Quantitative analysis of retinal microvascular structure and correlation with ocular parameters: A normative database of pediatric OCT angiography.

PURPOSE: To analyze the vascular structure of the healthy pediatric population using optical coherence tomography angiography (OCTA), and to investigate its relationship with ocular parameters. MATERIALS AND METHOD: This cross-sectional, prospective study included 142 eyes of 71 healthy subjects aged 8-18 years. All patients underwent a complete ocular assessment, biometric evaluation and OCTA analysis. Anterior chamber depth, axial length, corneal thickness values were also reported and their relationship with OCTA measurements was evaluated. RESULTS: There was no statistical difference between girls and boys in terms of demographic characteristics (p>0.05). Neither vascular density in the deep and superficial capillary plexus nor FAZ area was significantly related to the ocular parameters or age of any patient in the study. CONCLUSIONS: Despite the relatively small number of participants, this study may represent normative data for the Turkish pediatric population. It was also shown that vascular density and FAZ area in childhood are not affected by age, axis length, anterior chamber depth, cornea and foveal thickness.

Early-term Optical Coherence Tomography Angiographic Findings in Pediatric Patients Infected with COVID-19.

PURPOSE: The aim of this study was to investigate possible vascular changes in pediatric patients infected with COVID-19 and to compare these with an age-matched control group. METHODS: All patients underwent an ocular assessment and optical coherence tomography angiography examination. Two vascular networks were analyzed as the superficial and deep regions. RESULTS: Evaluation was made of 40 eyes of 20 patients who had recently recovered from COVID infection and 80 eyes of 40 healthy individuals. The DCP-VD values of the COVID group were significantly lower than the control group in most quadrants. The FAZ PERIM and FAZ area values in the COVID patients were higher than the control group, but not statistically significant (p>.05). CONCLUSION: Pediatric cases of COVID-19 may differ from adults based on structural and immune response differences, and that OCTA can be a noninvasive guide for analysis of the end-organ effects of pediatric COVID disease.

Longitudinal evaluation of retinal thickness and OCTA parameters before and following silicone oil removal in eyes with macula-on and macula-off retinal detachments.

BACKGROUND: To investigate the longitudinal retinal vascular and structural alterations by using OCTA following successful repair of retinal detachment (RD) by using silicone oil (SO) endotamponade. METHODS: A prospective cohort study was performed on 24 eyes of 24 subjects; 17 of them with macula-off and seven with macula-on RD. At least four OCTA scans were generated for each study eye; two before and two after SO removal (SOR). At each session, retinal thickness (RT), vascular density (VD) in the superficial (SCP) and deep capillary plexuses (DCP) and foveal avascular zone(FAZ) size were measured within the fovea, parafovea and whole macular image. The changes in repeated measures of the same parameters especially before and after SOR were performed and compared within macula-on and macula-off groups and between fellow eyes. RESULTS: "In the macula-off eyes, RT measurements within the whole macula, fovea and parafovea reduced as compared with their fellow eyes(p < 0.0001, p = 0.001 and p < 0.0001, respectively) and did not improve after SOR. Additionally, all of the whole macular, foveal, and parafoveal VD measurements at SCP and foveal VD at DCP were less than their fellow eyes after SOR (p = 0.026, p = 0.023 p = 0.026, and p = 0.002, respectively). In macula-on eyes, RT measurements decreased within the parafovea and whole macular area before SOR (p = 0.018 and p = 0.011, respectively) but improved after SOR. Also, VD measurements did not change during follow-up and were not statistically different than their fellow eyes (p > 0.05). FAZ enlargement was found in eyes with macular-off RD after SOR, whereas it was not observed with macular-on RD (p = 0.038and p = 0.237, respectively). CONCLUSIONS: Treatment of macula-off RD with SO tamponade has been associated with vascular retinal abnormalities which did not improve following SOR. On the contrary, successful treatment of RD with SO tamponade in macula-on eyes VD measurements of SCP and DCP were not statistically different than their fellow eyes.

Optical coherence tomography-signal strength index following trifocal and monofocal intraocular lens implantation.

PURPOSE: To evaluate the influence of trifocal and monofocal intraocular lens implantation on the optical coherence tomography-signal strength index values obtained during macular and peripapillary scanning. METHOD: Study group included 60 eyes of 60 patients with intraocular lens (Acriva BB UD 613 monofocal in 30 eyes and Acriva Trinova UD trifocal in 30 eyes) implantation after uneventful phacoemulsification. Thirty eyes of 30 healthy subjects without any intraocular surgery were selected as the control group. Eyes with best corrected visual acuity less than 20/20 due to any media opacity, high refractive errors excluded. Macular and retinal nerve fiber layer scans were generated by optical coherence tomography after pupillary dilation. Intergroup comparisons of signal strength index values of the macular and peripapillary scans were performed between eyes implanted with two different intraocular lenses and control group. RESULTS: The mean signal strength index of the peripapillary and macular scans obtained in the eyes implanted with both monofocal and trifocal intraocular lenses were statistically less than the control group (p < 0.05, for all). SSI's of macular and peripapillary scans recorded from the eyes implanted with either monofocal or trifocal intraocular lenses were not statistically different from each other (p = 0.957 and p = 0.877, respectively). CONCLUSION: In the present study despite different intraocular lenses properties, the image quality values were not found to be lower in eyes with trifocal sinusoidal intraocular lenses implantation compared to monofocal intraocular lenses during macular and peripapillary optical coherence tomography scans.

Assessment of lens autofluorescence in patients with well-controlled essential hypertension and those with renal failure secondary to hypertension undergoing hemodialysis.

PURPOSE: To compare the lens autofluorescence (AF) levels among patients with end-stage renal failure and undergoing hemodialysis secondary to hypertension, patients with well-controlled hypertension, and healthy controls. METHOD: This study was a prospective, cross-sectional, comparative study conducted between February and April 2018. Two groups of patients and a group of healthy individuals were included in the study. The first group of patients included individuals with a renal insufficiency due to essential hypertension who underwent regular hemodialysis treatment (dialysis group). The second group included patients with well-controlled essential hypertension (hypertension group). Lens autofluorescence was measured via a scanning confocal lens fluorescence biomicroscope optical system for all participants. The measurement of fluorescence ratio is given as a numerical data. The AF results were compared in all groups. RESULTS: The study included 87 individuals. There were 29 individuals (33.3 %) in the dialysis group, 30 (34.5 %) in the hypertension group, and 28 (32.2 %) in the healthy group. The mean fluorescence ratio(FR) was 0.20 ± 0.06, 0.20 ± 0.04, and 0.17 ± 0.04 in the dialysis, hypertension, and healthy groups respectively. There was a significant difference in the mean FR measurements between the three groups (p = .004). As a result of a binary comparison, mean FR values for patients in the dialysis group were higher (0.20 ± 0.06) than for healthy individuals (0.17 ± 0.04), which was statistically significant (p = .025). Mean FR measurements of hypertensive patients were higher (0.20 ± 0.04) than healthy individuals (0.17 ± 0.04), which was also statistically significant (p = .02). However, there was no statistically significant difference among the mean FR measurements between the hypertension and dialysis groups (p = .63). CONCLUSION: We demonstrated that lens autofluorescence increased in patients with renal failure undergoing hemodialysis and those with well-controlled hypertension. The mean lens autofluorescence levels were significantly higher in both patient groups than the healthy control group.

Visual performance and patient satisfaction following the implantation of a novel trifocal supplementary intraocular lens.

PURPOSE: To evaluate the visual quality, visual performance, and patient satisfaction after the implantation of the last generation supplementary intraocular lens (1stQ AddOn Trifocal) for achieving near vision spectacle-independence in pseudophakic patients who had primary monofocal capsular bag implantation. METHODS: Patients who underwent monofocal lens surgery in the past year, and who expressed their explicit desire to become spectacle-independent were included in this prospective observational study. Uncorrected and corrected distance, intermediate and near visual acuities (CDVA, UDVA, DCIVA, UIVA, CNVA, and UNVA), refractive outcomes, lens positioning, contrast sensitivity and patient satisfaction were assessed 6 months postoperatively. RESULTS: About 28 eyes of 18 patients were evaluated. No intra- or postoperative complications (iris chafing, iris capture, interlenticular opacification, IOL-dislocation, etc.) could be observed. The postoperative mean UDVA and CDVA were 0.05 ± 0.08 and 0.01 ± 0.03 (logMAR), respectively. The mean UNVA improved from the preoperative 0.50 ± 0.23 to 0.02 ± 0.05 (logMAR), postoperatively (p = 0.0104). The postoperative mean UIVA and DCIVA were 0.06 ± 0.020 and 0.01 ± 0.00 (logMAR), respectively. Twenty-five eyes (89%) had a residual spherical equivalent within 1.0 D from the target refraction, emmetropia. Contrast sensitivity measured in photopic and mesopic conditions were statistically indifferent from the preoperative curves. All patients had better visual function and quality scores compared to the preoperative responses. The highest improvement could be achieved in near vision activities, dependency, and limitation of social functioning. CONCLUSION: The 1stQ AddOn Trifocal lens represents a safe and effective option for pseudophakic patients aiming for high quality, spectacle-free vision.

Inter-Ocular Symmetry of Vascular Density and Retinal Thickness in Unilateral Anisometropic Amblyopia.

BACKGROUND: Inter-ocular symmetry of macular vascular anatomy in healthy subjects has been well documented in previous optical coherence tomography angiography (OCTA) studies. In our present study, we have demonstrated that the presence of anisometropic amblyopia in one eye does not alter this unique feature significantly. We investigated whether the presence of unilateral anisometropic amblyopia due to moderate amounts of hyperopia and/or astigmatism would have any significant influence on measurements of retinal thickness (RT) and superficial vessel density (SVD) in adult subjects. SUBJECTS AND METHODS: In the study group, both eyes of 21 adult subjects with unilateral anisometropic amblyopia were enrolled. Only one eye of an age-matched control group including 33 subjects was randomly selected. RT and SVD were measured in foveal and parafoveal retinal areas and compared in amblyopic eyes, their fellow eyes and in the control group. Inter-ocular symmetry of RT and SVD in amblyopic and fellow eyes were investigated by using correlation analysis. RESULTS: There were statistically significant inter-ocular correlations of foveal and parafoveal RT in amblyopic and fellow eyes (P < 0.0001, for both). Foveal and parafoveal RT of the control group were not statistically different from amblyopic eyes (P = 0.072 and P = 0.46, respectively). There was no difference between foveal SVD of amblyopic eyes and control group (P = 0.10) and a significant inter-ocular correlation was found between amblyopic and fellow eyes (P = 0.029). CONCLUSION: For our adult subjects, none of the investigated OCTA parameters of the amblyopic eyes were found to be statistically different from those of age-matched controls. The preservation of inter-ocular symmetry in the amblyopic and fellow eyes implies that the influence of anisometropic amblyopia in one eye would be relatively small and negligible on routine OCTA examination.

Pantoe Agglomerans Endophthalmitis after Phaco Surgery: The First Case in Literature.

Purpose: The aim of this study was to report endophthalmitis caused by pantoe agglomerans after phacoemulsification surgery for the first time in English literature.Material-method: A 44-year-old male patient was referred to Yeniyuzyil University Gaziosmanpasa Hospital because of sudden painful vision loss in his right eye.Result: Pantoea agglomerans was identified in the culture of humor from the anterior chamber and vitreous. Based on the antibiotic susceptibility test, P.Agglomerans species culture was sensitive to ciprofloxacin.Conclusion: This is the first reported case of endophthalmitis after cataract surgery.

5-Fluorouracyl added infusion fluid in patients with recurrent rhegmatogeneous retinal detachment.

PURPOSE: To compare the efficacy of 5-fluorouracil (5-FU) added the infusion fluid with a control group in the event of grade C PVR in recurrent retinal detachment (RD). METHODS: The records of the patients with recurrent retinal detachment with grade C PVR who underwent vitrectomy for retinal detachment surgery between April 2003 and October 2004 were reviewed retrospectively for this comparative study. The recurrent retinal detachment patients with grade C PVR who underwent vitrectomy and had a minimum post-operative follow-up period of 12 months were included. The patients were divided into two groups as study and control groups. 5-FU (200 microgram/ml) and low-molecular-weight-heparin (LMWH) (5 IU/ml) was added into the infusion solution of the study group. Primary outcome measure of this study was the single operation anatomical success at month 12. RESULTS: A total of 43 eyes of 43 patients were included. The control group was consisted of 26 eyes (60.5%) and the 5-FU group was consisted of 17 eyes (39.5%). At month 12, single operation anatomical success was obtained in 14 of the 26 patients (53.8%) in the control group and in 16 of the 17 patients (94.1%) in the 5-FU group (p = 0.005). CONCLUSION: Favorable outcomes were obtained in the patients with recurrent RD and grade C PVR in whom 5-FU and LMWH added infusion fluid which was used during vitrectomy.

The assessment of autofluorescence of the crystalline lens in diabetic patients and healthy controls: can it be used as a screening test?

BACKGROUND: Our purpose was to demonstrate if measuring lens autofluorescence (AF) with a scanning confocal biomicroscope may be used to identify subjects with undiagnosed type II diabetes mellitus (DM), and hence, for it to be used as a marker for the severity of diabetic retinopathy in diabetic patients. PATIENTS AND METHODS: In this cross-sectional, comparative study, lens AF was measured with scanning confocal lens fluorescence biomicroscope in diabetic and healthy groups. Full ophthalmological examination was performed. Blood tests of fasting plasma glucose, and glycosylated hemoglobin were also analyzed. The correlation between lens AF results and blood tests was evaluated in both groups. The cutoff value for the diagnosis of DM using lens AF was investigated. RESULTS: The study included 191 subjects with a mean age of 52.09±6.75 years. One hundred and seven (56.0%) subjects were female, and 84 (44.0%) were male. Eighty-two (42.9%) patients had type II DM, and 109 (57.1%) subjects self-reported as normal. The fluorescence ratio (FR) values ranged from 0.09 to 0.46 (0.23±0.06) in the total group. Mean FR measurements of diabetic subjects were significantly higher (0.27±0.06) than those without DM (0.20±0.05), (p=0.001). A statistically significant correlation was found between glycosylated hemoglobin, fasting plasma glucose, and FR. The cutoff point for the FR according to the presence of DM was found to be 0.24 and above (p=0.001), with a sensitivity of 71.95% and a specificity of 80.73%. CONCLUSION: Measuring AF of human lens as an indirect evidence of increased advanced glycaton end products may helpful in detecting impaired glucose metabolism. Our results show highly significant correlation between possibility of DM and FR.

The inner diameter of the optic disc pit decreases with pars plana vitrectomy.

To report a patient with optic disc pit who showed decreased inner diameter of the optic disc pit along with resolution of recurrent macular detachment after pars plana vitrectomy. Pneumatic retinopexy and peripapillary laser photocoagulation was performed in a 28-year-old female with optic disc pit and serous macular detachment. Two months after the initial therapy, serous macular detachment recurred. Then, pars plana vitrectomy with removal of the posterior hyaloid was performed, and intraocular perfluoro-octane (C3F8) tamponade was used. Fundus photography and ocular coherence tomography were obtained at each visit. The patient was followed up for 1 year. Visual acuity was 20/400 (Snellen) at first presentation, improved to 20/40 at 2 weeks after pneumatic retinopexy and peripapillary laser treatment. Then, 2 months later visual acuity decreased to 20/200, improved to 20/40 at 2 weeks after the vitreoretinal surgery, and stayed stable during the 1-year follow-up. It was also noticed on clinical examinations as well as fundus photographs that the inner diameter of the optic disc pit had decreased significantly. Vitreous traction plays an important role in the formation of serous macular detachments with optic disc pits. In these patients, pars plana vitrectomy and posterior hyaloid removal may be an effective treatment for reduction of the inner diameter of the optic pit and resolution of the serous macular detachments.

Evaluation of the corneal topographic characteristics of keratoconus with orbscan II in patients with and without atopy.

PURPOSE: : To analyze the differences in corneal topography in keratoconus patients with and without atopy. METHODS: : In the Beyoglu Eye Research and Training Hospital Refractive Surgery Department, corneal examination with the Orbscan II device (Bausch & Lomb) was done to all patients between May and June 2004 who were diagnosed as keratoconus with corneal topography findings and who did not have any surgical procedure. The atopy grading was done according to the criteria of the UK Atopy Study Group (1994). Patients were divided into 2 groups according to the presence of atopy. The Orbscan findings of the 2 groups were compared. RESULTS: : Among 70 keratoconus patients, 33 patients had partial or full atopy. Sixty-six eyes of the 33 patients were classified as the atopic group, whereas 74 eyes of the remaining 37 patients were classified as the control group. The mean age of the patients was 27.7 +/- 9.5 years in the atopic group and 26.9 +/- 9.5 years in the control group. The central corneal thickness was 428.5 +/- 37.1 mum in the atopic group and 491.8 +/- 56.3 mum in the control group. There was a statistically significant difference between the mean central and thinnest corneal pachymetric readings, the distance of thinnest point to corneal center, anterior and posterior elevation values, distances of the anterior and posterior elevation to the central cornea, and irregularity indexes in the 2 groups (P < 0.05). CONCLUSIONS: : This study shows that corneal topographic and pachymetric characteristics of keratoconus may be different in atopic eyes from those in nonatopic eyes. Atopic keratoconus patients could possibly be evaluated as a separate entity in keratoconus disease.

Comparative functional analysis of the hyolingual anatomy in lacertid lizards.

The tongue is often considered a key innovation in the evolution of a terrestrial lifestyle as it allows animals to transport food items through the oral cavity in air, a medium with low density and viscosity. The tongue has been secondarily coopted for a wide diversity of functions, including prey capture, drinking, breathing, and defensive behaviors. Within basal lizard groups, the tongue is used primarily for the purpose of prey capture and transport. In more derived groups, however, the tongue appears specialized for chemoreceptive purposes. Here we examine the tongue structure and morphology in lacertid lizards, a group of lizards where the tongue is critical to both food transport and chemoreception. Because of the different mechanical demands imposed by these different functions, regional morphological specializations of the tongue are expected. All species of lacertid lizards examined here have relatively light tongue muscles, but a well developed hyobranchial musculature that may assist during food transport. The intrinsic musculature, including verticalis, transversalis, and longitudinalis groups, is well developed and may cause the tongue elongation and retraction observed during chemoreception and drinking. The papillary morphology is complex and shows clear differences between the tongue tips and anterior fore-tongue, and the more posterior parts of the tongue. Our data show a subdivision between the fore- and hind-tongue in both papillary structure and muscular anatomy likely allowing these animals to use their tongues effectively during both chemoreception and prey transport. Moreover, our data suggest the importance of hyobranchium movements during prey transport in lacertid lizards.