Differences in Central Corneal Thickness between Spectral Domain-Optical Coherence Tomography and Ultrasound Pachymetry in Patients with Dry Eye Disease.

Purpose. To compare central corneal thickness (CCT) values via Spectral Domain-Optical Coherence Tomography (SD-OCT) and ultrasonic pachymetry in patients with severe dry eye disease (DED) to determine the level of agreement between these 2 methods. Methods. The paired samples t-test was used to compare CCT values in severe DED patients. Matching analysis between methods was performed using intraclass correlation coefficient (ICC). Intrasession reliability of the measurement methods was calculated via the concordance correlation coefficient (CCC), variation equivalent, and Pearson's correlation coefficient. The Bland-Altman procedure was used to graphically represent the differences between CCT values. Results. The study included 56 eyes of 24 female and 4 male patients. Mean age of the patients was 50.9 ± 11.3 years. Mean CCT via Cirrus SD-OCT was 523.82 ± 30.98 µm versus 530.050 ± 31.85 µm via ultrasonic pachymetry (paired samples t-test, P < 0.001). The Bland-Altman plot showed good agreement between the examiners. The ICC for repeatability was 0.974. The CCC between the 2 methods' CCT values was 0.973. The variation equivalent was 0.976 and Pearson's correlation coefficient was 99.3%, which also indicated high correlation between the 2 methods' measurements. Conclusions. The present findings show that in patients with severe DED Cirrus SD-OCT provides reliable intraobserver CCT values.

Effects of chronic smoking on color vision in young subjects.

AIM: To evaluate the effects of chronic smoking on color vision in young subjects. METHODS: This study included 91 smokers and 88 non-smokers (a total of 179 volunteers) without any ophthalmologic and systemical disorders. The subjects were between 18-40 years of age with a best corrected visual acuity (BCVA) of 20/20, normal anterior and posterior segment examinations and normal intraocular pressure. The color vision of the subjects were evaluated with Farnsworth-Munsell 100 Hue test (FMHT). The total error scores and axis calculation were performed for each subject and the results correlated. RESULTS: Mean age and the standard deviation was 28±5y in the smokers group, and 26.7±5.5y in the control group (P=0.101). Sex distribution was similar in the two groups (P=0.365). There was no significant correlation between age and FMHT total error scores (P=0.069). Median of FMHT total error scores of smokers and non-smokers were 65 and 50.50, respectively. FMHT total error scores was found significantly higher in smokers than non-smokers (P=0.004). There was no statisticaly significant difference between smoker and non-smoker groups with respect to axis ratio calculation (P=0.611). There was no significant correlation with FMHT total error scores with neither smoking duration nor number of cigarettes smoked per day (P=0.405, P=0.454, respectively). CONCLUSION: This study suggested that chronic smoking affects the color vision of young smokers but this may not be sector selective.

The efficacy of autologous serum eye drops for severe dry eye syndrome: a randomized double-blind crossover study.

BACKGROUND: To evaluate the efficacy of autologous serum (AS) eye drops for the symptomatic relief of severe dry eye syndrome (DES), as compared to conventional preservative-free artificial tears (PFAT). METHODS: This prospective double-blind randomized crossover study used the Ocular Surface Disease Index (OSDI), tear film break-up time (TBUT), Schirmer's Test, and OXFORD Scale at baseline and after each of two 1-month treatment periods to measure the effect of 20 % diluted AS eye drops vs. PFAT in 20 consecutive severe DES patients that were refractory to conventional treatment. RESULTS: The study included 20 (18 female and two male) severe DES patients (40 eyes). Significantly higher TBUT (P < 0.001, Wilcoxon signed-rank test) and a greater decrease in OSDI score (55.18 % decrease in the AS treatment group vs. 19.50 % decrease in the PFAT treatment group) (P < 0.001, Student's paired samples t-test) were observed in the AS treatment group after 1 month of treatment. There wasn't a significant difference in Schirmer's test and OXFORD conjunctival and corneal vital dying grading scores between the two treatment groups after 1 month of treatment (P > 0.05 [Mann-Whitney U test]). CONCLUSIONS: AS eye drops were more effective than conventional eye drops for improving tear film stability and subjective comfort in patients with severe DES.

Overexpression of vascular endothelial growth factor receptor 2 in pterygia may have a predictive value for a higher postoperative recurrence rate.

BACKGROUND: To investigate the expression levels of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 1 (VEGFR-1) and VEGFR-2 in pterygium and to clarify the prognostic significance of these expressions in pterygia. METHODS: A total of 40 surgically excised pterygia and 9 normal conjunctivae were immunohistochemically studied applying the streptavidin-biotin method in paraffin-embedded tissue sections. Monoclonal antibodies were targeted against VEGF, VEGFR-1 and VEGFR-2 proteins. At the sixth postoperative month, the recurrence rate was graded on a scale of 1-4. RESULTS: The mean percentage of VEGF-positive epithelial cells was comparable in pterygium and normal conjunctivae. However, the pterygium group presented higher expression levels of VEGF in pterygia endothelial cells (p=0.05). In terms of VEGFR-1 expression in epithelial cells, no statistically significant difference was found between two groups (p=0.658). However, normal conjunctivae exhibited higher expression levels of VEGFR-1 in endothelial cells (p=0.002). Epithelial cells in pterygium presented higher combined scores of VEGFR-2 (87.5% and 22.2%, respectively) (p=0.013). While higher expression levels of VEGFR-2 were documented in pterygia endothelial cells, no VEGFR-2 immunoreactivity was observed in the endothelial cells of normal conjunctivae (p<0.001). Expression levels of VEGFR-2 in epithelial cells and endothelial cells were positively correlated with the postoperative recurrence grading system (p<0.001 and τ=0.627, p=0.001 and τ=0.508, respectively). CONCLUSIONS: The results suggest that VEGF may play a key role through VEGFR-2 in the pathogenesis of pterygium. Moreover, overexpression of VEGFR-2 in pterygia may have a predictive value for a higher postoperative recurrence rate.

Age-related change in retinal nerve fiber layer thickness measured with spectral domain optical coherence tomography.

PURPOSE: We investigated age-related change in peripapillary retinal nerve fiber layer thicknesses (RNFLT) measured with spectral domain optical coherence tomography (SD-OCT) in healthy individuals. METHODS: In this cross-sectional study, peripapillary RNFL measurement was performed using a Cirrus SD-OCT device. Linear regression analysis and Spearman's correlation analysis were performed to investigate the level of difference in age-related change in the overall mean, 4 quadrants mean, and 12 clock-hour sectors mean RNFLT. RESULTS: Mean age of the 121 healthy participants was 39 years (range, 20-59 years). Mean 4 quadrant and mean 12 clock-hour sector RNFLT in the 121 randomly selected eyes in 121 healthy participants decreased significantly with age in the overall group (Spearman's correlation analysis, P < 0.05). Overall mean RNFLT decreased by 0.365 µm (95% confidence interval [CI], 0.47-0.26; linear regression analysis, P < 0.001) for every one year increase in age. Overall, the greatest decrease in mean RNFLT was in the lower quadrant (0.575 µm/y; 95% CI, 0.733-0.416), versus the least decrease in the nasal quadrant (0.141 µm/y; 95% CI, 0.272-0.010), and the greatest decrease in mean RNFLT was in the 6 clock-hour sector (0.656 µm/y; 95% CI, 0.939-0.374), versus the least decrease in the 3 clock-hour sector (0.119 µm/y; 95% CI, 0.266-0.029). CONCLUSIONS: Age-related decrease in RNFLT varied according to sector. Age-related change should be accounted for in any assessment of RNFLT. Regional age-related change is accounted for by Cirrus SD-OCT in its normative database.

Corneal endothelial characteristics and central corneal thickness in a population of Turkish cataract patients.

OBJECTIVES: The aim was to assess corneal endothelial characteristics and central corneal thickness (CCT) in a population of Turkish cataract patients and to define the impact of age and gender on these parameters. METHODS: Five hundred and seventeen cataract patients were examined with noncontact specular microscope preoperatively. The eye planned to be operated was selected for analysis. The parameters measured were endothelial cell density (ECD), cell area (CA), coefficient of variation (CV) of the CA, percentage of hexagonal cells (PHCs), and CCT. RESULTS: The mean values in ECD, CA, CV, PHC, and CCT in all eyes were 2,258 ± 474 cells per square millimeter, 468 ± 130 µm(2), 39%±7%, 49%±12%, and 500 ± 37 µm, respectively. Regression analysis revealed a statistically significant decrease in ECD (R=-0.169, P<0.0001), increase in CA (R=0.186, P<0.0001), and decrease in the CCT (R=-0.122, P=0.006) with increase in age. The changes in the CV (R=0.008, P=0.861) and PHC (R=-0,060, P=0.177) were not found to be dependent on age. The parameters showed no sex differences. The number of eyes with ECD below 1,000 and 2,000 cells per square millimeter was 5 (0.97%) and 130 (25.1%), respectively. CONCLUSIONS: The data from our study emphasize that age, but not gender, is the main determinant of ECD.

Topical cyclosporine A as a steroid-sparing agent in steroid-dependent idiopathic ocular myositis with scleritis: a case report and review of the literature.

OBJECTIVE: To report on a case of idiopathic orbital myositis with scleritis that was effectively controlled with topical 0.05% cyclosporine A and to provide a review of the literature on the treatment of ocular myositis with scleritis. METHODS: A case report. RESULTS: A 35-year-old woman presented with a longstanding history of intractable periorbital pain, redness on her left eye, and diplopia during ocular movement. Her medical history revealed that she had the same symptoms for 5 years and had used numerous prescribed medications for migraine and ocular myositis. During this period, her symptoms and signs had been lessened on systemic steroid treatment, which recurred or worsened after discontinuing or tapering the therapy. Magnetic resonance imaging scans demonstrated an isolated enlargement of the left medial rectus muscle. Laboratory examination results showed no evidence of dysthyroid ophthalmopathy or another systemic disease. Because of adverse affects of systemic corticosteroid and cyclosporine treatments, topical cyclosporine A (0.05%) and dexamethasone were administered four times daily. The patient continued to use topical 0.05% cyclosporine A for 6 months. Using only topical cyclosporine A, she currently has no recurrences of disease on the last examination after 6 months of treatment. Moreover, magnetic resonance imaging revealed a completely normal extraocular muscle configuration. CONCLUSIONS: Topical 0.05% cyclosporine A may be a safe and effective long-term treatment of ocular myositis and scleritis. It should be considered as a steroid-sparing agent, particularly in recurrent disease and in those patients who experience adverse effects of systemic medications.

Nitric oxide levels in tears of patients with mild forms of papillary conjunctivitis induced by rigid gas-permeable contact lenses.

PURPOSE: To determine whether nitric oxide (NO) is detectable in the tear fluid of patients with mild forms of papillary conjunctivitis who wear rigid gas-permeable contact lenses. METHODS: Tear samples were taken from 12 users of rigid gas-permeable contact lenses and 12 healthy controls. Samples were analyzed, and the levels of NO were determined. RESULTS: The mean level of NO in those who wore contact lenses was 118.98 micromol/L (95% CI: 91.85-146.10 micromol/L); whereas the level of NO found in the control subjects was 114.84 micromol/L (95% CI: 102.54-127.14 micromol/L). The difference was statistically insignificant (P>0.05). CONCLUSION: Nitric oxide levels in the tear fluid of rigid gas-permeable contact lens users did not correlate with the presence of mild symptoms of papillary conjunctivitis.