Evaluation of the choroidal vascular index and choroidal changes in migraine subgroups.

PURPOSE: To investigate binarized choroidal structural parameters, retinal nerve fiber layer (RNFL) thickness, and retina changes duringattack-free periods in patients with migraine using enhanced depth imaging optic coherence tomography (EDI-OCT), and compare patients with migraine with aura and without aura (MwA and MoA, respectively) and aura subgroups (visual aura, non-visual aura), with age and sex-matched healthy subjects. METHOD: This observational, prospective study included 102 patients with migraine and 36 healthy controls. Central macular thickness (CMT), retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), and choroidal thickness (CT) were measured using a Spectralis OCT device. The choroid vascularity index (CVI) was evaluated using the Image-J software. CVI was calculated as the proportion of the luminal area (LA) to the total choroidal area (TCA). RNFL, CMT, CT, and CVI measurements were compared statistically. RESULTS: Choroidal thickness at 1500 µm temporal of the fovea was found to be statistically significantly thinner in the MwA and MoA groups compared with the control group (p ≤ 0.01). There was a significant difference in the subfoveal CT values of the MwA and control groups (p < 0.05). The mean RNFL thickness of patients with migraine with visual aura was found to be statistically significantly thinner than in the migraine group with non-visual aura (98.73 ± 8.4 and 109.4 ± 16.8) (p < 0.05). There were no statistically significant differences between the RNFL CMT, GCC, and CVI values in the MwA, MoA, and control groups (p > 0.05). CONCLUSION: We found that the choroidal thickness was significantly decreased in patients with migraine, especially in the MwA group. In the visual aura subgroup, the mean RNFL thickness was significantly decreased compared with the non-visual aura subgroup.

Posterior pole analysis and ganglion cell layer measurements in Alzheimer's disease.

AIM: To compare posterior pole analysis and ganglion cell layer (GCL) of patients with Alzheimer's disease (AD) and controls. METHOD: Patients diagnosed with mild and moderate AD included in the study. Posterior pole analysis and GCL measurements were investigated by dividing the macula into superior and inferior hemifields and 5 corresponding zones. RESULTS: There were no significant differences between groups for retinal thickness measurements in any retinal zone. GCL measurements showed lower measurements in moderate AD group for GCL thickness in the superior zone 2 (p:0.025) and inferior zone 2 (p = 0.048) compared to mild AD and controls. A moderate AD status was found to cause a decrease of 5.349 µm in the GCL-SZ2 value [p:0.037]. CONCLUSION: GCL measurements in the moderate AD group show significant thinning in superior and inferior Zone 2, which may be a biomarker for AD.

Ozone-induced retinal vascular reactivity as assessed by optical coherence tomography angiography.

BACKGROUND: This study aimed to investigate the retinal vascular reactivity (RVR) of the macular and peripapillary capillary network in response to ozonated autohemotherapy (AHT) using optical coherence tomography angiography (OCTA). METHODS: This was a single-centre prospective study. All participants that were planned to have a combination of major and minor ozone AHT underwent a complete ocular examination and OCTA imaging before and after the ozone AHT. Foveal avascular zone (FAZ) metrics and vessel density (VD) of superficial (SCP), deep capillary plexus (DCP), and radial peripapillary capillary (RPC) plexus were assessed using the built-in software. RESULTS: A total of 40 right eyes of 40 individuals were included. No significant differences were observed for the mean values of the FAZ metrics and choriocapillaris flow area following ozone AHT compared with baseline values (p > 0.05). The mean whole VD of SCP and DCP was 47.80 ± 2.18% and 53.09 ± 3.00% before treatment, which decreased to 47.68 ± 2.7% and 52.38 ± 3.07% after treatment (p = 0.660 and p = 0.097, respectively). No significant differences were observed in the vascular densities of both SCP and DCP in any quadrant (p > 0.05). The RPC density did not show significant alterations compared with baseline values, except the inferior-hemi region. The VD in the inferior-hemi peripapillary quadrant was significantly increased after ozone AHT (p = 0.034). CONCLUSION: The ozone AHT did not cause evident RVR in the macular area, whereas the peripapillary area showed a partial response.

Intravitreal dexamethasone implant results in the treatment of non-infectious uveitis.

OBJECTIVE: The objective of this study was to evaluate the efficacy of intravitreal dexamethasone implant in non-infectious uveitic macular edema. METHODS: Between April 2013 and February 2017, 27 eyes of 21 patients were included in the study at Haydarpasa Numune Training and Research Hospital. The files of patients who underwent intravitreal dexamethasone implantation for non-infectious uveitic macular edema and followed up at least 6 months were retrospectively reviewed. The patients were evaluated in terms of best-corrected visual acuity (BCVA) and central macular thickness (CMT) before and at the 1st, 3rd, and 6th months after injection and the need for re-injection. RESULTS: Twenty-seven eyes of 21 patients were included in the study. The mean age of the patients was 39.2±11.7 years. The mean monitoring time was 24.15±10.08 months. In patients who received single-dose intravitreal dexamethasone implant, the decrease in CMT measurements and improvement in BCVA measurements at 1, 3, and 6 months after injection compared to baseline was found to be statistically significant (p=0.001 for each). Recurrence was detected in 33.3% (n=9) of the cases during follow-up; in cases with recurrence, second implants were repeated after an average of 9.67±3.12 months. The third dexamethasone implantation was applied due to the second relapse of four cases from nine relapsing cases. Third implants were performed at an average of 12.50±4.79 months. During the follow-up period, the most common complications in our patients were cataract (37%) and increased intraocular pressure (40.7%). CONCLUSION: Intravitreal dexamethasone implantation is an effective and reliable treatment option in non-infectious uveitic macular edema. There was no difference between the first dose and re-implantations in terms of efficacy and safety.