Is pseudoexfoliation syndrome associated with vitreoretinal interface abnormalities?

BACKGROUND: To evaluate vitreoretinal interface abnormalities in patients with pseudoexfoliation (PEX) syndrome. METHODS: This case-control study was performed in 136 patients diagnosed with unilateral PEX (PEX group) and 139 age- and sex-matched healthy volunteers (Control group). Both the affected and contralateral eyes were evaluated in the PEX group and the right eye was evaluated in the Control group. Vitreoretinal interface abnormalities and posterior vitreous detachment (PVD) were evaluated on optical coherence tomography (OCT) examination. RESULTS: The incidences of incomplete and complete PVD were significantly higher in the affected than contralateral eye in the PEX group and in the right eye in the Control group (P = 0.009, P = 0.012 and P = 0.004, P = 0.017, respectively). The rates of 'no PVD' were significantly higher in the contralateral eye in the PEX group and the Control group compared to the affected eye in the PEX group (P = 0.003 and P = 0.001, respectively). The odds ratio for incomplete PVD was 3.1 in PEX eyes compared to the contralateral eye in the PEX group and 3.9 compared to the Control group. The rate of epiretinal membranes (ERMs) in the affected eye was significantly different from the contralateral eye in the PEX and Control groups (P < 0.001 and P < 0.001, respectively). The odds ratio for ERM in PEX eyes was 3.51 compared to the contralateral eye in the PEX group and 4.23 compared to the Control group. In the presence of incomplete PVD, the odds ratio for ERM development was 3.81 in PEX eyes. CONCLUSIONS: We detected high rates of ERMs and incomplete PVD in patients with PEX. It is important to evaluate and follow up PEX cases in terms of vitreoretinal interface abnormalities.

Optical coherence tomography findings in toxoplasma retinochoroiditis.

Purpose: This study aimed to evaluate the optic coherence tomography (OCT) findings in patients with toxoplasmic retinochoroiditis (TRC). Methods: A total of 12 eyes of 12 patients with active TRC were included in the study. At baseline, at the first-month follow-up, at the sixth-month follow-up and at the 1-year follow-up, the TRC lesion OCT and macula OCT were evaluated. Results: Hyperreflectivity of the inner retinal layers and an increase in retinal thickness were observed on the OCT examinations of all the patients with an active TRC lesion. The retinal thickness decreased and the reflectivity of retinal layers was disorganized in the OCT images obtained in the follow-up period. Partial posterior hyaloid detachment (PHD) and no PHD were detected in 11 cases and 1 case, respectively. Epiretinal membrane (ERM) had developed in the adjacent region of the scar in 7 patients. With the regression of the lesion, the disruption of the ellipsoid zone (EZ), retinal pigment epithelium (RPE) and external limiting membrane (ELM) improved in the adjacent areas. In all the eyes, ERM and the PHD configuration did progress during the follow-up period. Vitreoschisis was found in 4 of the 11 patients with partial PHD. It was observed that ERM developed in all the patients with vitreoschisis. Conclusion: ERM and partial PHD were common in the TRC patients, and there was no progression during the follow-up period. Regeneration of the EZ, RPE and ELM was observed in the follow-up period.

THICKNESSES OF SCLERA AND LAMINA CRIBROSA IN PATIENTS WITH CENTRAL RETINAL VEIN OCCLUSION.

PURPOSE: To evaluate thicknesses of sclera and lamina cribrosa (LC) in central retinal vein occlusion (CRVO). METHOD: Thirty-two patients with CRVO (mean age 62.2 ± 11.6 years, women/men 18/14) and 35 age- and sex-matched healthy volunteers were included into the study. Scleral thickness was measured at scleral spur and at 1 to 3 mm from scleral spur in four quadrants (temporal, nasal, super, and inferior) using anterior segment optical coherence tomography. Lamina cribrosa was measured using optic disk enhanced depth imaging optical coherence tomography. RESULTS: The sclera was thicker in affected eyes of the CRVO group than healthy subjects at scleral spur in four quadrants (738.7 ± 30.9 µm vs. 702 ± 30.8 µm in temporal, 700.4 ± 19.7 µm vs. 673 ± 13.7 µm in superior, 693 ± 19.3 µm vs. 665.3 ± 24.2 µm in nasal, 810.7 ± 28.9 µm vs. 784.5 ± 23.7 µm in inferior quadrants, respectively; P < 0.05 for all). Lamina cribrosa thickness in affected eyes of the CRVO group was significantly higher than that of healthy subjects (285.2 ± 12.7 µm vs. 266.4 ± 10.7 µm, respectively; P < 0.01). The correlation between scleral thickness and LC thickness was moderate at scleral spur of temporal and superior quadrants of affected eyes (r = 0.510 and r = 0.420, respectively). CONCLUSION: Thicknesses of sclera and LC are increased in the CRVO, which may play a role in the pathogenesis of the disease.

Increased Subfoveal Choroidal Thickness and Retinal Structure Changes on Optical Coherence Tomography in Pediatric Alport Syndrome Patients.

OBJECTIVE: To evaluate optical coherence tomography (OCT) findings of pediatric Alport syndrome (AS) patients with no retinal pathology on fundus examination. MATERIALS AND METHODS: Twenty-one patients being followed up with the diagnosis of AS (Group 1) and 24 age- and sex-matched healthy volunteers (Group 2) were prospectively evaluated. All participants underwent standard ophthalmologic examination, retinal nerve fibre layer (RNFL) analysis, and horizontal and vertical scan macula enhanced depth imaging OCT (EDI-OCT). Statistical analysis of the data obtained in this study was performed with SPSS 15.0. RESULTS: Macula thickness was significantly decreased in the temporal quadrant in Group 1 compared to those of the control group (p=0.013). RNFL measurements revealed statistically significant thinning in the temporal, superior, inferotemporal, and inferonasal quadrants and in average thicknesses in cases with AS compared to the controls (p < 0.001, p < 0.001, p=0.022, p=0.016, p < 0.001, respectively). The mean subfoveal coronial thickness (SCT) was 362.2 ± 77.8 µm in Group 1 and 256,18 ± 71.7 µm in Group 2. There was a statistically significant difference between the two groups in terms of mean CT (p < 0.001). CONCLUSION: OCT provides valuable information in identifying the structural changes and evaluation of ocular findings in patients with AS. Even if no pathological retinal findings were found in the clinical examination, structural changes in the OCT examination begin in early period of AS.

Intravitreal Dexamethasone Implant for Postvitrectomy Macular Edema: A Retrospective Cohort of Patients with Postvitrectomy Macular Edema Treatment.

PURPOSE: To evaluate the clinical findings and the efficacy of dexamethasone intravitreal implant in patients with postvitrectomy macular edema. METHODS: The records of 14 patients diagnosed with postvitrectomy macular edema unresponsive to first-line treatment, treated with intravitreal dexamethazone implant injection and followed at least 6 months between October 2011 and May 2016 were retrospectively reviewed. All patients underwent standard ophtalmological examination, fluorescein angiography, and optical coherence tomography. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressures (IOPs) were recorded at baseline, at first and sixth months after the injection. RESULTS: The mean BCVA, which was 0.2 ± 0.14 logMAR at baseline significantly increased to 0.44 ± 0.2 logMAR at first month (P = 0.05) and to 0.4 ± 0.22 logMAR at sixth month of intravitreal dexamethazone implant injection (P = 0.01). CMT was also significantly decreased to 368.3 ± 90.4 µm at first month and to 323 ± 84.6 µm at sixth month from pre-injection value of 520.7 ± 90.3 µm (P = 0.001 and P = 0.002, respectively). IOP significantly increased from was 15 ± 2.1 mmHg at baseline to 20.6 ± 5.4 mmHg at first month of intravitreal dexamethazone implant injection (P = 0.01). CONCLUSION: Dexamethazone implant treatment may reduce CMT and improve BCVA in cases with postvitrectomy macular edema. IOP should be regularly screened in these cases.

Optic nerve and dura mater involvement as the first sign of multiple myeloma.

PURPOSE: To report a case of optic nerve and dura mater involvement as the first sign of multiple myeloma. METHODS: Case report. RESULTS: A 43-year-old woman presented with a headache and decreased vision in both eyes. Ophthalmic examination revealed anterior uveitis and subretinal mass around the optic nerves with accompanying disc edema bilaterally. Magnetic resonance imaging showed dural and optic nerve infiltration with tram-track enhancement in the optic nerve sheath. The diagnosis of multiple myeloma was made as a result of systemic investigations. The patient underwent systemic chemotherapy and cranial radiotherapy. After treatment, the patient's headache disappeared, the papilledema regressed, and the ocular findings improved but complete recovery could not be achieved because of fibrous subretinal tissue and degenerative changes of the optic nerve. CONCLUSIONS: Neurologic and ophthalmic involvement in multiple myeloma may appear as the first manifestation of disease. The correct diagnosis is important because it can be life-saving.