Evaluation and comparison of optical coherence tomography angiography (OCTA) parameters in normal and moderate myopic individuals.

OBJECTIVE: The objective of this study was to evaluate and compare Optical Coherence Tomography Angiography (OCTA) parameters in patients with moderate myopia and healthy individuals retrospectively. METHODS: A total of 80 male individuals aged 18-20 years were included in the study with 40 moderate myopic and 40 healthy persons. All participants underwent detailed ocular examination including refraction, intraocular pressure (IOP), visual acuity, biomicroscopy, OCTA measurement and optic biometry measurement. Retinal, retinal nerve fiber layer and choroidal layer thicknesses were evaluated in µm with the help of the software available in the OCTA device. RESULTS: The mean axial length (24.32 ± 0.53 mm) was statistically significantly higher in the moderate myopic group (24.32 mm) compared to the healthy group (23.33 ± 0.61 mm) (p < 0.001). Spherical equivalent (SE) was found as -3.79 ± 0.91 D in the moderate myopic group and -0.22 ± 0.32 D in the healthy group (p < 0.05). The mean superficial foveal mean density (FovSupMVD) and the mean deep foveal mean density (FovDepMVD) were statistically significantly lower in the moderate myopic group than in the healthy group (both, p < 0.001). The mean retinal temporal thickness (RTt) was statistically significantly lower in the moderate myopic group (p = 0.017). There was a mild negative correlation between axial length and FovSupMVD, FovDepMVD in myopes. In axial length ROC analysis, the cutoff value for moderate myopes was found to be 24.15 mm. Mean superficial foveal mean density (FovSupMVD) and mean deep foveal mean density (FovDepMVD), mean retinal temporal thickness (RTt) were significantly lower in the group above 24.15 mm axial length compared to the group below 24.15 mm axial length (all three, p < 0.001). Foveal avascular zone was significantly higher in the group above 24.15 mm axial length (p = 0.016) CONCLUSION: The results of our study indicate that the mean axial length and spherical equivalent were significantly higher, while retinal temporal thickness, the mean superficial foveal mean density and the mean deep foveal mean density were significantly lower in patients with myopia up to -6.0 D compared to the healthy individuals.

Preoperative Evaluation of White Cataracts with the Pentacam.

PURPOSE: To evaluate the use of the Pentacam to analyse the presence or absence of fluid pockets under the anterior capsule and their significance in terms of surgical management and prevention of complications. SETTINGS: Abant Izzet Baysal University Hospital, Bolu, Turkey DESIGN: Randomized, masked, prospective design METHODS: 60 patients with mature cataracts underwent standard phacoemulsification (Phaco) and intraocular lens (IOL) implantation. Patients were divided into 3 groups. Group 1 underwent Phaco+IOL implantation without imaging by Pentacam. Group 2 had fluid detected in Pentacam imaging before the operation and underwent Phaco+IOL implantation with Brazilian method. Group 3 had no fluid detected in Pentacam imaging before the operation and underwent standart Phaco+IOL implantation operation. RESULTS: When the complication rates of 3 different groups were examined separately, they were found to be 15 % in group 1; 5 % in group 2 and 5 % in group 3, respectively. When compared in pairs as Group 1-2, 1-3, and 2-3, respectively (p < 0.01), (p < 0.01), (p > 0.05). The nuclear density of Group 2 and Group 3 was measured, resulting in 30.2 % and 29.6 %, respectively (P = 0.614). Lens thickness, patients with fluid (+) had a thickness of 5.35 mm, while patients with fluid (-) had a thickness of 3.96 mm (p < 0.05). CONCLUSION: Patients who are not imaged with pentacam before surgery experience more complications than other groups because the presence of fluid is unknown. Central lens thickness was higher in patients with fluid, and there was no significant difference in nuclear density between the groups with and without fluid. Pentacam can show the presence of supcapsular fluid and we recommend that imaging tools be more widely used in cataract surgery. We think that this will enable surgeons to make a more accurate surgical planning and reduce the risk of complications.

The relationship between Choroidal Vascular Index and non-invasive ultrasonographic atherosclerosis predictors.

BACKGROUND: This study explores the intricate connections between choroidal vascular index (CVI) and non-invasive ultrasonographic atherosclerosis predictors, shedding light on the potential links between ocular vascular dynamics and systemic cardiovascular health. METHODS: We conducted a cross-sectional analysis of 81 participants, assessing CVI, intima-media thickness (IMT), extra-media thickness (EMT), and the PATIMA index. The presence of coronary artery disease (CAD) was also evaluated. Statistical methods included descriptive statistics, t-tests for group comparisons, Spearman correlation analysis, and receiver operating characteristic (ROC) curve analysis. RESULTS: Our findings revealed that patients with CAD had lower CVI values compared to those without CAD, underscoring a potential association between CVI and CAD. Significant negative correlations were observed between CVI and IMT, EMT, PATIMA, and CAD. ROC curve analysis identified optimal CVI cutoff values for hypertension and CAD detection, showcasing its potential as a diagnostic marker. DISCUSSION: Our results align with existing literature on ocular vascular changes, supporting the notion that CVI may be a promising indicator of systemic vascular conditions. The study contributes to the broader understanding of the relationships between ocular and cardiovascular health, providing a foundation for future research and clinical applications. CONCLUSION: The study suggests that CVI holds clinical relevance as a non-invasive marker for identifying systemic conditions, offering insights into the fields of neurology, physical therapy, and rehabilitation. Addressing its limitations, this research encourages further investigation into the multifaceted connections between CVI and atherosclerosis predictors.

Comparison of the Short-Term Effect of Coffee, Energy Drink, and Water on the Eyes in Young Healthy Subjects.

PURPOSE: We aim to compare the short-term effects of energy drink (ED), coffee, and water on the eyes of young healthy male subjects. MATERIALS AND METHODS: The right eyes of 30 healthy male subjects were included in this study. We measured the intraocular pressure (IOP), mean arterial pressure (MAP), retinal thickness (RT), choroidal thickness (CT), and retinal nerve fiber layer (RNFL) thickness using spectral domain optical coherence tomography (SD OCT). The measurements for RT and CT were taken at the fovea as well as 1,500 µm nasal and temporal to the fovea. The measurements of the subjects were performed on the first day before water consumption and at 30 minutes and 60 minutes following intake of 250 mL of water. Measurements were repeated at the same regime on the second day after drinking 250 mL of coffee containing an equal concentration of caffeine in ED (37.5 mg) and on the third day after drinking 250 mL of ED. Repeated measures one-way analysis of variance test was used for statistical analysis. RESULTS: No significant difference was found for ocular perfusion pressure (OPP), MAP, RT, and IOP between the measurements taken on three consecutive days (p>0.05 for all). The CT values for the central, nasal, and temporal segments were significantly reduced in 0-30 and 0-60 minutes following coffee and ED intake (the range of p-value was <0.001-0.027). CONCLUSIONS: Both coffee and ED intake caused acute and significant decreases in CT that persisted for one hour in young healthy male subjects. The impact of ED intake on CT was attributed mainly to its caffeine content.

The relationship between epicardial adipose tissue and choroidal vascularity index in patients with hypertension.

OBJECTIVE: The choroidal vascularity index (CVI) is a method that measures the density of blood vessels in the choroidal layer and can be used to evaluate the effects of hypertension. In this study we aimed to investigate the relationship between epicardial fat thickness (EFT) and CVI in patients with hypertension. METHODS: This prospective study included 112 patients diagnosed with hypertension and 120 healthy individuals. Patients' demographic data such as age, gender, weight, height, body mass index (BMI), smoking status, and presence of coronary artery disease and diabetes mellitus were recorded. BMI was calculated by dividing a patient's weight in kilograms by their height in metres squared. EFT was measured by echocardiography and CVI was calculated using the optical coherence tomography method. RESULTS: The mean CVI was found to be 66.57 ± 2.21 in the patient group and 69.22 ± 2.39 in the control group and the difference was significant (p < 0.001). The mean EFT was found to be 5.23 ± 3.25 mm in the patients and 2.57 ± 1.97 mm in the control group and the difference was statistically significant (p = 0.003). According to Spearman's correlation analysis, there was a significant positive correlation between BMI and EFT (r = 0.379, p < 0.001) and a significant negative correlation between CVI and EFT (r = -0.412, p < 0.001). CONCLUSION: The CVI value was significantly lower and the EFT value was significantly higher in patients with hypertension compared to non-hypertensive patients. There was a significant positive correlation between EFT and BMI and a significant negative correlation between EFT and CVI.

Investigation of the short-term effects of water drinking test on the eye using optical coherence tomography angiography in young healthy male subjects.

PURPOSE: To evaluate the acute effects of the water drinking test (WDT) on the eye using optical coherence tomography angiography (OCTA) on healthy young male subjects. METHODS: The study included 25 eyes of 25 male subjects. Selected parameters of the retinal vasculature were measured, including macular flow indices, foveal avascular zone, and vessel densities (VDs) of the macula using OCTA. The measurements were taken on the first day without drinking water at 0 min, 30 min and 60 min, then repeated on the second day before drinking water at 0 min, and after drinking water at 30 min and 60 min. The Paired Samples t-test and repeated measures One-way analysis of variance test were used in the statistical analyses. RESULTS: The repeated measures analysis of variance test using Bonferroni adjustment demonstrated a significant increase in superficial and deep foveal VD following WDT (p < 0.001 for both). Intraocular pressure, retinal nerve fibre layer thickness, foveal avascular zone, flow area of choriocapillaris, flow area of outer retina, foveal non-flow area of superficial layer, and retinal thickness measurements showed no significant changes following WDT. CONCLUSIONS: WDT is associated with temporary flow modifications in superficial and deep foveal vascular plexus in young male subjects.

Evaluation of the acute effects of cigarette smoking on the eye of non-Smoking healthy young male subjects by optical coherence tomography angiography.

Purpose: Investigation of the acute effects of cigarette smoking on the eye using optical coherence tomography angiography (OCTA) on young healthy non-smoking male subjects.Materials and methods: The right eye of 25 healthy non-smoking male subjects were included in this study. Selected parameters of the macular and circumpapillary vasculature were measured, including macular flow indices, foveal avascular zone, vessel densities of macula and optic disc using OCTA. The measurements of the subjects were performed on the first day without smoking at 0 min, 5 min, 30 min and 60 min. Measurements were repeated at the same regime on the second day after smoking. Paired samples t-test and repeated measures one-way analysis of variance test was used for the statistical analysis.Results: The repeated measures analysis of variance test using the Bonferroni adjustment demonstrated a significant change for superficial and deep foveal vessel density, flow area of choriocapillaris, and circumpapillary capillary density following smoking (range of p value was <0.001-0.004). Intraocular pressure, foveal avascular zone area, flow area of outer retina and foveal non-flow area of superficial layer measurements did not have any significant changes following smoking (range of p value was 0.192-0.812).Conclusion: In non-smoking cases, even smoking only one cigarette significantly decreased the vessel density parameters at the acute period. Even though there was an increase in measured parameters shortly after smoking, it had lessened when compared to non-smokers, even one hour following smoking.

Factors associated with mortality in patients presenting to the emergency department with severe hypernatremia.

Hypernatremia is a common electrolyte disorder associated with prolonged hospitalization and death. Severe hypernatremia is defined as a serum sodium (Na(+)) concentration >160 mmol/L. To the best of our knowledge, there is little information on patients with severe hypernatremia, Na(+) >160 mmol/L. Therefore, in this study, we aimed to determine the frequency, demographic and clinical characteristics, comorbid conditions and treatment strategies in patients presenting to the emergency department with severe hypernatremia, and also to evaluate the effects of these factors on mortality. A retrospective chart review was performed on patients presenting to the emergency department between January 2011 and June 2014. Patients with Na(+) >160 mmol/L were screened retrospectively via the hospital electronic information management system and patient medical record files. During the 3.5 years of screening, 256 patients (0.04 %) with Na(+) >160 mmol/L presented to the emergency department. The mean age of the patients included in the study was 74.4 ± 15.2 years, mean Na(+) level was 168.7 ± 7.4 mmol/L and, mean mortality was 49.5 % during the hospitalization. Multivariable Cox regression analysis showed that low systolic blood pressure, low pH, Na(+) >166 mmol/L, increased plasma osmolarity, mean sodium reduction rate ≤-0.134 mmol/L/h, dehydration, and, pneumonia to be independently associated with mortality. This study describes the demographic and clinical characteristics of patients with Na(+) >160 mmol/L in a large population along with comorbid conditions, incidence, treatment strategies and, its association with mortality.

Relationship between socioeconomic level, and the prevalence of masked hypertension and asymptomatic organ damage.

BACKGROUND: This study aimed to determine the prevalence of masked hypertension (MHT) and its association with asymptomatic organ damage (AOD) in a low socioeconomic district of Ankara, Turkey. MATERIAL AND METHODS: We retrospectively reviewed data obtained from the medical records of 712 patients with no known diagnosis of hypertension who presented to a polyclinic due to symptoms related to elevated blood pressure (BP) and were screened for MHT. Essential hypertension (EHT) existed in 86 patients screened for AOD. The presence of AOD in patients diagnosed with MHT and EHT was recorded. RESULTS: Among the 712 patients, 206 were diagnosed with EHT. Among the remaining 506 patients, 73 were diagnosed with MHT. The patients with MHT had significantly higher left ventricular mass index, carotid intima-media thickness, and 24-h urinary microalbuminuria level (all indicators of AOD) than those with EHT. CONCLUSIONS: A significantly higher percentage of patients with MHT had AOD, as compared to those with EHT, in a low socioeconomic district of Ankara. Based on this finding, patients who present with hypertensive symptoms but have a normal BP should be advised to measure their BP at home.