Olfactory dysfunction in primary Sjogren's syndrome and its correlation with dry eye.

OBJECTIVE: To evaluate the olfactory function in primary Sjögren's syndrome (pSS) patients and investigate its correlation with dry eye parameters. METHODS: Thirty-eight pSS patients (49.47 ± 10.06 years) and 20 healthy volunteers (47.40 ± 8.92 years) were enrolled in the study. All participants underwent ENT and eye examinations including a modified Connecticut Chemosensory Clinical Research Center (CCCRC) test, tear break-up time (TBUT), ocular surface staining (OSS) and Schirmer test. The parameters were compared between the two groups using Student-t test, and Pearson test was used to evaluate the correlations. RESULTS: Mean Schirmer and TBUT values were 2.39 ± 1.48 mm/5 min and 3.66 ± 1.5 sec in pSS and 18.30 ± 6.16 mm/5 min and 14.60 ± 3.64 sec in healthy subjects (p < 0.001, both). There was a significant decrease in mean odour threshold, odour identification, CCCRC and VAS scores in the pSS group (p < 0.001). Dry eye parameters showed moderate correlations with CCCRC parameters (r = 0.4-0.6, p < 0.001) and olfaction VAS score (r = 0.4-0.75, p < 0.05). CONCLUSIONS: There is a mild clinical impairment in smell sense in patients with pSS which seems to be correlated with dry eye parameters. Therefore, smell complaints should be queried in pSS patients suffering from severe dry eye.

Quantitative assessment of the effect of acute anaerobic exercise on macular perfusion via swept-source optical coherence tomography angiography in young football players.

AIM: To evaluate the effect of acute anaerobic exercise on macular perfusion measured by swept-source optical coherence tomography angiography (SS-OCTA) in young football players. MATERIALS AND METHODS: Football players with ages between 18 and 20 years were included into the study. After a detailed ophthalmological examination, physiological parameters including height (cm), body weight (kg), body fat percentage (%), systemic blood pressure (BP) (mmHg), hematocrit values (%), oxygen saturation pO2 (%) and heart rate (bpm) were recorded. Intraocular pressure (IOP) (mmHg) and SS-OCTA using DRI OCT Triton (Topcon, Tokyo, Japan) were measured immediately before and after Wingate test. RESULTS: Out of 20, 16 participants completed the study. All participants were males with a mean age of 18.12 ± .34 years. Systolic BP, hematocrit and heart rate increased, while pO2 and IOP decreased remarkably after Wingate test (p < .01). After anaerobic exercise, there was an increase in mean FAZ area in superficial capillary plexus (FAZs) which was not significant (p = .13), while decrease in FAZ area in deep capillary plexus (FAZd) (mm2) was remarkable (p = .04). No changes were observed in mean vessel density (VD) (%) in superficial capillary plexus (VDs), deep capillary plexus (VDd), choriocapillaris (VDcc), central macular thickness (CMT) (µm) and subfoveal choroidal thickness (SFCT) (µm) after Wingate test (p > .05). FAZd and some of the VD parameters showed a significant correlation with BP (p < .05). CONCLUSION: Acute anaerobic exercise seems not to alter either mean VD in retina and choroid or CMT and SFCT. Among OCTA parameters, only FAZd decreased remarkably.

Novel Application Software for the Semi-Automated Analysis of Infrared Meibography Images.

PURPOSE: To develop semi-automated application software that quickly analyzes infrared meibography images taken with the CSO Sirius Topographer (CSO, Italy) and to compare them to the manual analysis system on the device (Phoenix software platform). METHODS: A total of 52 meibography images verified as high quality were used and analyzed through manual and semi-automated meibomian gland (MG) detector software in this study. For the manual method, an experienced researcher circumscribed the MGs by putting dots around grape-like clusters in a predetermined rectangular area, and Phoenix software measured the MG loss area by percentage, which took around 10 to 15 minutes. MG loss was graded from 1 (<25%) to 4 (severe >75%). For the semi-automated method, 2 blind physicians (I and II) determined the area to be masked by putting 5 to 6 dots on the raw images and measured the MG loss area using the newly developed semi-automated MG detector application software in less than 1 minute. Semi-automated measurements were repeated 3 times on different days, and the results were evaluated using paired-sample t test, Bland-Altman, and kappa κ analysis. RESULTS: The mean MG loss area was 37.24% with the manual analysis and 40.09%, 37.89%, and 40.08% in the first, second, and third runs with the semi-automated analysis (P < 0.05). Manual analysis scores showed a remarkable correlation with the semi-automated analysis performed by 2 operators (r = 0.950 and r = 0.959, respectively) (P < 0.001). According to Bland-Altman analysis, the 95% limits of agreement between manual analysis and semi-automated analysis by operator I were between -10.69% and 5% [concordance correlation coefficient (CCC) = 0.912] and between -9.97% and 4.3% (CCC = 0.923) for operator II. The limit of interoperator agreement in semi-automated analysis was between -4.89% and 4.92% (CCC = 0.973). There was good to very good agreement in grading between manual and semi-automated analysis results (κ 0.76-0.84) and very good interoperator agreement with semi-automated software (κ 0.91) (P < 0.001). CONCLUSIONS: For the manual analysis of meibography images, around one hundred dots have to be put around grape-like clusters to determine the MGs, which makes the process too long and prone to errors. The newly developed semi-automated software is a highly reproducible, practical, and faster method to analyze infrared meibography images with excellent correlation with the manual analysis.