Evaluation of fundus autofluorescence imaging of diabetic patients without retinopathy.

PURPOSE: To evaluate the usefulness of fundus autofluorescence imaging of diabetic patients without retinopathy to investigate early retinal damage. METHODS: Fundus autofluorescence images of patients with type 2 diabetes mellitus without retinopathy (diabetic group) and age-sex matched healthy patients (control group) were recorded with a CX-1 digital mydriatic retinal camera after detailed ophthalmologic examinations. MATLAB 2013a software was used to measure the average pixel intensity and average curve width of the macula and fovea. RESULTS: Fifty-six eyes of 28 patients, as the diabetic group, and 54 eyes of 27 healthy patients, as the control group, were included in this study. The mean aggregation index was 168.32 ± 37.18 grayscale units (gsu) in the diabetic group and 152.27 ± 30.39 gsu in the control group (p=0.014). The mean average pixel intensity value of the fovea was 150.87 ± 35.83 gsu the in diabetic group and as 141.51 ± 31.10 gsu in the control group (p=0.060). The average curve width value was statistically higher in the diabetic group than in the control group (71.7 ± 9.2 vs. 59.4 ± 8.6 gsu, respectively, p=0.03). CONCLUSION: Fundus autofluorescence imaging analysis revealed that diabetic patients without retinopathy have significant fluorescence alterations. Therefore, a noninvasive imaging technique, such as fundus autofluorescence, may be valuable for evaluation of the retina of diabetic patients without retinopathy.

Eyes are mirror of the brain: comparison of multiple sclerosis patients and healthy controls using OCT.

Objective: To evaluate the thickness of choroid and retinal nerve fiber layer (RNFL) in multiple sclerosis (MS) patients with and without optic neuritis using enhanced depth imaging optical coherence tomography (EDI-OCT). Methods: In this cross-sectional study, both eyes of 52 MS patients [n = 104 eyes; 62 eyes of MS patients without optic neuritis (MS-NON) and 42 eyes of MS patients with optic neuritis (MS-ON)] and only one eye of 36 healthy control subjects (n = 36 eyes) were evaluated. Complete ophthalmologic examination and EDI-OCT scanning were completed for all participants. Choroidal thickness measurements were executed at three different points. Results: Choroidal thickness measurements were similar between MS patients and healthy control subjects. However, the mean subfoveal choroidal thickness was increased significantly in MS-ON group (399.13 ± 82.91 µm) compared to MS-NON group (342.71 ± 82.46 µm; p = 0.004). Mean RNFL thickness was significantly reduced in MS patients (90.42 ± 13.31 µm) compared to healthy controls (101.18 ± 10.75 µm; p < 0.001). Moreover, temporal RNFL thickness was significantly thinner in MS-ON group (54 ± 14.50 µm) than MS-NON group (62.15 ± 15.88 µm; p = 0.01). In MS patients, temporal RNFL thickness was correlated with both Expanded Disability Status Score (r = 0.383; p < 0.001) and longer disease duration (r=-0.202; p = 0.04). Conclusion: The results of the present study suggest that RNFL thickness can be used as an important parameter while following up with MS patients. However, more studies using EDI-OCT are required with larger MS patient groups and automated method.

Investigation of possible risk factors in the development of seasonal allergic conjunctivitis.

AIM: To analyze the possible risk factors in the development of seasonal allergic conjunctivitis (SAC) through an evaluation of skin allergy tests and data obtained from questionnaires. METHODS: The study included a total of 75 SAC patients and 71 control subjects without SAC diagnosis who were admitted to the Abant Izzet Baysal University Medical Faculty Ophthalmology Clinic between March 2016 and December 2016. Skin prick tests were performed for all participants. Serum levels of total IgE and 25-OH vitamin D were also measured. In the tear, total IgE levels were measured. Moreover, possible risk factors for the onset of SAC (smoking, paracetamol exposure, vitamin D supplementation and environmental factors etc.) were examined for all patients by both prenatal and postnatal aspects. RESULTS: The patients with SAC were found to have a history of maternal paracetamol exposure during the prenatal period. Likewise, in the same patient group, the duration of postnatal vitamin D supplementation was shorter (P<0.001). However, no significant correlation was found between SAC and maternal antibiotic exposure, maternal smoking, the mode of delivery and birth weight, as well as presence of pets. Moreover, patients with SAC were more likely to have asthma, allergic rhinitis and oral allergy syndrome. We have also found that SAC patients' mothers and siblings were more likely to have allergic conjunctivitis. Likewise, their fathers were more likely to have allergic rhinitis. CONCLUSION: Prenatal maternal paracetamol exposure and shorter duration of vitamin D supplementation in the postnatal period may play a role in development of SAC. Therefore prevention of unnecessary gestational paracetamol intake and vitamin D supplementation during infancy could potentially reduce the onset and development of SAC.

Tear and serum vitamin D levels in children with allergic rhinoconjunctivitis

BACKGROUND: Although solid cohort studies confirmed a preventative role for the anti-oxidant vitamin D in allergic asthma, a limited number of studies focused on allergic rhinoconjunctivitis (ARC). Here, we aimed to determine 25-hydroxycholecalciferol levels in tear and serum in young allergic rhinoconjunctivitis patients as compared to their apparently healthy matched controls. METHODS: In total, 22 children with allergic rhinoconjunctivitis and 31 healthy control subjects underwent serum total IgE and 25-hydroxycholecalciferol measurements. Tear levels of 25-hydroxycholecalciferol were also determined in both groups. RESULTS: The mean serum total IgE level in the ARC group (143.6 ± 132.8 IU/ml) was significantly higher than that in the control group (54.8 ± 44.1 IU/ml; p = 0.03). Serum 25(OH)D levels were significantly higher in the ARC group (34.1 ± 12.7 ng/ml) than in the healthy controls (21.8 ± 11.3 ng/ml; p = 0.001). CONCLUSIONS: To our knowledge, this is the first reported study to show an association between serum 25-hydroxycholecalciferol and ARC in a childhood group. Higher levels of serum 25-hydroxycholecalciferol in children with allergic rhinoconjunctivitis may indicate a possible aetiopathogenic mechanism in the development of allergic rhinoconjunctivitis. This is also the first report to examine tear fluid vitamin D levels in paediatric ARC patient

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Tear and serum vitamin D levels in children with allergic rhinoconjunctivitis.

BACKGROUND: Although solid cohort studies confirmed a preventative role for the anti-oxidant vitamin D in allergic asthma, a limited number of studies focused on allergic rhinoconjunctivitis (ARC). Here, we aimed to determine 25-hydroxycholecalciferol levels in tear and serum in young allergic rhinoconjunctivitis patients as compared to their apparently healthy matched controls. METHODS: In total, 22 children with allergic rhinoconjunctivitis and 31 healthy control subjects underwent serum total IgE and 25-hydroxycholecalciferol measurements. Tear levels of 25-hydroxycholecalciferol were also determined in both groups. RESULTS: The mean serum total IgE level in the ARC group (143.6±132.8IU/ml) was significantly higher than that in the control group (54.8±44.1IU/ml; p=0.03). Serum 25(OH)D levels were significantly higher in the ARC group (34.1±12.7ng/ml) than in the healthy controls (21.8±11.3ng/ml; p=0.001). CONCLUSIONS: To our knowledge, this is the first reported study to show an association between serum 25-hydroxycholecalciferol and ARC in a childhood group. Higher levels of serum 25-hydroxycholecalciferol in children with allergic rhinoconjunctivitis may indicate a possible aetiopathogenic mechanism in the development of allergic rhinoconjunctivitis. This is also the first report to examine tear fluid vitamin D levels in paediatric ARC patients.

Choroidal thickness changes during the menstrual cycle.

PURPOSE: To evaluate the effects of the menstrual cycle on the choroidal thickness of healthy women of reproductive age using spectral-domain optical coherence tomography. MATERIALS AND METHODS: A total of 23 right eyes of 23 women with regular natural menstrual cycles of 28-30 d and ages 22-30 years were included in this prospective study. The choroidal thicknesses of the women were measured using high-resolution spectral-domain optical coherence tomography line scans with the activated enhanced depth imaging mode in the early follicular, ovulatory and mid-luteal phases of the menstrual cycle (3rd, 14th and 21st days) using a follow-up scanning protocol of the Spectralis optical coherence tomograph by setting the early follicular phase scan as the reference image. Choroidal thickness measurements were taken at the fovea and at two points that were 1500 µm nasal and temporal to the fovea. The mean arterial pressure, spherical equivalent, intraocular pressure, central corneal thickness and retinal and retinal nerve fiber layer thicknesses were also measured. All measurements were taken within the same menstrual cycle. RESULTS: The mean ± standard deviation (standard error of the mean) of subfoveal choroidal thicknesses in the early follicular, ovulatory and mid-luteal phases were 383.87 ± 84.38 (17.59), 373.74 ± 82.40 (17.18) and 359.09 ± 79.65 (16.61) µm, respectively. The relative reductions in choroidal thickness between early follicular and ovulatory phases and early follicular and mid-luteal phases were 2.64% and 6.47%, respectively. The subfoveal choroidal thickness was decreased significantly in the mid-luteal phase when compared with both the early follicular (p < 0.001) and ovulatory phases (p = 0.003). However, the measures of subfoveal choroidal thickness in the early follicular phase were non-conclusively greater (p = 0.071) than in the ovulatory phase. Additionally, the mean arterial pressure, spherical equivalent, intraocular pressure, central corneal thickness and retinal and retinal nerve fiber layer thicknesses did not significantly differ during the menstrual cycle (p > 0.05 for all). CONCLUSIONS: The choroidal thickness decreased significantly in the mid-luteal phase of the menstrual cycle in young, healthy women. These findings emphasize the importance of the menstrual phase in the interpretation of choroidal thickness measurements in women of reproductive age.