Gastric Polyps Detected Incidentally during Gastroscopy and Follow-Up Results.

(1) Background: We aimed to identify the possible relationship between various diseases of the upper digestive system and colon polyps by analyzing patients with gastric polyps and evaluating the cancers and diseases accompanying the polyps. (2) Methods: Each patient's age; gender; polyp type and size; presence of Helicobacter pylori (H. pylori), atrophic gastritis, and intestinal metaplasia; status of whether cancer developed during follow-up; status of whether a colonoscopy was performed or not; and colon pathologies detected during colonoscopy were analyzed retrospectively using hospital records. (3) Results: Between the study dates, 19,214 esophagogastroduodenoscopies were performed in the endoscopy unit of our hospital. Gastric polyps were detected in 178 (0.9%) patients. No significant relationship was found between the gastric polyp size and the occurrence of gastric cancer or gastrointestinal system malignancy (p > 0.05). A colonoscopy was performed in 86 of the 178 patients who underwent gastroscopy. The frequency of polyp detection during colonoscopy was statistically significantly higher in patients with gastric polyps than in patients without gastric polyps (p < 0.001). (4) Conclusions: New prospective studies are needed regarding the relationship between gastric polyps and gastrointestinal system diseases. Going forward, a colonoscopy will be required in gastric polyp patients, especially with FGP.

COMPARISON OF THE CHOROIDAL VASCULARITY INDEX MEASUREMENTS OF IMAGES ACQUIRED WITH DIFFERENT OPTICAL COHERENCE TOMOGRAPHY SCAN SCALE TYPES.

PURPOSE: To evaluate the differences in choroidal vascularity index (CVI) measurements between images acquired at the 1:1 pixel scale and at the 1:1 µ m scale of the Heidelberg optical coherence tomography device. METHODS: Forty-five healthy eyes of 45 healthy subjects were included for this study. Fovea-centered scans were obtained with an enhanced-depth imaging mode with a high-speed protocol scan. Each scan was exported in 3 different types: 1) 1:1 pixel scale type; 2) 1:1 µ m scale type (MST); and 3) 4×-magnified MST (4×MST; 400%-magnified 1:1 µ m images exported via screenshot). A comparison between CVI measurements based on the different scale types of optical coherence tomography images was conducted using the Bland-Altman analysis and intraclass correlation coefficient. RESULTS: The image with the worst clarity was acquired via the MST, and the CVI was found to be higher in MST images (69.05 ± 3.21) compared with the other groups. The intraclass correlation coefficient between the CVI values of the 4×MST and pixel scale type images was 0.92, between those of the 4×MST and MST images was 0.33, and between those of the pixel scale type and MST images was 0.44. CONCLUSION: The optical coherence tomography scale and export method type significantly influence the image resolution, CVI, and choroidal area measurements.

Quantitative analysis of deep learning-based denoising model efficacy on optical coherence tomography images with different noise levels.

BACKGROUND: To quantitatively evaluate the effectiveness of the Noise2Noise (N2N) model, a deep learning (DL)-based noise reduction algorithm, on enhanced depth imaging-optical coherence tomography (EDI-OCT) images with different noise levels. METHODS: The study included 30 subfoveal EDI-OCT images averaged with 100 frames from 30 healthy participants. Artificial Gaussian noise at 25.00, 50.00, and 75.00 standard deviations were added to the averaged (original) images, and the images were grouped as 25N, 50N, and 75N. Afterward, noise-added images were denoised with the N2N model and grouped as 25dN, 50dN, and 75dN, according to previous noise levels. The choroidal vascularity index (CVI) and deep choroidal contrast-to-noise ratio (CNR) were calculated for all images, and noise-added and denoised images were compared with the original images. The structural similarity of the noise-added and denoised images to the original images was assessed by the Multi-Scale Structural Similarity Index (MS-SSI). RESULTS: The CVI and CNR parameters of the original images (68.08 ± 2.47 %, and 9.71 ± 2.80) did not differ from the only 25dN images (67.97 ± 2.34 % and 8.50 ± 2.43) (p:1.000, and p:0.062, respectively). Noise reduction improved the MS-SSI at each noise level (p < 0.001). However, the highest MS-SSI was achieved in 25dN images. CONCLUSIONS: The DL-based N2N denoising model can be used effectively for images with low noise levels, but at increasing noise levels, this model may be insufficient to provide both the original structural features of the choroid and structural similarity to the original image.

Characteristics of myopic and hyperopic eyes in patients with antimetropia.

CLINICAL RELEVANCE: Antimetropia is a rare type of anisometropia in which one eye is myopic and the fellow is hyperopic, This optical condition condition permits the evaluation of both sides of the emmetropisation process failure in the same individual by minimising genetic and environmental factors. BACKGROUND: This study aimed to evaluate the ocular biometric, retinal, and choroidal characteristics of myopic and hyperopic eyes of antimetropic subjects older than six years. METHODS: In this retrospective study, myopic and hyperopic eyes of 29 antimetropic patients with a spherical equivalent (SE) difference of at least 2.00D between the eyes were included. Axial length (AL), mean corneal keratometry, anterior chamber depth, the proportion of anterior chamber depth in AL, crystalline lens power, central macular thicknesses, disc-to-fovea distance, fovea-disc angle, peripapillary retinal nerve fibre layer (RNFL) thicknesses, and subfoveal choroidal features were compared between the eyes. The prevalence of amblyopia was determined. Refractive parameters and total astigmatic profile were evaluated in eyes with and without amblyopia. RESULTS: The median absolute SE and AL differences between the eyes were 3.50D (interquartile range:1.75) and 1.18 mm (interquartile range:0.76), respectively (p < 0.001). Myopic eyes had lower crystalline lens power and proportion of anterior chamber depth in AL, and longer disc-to-fovea distance. Macular thicknesses, global RNFL, and temporal RNFL were thicker in myopic eyes, and there was no difference in other RNFL quadrants. Despite the increase in the choroidal vascularity index, other choroidal parameters were decreased in myopic eyes. Amblyopia was found in three of the myopic eyes and seven of the hyperopic eyes (p = 0.343). The highest interocular SE and AL difference and the highest frequency of anisoastigmatism were observed in patients with amblyopia in the myopic eye. CONCLUSION: Each ocular structure may respond differently to, or may be affected differently by, ametropic conditions.

Incidental appendiceal neoplasms: Single-centre results.

BACKGROUND: Histopathological examination of appendectomy specimens may reveal malignancies. Based on these results, either appendectomy is sufficient or sometimes a further treatment protocol can be needed. In this study, malignancy-diagnosed cases on appendectomy specimen were examined. METHODS: Patients who underwent appendectomy between January 2013 and December 2018 with a pre-diagnosis of acute appendicitis were evaluated retrospectively and those cases with malignancy were included in the study. Patients' age, sex, tumor type, tumor diameter, tumor grade, tumor localization, surgical margin, Ki-67 index, state of lymphovascular invasion, state of peri-neural invasion, and follow-up period duration were recorded. RESULTS: On examination of 2336 appendectomy specimens, 16 patients (0.7%) were found to have neuroendocrine tumors (NET), 11 patients (0.5%) were found to have low-grade mucinous neoplasm (LAMN), and five patients (0.2%) were found to have primary appendix carcinomas. Appendix tumors usually present with acute appendicitis symptoms. Despite re-operation with right hemicolectomy (RHC) being required in the treatment of adenocarcinoma cases, appendectomy provides adequate treatment in most cases with NET and LAMN. With these tumors, which usually have a benign prognosis, it is important to perform the necessary screening in the postoperative period and not to interrupt follow-up.

MicroRNA-626 inhibits mTOR pathways activity of retinal pigment epithelial cells by targeting SLC7A5 in human ARPE-19 Cells.

Recent studies have shown that miRNAs are associated with the pathological process involved in age-related macular degeneration (AMD). However, the microRNA-mediated post-transcriptional regulation in human retinal pigment epithelium (RPE) cells has not been adequately investigated. We investigated how miR-626 inhibits mTOR activity pathways and pathway-related genes in retinal pigment epithelial cells by targeting the solute carrier family seven-member 5 (SLC7A5) in ARPE19 cells.    We transfected mir-626 mimic, mir-626 inhibitör and siRNA in human retinal pigment epithelial cell line was examined using RT-PCR and western blot, respectively. We knocked down mir-626 levels and overexpression by mir-626-siRNA transfection of human RPE cell lines, and using an MTT assay, we assessed the role of SLC7A5 on RPE cell proliferation. We additionally measured the expression of mTOR, Akt1, caspase 3, Bax, SLC17A7, SLC17A8, Creb1, Pten, HIF1A, HIFI. The findings demonstrate that mir-626 inhibits SLC7A5 gene expression and proliferation of ARPE-19 cells. Short interfering RNA (siRNA) mediated suppression of SLC7A5, a predicted target of mir-626, has the same effect on ARPE-19 cells. We identified how miR-626 causes apoptosis and macula degeneration in RPE cells by targeting SLC7A5 through the mTOR signaling pathway. miR-626 was an essential regulator of the expression of the Slc7a5 gene. Importantly, we determined that miR-626 is essential to play a role in AMD. This research project shows that SLC7A5 is a direct target of mir-626 in ARPE-19 cells for the first time.

Detection and Classification of Diabetic Macular Edema with a Desktop-Based Code-Free Machine Learning Tool.

Objectives: To evaluate the effectiveness of the Lobe application, a machine learning (ML) tool that can be used on a personal computer without requiring coding expertise, in the recognition and classification of diabetic macular edema (DME) in spectral-domain optical coherence tomography (SD-OCT) scans. Materials and Methods: A total of 695 cross-sectional SD-OCT images from 336 patients with DME and 200 OCT images of 200 healthy controls were included. Images with DME were classified into three main types: diffuse retinal edema (DRE), cystoid macular edema (CME), and cystoid macular degeneration (CMD). To develop the ML model, we used the desktop-based code-free Lobe application, which includes a pre-trained ResNet-50 V2 convolutional neural network and is available free of charge. The performance of the trained model in recognizing and classifying DME was evaluated with 41 DRE, 28 CMD, 70 CME, and 40 normal SD-OCT images that were not used in the training. Results: The developed model showed 99.28% sensitivity and 100% specificity for class-independent detection of DME. Sensitivity and specificity by labels were 87.80% and 98.57% for DRE, 96.43% and 99.29% for CME, and 95.71% and 95.41% for CMD, respectively. Conclusion: To our knowledge, this is the first evaluation of the effectiveness of Lobe with ophthalmological images, and the results indicate that it can be used with high efficiency in the recognition and classification of DME from SD-OCT images by ophthalmologists without coding expertise.

Preventive effects of Capparis Spinose extract on experimental periodontitis in rats: a histopathological and biochemical study.

This study aimed to assess the effectiveness of Capparis Spinose (CS) in preventing the initiation and progression of experimental periodontitis and to evaluate the effect of its on systemic oxidative stress in rats by experimental periodontitis model. Twenty-four male rats were equally divided into; Ligatured (L), non-ligatured (NL), and Ligatured with CS (11 days/day per 20 mg/kg) (LC) groups. Experimental periodontitis was induced with the silk suture technic. Alveolar bone loss was examined, and total antioxidant capacity(TAOC), total oxidant status(TOS), and oxidative stress index(OSI) were analyzed in rat serum. Although; alveolar bone loss showed statistically significant lower values in the LC group compared to L (p < 0.05), not NL. In the LC group, osteoclast and osteoblast numbers were statistically significant compared to L, but there were no statistical differences between LC and NL. Serum TAOC levels were significantly lower in group L compared to others and also LC group showed significant differences from NL. TOS and OSI levels were significantly higher in group L than in other groups. Within the limitation of the present study, it can be said that the destruction via local inflammation that may occur after the experimental periodontitis can be prevented by using CS.

HENLE FIBER LAYER THICKNESS AND AREA MEASUREMENT IN TYPE 2 DIABETES MELLITUS WITH AND WITHOUT RETINOPATHY USING A MODIFIED DIRECTIONAL OPTICAL COHERENCE TOMOGRAPHY STRATEGY.

PURPOSE: To investigate the thicknesses and areas of Henle fiber layer (HFL), outer nuclear layer, and outer plexiform layer in the eyes of patients with diabetes with no diabetic retinopathy, in eyes with nonproliferative diabetic retinopathy without diabetic macular edema, and in healthy eyes using a modified directional optical coherence tomography strategy. METHODS: In this prospective study, the no diabetic retinopathy group included 79 participants, the nonproliferative diabetic retinopathy group comprised 68 participants, and the control group had 58 participants. Thicknesses and areas of Henle fiber layer, outer nuclear layer, and outer plexiform layer were measured on a horizontal single optical coherence tomography scan centered on the fovea using directional optical coherence tomography. RESULTS: The foveal, parafoveal, and total HFL were significantly thinner in the nonproliferative diabetic retinopathy group than in the no diabetic retinopathy group and the control group (all P < 0.05). The no diabetic retinopathy group had significantly thinner foveal HFL thickness and area compared with the control group (all P < 0.05). The nonproliferative diabetic retinopathy group had significantly thicker outer nuclear layer thickness and area in all regions than the other groups (all P < 0.05). The outer plexiform layer measurements did not differ between the groups (all P > 0.05). CONCLUSION: Directional optical coherence tomography provides isolated thickness and area measurement of HFL. In patients with diabetes, the HFL is thinner, and HFL thinning begins before the presence of diabetic retinopathy.

Expert recommendations for the management of diabetic macular edema with intravitreal dexamethasone implant: A Turkish Delphi study.

PURPOSE: To provide consensus on the clinical use of intravitreal dexamethasone (DEX) implant for the treatment of diabetic macular edema (DME) in Turkey. METHODS: A panel of 22 retina experts prepared 77 statements of recommendation, and 80 retinal specialists practicing in Turkey were chosen to vote either in support or against each one. A Delphi-based method was used through which the ophthalmologists were able to view all of the results anonymously after two rounds and modify their subsequent answers. The survey was conducted via a mini website, and statements without consensus were resent to the specialists with the latest vote results a week later. RESULTS: A total of 72 ophthalmologists answered the first and second round questions. After the first stage, consensus was achieved on 55 of the statements, leaving 22 without agreement. After the second stage, consensus was reached on 11 of the remaining statements. Strong consensus was achieved on statements regarding the etiopathogenesis of DME and the first-line indications and safety of the DEX implant procedure. The panel recommended the use of DEX implant for patients with an arterial thromboembolic event in the last three months and also agreed that pro re nata DEX implant treatment not only provides better outcomes for DME patients but also reduces the treatment burden for those who could not receive an adequate number of anti-vascular endothelial growth factor (VEGF) injections. CONCLUSION: This study provides clinical consensus and recommendations about the use of DEX implant in the clinical practice of DME management in Turkey.

Optical coherence tomography image dataset of textile fabrics.

We record Optical coherence tomography (OCT) images of various textile fabrics. Each textile fabric consisted of one material only: wool, cotton or polyester. We took OCT images from three different fabrics for each material type giving a total of 9 different fabrics. We scan each material at least a hundred times at different places on each surface. In order to have approximately consistent data between samples, the scans for each image were fixed to 2 mm scan length and saved in a portable network format. We divide the material data into three categories. Groups 1, 2, and 3 consisted only of cotton, wool, and polyester fabrics, respectively. These were placed in folders, becoming the labelled dataset for deep learning training classes. We publish this OCT fabric image dataset publicly. Researchers can utilize the data to train deep learning networks, test existing machine learning algorithms, or develop new systems for automated material classification and recycling.

Effect of foveal herniation on surgical outcomes in patients with idiopathic epiretinal membrane.

PURPOSE: This study aimed to compare the anatomical and visual outcomes of idiopathic epiretinal membrane peeling surgery, with and without foveal herniation. METHODS: This retrospective, comparative, two-center study included age- and sex-matched patients exhibiting an idiopathic epiretinal membrane with and without foveal herniation (epiretinal membrane + foveal herniation group and epiretinal-membrane-only group, respectively). The baseline best-corrected visual acuity and central foveal thickness were compared within the groups through months 1, 3, 6, and 12 of follow-up postoperatively. Then, changes in these two parameters at all follow-up points were compared between the groups. RESULTS: We enrolled 16 patients per study group. The baseline best-corrected visual acuity and central foveal thickness were not significantly different between the two groups (p>0.05). Compared with the baseline, both the best-corrected visual acuity and central foveal thickness improved significantly in both groups in all follow-ups (p<0.05), except for the best-corrected visual acuity of the epiretinal-membrane-only group after month 1 (p<0.05). The mean best-corrected visual acuity improvement after month 1 and the mean central foveal thickness reduction after months 1, 3, and 6 were significantly better in the foveal herniation + epiretinal membrane group than in the epiretinal-membrane-only group (p<0.05). However, the best-corrected visual acuity and central foveal thickness changes were not significantly different between the groups at the final visit (p>0.05). CONCLUSIONS: Although epiretinal membrane + foveal herniation demonstrated prompt anatomical and functional improvement, foveal herniation occurrence did not affect the final surgical outcomes in patients with idiopathic epiretinal membrane.

Effect of foveal herniation on surgical outcomes in patients with idiopathic epiretinal membrane / O Efeito da herniação foveal nos resultados cirúrgicos em pacientes com membrana epirretiniana idiopática

ABSTRACT Purpose: This study aimed to compare the anatomical and visual outcomes of idiopathic epiretinal membrane peeling surgery, with and without foveal herniation. Methods: This retrospective, comparative, two-center study included age- and sex-matched patients exhibiting an idiopathic epiretinal membrane with and without foveal herniation (epiretinal membrane + foveal herniation group and epiretinal-membrane-only group, respectively). The baseline best-corrected visual acuity and central foveal thickness were compared within the groups through months 1, 3, 6, and 12 of follow-up postoperatively. Then, changes in these two parameters at all follow-up points were compared between the groups. Results: We enrolled 16 patients per study group. The baseline best-corrected visual acuity and central foveal thickness were not significantly different between the two groups (p>0.05). Compared with the baseline, both the best-corrected visual acuity and central foveal thickness improved significantly in both groups in all follow-ups (p<0.05), except for the best-corrected visual acuity of the epiretinal-membrane-only group after month 1 (p<0.05). The mean best-corrected visual acuity improvement after month 1 and the mean central foveal thickness reduction after months 1, 3, and 6 were significantly better in the foveal herniation + epiretinal membrane group than in the epiretinal-membrane-only group (p<0.05). However, the best-corrected visual acuity and central foveal thickness changes were not significantly different between the groups at the final visit (p>0.05). Conclusions: Although epiretinal membrane + foveal herniation demonstrated prompt anatomical and functional improvement, foveal herniation occurrence did not affect the final surgical outcomes in patients with idiopathic epiretinal membrane.

RESUMO Objetivo: Comparar os resultados anatômicos e visuais da cirurgia com peeling da membrana epirretiniana idio pática na presença e ausência de herniação foveal. Métodos: Estudo retrospectivo, comparativo, de dois centros. Pacientes com membrana epirretiniana idiopática pareados por idade e sexo com herniação foveal (grupo membrana epirretiniana + herniação foveal) e sem herniação foveal (grupo apenas com membrana epirretiniana) foram incluídos. Mudanças na acuidade visual melhor corrigida e espessura foveal central em todos os pontos de acompanhamento foram comparadas entre os grupos. A linha de base da melhor acuidade visual corrigida e a espessura foveal central foram comparadas dentro dos grupos no 1º, 3º, 6º e 12º meses de acompanhamento após a cirurgia Resultados: Dezesseis pacientes com membrana epirretiniana + olhos com herniação foveal e 16 pacientes com olhos apenas com membrana epirretiniana foram incluídos no estudo. Não houve diferença significativa entre os grupos na linha de base com melhor acuidade visual corrigida e espessura foveal central (p>0,05), exceto para a melhor acuidade visual corrigida do grupo da membrana epirretiniana após o 1º mês (p> 0,05), a melhor acuidade visual corrigida e a espessura foveal central melhoraram significativamente em ambos os grupos em todos os acompanhamentos em comparação com a linha de base (p<0,05). A média da melhor acuidade visual corrigida melhorou após o 1º mês e a redução média da espessura foveal central após o 1º, 3º e 6º meses foram significativamente melhores no grupo de herniação foveal + membrana epirretiniana do que no grupo com apenas membrana epirretiniana (p<0,05). Não houve diferença significativa na melhor acuidade visual corrigida e nas alterações da espessura foveal central entre os grupos na visita final (p>0,05). Conclusões: Embora uma melhora anatômica e funcional bem mais precoce tenha sido mostrada no grupo membrana epirretiniana + herniação foveal, a presença de her niação foveal não afetou os resultados cirúrgicos finais em pacientes com membrana epirretiniana idiopática.

Comparison of the non-absorbable polymer clips, knot-tying, and loop ligature appendiceal stump closure methods in laparoscopic appendectomy.

OBJECTIVE: In laparoscopic appendectomy (LA), closure of the appendix stump is important. This method must be safe and easy-to-use as well as an economical one. We compared three methods of the appendix stump closure in terms of safety, easiness, and financial cost. MATERIALS AND METHODS: Three-hundred and ten LA patients operated between January 2011 and December 2019 and appendix stump was closed using one of the three methods, namely, non-absorbable polymeric clips (Group 1, n = 126), knot-tying group (Group 2, n = 101), and laparoscopic loop ligature group (Group 3, n = 83) were retrospectively analyzed in terms of stump leakage, infection, operation, and hospital stay duration. RESULTS: There were 148 female and 162 male patients. The mean age was 33.57 ± 12.60 years. There was not any appendiceal stump leakage nor intra-abdominal infection in none of the groups. Local trocar site infection in 11 patients was medically treated. Surgical site infection and hospital stay period did not show statistically important difference among the groups. The operation duration in Group 1 was found to be shorter compared to the other groups. CONCLUSIONS: All three techniques are safe in LA. Non-absorbable polymer clips provide a shorter operation time. Extracorporeal knot-tying with knot-pusher provides the cheapest closure of the stump.

OBJETIVO: En la apendicectomía laparoscópica (LA), el cierre del muñón del apéndice es importante. Comparamos tres métodos de cierre de tocones del apéndice en términos de seguridad, facilidad y costo financiero. MATERIALES Y MÉTODOS: Se incluyeron 310 pacientes de AL intervenidos entre 2011-2019 con cierre del muñón del apéndice mediante uno de los tres métodos: clips poliméricos no absorbibles (grupo 1), grupo de anudado (grupo 2) y grupo de ligadura de asa laparoscópica (grupo 3). Se analizaron las complicaciones, la operación y la duración de la estancia hospitalaria. RESULTADOS: Hubo 148 pacientes mujeres y 162 hombres. La edad media fue de 33.57 ± 12.60 años. No hubo ninguna fuga del muñón apendicular ni infección intraabdominal en ninguno de los grupos. La infección local del sitio del trocar en 11 pacientes fue tratada médicamente. La infección del sitio quirúrgico y el período de estancia hospitalaria no mostraron diferencias estadísticamente importantes entre los grupos. CONCLUSIONES: Las tres técnicas son seguras en LA. Los clips de polímero no absorbible brindan un tiempo de operación más corto. El atado de nudos extracorpóreo con empujador de nudos proporciona el cierre más económico del muñón.

Evaluation of the protective effects of non-thermal atmospheric plasma on alveolar bone loss in experimental periodontitis.

OBJECTIVES: The inhibition of bone destruction is one of the main goals of periodontitis treatment. The aim of this study was to investigate the protective effects of non-thermal atmospheric plasma (NTAP) on alveolar bone loss radiographically, histomorphometrically, and histologically in experimental periodontitis in rats. MATERIALS AND METHODS: A total of twenty-eight rats were randomly divided into three groups: control group (CG) (n = 8), periodontitis group (PG) (n = 10), and NTAP group (NTAPG) (n = 10). In PG and NTAPG, experimental periodontitis was created with ligating. The kINPen 11 plasma jet was applied around the ligatured teeth in NTAPG. The samples from each group were radiographically assessed with microcomputed tomography (micro-CT); then, histological (presence of osteoclasts and inflammatory cells) and immunohistochemical (immunoreactive of OCN and ALP) findings were compared. RESULTS: The results revealed a significant increase in alveolar bone loss in the PG compared with CG and NTAPG (p < 0.05). Inflammation, alveolar resorption, and cement damage were reduced significantly in the group treated with NTAP compared to the PG (p < 0.05). Significantly higher levels of osteoclasts were detected in the PG in comparison with both CG and NTAPG (p < 0.05). The lowest osteocalcin and ALP values were determined in PG, and the differences between PG and both groups were also significant (p < 0.05). CONCLUSION: Within the limitations of the present study, we can say that NTAP may enhance the bone remodeling process by inhibiting inflammation and preventing alveolar bone destruction. CLINICAL RELEVANCE: NTAP has clinical potential for accelerating and treating periodontitis with the inflammatory response modulation, osteoblast differentiation, and alveolar bone loss reduction.

Cilioretinal artery occlusion with paracentral acute middle maculopathy associated with COVID-19.

The purpose of the study is to describe cilioretinal artery (CILRA) occlusion that is presumed to be associated with COVID-19 without severe respiratory distress and inform ophthalmologists of unusual ocular presentations of COVID-19. Here, we present the first case of a patient with isolated CILRA occlusion and paracentral acute middle maculopathy (PAMM) after recently polymerase chain reaction-proven COVID-19. A 26-year-old female patient presented with a visual field defect in her left eye for 2 days and decreased vision compared to her right eye. It was learned that the patient had a laboratory-proven COVID-19 infection with mild respiratory symptoms that did not require hospitalization 2 weeks ago. Fundus examination revealed retinal edema in the left eye area supplied by the CILRA. Spectral-domain optical coherence tomography revealed a prominent hyperreflective band at the inner nuclear layer level. These findings led us to the diagnosis of isolated CILRA occlusion and PAMM associated with recent COVID-19. CILRA occlusion and PAMM could be associated with the inflammatory and procoagulant condition caused by the SARS-CoV-2 infection.

Regional analysis of segmented-macular structure in patients with myopic anisometropia.

PURPOSE: To compare intraretinal layers between the eyes in patients with myopic anisometropia, and evaluate the relationship between the layers with spherical equivalent (SE) and axial length (AL). METHODS: In this retrospective study, the more myopic (MM) and fellow (F) eyes of 41 patients with myopic anisometropia, and 38 emmetropic (± 0.50 diopter) control (C) eyes were inclueded. Intraretinal layer segmentation was performed by optical coherence tomography. Global volumes of retinal layers and their thicknesses in nine macular regions were compared. Correlation analysis was used to determine the relationship with SE and AL in each layer. RESULTS: Total retinal, ganglion cell (GCL), inner nuclear (INL), and outer plexiform (OPL) layer volumes in MM eyes were less than in C eyes, while INL and OPL were less than in F eyes. There was no difference in the fovea, except for the retinal pigment epithelium. In MM eyes, only INL and OPL were thin in at least one perifoveal and parafoveal quadrant compared to F eyes. Only INL and OPL thicknesses were significantly correlated with both SE and AL in all perifoveal quadrants. In contrast to the thinning found in MM eyes, the only layer in which thickening was detected to compare to C eye was nerve fiber layer (NFL), which correlated positively with SE and negatively with AL. CONCLUSION: While the fovea is less affected by myopia, thinning becomes remarkable in the perifoveal quadrants. Despite thinning in many layers, especially INL and OPL, NFL thickening may be seen due to myopia.

Effects of 1,25 Dihydroxyvitamin D3 on Human Retinal Pigment Epithelial Cell Lines.

PURPOSE: To assess the effects of 1,25 dihydroxyvitamin D3 (vitamin D3) either alone or under oxidative damage on human retinal pigment epithelium cell lines. METHODS: The human retinal pigment epithelial cell lines were pretreated with hydrogen peroxide with different concentrations (100-1000 µM) and durations (4, 12 and 24 h) to determine the appropriate dose. A group of cells were treated with vitamin D3 alone, and another group of cells were co-treated with different concentrations of (10-100 nM) vitamin D3 and hydrogen peroxide. Anti-cytotoxic, anti-apoptotic and anti-genotoxic effects of vitamin D3 on the hydrogen peroxide treated cell line were evaluated. In addition, mitochondrial membrane potentials of treated cell lines were measured. RESULTS: Vitamin D3 showed statistically significant anti-cytotoxic effects and increased cell viability in all concentrations (p < 0.001). It has also significantly decreased the intracellular ROS generation at concentrations between 10-60 nM and increased intracellular reactive oxygen species in high doses over 90 nM (p < 0.01). When apoptosis was evaluated, vitamin D3 caused statistically significant decrease in a dose-dependent manner (p < 0.001). In terms of DNA damage which was caused by oxidative stress, it was observed that vitamin D3 significantly reduced the damage in a dose-dependent manner (p < 0.001). At the doses of 10-50 nM, vitamin D3 significantly decreased the mitochondrial membrane potential (p < 0.01). CONCLUSION: Our study suggests that 1,25 (OH)2 D3 is capable for alleviating the oxidative damage in ARPE cell lines. With these results, vitamin D is thought to be a therapeutic alternative for the prevention of age-related macular degeneration. This warrants further investigations.