Examination of retinal vascular density changes via optical coherence tomography angiography in patients with glaucoma.

PURPOSE: The aim of this study was to investigate the changes in vessel density (VD) in glaucoma patients and to investigate the relationship between VD and structural parameters using optical coherence tomography angiography. METHODS: Our study included 25 primary open-angle glaucoma (POAG) patients, 25 pseudoexfoliation glaucoma (PXG) patients and 25 healthy individuals. All patients underwent 6 × 6 mm retinal angiography (upper limit: internal limitan membrane [ILM], lower limit: 10 µm inferior to inner plexiform layer) and 4.5 × 4.5 mm disk angiography (upper limit: ILM, lower limit: posterior border of the retinal nerve fiber layer [RNFL]) via an optical coherence tomography (OCT) system (AngioVue, Optovue). Measures of vascular density were as follows: total area VD (tVD), intrapapillary VD (iVD), peripapillary VD (pVD) and parafoveal VD (pfVD). In addition to performing comparisons, the correlations between pVD, retinal nerve fiber layer (RNFL) thickness and optic nerve head measurement results were investigated. RESULTS: A total of 75 individuals were included in our study. In the POAG and PXG groups, tVD and pVD values were significantly lower than the control group (median tVDs were: 45.4, 45.9, 50.0, and median pVDs were: 50.0, 50.3, 53.1, respectively) (confidence intervals were: - 9.8/- 1.1 for pVD and - 8.6/- 1.4 for tVD). Significantly lower pf-VD values were detected in the PXG group compared to the control group (p < 0.05). There were strong positive correlations between RNFL thickness and pVD in in glaucoma groups (p < 0.001). There was no correlation between pVD and disk area, intraocular pressure and age in glaucoma patients. Patients using beta-blockers had significantly lower tVD and pVD values compared to those who did not (p < 0.05). CONCLUSION: The low VD values in glaucomatous eyes and the strong correlations between that values and RNFL thickness demonstrate a relationship between structural parameters and vascular parameters.

Assessment of cataract forming effect of diabetes in young adults by lens densitometer.

PURPOSE: To investigate the effect of the diabetes on cataract formation by Pentacam Scheimpflug topography system. MATERIALS AND METHODS: Thirty diabetic patients and thirty-five healthy control subjects were included in the study. Exclusion criteria were smoking, high refractive error, any systemic disease or drug usage associated with cataract formation and to have diabetic retinopathy. The duration of diabetes and HbA1c level were recorded. A comprehensive ophthalmologic examination was performed in all cases. Pentacam (Oculus, Wetzlar, Germany) three-dimensional lens densitometer module was used to measure density of anterior, nuclear and posterior lens regions. RESULTS: Mean age of group 1 and group 2 was 37.80 ± 5.51 years and 36.51 ± 3.77 years, respectively. There were not any difference between groups in the means of age and sex (P = .271; P = .700). The mean duration of diabetes in group 1 was 4.23 ± 3.71 years (6 months-10 year). The mean HbA1c level was 8.12 ± 2.07% (5.4-12.7%). Anterior, nuclear and posterior mean lens densitometry measurements were significantly higher in group 1 (diabetic group) than group 2 (control group) [(8.90 ± 0.59%; 8.05 ± 0.72% P = < .001), (7.52 ± 0.31%; 7.00 ± 0.59% P = < .001), (7.25 ± 0.31%; 6.90 ± 0.73% P = .006), respectively]. CONCLUSION: Diabetes may have cataractous effect in anterior, nuclear and posterior regions of the lens.

Analysis of multiple sclerosis patients with electrophysiological and structural tests.

We aimed to analyze the effects of progressive myelin loss and neurodegeneration seen in patients with multiple sclerosis (MS) on visual tract with electrophysiological and structural tests. Fifty-one patients diagnosed with MS in the Neurology Department were followed up in neuro-ophthalmology outpatient clinic irrespective of their visual symptoms, and were included in our study. The patients were classified as the ones with the history of optic neuritis (group II) and ones without the history (group I) of optic neuritis. The data, including clinical presentation, retinal nerve fiber layer thickness (RNFLT) measurements, pattern visual evoked potential (pVEP) and flash electro retino grams (ERG) test results, were recorded. In our study, comparison of pVEP test latencies of groups I and II with each other, and with those of healthy subjects revealed statistically significant differences (p < 0.05). The analysis of rod functions on ERG did not show any significant changes (p > 0.05). However, both groups showed significantly decreased cone b-wave amplitudes, elongation of latencies, and decreased flicker amplitudes on cone and flicker potentials obtained after light adaptation (p < 0.05). There was significant thinning in RNFLT of the both groups when compared to the normal standards. The difference between two groups was statistically significant (p < 0.05). Axon loss is seen in the optic nerve with subclinical or acute optic neuritis in patients with MS. RNFLT analysis and electrophysiological tests are of great importance in diagnosis of MS, as well as to determine progression and to direct neuroprotective therapy in patients diagnosed with MS. Objective analysis methods gain more importance in the diagnosis and follow-up of MS patients, parallel to technological advancements.

The effect of deep sclerectomy on ocular blood flow: a 6-month clinical trial.

BACKGROUND/AIM: To investigate the effect of deep sclerectomy on retrobulbar blood flow. MATERIALS AND METHODS: This prospective study included 20 eyes of 20 patients with open angle glaucoma. Color Doppler imaging (CDI) examinations were performed before and 2, 12, and 24 weeks after deep sclerectomy. Peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) were measured for the ophthalmic artery (OA), central retinal artery (CRA), and temporal and nasal short posterior ciliary arteries (SPCAs) at each examination and the results were compared. RESULTS: A significant decrease was determined in intraocular pressure (IOP) (P < 0.001) and a significant increase in ocular perfusion pressure (OPP) (P < 0.001) at all postoperative examinations. The EDV in OA increased significantly (P < 0.001), but the change in RI was not statistically significant (P = 0.67). EDV increased and RI decreased significantly in CRA and SPCA (P < 0.001). CONCLUSION: Deep sclerectomy decreases IOP and increases OPP significantly. Retrobulbar blood flow was seen to improve after deep sclerectomy.

Geleophysic dysplasia associated with bilateral angle closure glaucoma.

In this case report, we present occurrence of bilateral angle closure glaucoma in a 9-year-old girl with geleophysic dysplasia. Bilateral YAG laser iridotomy was applied, but intraocular pressure (IOP) remained at high levels, necessitating bilateral trabeculectomy with mitomycin C. On her follow-up examinations for 3 years, IOP remained in the mid-20s with no need for further intervention or antiglaucoma medication. There are few reports describing the ocular findings of geleophysic dysplasia in literature. To our knowledge, this is the first case report describing an application of glaucoma surgery and its results at geleophysic dysplasia.

Decompression retinopathy and possible risk factors.

PURPOSE: To discuss the underlying mechanisms in decompression retinopathy. METHODS: Report of two cases. RESULTS: Retinal hemorrhages secondary to decompression retinopathy occurred following combined trabeculotomy-trabeculectomy with mitomycine-C (MMC) in one eye of a case of congenital glaucoma and pars plana vitrectomy-lensectomy in a case of vitreous condensation secondary to pars planitis. Both cases were operated under general anesthesia. Postoperative hypotony did not take place in either eye. The same surgical procedure was performed on the other eye of the patient with congenital glaucoma 1 week apart. Postoperative decompression retinopathy was not seen in this eye despite hypotony was recorded. CONCLUSION: Valsalva manoeuvre, hypotony and other factors may play a role individually or in combination in the pathogenesis of decompression retinopathy.