Retinal thickness changes in preobese and obese patients without hyperglycemia: Optical coherence tomography study.

PURPOSE: To evaluate retinal thickness changes by optical coherence tomography in preobese and obese patients without hyperglycemia. METHODS: This comparative cross-sectional study was conducted on 55 normal (18.5-24.9 kg/m2), 42 preobese (25-29.9 kg/m2), 34 obese (>30 kg/m2), a total of 131, according to body mass index (BMI) value at the time of examination. All participants were examined in the internal medicine department and fasting serological biochemical and lipid tests were performed, and those with hyperglycemia were excluded from the study. All participants underwent a full ophthalmological examination and sectoral examination of the retina with optical coherence tomography. RESULTS: The study included 55 right eyes of 55 normal, 42 of 42 preobese, and 34 of 34 obese, age- and sex-matched participants, without hyperglycemia. The mean BMI of the normal group was 22.3 ± 1.3, 26.8 ± 1.3 in the preobese group, and 33.2 ± 4.2 in the obese group. Central foveal thickness (normal 229.8 ± 20.1 µm, preobese 234.7 ± 18.8 µm and obese 222.0 ± 23.4 µm, P:0.031) and mean inferior (normal 280.7 ± 55.8 µm, preobese 296.7 ± 11.1 µm and obese 285.3 ± 9.9 µm) thickness in the 3 mm The Early Treatment Diabetic Retinopathy Study (ETDRS) circle was significantly higher in the preobese group and significantly lower in the obese group. Mean nasal, temporal, and superior thickness in the 3 mm ETDRS circle and peripapillary retinal nerve fiber layer was higher in the preobese group and lower in the obese group but this difference was statistically not significant. CONCLUSION: The fact that preobesity, which is not accompanied by hyperglycemia, causes an increase in the thickness of the central macular regions and obesity causes thinning of the retina, supports that lipid metabolism in the body alone can affect retinal thickness changes and retinal neurodegeneration.

Retinal neurodegeneration in metabolic syndrome: a spectral optical coherence tomography study.

AIM: To evaluate the effects of metabolic syndrome (MetS) on retinal neurodegeneration by optical coherence tomography (OCT). METHODS: Patients diagnosed as MetS were compared with the age and sex-matched healthy control group (CG). Waist circumference measurements, fasting serological biochemical tests, and systemic blood pressures of all participants were evaluated. The MetS group was divided into 3 subgroups according to the number of MetS components: hypertension, diabetes mellitus, dyslipidemia (low-, high-density lipoprotein, hypertriglyceridemia), and visceral obesity findings; 3-component MetS3, 4-component MetS4, and all-component MetS5. All patients underwent complete eye examination and spectral OCT retinal imaging. RESULTS: Totally 58 eyes of 58 patients were included in the MetS group and 63 eyes of 63 age and sex-matched healthy subjects were included in CG. MetS group was composed of 22 subjects in MetS3, 21 subjects in MetS4, and 15 subjects in the MetS5 subgroup. Mean foveal thickness (MetS, 218.7±23.1 µm vs CG, 228.8±21.9 µm, P=0.015), mean inferior (MetS, 283.4±17.0 µm vs CG, 288.7±38.4 µm, P=0.002), superior (MetS, 287.0±18.5 µm vs CG 297.3±17.1 µm, P=0.001), nasal (MetS 287.3±16.7 µm vs CG 297.9±13.9 µm, P=0.000) and temporal (274.5±17.6 µm vs CG 285.6±13.6 µm, P=0.000) thickness in the 3 mm Early Treatment of Diabetic Retinopathy Study (ETDRS) circle was significantly lower in the MetS group. There was no statistically significant difference in the mean inferior, superior, nasal, and temporal thickness of 6 mm ETDRS circle, total macular volume, peripapillary and macular retinal nerve fiber layer, macular ganglion cell layer with inner plexiform layer, and ganglion cell complex. No statistically significant difference was found in these values ​​between the MetS3, MetS4, and the MetS5 groups. CONCLUSION: A significant reduction in central macular region thickness in MetS is detected and macular thickness is more susceptible to MetS induced neurodegeneration than peripapillary retinal nerve fiber layer.

Real-Life Data of Patients with Exudative Age-Related Macular Degeneration.

OBJECTIVES: The aim of this study was to examine and provide real-life data of patients with exudative-type age-related macular degeneration (AMD). METHODS: A total of 189 eyes of 160 patients with exudative AMD treated with intravitreal anti-vascular endothelial growth factor therapy (anti-VEGF) injections (ranibizumab 0.3 mg/0.05 mL, aflibercept 2 mg/0.05 mL, bevacizumab 1.25 mg/0.05 mL) were included in the study. Patient demographic characteristics, and details of the clinical examinations, number of injections, best-corrected visual acuity (BCVA) measured with the Snellen chart, optical coherence tomography, and fundus fluorescein angiography images were evaluated at the first visit and during the follow-up period. RESULTS: In the study group, 78 of the patients were female (48.8%) and 82 were male. The mean age was 72.20±8.97 years. While no treatment had been applied to 151 eyes before the first examination, 38 had previously received an intravitreal injection at another center. The mean number of patient visits was 5.83 in the first year, 4.68 in the second year, and 3.84 in the third year, and the mean number of injections was 4.70 in the first year, 2.08 in the second year, and 1.51 in the third year. The mean BCVA change between the first visit and the first, second, and third years was not statistically significant (p>0.05), and a significant change was observed in the mean central macular thickness (p<0.05). CONCLUSION: Anatomical and functional success was achieved with anti-VEGF treatment after fewer injections and visits than have been reported in randomized, controlled, clinical studies in the literature. The number of injections and visits recorded in this study was consistent with the data of other real-life studies.

Secondary iris claw intraocular lens implantation for the correction of aphakia after pars plana vitrectomy.

PURPOSE: The purpose of this study was to evaluate the safety and efficacy of iris claw intraocular lens implantation for correction of aphakia in vitrectomized eyes without capsular support. METHODS: This was a prospective interventional case series. Twelve aphakic vitrectomized eyes without capsular support underwent iris claw intraocular lens implantation. The main outcome measures were changes in uncorrected visual acuity, best-corrected visual acuity, spheric equivalent, corneal endothelial cell density, corneal thickness, central macular thickness, and complications. RESULTS: Mean follow-up was 15.58 +/- 3.80 months with no intraoperative complications. Postoperatively, uncorrected visual acuity increased significantly at all follow-up visits (P < 0.05). Mean best-corrected visual acuity increased 10 letters/2 lines at the final follow-up visit (P = 0.023). Mean postoperative spheric equivalent at the last visit was -1.68 +/- 063 D, and the spheric equivalent was within +/-2.00 D of emmetropia in 9 (75%) eyes. Mean central macular thickness increased only at postoperative Month 3 (P = 0.043). Mean endothelial cell density loss was 23.87% at the last visit. Mean corneal thickness did not change during follow-up (P > 0.05). No corneal edema was observed. Complications were transient intraocular pressure increase (n = 1), cystoid macular edema (n = 1), and haptic dislocation replaced by surgery (n = 1). Retinas remained attached in all eyes. CONCLUSION: Secondary iris claw intraocular lens implantation is clinically safe and effective to correct aphakia in vitrectomized eyes without capsular support. Larger studies with longer follow-up are warranted.