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.

Effect of quadrant switch on intraocular pressure change in intravitreal aflibercept or ranibizumab injection applications.

OBJECTIVE: To evaluate the effect of injection quadrant switch on the intraocular pressure (IOP) change in intravitreal aflibercept or ranibizumab applications. METHODS: 123 eyes of 123 patients who received intravitreal injection (IVE) into the superotemporal quadrant at least 10 times for age-related macular degeneration or diabetic macular edema have been recruited. The demographic data, lens status, IOP values (preoperative, postoperative 0th min, and postoperative 30th min), and amount of vitreous reflux (VR) following IVE have been recorded. Next IVE application was performed into the inferotemporal quadrant of the patient, which had never been injected before. RESULTS: The mean IOP value at postoperative 0th min was 50.24 ± 7.66 mmHg after injections into the superotemporal quadrant and was 34.85 ± 4.96 mmHg after injections into the inferotemporal quadrant. No significant difference was observed between the preoperative and postoperative 30th min-IOP values (p > 0.05), while a significant difference was found between the postoperative 0th min-IOP values among quadrants (p < 0.001). VR was significantly higher in applications into the inferotemporal quadrant than those into the superotemporal quadrant (p < 0.001). CONCLUSION: One of the most principal factors affecting the postoperative short-term IOP increase is the amount of VR, and this amount decreases the IOP following an IVE. The high amount of VR produced in the quadrant where the injection was applied for the first time caused a low-level IOP, while the low amount of VR formed in the quadrant where the repeated injections were applied caused a higher IOP.

Intrastromal versus subconjunctival anti-VEGF agents for treatment of corneal neovascularization: a rabbit study.

OBJECTIVE: To determine whether subconjunctival or intrastromal administration of anti-VEGF agents is more effective on suture-induced corneal neovascularization (CoNV) in rabbits. METHODS: CoNV was induced in 48 eyes of 24 New Zealand white rabbits by using an 8/0 silk suture. On the 7th day after suturing, the rabbits were divided into four treatment groups as follows: six rabbits received subconjunctival bevacizumab (group 1), six rabbits received subconjunctival aflibercept (group 2), six rabbits received intrastromal bevacizumab (group 3) and six rabbits received intrastromal aflibercept (group 4). On the 7th and 14th days after suturing, the CoNV area was calculated by standardised analysis of photographs using the Image-J program. On the 14th day after suturing, all rabbits were sacrificed and then corneal tissue was harvested for the analysis of vascular endothelial growth factor (VEGF)-A, VEGF-B and placental growth factor (PIGF) levels. RESULTS: On the 7th day after suturing, CoNV areas were 17.10 ± 2.98, 18.88 ± 3.78, 17.36 ± 4.52, 18.57 ± 4.16 and 17.31 ± 2.81 mm2 in the groups 1-4 and control group, respectively. On the 7th day after intervention and removal of suture, CoNV areas were 4.85 ± 1.99, 6.66 ± 1.73, 2.83 ± 1.08, 2.63 ± 1.16 and 11.93 ± 2.64 mm2 in the group 1-4 and control group, respectively. CoNV area was reduced by 88.1% and 82.5% in eyes receiving intrastromal aflibercept and bevacizumab, respectively (both p < 0.001), and by 64.5% and 69.9% in eyes receiving subconjunctival aflibercept and bevacizumab, respectively (both p = 0.001). CONCLUSION: Intrastromal anti-VEGF therapy regressed CoNV more effectively than subconjunctival therapy regardless of the type of anti-VEGF agent.

Evaluation of the Effect of Fasting on Glaucoma Patients.

OBJECTIVES: The aim of this research was to evaluate the effect of daytime Ramadan fasting and dehydration on intraocular pressure (IOP) and biometric parameters in primary open-angle glaucoma (POAG) patients. METHODS: This prospective study included 30 eyes of 30 POAG patients who were fasting during Ramadan (Group 1), 40 healthy participants who were fasting (Group 2), and 40 healthy individuals who were not fasting (Group 3). The eyes were evaluated twice a day at approximately 8 am and 4 pm during Ramadan and 1 month after Ramadan. RESULTS: IOP values at 4 pm were higher in Group 1 than Groups 2 and 3 in Ramadan (p=0.029 and 0.007, respectively). The diurnal reduction in IOP was significantly smaller during fasting in the glaucoma patients compared with Groups 2 and 3 (p=0.012 and 0.007, respectively). Comparisons of biometric parameters revealed less reduction in central corneal thickness (CCT) values from 8 am to 4 pm in glaucoma patients than in Groups 2 and 3 (p<0.05 for all comparisons) during Ramadan and after Ramadan. CONCLUSION: POAG patients had a higher IOP at 4 pm during the fasting period than was seen following Ramadan. In addition, the diurnal reduction of IOP and CCT was smaller in patients with POAG compared with healthy 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.

Can Hypothyroidism Cause Acute Central Serous Chorioretinopathy?

Purpose: To evaluate selected systemic findings, especially thyroid functions, in acute central serous chorioretinopathy (CSC) patients.Materials and Methods: In all, 71 consecutive acute CSC patients who fulfilled the inclusion criteria and 70 age-matched healthy control subjects were included in the study. Systemic findings, including serum levels of thyroid hormones, thyroid stimulating hormone (TSH), mean arterial pressure (MAP), pulse rate, serum lipid levels and optical coherence tomography findings, were compared between the groups. Independent samples t-test was used for statistical analysis.Results: The mean ages of the CSC and control groups were 41.06 ± 6.49 and 40.06 ± 7.08 years old, respectively. Retinal thickness, choroidal thickness, TSH levels, pulse rate and MAP were significantly different between CSC patients and healthy control subjects (range of p values: <0.001-0.042). In the logistic regression analysis, MAP, serum triglyceride concentration and central choroidal thickness were positively associated with CSC (range of p values: <0.001-0.035).Conclusion: Acute CSC patients had significantly higher pulse rates and MAP and significantly thicker choroidal thickness than were found in healthy subjects. TSH levels were also significantly higher in CSC patients than in controls. Hence, hypothyroidism might be associated with CSC.

Major factors affecting intraocular pressure spike after intravitreal ranibizumab injection: Vitreous reflux and its amount.

PURPOSE: The aim of this study was to assess the effect of vitreous reflux and its amount on short-term intraocular pressure after intravitreal injection of ranibizumab. METHODS: The study included 316 eyes of 276 patients. Intraocular pressures were measured before intravitreal injection (preIOP), immediately after intravitreal injection (postIOP0), and 30 min after intravitreal injection (postIOP30). The amount of vitreous reflux was evaluated by measuring conjunctival bleb diameter, and patients were grouped as; group 1: no vitreous reflux, group 2: less vitreous reflux, and group 3: more vitreous reflux. The data were analyzed using variance analysis, chi-square test, and regression analysis. RESULTS: PostIOP0 values were highest in group 1, followed by group 2 and group 3 (all p values < 0.001). PostIOP30 values were similar in group 1 and group 2 (p = 0.261), but were lower in group 3 than other two groups (p < 0.001, p = 0.001, respectively). Vitreous reflux was identified as the only factor affecting postinjection intraocular pressure changes (p < 0.001), and a negative correlation was found between the total number of intravitreal injection and vitreous reflux (p = 0.032). CONCLUSION: The major factor affecting short-term postinjection intraocular pressure elevation was vitreous reflux, and intraocular pressure levels increased as the amount of vitreous reflux decreased. Vitreous reflux and its amount decreased as the total number of intravitreal injection increased.

Effect of Fasting on Choroidal Thickness and Its Diurnal Variation.

Purpose: The aim of this study was to assess the effect of Ramadan fasting on choroidal thickness (CT) and its associated diurnal variations using spectral domain optic coherence tomography. Materials and Methods: Ocular measurements were performed on a single eye of 87 healthy individuals. Eyes were evaluated twice a day around 8.00 a.m. and 4.00 p.m. during Ramadan. Evaluations were repeated at the same time of the day, 1 month following Ramadan on the same subjects. Measurements of choroidal and retinal thickness were performed at central, temporal and nasal segments. Results: The comparison of measurements revealed that temporal CT at 8.00 a.m. and foveal, temporal and nasal CTs at 4.00 p.m. were significantly reduced during fasting (p values were 0.005, <0.001, 0.001 and 0.046, respectively). Mean changes of CTs during fasting were 14.76 ± 16.01, 9.90 ± 19.57 and 8.10 ± 16.81 µm at the fovea, temporal and nasal segments, respectively. However, CTs at non-fasting conditions were measured as 6.13 ± 12.93, 3.78 ± 15.23 and 5.05 ± 13.60 µm, respectively. In comparison, diurnal variations of foveal and temporal CTs during fasting were significantly higher than the controls (p values were <0.001 and 0.004, respectively). Additionally, retinal thicknesses during fasting were significantly reduced compared to the controls in all segments measured at 4.00 p.m. (p for all values <0.05) Conclusions: The results of the present study revealed that fasting and dehydration caused a reduction of the choroidal and retinal thicknesses. Likewise, they are also responsible for the increased diurnal variation of CTs. Therefore, early hours of the day may be preferred to evaluate retinal and choroidal thicknesses during Ramadan to avoid the effects of dehydration on the measurement results.

Investigation of the choroidal thickness in patients with hypothyroidism.

PURPOSE: The effect of hypothyroidism on the choroidal thickness (CT) was investigated in patients with subclinical hypothyroidism and overt hypothyroidism, and biochemically and clinically euthyroid patients receiving levothyroxine treatment. The patients were compared with healthy subjects. MATERIALS AND METHODS: One eye of 71 hypothyroid and 22 healthy subjects between 20 and 40 years of age were included in this study. CT measurements were taken at the fovea and at 2 points that were 1500 µm nasal and temporal to the fovea using spectral-domain optical coherence tomography. Independent sample t-test's and was used for statistical analysis of the data. RESULTS: The CT was significantly thicker in hypothyroid patients compared to healthy subjects (P values were 0.013 for subfoveal, 0.015 for temporal and 0.020 for nasal segments). The intraocular pressure (IOP) and body mass index (BMI) were also significantly higher in hypothyroid patients (P values were 0.021 and 0.003, respectively). There was not a statistically significant difference in the BMI and IOP measurements between healthy subjects and euthyroid patients (P > 0.05). However, there was a statistically significant difference in the subfoveal, temporal and nasal CT measurements between healthy subjects and euthyroid patients (P values were 0.006, 0.031 and 0.013, respectively). CONCLUSIONS: All subgroups of hypothyroid patients had thicker CT compared to healthy subjects. Euthyroid patients receiving levothyroxine treatment had lower IOP, BMI levels, and serum lipid levels than patients with subclinical hypothyroidism and overt hypothyroidism.

Evaluation of subjects with a moderate cup to disc ratio using optical coherence tomography and Heidelberg retina tomograph 3: impact of the disc area.

AIM: The aim was to evaluate subjects with a moderate cup to disc ratio using optical coherence tomograph (OCT) and Heidelberg retina tomograph (HRT) 3. SETTINGS AND DESIGN: We included 80 patients with early glaucoma and 80 nonglaucomatous subjects with moderate cup/disc ratio (range of 0.5-0.8) to this cross-sectional study. SUBJECTS AND METHODS: We compared results of color-coded algorithms of HRT 3 (Moorfields regression analysis [MRA] and Glaucoma probability score [GPS]) and OCT. All outputs are classified into three categories: Within normal limits (WNLs), borderline and outside normal limits (ONLs). Diagnostic accuracies of algorithms were determined using the highest sensitivity criteria. RESULTS: The sensitivities of global MRA, GPS and OCT were 0.75, 0.925 and 0.725, respectively, in average disc area group and 0.85, 1.0 and 0.425, respectively, in large disc area group. The specificities of global MRA, GPS and OCT were 0.55, 0.15 and 0.85, respectively, in average disc area group and 0.425, 0.025 and 0.80, respectively, in large disc area group. Area under receiver operating characteristic curve (AUROC) of global MRA, GPS and OCT were 0.667, 0.617 and 0.792, respectively, in average disc area group and 0.746, 0.576 and 0.627, respectively, in large disc area group. AUROC of global MRA and OCT combination in the average and large disc area groups were 0.828 and 0.825, respectively. CONCLUSIONS: In contrast to GPS and OCT algorithms, diagnostic performance of MRA algorithm increased in large disc area group. Combining MRA and OCT algorithms produced satisfactory diagnostic performance in subjects with an average and large disc area.

Comparison of the effect of intravitreal bevacizumab and intravitreal fasudil on retinal VEGF, TNFα, and caspase 3 levels in an experimental diabetes model.

AIM: To evaluate the influence of an intravitreal injection of bevacizumab and fasudil on the retinal vascular endothelial growth factor (VEGF), tumor necrosis factor alpha (TNFα), and caspase 3 levels in a diabetic rabbit model. METHODS: The study included 6 healthy rabbits (Group 1), 6 rabbits with experimentally induced diabetes mellitus (DM) (Group 2), 7 rabbits with experimentally induced DM to which intravitreal bevacizumab was administered (Group 3), and 7 rabbits with experimentally induced DM to which intravitreal fasudil was administered (Group 4). An intravitreal injection of 1.25mg/50µL bevacizumab in the right eye of rabbits in Group 3 and an intravitreal injection of 0.0064mg/50µL fasudil in the right eye of rabbits in Group 4 were administered on day 21 after the induction of DM. The studied eyes of the rabbits were enucleated three days after the intravitreal injection. The TNFα, VEGF, and caspase 3 levels were determined using the ELISA method. RESULTS: There was a statistically significant difference in the VEGF and caspase 3 levels between groups (P=0.005 and P =0.013, respectively), but the TNFα level did not differ significantly between groups (P=0.792). It was found that VEGF levels were significantly lower in Group 1 and Group 3 than in Group 2 using the Mann-Whitney U test with the Bonferroni correction (P=0.004 for both comparison). There was no statistically significant difference between other groups with regard to VEGF levels (the P value ranged between 0.015 and 0.886). Although the P values of the caspase 3 levels were 0.015 for Group 1 and Group 4, 0.038 for Group 2 and Group 3, and 0.018 for Group 3 and Group 4, these P values remained above the threshold P value of 0.0083, which was the statistically significant level for post hoc tests. CONCLUSION: An intravitreal injection of bevacizumab decreased both the VEGF level, which plays a role in angiogenesis, and the caspase 3 level, which plays a role in apoptosis. Although not as effective as bevacizumab, fasudil had a beneficial effect on the VEGF levels but significantly increased the caspase 3 levels.

Effect of smoking on choroidal thickness in healthy smokers.

PURPOSE: To evaluate the acute and chronic effects of cigarette smoking on the choroidal thickness of young male smokers with smoking histories exceeding 10 years using spectral domain optical coherence tomography (SD OCT). MATERIALS AND METHODS: The right eyes of 40 never-smoking and 30 smoking healthy subjects were included in this study. We measured the choroidal thicknesses of the never-smoking subjects as a control group. The choroidal thicknesses of the smoking subjects were measured before, 5, 30 and 60 min after smoking. Choroidal thickness measurements were taken at the fovea and at two points that were 1500 µm nasal and temporal to the fovea. RESULTS: No significant difference was found for the retinal thickness, choroidal thicknesses, spherical equivalent, intraocular pressure and central corneal thickness of the smokers and non-smokers (p > 0.05 for all). In the measurements that were taken after smoking, a statistically significant increase was found in choroidal thickness that was observed between 0 and 5 min for the central, nasal and temporal segments (p < 0.001 for all). CONCLUSIONS: Smoking caused acute, significant increase in choroidal thickness that returned to baseline levels after 1 h. The choroidal and retinal thicknesses did not differ significantly between the healthy young smokers and non-smokers.

Effects of a water-loading test on intraocular pressure and corneal hysteresis in young healthy subjects.

PURPOSE: To evaluate the influence of a water-loading test on corneal compensated intraocular pressure (IOPcc) and corneal hysteresis (CH) in young healthy subjects. MATERIALS AND METHODS: Forty healthy adult subjects (20 female and 20 male), with a mean age of 27.55±2.57 years (range, 24 to 35 y), participated in this prospective study. IOPcc and CH were measured for 1 eye from each participant with an Ocular Response Analyser. These measurements were taken before and 10, 20, and 30 minutes after water loading. RESULTS: Thirty-seven right and 3 left eyes of the 40 subjects fulfilled the study's inclusion criteria. A statistically significant increase in IOPcc was observed between 0 and 10 minutes (P=0.002) and a significant decrease between 10 and 30 minutes (P<0.001). We did not observe any statistically significant changes in CH. The Pearson correlation revealed that there was a weak negative correlation between IOPcc and CH measurements taken at the baseline, 10 minutes, and 30 minutes [r values were -0.275 (P=0.086), -0.369 (P=0.019), and -0.246 (P=0.125), respectively]. CONCLUSIONS: This study revealed changes in IOPcc and CH after a water-loading test, but only the change in the IOPcc measurement was statistically significant. The association of changes in IOP and CH identified in this study suggests that IOP changes might alter corneal biomechanical properties.

Inhibitory effects of topical cyclosporine A 0.05% on immune-mediated corneal neovascularization in rabbits.

BACKGROUND: We aimed to study the inhibitory effects of topical cyclosporine A (CsA) 0.05% on immune-mediated corneal neovascularization, and to compare its efficacy with those of dexamethasone 0.1% and bevacizumab 0.5%. METHODS: Immune-mediated corneal neovascularization was created in 36 right eyes of 36 rabbits. The rabbits were then randomized into four groups. Group I received CsA 0.05%, Group II received dexamethasone 0.1%, Group III received bevacizumab 0.5%, and Group IV received isotonic saline twice a day for 14 days. The corneal surface covered with neovascular vessels was measured on the photographs. The rabbits were then sacrificed and the corneas excised. Paraffin-embedded sections were stained with hematoxylin-eosin and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay. RESULTS: The means of percent area of corneal neovascularization in Group I, II, III, and IV were 24.4%, 5.9%, 37.1%, and 44.1%, respectively. The inhibitory effect of CsA 0.05% was found to be better than the effect found in the bevacizumab 0.5% and control groups (p = 0.03 and p = 0.02, respectively). CsA 0.05% was found to have significantly lesser inhibitory effects on corneal neovascularization than dexamethasone 0.1% (p < 0.001). Apoptotic cell density was higher in Group III and Group IV than in Group I and Group II. There was no difference between Group I and Group II in terms of apoptotic cell density (p = 0.7). CONCLUSIONS: Topical CsA 0.05% was shown to have an inhibitory effect on immune-mediated corneal neovascularization in rabbits.

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.

Evaluation of choroidal and retinal thickness measurements using optical coherence tomography in non-diabetic haemodialysis patients.

The aim of this study is to evaluate the effects of haemodialysis with a high ultrafiltration rate on the choroidal and retinal thickness of non-diabetic end-stage chronic renal failure (CRF) patients using optical coherence tomography (OCT). Twenty-one eyes of 21 male CRF patients aged between 46 and 80 years were included in this prospective study. Retinal and choroidal thicknesses of the patients were measured using high-resolution OCT line scans with the activated enhanced depth imaging mode before and shortly after haemodialysis. Retinal and choroidal thickness measurements were taken at the fovea and at two points that were 1,500 µm nasal and temporal to the fovea. The relationships between the haemodynamic changes, intraocular pressure (IOP) and central corneal thickness (CCT) were also evaluated. The mean choroidal thicknesses before haemodialysis at the subfoveal, temporal and nasal locations were 232.81 ± 71.92, 212.43 ± 70.50 and 182.14 ± 68.88 µm, respectively. The mean choroidal thicknesses after haemodialysis at the subfoveal, temporal and nasal locations were 210.90 ± 65.53, 195.38 ± 66.48 and 165.19 ± 66.73 µm, respectively. There were significant differences between the choroidal thicknesses before and after haemodialysis (p < 0.001 for all). The mean retinal thicknesses before haemodialysis at the foveal, temporal and nasal locations were 215.86 ± 41.06, 308.86 ± 37.73 and 338.00 ± 33.32 µm, respectively. The mean retinal thicknesses after haemodialysis at the foveal, temporal and nasal locations were 216.90 ± 39.70, 313.86 ± 32.89 and 335.29 ± 36.85 µm, respectively. There was no significant difference between the retinal thicknesses before and after haemodialysis (p > 0.05 for all). The mean CCT decreased insignificantly from 550.48 ± 17.46 to 548.10 ± 21.12 µm (p = 0.411). The mean IOP decreased significantly from 14.09 ± 2.58 to 12.54 ± 2.23 mmHg (p = 0.003), which did not correlate with the CCT [r = (-)0.134, p = 0.562]. Haemodialysis with a high ultrafiltration volume did not alter the retinal thickness but caused a significant choroidal thinning and an IOP decrease in non-diabetic end-stage CRF patients.

Effect of prophylactic intraocular pressure-lowering medication on pain during cataract surgery.

PURPOSE: This study evaluated the effects of acetazolamide, latanoprost, travoprost, bimatoprost, brimonidine, brinzolamide, and timolol on pain during phacoemulsification cataract surgery. METHODS: This prospective randomized comparative study included 323 eyes of 323 patients with no history of intraocular surgery or chronic eye disease who underwent uncomplicated phacoemulsification cataract surgery and foldable intraocular lens implantation under topical anesthesia. Patients were divided into 8 groups according to the preoperative prophylactic intraocular pressure (IOP)-lowering medication. The intraoperative pain was assessed postoperatively using a visual analog pain scale. The Kruskal-Wallis test investigated the differences in the visual analog pain-scale scores of the groups, and the Mann-Whitney U test investigated the pairwise comparison of the groups. RESULTS: The median visual analog pain-scale score of the group that did not receive any IOP-lowering medication was 2.0±1.89. The brimonidine group exhibited the lowest visual analog pain-scale scores, and the prostanoids, especially the bimatoprost group, demonstrated the highest visual analog pain-scale scores (median±standard deviation were 0.0±1.50 and 2.0±1.91, respectively). The median visual analog pain-scale scores of the acetazolamide, latanoprost, travoprost, brinzolamide, and timolol groups were 0.0±1.62, 2.0±1.67, 2.0±1.73, 0.0±1.66, and 1.0±1.54, respectively. A pairwise comparison using the Mann-Whitney U test with Bonferroni correction revealed significant differences between the groups of acetozolamide and travoprost (p=0.001), acetozolamide and bimatoprost (p<0.001), travoprost and brimonidine (p<0.001), bimatoprost and brimonidine (p<0.001), and bimatoprost and timolol (p=0.001). CONCLUSIONS: Prophylactic application of the IOP-lowering medication may alter the pain sensation during phacoemulsification cataract surgery.

Association of dehydroepiandrosterone sulfate, serum lipids, C-reactive protein and body mass index with age-related macular degeneration.

The present study was designed to evaluate the associations between exudative age-related macular degeneration (AMD) and the serum concentrations of C-reactive protein (CRP), dehydroepiandrosterone sulfate (DHEAS), and lipids as well as the relationship between exudative AMD and body mass index (BMI). This cross-sectional study included of 141 healthy control subjects (70 males and 71 females with a mean age of 71.01 ± 3.84 years) and 142 exudative AMD patients (70 males and 72 females with a mean age of 70.92 ± 3.60 years). BMI and the serum concentrations of CRP, DHEAS, and lipids were measured in both groups. The data were statistically analysed using the Mann-Whitney U test, Chi squared test, independent sample t test, Cramer's V, point biserial correlation and logistic regression analysis. BMI values and serum concentrations of CRP, total cholesterol, and low-density lipoprotein (LDL) cholesterol were significantly higher in exudative AMD patients compared with normal controls (p values were 0.001, <0.001, 0.005 and <0.001, respectively). The serum concentrations of DHEAS were not significantly different between the controls and the exudative AMD patients for the subgroups of either gender (p values in males and females were 0.785 and 0.159, respectively). A logistic regression analysis revealed that the BMI and serum concentration of CRP moderately contributed to the predictive ability of the model (odds ratios were 1.205 and 1.179, respectively). Elevated total cholesterol concentrations and LDL cholesterol concentrations, BMI values and serum concentrations of CRP were associated with exudative AMD. However, no association between the serum DHEAS concentration and exudative AMD was established.

Aqueous humour and serum concentration of asymmetric dimethyl arginine in pseudoexfoliation syndrome.

OBJECTIVE: Asymmetric dimethyl arginine (ADMA) is the major endogenous inhibitor of nitric oxide synthase. ADMA is related to endothelial dysfunction and is an independent cardiovascular risk factor. This study aimed to evaluate the concentration of ADMA in aqueous humour and serum samples of patients with pseudoexfoliation (PEX) syndrome. MATERIALS AND METHODS: 21 cataract patients with PEX syndrome (PEX group) and 18 cataract patients without PEX syndrome (control group) were enrolled in the study. ADMA was measured in the aqueous humour and serum of the PEX and control groups. ELISA was used to determine the ADMA concentration. RESULTS: Mean aqueous humour ADMA concentration in the PEX group was 0.39 ± 0.07 µmol/l and in the control group was 0.34 ± 0.06 µmol/l. Mean serum ADMA concentration in the PEX group was 0.56 ± 0.21 µmol/l and in the control group was 0.44 ± 0.12 µmol/l. ADMA concentration of aqueous humour in the PEX group was significantly higher than the control group (p=0.026). Similarly, ADMA concentration of serum in the PEX group was significantly higher than the control group (p=0.039). CONCLUSIONS: The findings of the present study could suggest that ADMA might play a role in the aetiopathogenesis of PEX syndrome. Higher aqueous and serum levels of ADMA might be potential evidence of endothelial dysfunction in PEX syndrome.

Isolated lateral rectus muscle involvement as a presenting sign of euthyroid Graves disease.

A 27-year-old man who presented with diplopia and proptosis and was diagnosed with euthyroid Graves disease and restrictive strabismus. It was determined that his symptoms were caused by isolated lateral rectus muscle involvement. Diplopia resolved and ocular motility improved substantially following 6 weeks of oral corticosteroid therapy.