Ophthalmologic Assesment of Patients with Syphilitic Optic Neuropathy.

PURPOSE: To assess the different clinical findings and symptoms of patients with optic neuritis (ON) and uveitis, who were diagnosed with syphilis. METHODS: The medical records of patients, who had ocular involvement of syphilis, were retrospectively reviewed. Thirteen patients with syphilitic optic neuropathy (SON) were enrolled and underwent complete ophthalmological examinations and auxiliary laboratory testing. RESULTS: Nine patients (69.2%) had comorbidities in addition to syphilis. One patient (with two eyes) presented with retrobulbar neuritis, and 12 patients (with 17 eyes) presented with anterior optic neuritis. Three patients (23.1%) had no uveitis, and 10 patients (76.9%) had uveitis in cases with SON. Four eyes (16.6%) had subretinal fluid, and three eyes (12.5%) had cystoid macular edema. CONCLUSIONS: Visual function can be preserved with early diagnosis and proper treatment. Accordingly, newly diagnosed patients with ON and uveitis should undergo syphilitic investigation in routine practice.

The prevalance of congenital optic disc anomalies in Turkey: a hospital-based study.

PURPOSE: The aim of this study was to investigate the prevalence of congenital optic disc anomalies in Turkey. METHODS: The 11,123 eyes of 5570 patients were screened for optic disc anomalies. All patients were underwent a complete ophthalmic examination including best corrected visual acuity, refraction, spherical equivalent, slit lamp biomicroscopy, intraocular pressure measurements, dilated stereoscopic fundus examination. Data analyses were performed by using SPSS for Windows, version 22.0 (SPSS Inc., Chicago, IL, United States). RESULTS: 11,123 eyes of 5570 participants were screened. Of the 5570 participants who underwent optic disc examination, 246 eyes of 174 patients (3.12%, 95% CIs 2.66-3.58%) had optic disc anormalies. 92 (52.9%) were female, 82 (47.1%) were male and the mean of age was 44.25 ± 15.67 years. 72 (41.4%) patients were bilateral, 102 (58.6%) patients were unilateral involvement. The tilted disc was the most common anomaly and was found at least one eye in 46 patients (75 eyes) and 0.83% of all screened patients. Peripapillary myelinated nerve fibers was the second common anomaly and was found at least one eye in 31 subjects (35 eyes) and 0.56% of all screened subjects. Peripapillary atrophy was the third common anomaly, and was found in at least one eye in 24 patients (37 eyes) and 0.43% of all screened subjects. CONCLUSION: To our knowledge, this is the first study that the prevalences of all congenital optic disc anomalies from Turkey. The prevalence of congenital optic disc anomalies is higher than in other countries.

Assessment of inner retina layers thickness values in eyes with pituitary tumours before visual field defects occur.

BACKGROUND: The purpose of this study was to evaluate macula, retinal nerve layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL) and macular nerve fibre layer (mNFL) thickness in patients with pituitary tumours who has normal visual field (VF). METHODS: Thirty-five eyes of 35 patients with pituitary tumours with normal VF and 41 eyes of 41-healthy subjects were underwent a complete ophthalmic examination. The spectral domain- optical coherence tomography (OCT) was used to measure macular and optic disc parameters. Layer-by-layer segmentation was done automatically by using the new software. Data analyses were performed by using SPSS for Windows, version 22.0. RESULTS: Average of total macula thickness inner temporal (p: 0.006), outer temporal (p < 0.001), inner nasal (p: 0.03), outer nasal (<0.001) were significantly lower in pituitary tumour group than normal group. Average of RNFL (p:0.009), temporal (p: 0.001), superiotemporal (p:0.004) and inferiotemporal (p: 0.01) were significantly lower in pituitary tumour group than normal group. Average of central GCL (p: 0.01) and central NFL (p: 0.03) were significantly lower in pituitary tumour group than normal group. There was no statistically significant difference between the two groups in IPL averages. CONCLUSIONS: Pituitary tumour patients with normal VF had reduced nasal and temporal section of the total macula, temporal RNFL, central mGCL and mNFL thicknesses, reflecting the corresponding to the anatomical substrate of the underlying pathology of chiasmal compression. This indicates that the presence of retinal thinning may be a sign of early detection of anterior visual pathway injury before VF loss becomes apparent.

Anterior segment parameters in Behçet's patients with ocular involvement.

PURPOSE: To evaluate anterior segment findings in Behçet's disease patients within the ocular involvement inactive period. METHODS: One hundred twenty patients with Behçet uveitis in the inactive period (Behçet's disease group) and 121-age and sex matched healthy subjects (control group) were examined. Anterior segment parameters were assessed by Scheimpflug camera. RESULTS: In Behçet's disease group, the mean age was 39.89 ± 10.16 years, and 55.8% of patients were male; in the control group, the mean age was 38.69 ± 14.08 years, and 56.2% of control subjects were male. Pachymetric measurements of corneal apex (523.84 ± 30.36 µ vs 540.73 ± 27.85 µ, p < 0.001) thinnest point (518.70 ± 30.75 µ vs 537 ± 28.66 µ, p < 0.001), mean corneal volume (57.90 ± 3.39 mm3 vs 59.57 ± 3.37 mm3, p < 0.001) were significantly lower and anterior elevation [5.0 (1.0-34.0) vs 2.0 (1.0-7.0) diopter(D), p < 0.001], posterior elevation [11.0 (1.0-66.0) vs 4.0 (0-22.0) D, p < 0.001)] and corneal astigmatism [1.1 (0-7.1) vs 0.7 (0.1-5.7) D, p = 0.005] were significantly higher in the Behçet's disease group than in control group. No significant difference was found in other anterior segment parameters between the Behçet's disease group and control group. Concurrent keratoconus was detected in two cases (1.7%). A statistically significant correlation was found between the corneal measurements and frequency of uveitis attacks. CONCLUSION: The chronic inflammatory process associated with various proinflammatory cytokines, which play a role in the pathogenesis of keratoconus, may also contribute to a decrease in corneal thickness and corneal volume in Behçet's patients with ocular involvement.

Assessment of ganglion cell complex, macular thickness, and optic disc parameters in keratoconus patients.

PURPOSE: Keratoconus (KC) is bilateral noninflammatory corneal disorder characterized by progressive corneal thinning, protrusion, and scarring. The purpose of this study was to evaluate ganglion cell complex(GCC), macula thickness(MT) and optic head disc parameters in keratoconus patients. METHODS: A hospital based prospective clinical case series was performed in Inonu University School of Medicine. 52 eyes of 52 keratoconus patients and 50 eyes of 50 normal patients were enrolled. RESULTS: There is no statistically significant in MT between groups. GCC in nasal superior, temporal superior and temporal inferior 9 mm from macula were found statistically significant decrease in keratoconus group (p<0,05). In optic disc analysis fifth and the eleventh clock-hour quadrants of peripapiller retina nerve fiber layer and cup area ratio were found statistically significant decrease in keratoconic eyes (p<0,05). CONCLUSION: We thought that structural retinal changes seem in keratoconus eyes; keratoconus pathogenesis may affect not only cornea but also retina and optic nerve head.

Clinical Features and Prognosis of Uveitis in a Turkish Patient Population with Ankylosing Spondylitis: Incidence and Management of Ocular Complications.

Purpose: To investigate clinical features, visual prognosis, and ocular complications in patients with ankylosing spondylitis (AS)-associated anterior uveitis (AU). Methods: Data of 211 eyes of 145 patients with AU associated with AS were reviewed retrospectively. Results: Mean follow-up time was 6.31 ± 6.33 years. Men were younger than women at AS diagnosis (p = 0.035). The mean number of uveitis flares was highest during the first quarter of the year and lowest during the third quarter (p = 0.017). Immunosuppressive agent use was higher in women than men (p = 0.052). Ocular complications developed in 120 eyes (56.9%), and the complication rate was 0.146/eye year. Males developed cystoid macular edema more frequently than females (p = 0.05). Glaucoma was observed more often in early-onset disease (age at AS onset <45 years) than late-onset disease (p = 0.028). Conclusions: Visual prognosis of AU in patients with AS was good, although more than half of the eyes developed ocular complications (56.9%).

Influence of corneal parameters in keratoconus on IOP readings obtained with different tonometers.

BACKGROUND: Accurate intraocular pressure (IOP) measurement is important but of unsure reliability in patients with keratoconus. Different types and models of tonometers are available. This study investigated the influence of corneal parameters on IOP readings obtained by a Goldmann applanation tonometer, a non-contact tonometer and a dynamic contour tonometer. METHODS: IOP readings with the Goldmann applanation, non-contact and dynamic contour tonometers were obtained from 52 patients with keratoconus and from 50 normal subjects and their corneal parameters were measured using a Pentacam. RESULTS: The mean IOP measurements in keratoconus obtained with the Goldmann applanation, non-contact and dynamic contour tonometers were statistically significantly different from the mean IOP measurements in the normal subjects (p < 0.0001; p < 0.005; p < 0.0001, respectively). In the keratoconus group, the thinnest corneal thickness (TCT), steepest keratometry, the corneal curvature (CC), central corneal thickness (CCT) and the posterior corneal curvature (PCC) had a significant effect on the Goldmann applanation and non-contact tonometers but not on the dynamic contour tonometer. In the control group, thinnest and central corneal thicknesses had a significant effect on findings with the Goldmann and non-contact tonometers but not on the dynamic contour tonometer. The corneal volume (CV) had no significant effect on the three tonometers in both groups. CONCLUSIONS: The corneal parameters affecting the IOP readings of the Goldmann applanation tonometers, non-contact tonometers and the dynamic contour tonometers are not the same. While the Goldmann applanation and non-contact tonometers were significantly affected by the corneal parameters that were measured, the dynamic contour tonometer was not affected by any of these corneal parameters.

Endoscopic transcanalicular diode laser dacryocystorhinostomy: is it an alternative method to conventional external dacryocystorhinostomy?

PURPOSE: To compare the success rates of endoscopic transcanalicular diode laser dacryocystorhinostomy (EL-DCR) and external DCR. MATERIALS AND METHODS: Operations were performed on 55 eyes of 54 patients who had distal nasolacrimal canal obstruction. External DCR was performed on 29 of the eyes and EL-DCR on 26 of them. Success was defined based on subjective relief of patients reported at their final examinations. RESULTS: There were 23 women and 6 men in group 1 and 19 women and 6 men in group 2 (p = 0.77). The mean ages of groups were 45.24 ± 12.08 (range, 15-74) and 43.2 ± 17.01 (range, 11-72) years, respectively (p = 0.63). The mean follow-up times were 8.82 ± 5.51 (range, 3-18) and 7.12 ± 2.96 (range, 2-12) months, respectively in groups (p = 0.58). The success rates based on symptoms were measured at 25 of 29 (86%) and 17 of 25 (68%) for 2 groups. The difference in the success rates was higher but not found to be statistically significant (p = 0.202). The authors found various conditions related to nasal passage in 4 of 8 unsuccessful EL-DCR, including allergic rhinitis, nasal crust, silicone tube reaction, and unsuitable passage for endoscopic surgery. CONCLUSIONS: The success rate of EL-DCR was lower than that of the external DCR; however, no statistically significant difference was observed. Endoscopic transcanalicular diode laser DCR may be considered as an alternative method to external DCR with these results.