferior, and 6-mm nasal and inferior PRL thickness; and 6-mm inferior RPE thickness were significantly thinner in patients with PCOS than that of healthy controls.Conclusion: The results of our retinal segmentation analysis indicate that patients with PCOS tend to have thinner GCL, IPL, and PRL than healthy, age-matched controls due to neurodegeneration likely caused by insulin resistance, or subclinical retinal inflammation.

Elevated Monocyte-to-High-Density Lipoprotein Ratio as an Indicator of Systemic Inflammation in Patients with Branch Retinal Vein Occlusion.

OBJECTIVES: This study was designed to assess the monocyte-to-high-density lipoprotein (HDL) ratio (MHR) as a possible marker of systemic inflammation in patients with branch retinal vein occlusion (BRVO). METHODS: A study group of 62 patients with BRVO and a control group of 60 age-matched, healthy individuals were enrolled in the study. The blood lipid profile, hematology profile, and C-reactive protein (CRP) level were measured. The MHR was calculated as the ratio of the monocyte count to the HDL level, and the neutrophil-to-lymphocyte ratio (NLR) was calculated as the ratio of the neutrophil count to the lymphocyte count. RESULTS: In patients with BRVO versus controls, the mean MHR was 14.1±5.1 vs 12.2±4.3 (p=.032), the mean NLR was 1.99±0.69 vs 2.01±0.86 (p=.889), and the mean CRP level was 3.44±2.53 mg/L vs 2.81±1.57 mg/L (p=.102). The area under the receiver operating characteristic curve for the MHR and the NLR was 0.621 and 0.519, respectively. The sensitivity and specificity of the MHR and the NLR to predict BRVO was 51% and 73% vs 79% and 35%, respectively. CONCLUSION: The MHR values were higher in patients with BRVO compared with those of the control group. BRVO seems to be associated with systemic inflammation.

Does wearing swimming goggles affect corneal morphology in keratoconic eyes?

PURPOSE: A significant transient increase in intraocular pressure in individuals wearing swimming goggles has been demonstrated in previous studies. These findings suggested that wearing swimming goggles could represent a significant risk factor for worsening of corneal parameters in patients with keratoconus who swim regularly. The aim of this study was to investigate corneal parameters in patients with keratoconus after wearing swimming goggles. METHODS: Comprehensive ocular examinations were performed on 74 eyes of 37 patients with keratoconus. Measurements of the corneal front keratometry values (Kflat, Ksteep, and Kmax), central corneal thickness, corneal apex thickness, thinnest corneal thickness, corneal volume, anterior chamber volume, anterior chamber depth, and iridocorneal angle were performed in outpatient clinics using a Pentacam® Scheimpflug camera (Oculus, Wetzlar, Germany) before the patients wore swimming goggles and after they wore swimming goggles for 1, 10, and 20 min. A p-value of <0.05 was regarded as statistically significant. RESULTS: The average values before and after wearing swimming goggles for 1, 10, and 20 min were 52.72 ± 5.36, 52.64 ± 5.52, 52.62 ± 5.38, and 52.22 ± 4.86, respectively (p=0.257). The average values before and after wearing swimming goggles for 1, 10, and 20 min were 46.01 ± 3.17, 46.09 ± 3.17, 46.06 ± 3.26, and 46.04 ± 3.17, respectively (p=0.426). The average values before and after wearing swimming goggles for 1, 10, and 20 min were 49.02 ± 3.56, 49.06 ± 3.61, 49.08 ± 3.62, and 49.07 ± 3.61, respectively (p=0.750). No other corneal parameters showed changes after wearing swimming goggles (p>0.05). However, the anterior chamber volume markedly decreased after wearing swimming goggles (p<0.001). CONCLUSIONS: These findings suggested that the short-term use of swimming goggles does not increase the risk of corneal parameter worsening in patients with keratoconus.

Evaluation of retina nerve fiber layer, ganglion cell-inner plexiform layer and lamina cribrosa in clinically unilateral exfoliative glaucoma.

PURPOSE: To compare retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GC-IPL), the lamina cribrosa depth (LCD) and thickness (LCT) in unilateral exfoliative glaucoma (EXG) patients with their fellow eyes without exfoliation and control eyes. METHODS: This cross-sectional prospective single-center study consisted of 64 eyes of 32 patients with unilateral EXG and 35 eyes of controls. All subjects were examined with spectral domain optical coherence tomography for the RNFL and GC-IPL measurements. The LCD and LCT measurements were also obtained. RESULTS: The RNFL measurements at all quadrants were statistically thinner in EXG eyes than those in their eyes without EXG and control eyes (p < 0.001 for average, superior, temporal and inferior; p = 0.004 for nasal). The EXG group had deeper LCD than their eyes without EXG and control eyes (p < 0.001, for both). The fellow eyes of EXG group had also deeper LCD than control eyes, with no statistical significance (p = 0.058). The mean LCT was thinner in EXG eyes compared to those in the eyes without EXG and control eyes (p < 0.001, for both). The eyes without EXG and control eyes had similar LCT (p = 0.293). CONCLUSIONS: Recent developments in imaging technology give the clinician detailed structural information about optic nerve head and retina such as GC-IPL, LCD and LCT. In addition to follow-up of RNFL changes, these new parameters may be useful in recognizing progression in EXG patients.

Does wearing swimming goggles affect corneal morphology in keratoconic eyes? / Uso de óculos de natação afeta a morfologia da córnea em olhos ceratocônicos?

ABSTRACT Purpose: A significant transient increase in intraocular pressure in individuals wearing swimming goggles has been demonstrated in previous studies. These findings suggested that wearing swimming goggles could represent a significant risk factor for worsening of corneal parameters in patients with keratoconus who swim regularly. The aim of this study was to investigate corneal parameters in patients with keratoconus after wearing swimming goggles. Methods: Comprehensive ocular examinations were performed on 74 eyes of 37 patients with keratoconus. Measurements of the corneal front keratometry values (Kflat, Ksteep, and Kmax), central corneal thickness, corneal apex thickness, thinnest corneal thickness, corneal volume, anterior chamber volume, anterior chamber depth, and iridocorneal angle were performed in outpatient clinics using a Pentacam® Scheimpflug camera (Oculus, Wetzlar, Germany) before the patients wore swimming goggles and after they wore swimming goggles for 1, 10, and 20 min. A p-value of <0.05 was regarded as statistically significant. Results: The average values before and after wearing swimming goggles for 1, 10, and 20 min were 52.72 ± 5.36, 52.64 ± 5.52, 52.62 ± 5.38, and 52.22 ± 4.86, respectively (p=0.257). The average values before and after wearing swimming goggles for 1, 10, and 20 min were 46.01 ± 3.17, 46.09 ± 3.17, 46.06 ± 3.26, and 46.04 ± 3.17, respectively (p=0.426). The average values before and after wearing swimming goggles for 1, 10, and 20 min were 49.02 ± 3.56, 49.06 ± 3.61, 49.08 ± 3.62, and 49.07 ± 3.61, respectively (p=0.750). No other corneal parameters showed changes after wearing swimming goggles (p>0.05). However, the anterior chamber volume markedly decreased after wearing swimming goggles (p<0.001). Conclusions: These findings suggested that the short-term use of swimming goggles does not increase the risk of corneal parameter worsening in patients with keratoconus.

RESUMO Objetivo: Um aumento transitório significativo da pressão intraocular em indivíduos usando óculos de natação foi demonstrado em estudos anteriores. Esses achados sugerem que o uso de óculos de natação pode representar um fator de risco significativo para o agravamento dos parâmetros corneanos em pacientes com ceratocone que nadam regularmente. O objetivo deste estudo foi investigar os parâmetros corneanos em pacientes com ceratocone após o uso de óculos de natação. Métodos: Foram realizados exames oftalmológicos completos em 74 olhos de 37 pacientes com ceratocone. As medidas dos valores de ceratometria frontal da córnea (Kflat, Ksteep e Kmax), espessura corneana central, espessura apical da córnea, espessura corneana mais fina, volume da córnea, volume da câmara anterior, profundidade da câmara anterior e ângulo iridocorneano foram realizados em ambulatórios usando câmera Pentacam® Scheimpflug (Oculus, Wetzlar, Alemanha) antes dos pacientes usarem óculos de natação por 1, 10 e 20 min. Um valor p<0,05 foi considerado estatisticamente significativo. Resultados: Os valores médios de antes e após o uso de óculos de natação por 1, 10 e 20 min foram: 52,72 ± 5,36, 52,64 ± 5,52, 52,62 ± 5,38 e 52,22 ± 4,86, respectivamente (p=0,257). Os valores médios do (antes e após o uso de óculos de natação por 1, 10 e 20 min foram: 46,01 ± 3,17, 46,09 ± 3,17, 46,06 ± 3,26 e 46,04 ± 3,17, respectivamente (p=0,426). Os valores médios de antes e após o uso de óculos de natação por 1, 10 e 20 min foram: 49,02 ± 3,56, 49,06 ± 3,61, 49,08 ± 3,62 e 49,07 ± 3,61, respectivamente (p=0,750). Nenhum outro parâmetro da córnea apresentou alterações após o uso de óculos de natação (p>0,05). No entanto, o volume da câmara anterior diminuiu acentuadamente após o uso de óculos de natação (p<0,001). Conclusões: Esses achados sugerem que o uso de óculos de natação a curto prazo não aumenta o risco de piora dos parâmetros corneanos em pacientes com ceratocone.

Monocyte to high-density lipoprotein and neutrophil-to-lymphocyte ratios in patients with acute central serous chorioretinopathy.

Purpose: To investigate monocyte to high-density lipoprotein (HDL) ratio (MHR) and neutrophil-to-lymphocyte ratio (NLR) as indicators of systemic inflammation in acute central serous chorioretinopathy (CSC). Methods: The HDL levels, hematological profiles, erythrocyte sedimentation rates (ESR), and C-reactive protein (CRP) levels of 38 patients with acute CSC (Group I) and 38 controls without CSC (Group II) were measured. Results: MHRs were significantly higher in Group I (13.30 ± 2.95) than in Group II (11.52 ± 2.42, P = 0.005), whereas NLRs, CRP values, and ESR values did not significantly differ between the groups (P = 0.726, P = 0.219, and P = 0.441, respectively). Multivariate analysis revealed that the MHR was an independent predictor of acute CSC (OR = 1.266, 95% CI = 1.054-1.521, P = 0.012). Conclusion: Indicating an association between increased MHRs and acute CSC, the MHR might represent simple, inexpensive, reliable biomarkers of inflammation in acute CSC.

Diurnal variation of anterior segment parameters handled with Scheimpflug imaging in keratoconus patients.

PURPOSE: To define diurnal changes in anterior segment parameters of keratoconus patients by using Scheimpflug imaging. METHODS: All keratoconus patients had corneal topography measurements 3 times a day (around 09:00 AM, 13:00 PM and 17:00 PM) by the same experienced operator. Three consecutive scans in each measurement session were obtained. The average of three measurements was used for analysis. A repeated measures analysis of variance with one within-subject factor (time of day) was carried out to assess diurnal variation. RESULTS: This study included 26 eyes of 26 patients with keratoconus. Significant diurnal variation was found in CCT and TCT measurements (P < 0.01, and P < 0.01, respectively). The mean amplitudes of change in CCT and TCT were 4.2 ± 1 µm (95% CI: 1.7-6.8 µm) and 4.1 ± 1.1 µm (95% CI: 1.2-8.0 µm), while the mean of CCT and TCT were 462.4 ± 34.5 µm (95% CI: 448.4-476.6 µm) and 452.9 ± 6.6 µm (95% CI: 439.3-466.5 µm), respectively. The maximum value and the lowest value were observed at 09:00 AM and at 17:00 PM, respectively. Other parameters except CCT and TCT did not show diurnal variation. CONCLUSION: Statistically significant but clinically insignificant diurnal variation in CCT and TCT measurements of the keratoconus patients were detected over an 8-hour period (09:00 AM-17:00 PM).

Long-term Outcomes of Accelerated Corneal Cross-linking in the Treatment of Keratoconus: Comparison of Hypotonic Riboflavin Solution With Standard Riboflavin Solution.

PURPOSE: To determine 2-year efficacy of accelerated corneal cross-linking (CXL) in keratoconus treatment using standard riboflavin-dextran or hypotonic riboflavin solutions. METHODS: Patients undergoing accelerated CXL (epitheliumoff 10 minutes, 9 mW/cm2 protocol) with standard riboflavin solution (48 eyes of 48 patients) or hypotonic riboflavin solution (43 eyes of 43 patients) were included and followed up for 2 years. Thinnest corneal thickness (TCT), maximum keratometry, and visual acuity were measured and changes from baseline to postoperative 6, 12, and 24 months were compared between the two groups. RESULTS: The preoperative mean TCT with intact epithelium was 472.0 ± 23.9 and 427.5 ± 22.3 µm in the standard riboflavin and hypotonic riboflavin groups, respectively (P < .001). The decreases in the mean TCT values from baseline to postoperative 6 months were similar between the standard riboflavin (from 472 to 436 µm) and hypotonic riboflavin (from 427 to 394 µm) groups. This suggested that the hypotonic riboflavin solution was comparable with the standard riboflavin solution in preserving corneal thickness in keratoconus. There were no significant differences between the study groups regarding the postoperative changes in maximum keratometry or visual acuity. CONCLUSIONS: The efficacy of accelerated CXL with hypotonic riboflavin solution was comparable to that with the standard riboflavin solution in reducing keratoconus progression in a 2-year follow-up period. [J Refract Surg. 2020;36(2):110-117.].

Using Anterior Segment Optical Coherence Tomography to Assess Angle Anatomy in Patients with Neurofibromatosis Type 1.

SIGNIFICANCE: Lisch nodules have been identified in more than 90% of patients 16 years or older with neurofibromatosis type 1 (NF1). According to our hypothesis, the presence of Lisch nodules in patients with NF1 might affect the anterior chamber angle (ACA) parameters. PURPOSE: The aim of this study was to evaluate the anterior segment angle parameters using anterior segment optical coherence tomography in patients with NF1. METHODS: A total of 42 eyes from 21 patients with NF1 (study group) and 42 eyes from 21 age- and sex-matched healthy individuals (control group) were included in this study. Angle opening distance at 500 (AOD500) and 750 µm (AOD750) anterior to the scleral spur, ACA, and iris thickness (IT) values were measured in the temporal (T) and nasal (N) quadrants using anterior segment optical coherence tomography. RESULTS: The mean AOD500 and AOD750 values in both quadrants were significantly lower in the study group compared with the control group (T-AOD500: 548 ± 151 vs. 761 ± 288 [P < .001], T-AOD750: 705 ± 175 vs. 921 ± 334 [P < .001], N-AOD500: 599 ± 223 vs. 777 ± 292 [P = .002], and N-AOD750: 756 ± 268 vs. 948 ± 303 [P = .003], respectively). The mean ACA values in both quadrants were significantly narrower in the study group compared with the control group (T-ACA: 29.52 ± 6.36 vs. 40.83 ± 8.90 [P < .001] and N-ACA: 30.05 ± 7.11 vs. 41.29 ± 8.68 [P < .001], respectively). The IT values in both quadrants were significantly thicker compared with the control group (T-IT500: 406 ± 78 vs. 355 ± 59 [P = .001], T-IT750: 453 ± 103 vs. 362 ± 100 [P < .001], N-IT500: 416 ± 93 vs. 353 ± 54 [P < .001], and N-IT750: 437 ± 91 vs. 370 ± 95 [P = .002], respectively). CONCLUSIONS: We have revealed lower angle opening distance values in individuals with NF1 than in the healthy ones, as well as significantly narrower ACA values and significantly thicker IT values.

Effects of senofilcon A and lotrafilcon B bandage contact lenses on epithelial healing and pain management after bilateral photorefractive keratectomy.

PURPOSE: The purpose of this study was to compare postoperative epithelial healing time and ocular discomfort score in patients wearing two types of silicon hydrogel bandage contact lenses (BCLs) following bilateral photorefractive keratectomy (PRK). METHODS: For the study's contralateral eye comparison, 43 patients who underwent bilateral PRK were randomized to be fitted for a senofilcon a lens in one eye and a lotrafilcon B lens in the other. The patients were masked to the specific BCL in each eye. On the first 3 days after PRK, the epithelial defect size was calculated, and patients reported their level of ocular discomfort, including pain, epiphora, and photophobia, on a visual analog scale (0 = no pain or discomfort, 10 = highest level of pain and discomfort). RESULTS: Epithelial defect size (mm2) did not differ significantly between the BCLs on Day 1 (senofilcon A vs. lotrafilcon B: 14.15 ±â€¯5.59 vs. 14.93 ±â€¯5.72, p = .327), Day 2 (senofilcon A vs. lotrafilcon B: 7.43 ±â€¯4.67 vs. 7.04 ±â€¯3.82, p = .586), or Day 3 (senofilcon A vs. lotrafilcon B: 0.59 ±â€¯1.44 vs. 0.38 ±â€¯1.08, p = .348) postoperation. By Day 3, re-epithelialization was complete in 35 eyes (81.3%) with senofilcon A lenses and 36 eyes (83.7%) with lotrafilcon B lenses. Patients reported less pain in eyes with senofilcon A lenses during the first 3 days postoperation (for all, p < .001) and less epiphora during the first 2 days postoperation (Day 1: p =  .008, Day 2: p <  .001, Day 3: p = .267) than in eyes with lotrafilcon B lenses. No significant difference in photophobia emerged between the BCLs postoperatively (for all, p > .05). CONCLUSIONS: Although duration of corneal re-epithelialization after PRK between the two BCLs did not differ significantly, senofilcon A lenses caused significantly less pain and epiphora after PRK.

THE EFFECT OF AGE ON AFLIBERCEPT (EYLEA) RESPONSE IN DIABETIC MACULAR EDEMA.

PURPOSE: To investigate the effect of age on aflibercept (Eylea) response in macular edema secondary to treatment-naive diabetic eyes. METHODS: Two hundred seventy-three eyes of 273 treatment-naive patients with macular edema secondary to diabetes mellitus were enrolled in this study. The patients in the study were divided into the following 4 groups according to their ages: Group 1 (40-50 years), Group 2 (51-60 years), Group 3 (61-70 years), and Group 4 (>70 years). Three consecutive injections at intervals of 1 month were applied to all diabetic patients. The efficacy of the aflibercept treatment on macular edema according to age groups was assessed by optical coherence tomography by comparing the central foveal thickness (CFT) values and mean visual acuity changes after initial and three loading dose injections. RESULTS: After three consecutive aflibercept injections, the mean reduction of CFT in Groups 1, 2, 3, and 4 were -256.4 ± 110.9, -197.4 ± 96.4, -189.4 ± 110.8, and -186.2 ± 118.9 µm, respectively. The changes of CFT was significantly different between age groups (P = 0.003, analysis of covariance). The improvement of visual acuity was significantly different in each group (P < 0.001 in all groups, paired-samples t-test), and changes of visual acuity was significantly different between age groups (P < 0.05, analysis of covariance). In addition, ages of patients were correlated with the mean reduction of CFT and mean improvement of visual acuity for the whole study group (r = -0.183, P = 0.002 for CFT; r = -0.682, P < 0.001 for visual acuity, Pearson correlation). CONCLUSION: In this study, it was observed that the efficacy of aflibercept treatment was found to be more effective in younger patients in treatment-naive diabetic macular edema patients.

Preservative-free versus preserved brimonidine %0.15 preparations in the treatment of glaucoma and ocular hypertension: short term evaluation of efficacy, safety, and potential advantages.

Purpose: To compare the efficacy, safety, and potential advantages of the preservative-free versus preserved brimonidine %0.15 preparations in patients with primer open-angle glaucoma (POAG) or ocular hypertension (OHT).Methods: Forty-two eyes of the 21 treatment-naive patients with POAG or OHT were enrolled in this study. Eyes were randomly assigned to receive brimonidine-purite 0.15% or preservative-free brimonidine 0.15% two times daily. Efficacy of the two eye drops was assessed by measuring the intraocular pressure (IOP) at 9-10 am at baseline and week 4. Safety and potential advantages of the drops were evaluated at weeks 4 in terms of ocular symptoms and tear parameters. Ocular symptom values of the patients were evaluated with a scale of 0-4 (0 = no discomfort and 4 = severe discomfort).Results: Both of the brimonidine tartrate formulations resulted in statistically similar IOP reduction (preserved formulation; -5.2 mmHg [22.9% reduction] preservative-free formulation; -5.7 mmHg [24.1% reduction], p = 0.37). It was found that brimonidine tartrate formulations with and without topical preservatives did not produce a statistically significant difference in pain, stinging, and blurred vision at the upon instillation (p > 0.05). However, the burning sensation was significantly higher in the preservative-free formulation at the first instillation compared to the preserved formulation (p = 0.01). Also, there was no statistically significant difference between the two formulations in terms of symptoms (itching, burning, tearing, stinging, and photophobia) and tear parameters during the day (p > 0.05).Conclusions: Although topical preservative-free brimonidine tartrate treated eyes had a more burning sensation at the first drop, the two formulations were similar in terms of ocular tolerability in the short term period. Also, both formulations were found to reduce IOP at a similar rate.

Does using topical latanoprost affect subfoveal choroidal thickness?

Purpose: The aim of our prospective study was to investigate the effect of using latanoprost eye drops on subfoveal choroidal thickness in the macular area, as measured by using enhanced depth imaging optical coherence tomography (EDI-OCT). Materials and methods: A total of 39 eyes from 39 patients with bilateral glaucoma or ocular hypertension who had never received hypotensive therapy (study group) and 39 eyes from 39 age- and gender-matched healthy individuals (control group) were included in this study. The EDI-OCT measurements of subfoveal choroidal thickness were obtained during an initial visit before latanoprost therapy and at visits after 1 and 3 months of latanoprost therapy. Results: The mean subfoveal choroidal thickness was 309.5 ± 38.5 µm before latanoprost therapy in the study group and 307.3 ± 31.8 µm in the control group (p = .794). During latanorprost therapy in the study group, mean values of subfoveal choroidal thickness at the initial visit and at intervals of 1 and 3 months were 309.5 ± 38.5 µm, 314.2 ± 39.7 µm, and 318.3 ± 33.4 µm, respectively, which indicated a statistically significant difference between the initial and third visits only (p=.002). Conclusion: Subfoveal choroidal thickness increased after 3 months of topical latanoprost therapy.

Evaluation of Corneal Morphology in Patients With Hemifacial Spasm.

PURPOSE: To determine whether the corneal topographic parameter values, individual corneal layer thicknesses, and its endothelial layer morphology are different in patients with hemifacial spasm (HFS) than in the control contralateral eye. METHODS: This study was designed as a prospective study. Among patients who applied to our hospital within the past 3-year period, those with HFS in one eye (study eyes) and a completely normal contralateral eye (control eyes) were included in this study. In addition to a complete ophthalmologic examination, all patients were scanned by the Pentacam Scheimpflug camera, and a corneal endothelium cell count was taken using a Topcon Specular Microscope. Also, the thickness of the corneal sublayers was measured on the central cornea with anterior segment module of spectral domain optical coherence tomography. Data entered using SPSS software were then evaluated by paired t test; P<0.05 value was considered statistically significant. RESULTS: Twenty-eight patients (16 women and 12 men) were evaluated. Steep K, Kmax, and astigmatism values were significantly higher in the study eyes of patients with HFS than in the control eyes (P<0.05, for all). In addition, the total corneal thickness and corneal stromal thickness measurements in the study eyes were statistically significantly thinner than the control eyes (P=0.04 and P<0.001, respectively). Specular microscopy parameters were not statistically significant between the study eyes and control eyes (P>0.05, for all). CONCLUSION: Corneal stromal thinning suggests that chronic exposure to hypoxia may induce this effect through extracellular matrix remodeling and losses in collagen framework content in patients with HFS.