Corneal topometric indices and proclivity toward corneal ectasia in vernal keratoconjunctivitis.

PURPOSE: To investigate changes in topometric corneal indices and proclivity toward corneal ectasia, as well as keratometric indices and anterior chamber dimensions in palpebral vernal keratoconjunctivitis (VKC). METHODS: This study included 80 patients with clinically established symptoms of grade 0 or grade 1 palpebral VKC (group 1) and 66 healthy participants (group 2). After a comprehensive ophthalmic examination including best-corrected visual acuity, intraocular pressure measurements and slit-lamp biomicroscopy, pachymetric indices and anterior chamber dimensions were measured using the Pentacam HR rotating Scheimpflug device. Topometric indices, which are particularly useful for determining proclivity toward corneal ectasia, were extracted from a topometric map. RESULTS: In groups 1 and 2, the mean ages were 13.11±5.22 and 16.45±5.09 years, respectively. The mean age at disease onset in group 1 was 10.09±5.03 years, and the mean disease duration was 36.23±8.43 months. Group 1 had significantly higher mean topometric indices than group 2, particularly the index of surface variance (P=0.001), index of vertical asymmetry (P=0.007), center keratoconus index (P=0.050), and Belin/Ambrosio enhanced ectasia total deviation value (P=0.032). Mean posterior corneal astigmatism differed significantly between groups 1 and 2 (P=0.003). CONCLUSIONS: Significantly higher mean topometric indices in VKC indicate a proclivity for corneal ectasia, which could be attributed to general changes in the corneal ultrastructure caused by persistent itching-induced eye rubbing.

Eyelid edema following the first Pfizer-BioNTech COVID-19 vaccination: is it a coincidence?

OBJECTIVE: This report describes an ocular allergic reaction manifested as eyelid edema after Pfizer-BioNTech COVID-19 vaccination. CASE DESCRIPTION: A 28-year-old female had the first Pfizer-BioNTech COVID-19 vaccine dose and was discharged following a 20-minute post-vaccination observation for potential adverse complications. She came to the emergency department after her left eyelid swelled unexpectedly two hours later, accompanied by itching and redness. Aside from left eyelid edema and redness, there were no other remarkable bilateral ocular findings. The lack of recent history of any cause of eyelid edema suggested a vaccine-induced ocular allergy. Immediate administration of systemic and topical anti-allergic medications resulted in a significant clinical improvement within 4-6 hours. CONCLUSIONS: Reporting any adverse reactions to vaccines, especially recently approved ones, is extremely critical. Local ocular allergy, as opposed to systemic allergy, could be considered one of the COVID 19 vaccine's rare and mild side effects.

Quantitative OCT angiography of the retina and choroid in non-ocular sarcoidosis.

OBJECTIVE: The aim of the study was to evaluate retinal and choroidal microvascular morphological changes in non-ocular sarcoidosis (NOS) patients using optical coherence tomography angiography (OCTA) and compare the results to age- and gender-matched healthy individuals. PATIENTS AND METHODS: This study included 37 NOS patients (group 1, 37 right eyes) referred to the Ophthalmology Department between 2019 and 2021, as well as 31 healthy individuals (group 2, 31 right eyes). Non-ocular sarcoidosis was defined as sarcoidosis confirmed by a positive lung X-ray and biopsy without ocular manifestation. All participants underwent a comprehensive ophthalmic examination. The SPECTRALIS® OCT was used for both fundus photography and macular analysis. All OCTA procedures were performed in the Angio Retina mode (6.0x6.0 mm) to assess retinal and choroidal microvascular morphology. RESULTS: Groups 1 and 2 had mean ages of 46.41±12.52 and 47.55±13.81 years, respectively (p=0.482). Group 1 had significantly increased superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel densities (VDs) in whole (p=0.059, 0.016), parafoveal (p=0.051, 0.015), and perifoveal (p=0.060, 0.010) regions relative to group 2. Group 1 was also associated with increased foveal avascular zone (FAZ) area (p=0.196), FAZ circumference (p=0.262), and foveal VD in 300 µm wide regions surrounding FAZ (p=0.003) relative to group 2. The outer retinal (p=0.712) and choriocapillaris (p=0.684) flows did not differ significantly between the two groups. CONCLUSIONS: Quantitative OCTA analysis revealed a higher tendency for retinal and choroidal microvascular morphological changes in NOS patients, demonstrating the potential of this novel, non-invasive imaging technology, which may provide sensitive and reliable results without using contrast materials.

Consequences of seasonal allergic conjunctivitis on ocular parameters of anterior and posterior segments: An up-to-date imaging approach.

AIMS: To investigate consequences of seasonal allergic conjunctivitis (SAC) on the ocular anterior and posterior segment parameters. MATERIALS AND METHODS: Forty healthy participants (mean age: 25.90 ± 5.7 years, 20 females, 20 males) and 40 patients with SAC (mean age: 26.20 ± 5.7 years, 20 females, 20 males) were included in this prospective study. The anterior segment parameters including central corneal thickness (CCT) and anterior chamber depth (ACD) were measured by Scheimpflug imaging system. Axial length (AL) was measured by optical biometry. The posterior segment parameters, including retinal nerve fiber layer (RNFL), subfoveal choroidal thickness, and central macular thickness were measured by optical coherence tomography. RESULTS: Similar values of the ACD, AL, RNFL as well as central macular thickness between healthy participants and patients with SAC were revealed. Despite the CCT being thinner in SAC, there was no statistically significant difference between the two groups. On the other hand, SAC was found to be associated with an increase in subfoveal choroidal thickness, the condition of which may be attributed to the inflammatory nature of the disease. CONCLUSION: The present study has managed to demonstrate non-significant alterations in the ocular anterior and posterior segment parameters of patients with SAC. Yet, the increase in subfoveal choroidal thickness may be linked to the accompanying inflammation of both the conjunctiva and other ocular tissues, particularly the choroidal layer.

The effect of intravitreal dexamethasone implant on central foveal thickness and choroidal thickness in retinal vein occlusion.

AIM: To investigate the effect of intravitreal dexamethasone implant on central foveal thickness and choroidal thickness in retinal vein occlusion. MATERIALS AND METHODS: Clinical records and optical coherence tomography (OCT) scans of 41 naïve patients with retinal vein occlusion (RVO), who were initially treated with intravitreal dexamethasone (DEX) implant between 2016 and 2017 at Kocatepe University Faculty of Medicine, Department of Ophthalmology were investigated. Collected data included age and sex of the patients, crystalline lens status, baseline and final intraocular pressure, and OCT parameters including central foveal thickness and choroidal thickness. RESULTS: Twenty-two (53.7%) female and 19 (46.3%) male patients were enrolled in the study. There were 30 phakic and 11 pseudophakic patients. The intraocular pressure increased significantly from 15.19 mmHg to 17.8 mmHg (P = 0.005), and cataract extraction was performed in two patients who developed cataract after the treatment. There was a significant decrease in the central foveal thickness from 556 µm to 288 µm (P < 0.001). In addition, although there was no statistically significant change in choroidal thickness in the patients with branched retinal vein occlusion (P = 0.423), the patients with central retinal vein occlusion had statistically significant decrease in choroidal thickness measurements (P = 0.049). CONCLUSION: Therapeutic effect of the DEX implant not only influences retinal layer. Its influence may also extend further to the choroid layer, thereby leading to decrease in the choroidal thickness. Our results were mostly similar to the results of studies in literature which investigated the effects of the DEX implant therapy on the choroidal thickness of the patients with RVO.